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Postoperative Arrhythmia after Open Heart Surgery - Cause, Incidence and It`s Management - (개심수술후 심장부정맥에 대한 임상적 연구: 원인,빈도 및 치료)

  • 장병철
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.843-852
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    • 1991
  • We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

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Initial Risk Assessment of Acetanilide in OECD High Production Volume Chemical Program

  • Park, Hye-Youn;Park, Yoonho;Sanghwan Song;Kwon, Min-Jeoung;Koo, Hyun-Ju;Jeon, Seong-Hwan;Na, Jin-Gyun;Park, Kwangsik
    • Toxicological Research
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    • v.18 no.1
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    • pp.13-22
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    • 2002
  • In Korea, 2,320 tonnes of acetanilide were mostly wed as intermediates for synthesis in phar-maceuticals or additives in synthesizing hydrogen peroxide, varnishes, polymers and rubber. Only small amount of 120 kg were wed as a stabilizer for hydrogen peroxide solution for hair colouring agents in 1998. Readily available environmental or human exposure data do not exist in Korea at the present time. However, potential human exposures from drinking water, food, ambient water and in work places are expected to be negligible because this chemical is produced in the closed system in only one company in Korea and the processing factory is equipped with local ventilation and air filtering system. Acetanilide could be distributed mainly to water based on EQC model. This substance is readily biodegradable and its bioaccumulation is low. Acute toxicity of acetanilide is low since the L $D_{50}$ of oral exposure in rats is 1,959 mg/kg bw. The chemical is not irritating to skin, but slightly irritating to the eyes of rabbits. horn repeated dose toxicity, the adverse effects in rats were red pulp hyperplasia of spleen, bone marrow hyperplasia of femur and decreased hemoglobin, hematocrit and mean corpuscular hemoglobin concentration. The LOAEL for repeated dose toxicity in rats was 22 mg/kg/day for both sexes. Acetanilide is not considered to be genotoxic. In a reproductive/developmental toxicity study, no treatment-related changes in precoital time and rate of copulation, impregnation, pregnancy were shown in all treated groups. The NOAELs for reproduction and developmental toxicity (off-spring toxicity) are considered to be 200 mg/kg bw/day and 67 mg/kg bw/day, respectively. Ecotoxicity data has been generated in a limited number of aquatic species of algae (72 hr- $E_{b}$ $C_{50}$; 13.5 mg/l), daphnid (48hr-E $C_{50}$ > 100 mg/l) and fish (Oryzias latipes, 96hr-L $C_{50}$; 100 mg/l). Form the acute toxicity values, the predicted no effect concentration (PNEC) of 0.135 mg/1 was derived win an assessment factor of 100. On the basis of these data, acetanilide was suggested as currently of low priority for further post-SIDS work in OECD.in OECD.D.

Effects of Telephone Counseling on Health and Service Satisfaction after Discharge in Gynecologic Cancer Women (퇴원 후 전화상담중재가 부인암환자의 지각된 건강상태, 심리적 안녕과 간호만족도에 미치는 효과)

  • Park, Young-Sook;Han, Kyung-Ja;Ha, Yang-Sook;Song, Mi-Soon;Kim, Sung-Jae;Chung, Chae-Weon;Park, Yeon-Hwan;Koh, Chin-Kang;Kwon, Won-Kyung;Lee, Joo-Young;Hwang, Shin-Woo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.2
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    • pp.294-304
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    • 2008
  • Purpose: Cancer patients experience a range of physical and psychological sequelae. Consistent nursing support should be provided along the cancer treatment path. This study aimed to i)examine the effects of a telephone counseling program after discharge on perceived health, psychological well-being, and satisfaction with nursing services, and ii)describe symptom distress and their coping methods. Method: The study was a quasi-experimental design with a non-equivalent pre-post test. The sample included 20 women with gynecologic cancer in the experimental group and the same in the control group from a university hospital in Seoul. The telephone intervention was given once from 5 to 7 days after the chemotherapy. The General Well-Being Schedule and Symptom Distress Scale were used. Result: An effect from telephone counseling was found only in the vitality subscale of psychological well-being. Other subscores, perceived health, or satisfaction with nursing services did not differ between the two groups. Pain, skin change, decreased appetite, and constipation were the major symptoms and a relatively few coping strategies were utilized. Conclusion: Protocol of telephone counseling led by a nurse needs to be further developed in regard to best timing, amount, and target effects for follow-up care of gynecologic cancer patients.

