• Journal of Chest Surgery
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• 제18권2호
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• pp.299-304
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• 1985

The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

• Journal of Chest Surgery
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• 제11권3호
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• pp.348-354
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• 1978

Myxoma constitue about 50% of a II primary cardiac, tumor (incidence 0.03%) and occur in any of the cardiac chambers, but about 75% of themare found in the left atrium. As is well known, left atrial myxoma usually simulates mitral valvular disease, and it tends to bring about postural syncope and frequent embolic manifestaticns. The clinical manifestation of left atrial myxoma upon the circulation are obstructive effects, embolic effects and constitutional effects. Diagnosis is now most of all important since surgery can be dramatically curable, whereas untreated myxoma apparently invariably lead to deadful course. Preaprative diagncsis by echocardiogram is so simple and accurate for detection of myxoma that awareness of mitral valvular heart disease with rapid deterioration must be screened. We have diagnosed one case of the left atrial myxoma preopratively by phonocardiogram, echocardiogram and levophase pulmonary angiograJ;n and successfully treated by operation under extra corporeal circulation. A 38 years old housewife was admitted to the National Medical Center because of dyspnea, and paroxysmal cough on occasions for prior to hospitalization. Operation was carried out by median sternotomy and left atriotomy with mild hypothermia under E.C.C. The left atrial myxoma was extirpated including endocardial fragment and its weight was 23gm. The hospital course was not eventful and she can work nowadays without symptoms.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.191-192
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• 2002

Since capsaicin was found as an excellent vanilloid receptor agonist, considerable efforts toward the development of a novel analgesic have been continued. However, the small therapeutic window between these effects and the excitatory side effects, such as hypothermia, bronchoconstriction, increased GI mobility, and hypertension, precluded the development of capsaicin as a systemic agent. (omitted)

• Journal of Chest Surgery
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• 제11권1호
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• pp.69-74
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• 1978

Coarctation of the aorta is rare condition among the congenital cardiovascular defects in Korea. We experienced one case of coarctation of the aorta [postductal type], which was successfully corrected with Dacron graft. This 20 year old man was admitted to our hospital for evaluation of hypertension in the upper extremities and frequent occipital headache of 2 month duration. On physical examination, grade II systolic murmur was heard over the apex and mid back, but thrill was not palpable. Blood pressures were measured at both extremities, its values were 190/70mmHg. in the arms and 120/60mmHg in the legs. Routine chest roentgenogram showed the dilated left subclavian artery high on the left mediastinal border and associated with left ventricular prominence, but notchings of lower border of rib was not seen. Electrocardiogram also showed left ventricular hypertrophy. Final Pre-operative diagnosis was made by the aortic catheterization and aortography, which showed the typical configuration of postductal type of coarctation with poststenotic dilatation of aorta. Under the moderate hypothermia by surface cooling, coarcation was resected 3.5cm in length and then Dacron graft was inserted. After prosthetic correction, blood pressures were recorded 120/60mmHg in arms and 160/120mmHg in legs. The post-operative course was uneventful.

• Journal of Chest Surgery
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• 제20권2호
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• pp.404-410
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• 1987

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

• Journal of Chest Surgery
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• 제24권3호
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• pp.253-260
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• 1991

The adequacy of anticoagulation with heparin during cardiopulmonary bypass, and precise neutralization with protamine at the conclusion of cardiopulmonary bypass, were important. In sixty children undergoing cardiopulmonary bypass, ACT and heparin dose-response curve were studied. Total dose of heparin before bypass were 2.80$\pm$0.74 mg/kg and the amount of protamine administered after bypass were 3.0$\pm$1.23 mg/kg. So protamine: heparin ratio was 1.07: l.c After administration of protamine which dose is calculated with heparin dose-response curve, ACTs were returned to normal range[mean 114.8 $\pm$13 second]. The heparin sensitivity and its half-life do not have relationship with age, weight, height, surface area and urine amount during operation. And there are too much individual variations in heparin sensitivity and its half-life. So conventional heparin protocols can overestimate or underestimate the amount of heparin and protamine. Heparin dose-response curve makes it possible to maintain anticoagulation in a safe range during bypass with adequate amount of heparin individually. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine amount of protamine needed for neutralization of the heparin. But heparin dose-response curve to be used clinically, further studies will be needed about relationship between ACT and heparin level in the high range, influence of hemodilution and hypothermia to ACT and discrepancy between true adequate amount of protamine and calculated amount by heparin dose-response curve.

• Journal of Korean Biological Nursing Science
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• 제13권3호
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• pp.269-275
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• 2011

Purpose: This study was designed to help preparing the evidence-based data for the manual of heat applications by finding the differences of superficial and core temperatures after applying dry and moist heats on shoulder and thigh. Methods: Moist and dry heats were alternately applied on the 33 subjects a day apart from May 15, 2010 through June 9, 2010. The experiment was conducted with $23^{\circ}C$ to $25^{\circ}C$ room temperature and 50% to 66% of moisture from 2 to 6 p.m. After heat was applied on the shoulder of the subjects wearing shorts and gowns for 30 minutes, their superficial and core temperatures were measured. The same method was used on the thigh after two hours. Results: Both superficial and core temperatures on the shoulder and thigh increased significantly after heat therapy. There was no significant difference between the temperatures before and after intervention according to applying methods and regions. Conclusion: This study provides a theoretical basis that a dry heat is a convenient nursing intervention for hypothermic patients.

• 대한간호학회지
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• 제31권5호
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• pp.793-806
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• 2001

To identify nursing interventions performed by Chosunjok nurses in Yanbian using NIC. Methods: The sample consisted of 36 nurses working in 2 hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Results: Twenty-eight interventions were performed at least daily. Interventions in the Physiological: Basic domain were most frequently used at least daily. The most frequently used interventions was Positioning, followed by the interventions Pressure Ulcer Prevention, Intravenous (IV) Therapy, Hypothermia Treatment and Intravenous (IV) Insertion. The least frequently used interventions was Electronic Fetal Monitoring: Antepartum. Nurses working in special medical care units performed interventions most often, while nurses working in general surgical units performed them least. Nurses working in general medical, special medical and other care units performed interventions in the Physiological domain more often than the nurses working in general surgical units. Conclusion: Chosunjok nurses in Yanbian performed physiological interventions frequently. Further studies will be needed to compare interventions performed by nurses in two countries.

• Journal of Chest Surgery
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• 제12권2호
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• pp.119-126
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• 1979

This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

• Journal of Chest Surgery
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• 제28권10호
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• pp.885-891
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• 1995

In order to test the hypothesis that the pulmonic valve, when used to replace the aortic root as a pulmonary autograft, will remain a viable anatomical structure and will grow and develop normally along with the host, we performed aortic valve replacement with the pulmonary autograft in 15 neonatal piglets. The weight of the donor was 9.3 $\pm$ 0.2 kg, the recipient 9.6 $\pm$ 0.3 kg. Measured diameters of pulmonic annulus were 14 $\pm$ 0.2 mm for autograft and 14.2 $\pm$ 0.2 mm for pulmonary artery homograft. Operation was performed under cardiopulmonary bypass with deep hypothermia [20oC at low flow perfusion [70 ml/kg/min . The mean operation time was 227 $\pm$ 10 min., bypass time 152$\pm$ 7.6 min. and aortic cross clamp time 73$\pm$ 4.6 min.. 9 piglets survived more than 12 hours. One survived 12 days and died of pneumonia and the latest one survived in good condition and sacrificed at postoperative 6th week for cardiac catheterization and pathologic examination that revealed the viability and growing of the pulmonary autograft. Currently we are able to complete the operation with good preservation of cardiac function, and our postoperative care has evolved to the extent that we are now confident enough of having an acceptable percentage of long term survivors to undertake a definite study in this regard.