Clinical Experience of Rigid Bronchoscopy in Single Center

  • Kim, Hyun-Jin;Kim, Sei-Won;Lee, Hye-Yeon;Kang, Hyeon-Hui;Kang, Ji-Young;Kim, Ju-Sang;Kim, Myung-Sook;Kim, Seung-Soo;Kim, Jin-Woo;Yun, Hyeong-Gyu;Kim, Chi-Hong;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Cho, Kwang-Jae;Moon, Seok-Hwan;Lee, Sang-Haak
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.486-492
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    • 2012
  • Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

Acupuncture and Moxiburstion Alleviates Chronic Postoperative Pain as a Comlication of Gastrointestinal Surgery: Apropos 8 Cases (침구치료를 통해 소화기계 수술 후 발생한 만성적 수술 후 통증이 호전된 환자 8례)

  • Choi, Jun-Yong;Kim, So-Yeon;Cho, Min-Kyoung;Kim, Do-Hyung;Park, Seung-Chan;Kwon, Jung-Nam;Hong, Jin-Woo;Lee, In;Park, Seong-Ha;Han, Chang-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.2
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    • pp.206-211
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    • 2012
  • Here we described 8 patients treated with acupuncture and moxiburstion due to chronic postoperative pain as a comlication of gastrointestinal surgery. The patients were suffering from pain that continued for more than 6 months after laparotomy for gastric cancer (n=1), rectal cancer (n=2), cholangiocarcinoma (n=2), hepatocellular carcinoma (n=2) and ischemic colitis (n=1), respectively. Mean time elased from surgery were 31.25(${\pm}21.72$)months, pain grade on first visit by VAS(visual analogue scale, 0~10mm) was 3.75(${\pm}0.97$)point, and acupuncture and moxiburstion were performed 12.63(${\pm}5.74$)times during 5.5(${\pm}2.4$)weeks, on average. At the end of treatment, pain was decreased 2.75(${\pm}0.97$)point compared to first visit. Based on the that results, it is reasonable to assume that acupuncture and moxiburstion can be effective to persistent post-surgical pain after laparotomic gastrointestinal surgery, at least to some laparotomized patients.

Fabrication and Characterization of Hybrid NTC Thermistor Films with Conducting Oxide Particles by an Aerosol-Deposition Process (상온 분사 공정에 의한 산화물전도 입자 복합 하이브리드 NTC 서미스터 필름의 제작 및 특성)

  • Kang, Ju-Eun;Ryu, Jungho;Choi, Jong-Jin;Yoon, Woon-Ha;Kim, Jong-Woo;Ahn, Cheol-Woo;Choi, Joon Hwan;Park, Dong-Soo;Kim, Yang-Do
    • Journal of the Korean Ceramic Society
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    • v.50 no.1
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    • pp.63-69
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    • 2013
  • Negative-temperature coefficient (NTC) thermistors based on nickel manganite spinel ($NiMn_2O_4$) are widely used for many applications, such as sensors and temperature compensators, due to their good thermistor characteristics and stabilities. However, to achieve thermistors with a high NTC B constant, which is an important figure of merit pertaining to the degree of temperature sensitivity, the activation energy should be high such that high resistivity at ambient temperatures results. To obtain a high B constant and low resistivity, Al and Si modified spinel structured $Ni_{0.6}Si_{0.2}Al_{0.6}Mn_{1.6}O_4$ hybrid thick films with the conducting metal oxide of $LaNiO_3$ were fabricated on a glass substrate by aerosol deposition at room temperature (RT). The NTC-$LaNiO_3$ hybrid thick films showed resistivity as low as < $100k{\Omega}\;cm$ at $90^{\circ}C$, which is one or two orders of magnitude lower than that of the monolithic NTC films, while retaining a high B constant of $NiMn_2O_4$ of over 5500 K when 20 wt% $LaNiO_3$ was added without a post-thermal treatment. These phenomena are explained by the percolation threshold mechanism.

Prospect for 3D Printing Technology in Medical, Dental, and Pediatric Dental Field (의료 3D 프린팅 기술의 전망 및 소아치과분야에서의 활용)

  • Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.93-108
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    • 2016
  • One of the fields to which the 3D printing technology can be applied is the field of medicine. Recently, the application of 3D printing technology to the bio-medical field has been gradually increasing with the commercializing of the bio-compatible or bio-degradable materials. The technology is currently contributing to the biomedical field by reducing times required for operations or minimizing adverse effects through preoperative identification of post-surgical consequences or model surgery with artificial bones and organs. This technology also enables the production of customized biomedical auxiliary products like hearing aids or artificial legs etc. For the field of dentistry, the 3D printing technology is also expected to elevate the level of dental treatment by making the customized orthodontic models, crown, bridge, inlay, and surgical guides for implant and surgery. However, issues remaining unidentified or incomplete in printing materials, modeling technology, software technology associated with CAD, verification of bio-stability and bio-effectiveness of materials or in compatibility and standardization of the technology are yet to be solved or be clarified for the full-scale application of the 3D printing technology, thus, it seems such issues should be resolved through further studies.

The Effect of Lumbosacral Stabilization Exercise on Oswestry Disability Index and Gait Velocity of Patients with Chronic Low Back Pain (허리엉치 안정화운동이 만성허리통증환자의 허리통증장애지수와 보행속도에 미치는 영향)

  • Kang, Jeong-Il;Jeong, Dae-Keun
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.243-250
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    • 2013
  • The present study is to determine the effect of lumbosacral stabilization exercise program on back pain disorder and gait velocity of patients with chronic low back pain. The subject was extracted randomly from 34 patients with chronic low back pain and divided into 18 patients of experimental group and 16 patients of control group. Before the experiment, the Oswestry disability index examination and analysis of gait speed were performed. Then, a conventional interventional therapy of physiotherapy was performed with the experimental group along with the lumbosacral stabilization exercise while only the conventional interventional therapy was done to the control group. Both groups did the above treatment every 30 minutes, four times a week for four weeks. Then, post-examination was carried out followed by comparing the back pain disorder index and gait velocity before and after the experiment for the two groups. The back pain disorder index showed that both experimental and control groups had significant difference within the group (p>.01)(p>.05), With regard to the gait velocity, both experimental and control groups had a significant difference within the experimental group and between the groups (p>.001)(p>.05).

Thermal Stability and Cure Behavior of Waterborne Phenol-Formaldehyde Resin (수용성 페놀-포름알데히드 수지의 열안정성 및 경화거동)

  • Yoon, Sung Bong;Kim, Jin Woo;Cho, Donghwan
    • Journal of Adhesion and Interface
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    • v.7 no.1
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    • pp.16-22
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    • 2006
  • In this work, the effect of cure temperature and time on the thermal stability and the exothermic cure reaction peak of a waterborne resol-type phenol-formaldehyde resin, which may be used for preparing phenolic sheet molding compounds (SMC), has been investigated using a thermogravimetric analyzer and a differential scanning calorimeter. The weight loss of waterborne phenol-formaldehyde resin was mainly occurred at three temperature stages: near $200^{\circ}C,\;400^{\circ}C$, and $500^{\circ}C$. The carbon yield at $750^{\circ}C$ for the cured resin was about 62%~65%. Their thermal stability increased with increasing cure temperature and time. Upon cure, the exothermic reaction was taken placed in the range of $120^{\circ}C{\sim}190^{\circ}C$ and the maximum peak was found in between $165^{\circ}C$ and $170^{\circ}C$. The shape and the maximum of the exothermic curves depended on the given cure temperature and time. To remove $H_2O$ and volatile components, the uncured resin needed a heat-treatment at $100^{\circ}C$ for 60 min at least prior to cure or molding. Curing at $130^{\circ}C$ for 120 min made the exothermic peak of waterborne phenol-formaldehyde resin completely disappeared. And, post-curing at $180^{\circ}C$ for 60 min further improved the thermal stability of the cured resin.

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Studies on Cryotop Vitrification Method for Simple Freezing of Hanwoo Embryos (한우 수정란의 간이 동결을 위한 유리화 동결법에 관한 연구)

  • Lee, Hae-Lee;Kim, Sang-Hun;Kim, Yong-Jun
    • Journal of Embryo Transfer
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    • v.29 no.1
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    • pp.13-19
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    • 2014
  • This study was carried out to study the survival rate of thawed Hanwoo embryos frozen by the slow-rate freezing or the cryotop vitrification method. Hanwoo cumulus-oocyte complexes were recovered from ovaries at a slaughter house, matured for 20~22 hours, fertilized with Hanwoo semen for 5~6 hours, and cultured for 7~9 days in $38.5^{\circ}C$, 5% $CO_2$ incubator. For freezing, Day 7~9 blastocysts were collected. Embryos for the slow-rate freezing were equilibrated in 1.8 M ethylene glycol (EG) with Dulbecco's phosphate-buffered saline (D-PBS). Programmable cell freezer was precooled down to $-7^{\circ}C$, and the straw was seeded during 8 minutes-holding time, and was cooled to $-35^{\circ}C$ at the cooling rate of $0.3^{\circ}C/min$, and then was plunged and stored in liquid nitrogen. Embryos for the cryotop vitrification were treated in TCM199 with 0.5 M sucrose, 16% EG, 16% dimethylsulfoxide (DMSO). Embryos were then loaded individually onto cryotop and plunged directly into liquid nitrogen. The survival rates of embryos frozen by these two freezing methods were evaluated at 12 to 24h post-thawing. The survival rates of frozen/thawed Hanwoo embryos by the cryotop vitrification method ($56.86{\pm}26.53%$) were slightly higher than those by the slow-rate freezing method ($55.07{\pm}26.43%$) with no significant difference. Using the cryotop vitrification and the slow-rate freezing of Hanwoo blastocysts on Day 7 following in-vitro fertilization (IVF) treatment, the survival rates of frozen/thawed Hanwoo embryos were $72.65{\pm}18.3%$ and $79.06{\pm}17.8%$, respectively. The survival rates by the cryotop vitrification were higher than those by the slow-rate freezing on both Day 8 and 9 with significantly higher survival rate on Day 9 (p<0.05). Using the cryotop vitrification and the slow-rate freezing of Hanwoo embryos to compare between three different blastocyst stages, the survival rates of the blastocyst stage embryos were $66.22{\pm}18.8%$ and $45.76{\pm}12.8%$, respectively with higher survival rate by the vitrification method (p<0.05). And the survival rate of expanded blastocysts was higher than those of early blastocysts and blastocysts in two freezing methods with significantly higher survival rate by the slow-rate freezing method (p<0.05).