• 제목/요약/키워드: and heart

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개심술 450례의 임상적 고찰 (Clinical Analysis of Open Heart Surgery -Review of 450 Cases)

  • 이서원;이계선
    • Journal of Chest Surgery
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    • 제30권8호
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    • pp.770-779
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    • 1997
  • 본원에서는 1985년 2월 부터 1996년 8월까지 450례의 개심술을 시행하였다. 450례중 선천성 심질환은 222례(49.3%), 후천성 심질환은 228례(50.7%)로 거의 비슷한 비율이었으며, 후반 기 5년간은 후천성 심질환이 더 많았다. 선천성 심질환은 비청색증심질환이 201례, 청색증 심질환이 21례를 차지 하였으며, 수술 사망율은 각각 5.5%와 38.1%를 차지하였다. 청색증 심질환은 대부분 활롯 4징증 이었다. 후천성 심질환 228례중 판막질환은 17례, 허혈성 심질환은 32례, 대동맥 질환은 12례, 심장종양은 6례 있었다. 판막질환은 승모판치환술이 87fll, 대동맥판막 치환술이 45례, 이중판막 치환술이 35례를 차지하였다. 허혈성 심장병의 평균문합순는 2.37개소 였으며, 사망율은 6.3%였다. 판막질환의 사망율은 10.8%, 대동맥질 환의 사망율은 16.7%였다. 전체 사망율은 9.6%이며, 선천성 심질환은 9.0%, 후천성 심질환은 10.1%였다.

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개심술 610례에 관한 임상적 고찰 (The Clinical Experience of 610 Cases Open Heart Surgery)

  • 정황규
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.36-47
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    • 1988
  • 610 cases of open heart surgery was performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July 1981 to September 1987. The clinical data was summarized as follows: 1. The age distribution of congenital heart surgery patients was 2 to 41 years old [mean; 13.2 years] and surgery for acquired heart disease was 10 to 57 years old [mean: 32.8 years]. 2. There were 389 cases [63.8%] of acyanotic congenital heart anomalies, 63 cases [10.3%] of cyanotic congenital anomalies and 158 cases [25.9%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and then since 1983, GIK solution has been used with repeated infusion method once for every 20 to 30 minutes of time interval after starting initial cardioplegia during operation with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, sodium bicarbonate, mannitol, potassium chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 96 cases [15.7%] of mild hypothermia, 333 cases [54.6%] of moderate hypothermia and 181 cases [29.7%] of intermediate hypothermia. 6. The mortality rate was 2.3% [9 out of 389 cases] in acyanotic congenital heart disease, 36.5% [23 out of 63 cases] in cyanotic congenital heart disease and 10.8% [17 out of 158 cases] in acquired heart disease, with overall mortality rate of 8.0% [49 out of 610 cases].

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진공성형을 이용한 삼엽식 고분자 심장판막의 제작과 혈류역학적 성능평가 (Assessment of Hemodynamic Properties of Trileaflet Polymer Heart Valve Manufactured By Vacuum Forming Process)

  • 김경현;황창모;정기석;안치범;김범수;이정주;남경원;선경
    • 대한의용생체공학회:의공학회지
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    • 제27권6호
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    • pp.418-426
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    • 2006
  • In the artificial heart application, productivity and hemodynamic properties of artificial heart valves are crucial in successiful application to long term in vivo trials. This paper is about manufacture and assessment of trileaflet polymer heart valves using vacuum forming process(VFP). The VFP has many advantages such as reduced fabrication time, reproducibility due to relatively easy and simple process for manufacturing. Prior to VFP of trileaflet polymer heart valves, polyurethane(Pellethane 2363 80AE, Dow Chemical) sheet was prepared by extrusion. The sheets were heated and formed to mold shape by vacuum pressure. The vacuum formed trileaflet polymer heart valves fabrication is composed of two step method, first, leaflet forming and second, conduit forming. This two-step forming process made the leaflet-conduit bonding stable with any organic solvents. Hydrodynamic properties and hemocompatibility of the vacuum formed trileaflet polymer heart valves was compared with sorin bicarbon bileaflet heart valve. The percent effective orifice area of vacuum formed trileaflet polymer heart valves was inferior to bileaflet heart valve, but the increase of plasma free hemoglobin level which reflect blood damage was superior in vacuum formed trileaflet polymer heart valves Vacuum formed trileaflet polymer heart valves has high productivity, and superior hemodynamic property than bileaflet heart valves. Low manufacturing cost and blood compatible trileaflet polymer heart valves shows the advantages of vacuum forming process, and these results give feasibility in in vivo animal trials in near future, and the clinical artificial heart development program.

신장이식 수혜자의 경험 (A Study on the Experience of Patients with Chronic Renal Failure who have Received a Kidney Transplant)

  • 이숙희;김경희;정혜경
    • 기본간호학회지
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    • 제6권1호
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    • pp.78-95
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    • 1999
  • The grafting of a kidney has been found to be the best medical treatment for patients who have renal insufficiency failure, but the patients still have experienced much trouble and apprehension. This study was done to further nursing theory developing for patients who have has a kidney graft from another person. The research method followed grounded theory methodology of Strauss and Corbin. The subjects were three female and four male patients. This study done befween Oct. 1997 and Mar. 1998. All of the subjects were interviewed by the author. Interview were done by the long interview technique and observation. In the process of data analysis, 'heart-boiling' was found to be the core phenomenon. The results were composed to 101 concepts. These concepts were grouped into nineteen categories, and then to twelve categories. There were 12 super-class categories as follows ; 'pain', 'heart-boiling', 'experience of dialysis', 'term of admission to a hospital', 'support of other person', 'dependence on God', 'direction', 'negative reaction', 'positive reaction', 'comfortable', 'lacking', 'acceptance'. In this process, 14 hypotheses were derived from the categories as follows ; (1) The more experience with dialysis that the patients have, the stronger the heart-boiling will tend to be. (2) The less experience with dialysis the patients have, the weaker the heart-boiling will tend to be. (3) The longer admission to hospital the patients have, the stronger the heart-boiling will be. (4) The shorter the admission to hospital the patients have, the weaker the heart-boiling will be. (5) The weaker the intense-grief is, the more positive the reaction to heart-boiling the patients wll have. (6) The stronger the intense-grief is, the more negative the reaction to heart-boiling the patients will have. (7) The stronger the support of other persons that the patients have, the more positive the reaction to heart-boiling the patients will have. (8) The weaker the support of other person that the patients have, the more negative the reaction to heart-boiling the patients will have. (9) The stronger the dependence on God that the patients have, the mure positive reaction to heart-boiling the patients will have. (10) The weaker the dependence on God that the patients have, the more negative reaction to heart-boiling the patients will have. (11) The more positive thoughts that the patients have, the more positive reaction to heart-boiling the patinets will have. (12) The more negative thoughts that the patients have, the more negative reaction to heart-boiling the patients will have. (13) The more positive reaction the patients have, the more free from heart-boiling the patients tend to be. (14) The more negative reaction the patients have, the less free from heart-boiling the patients tend to be. From the analysis of observed data and comparing each class, I concluded that there are four formula relation types between reaction of patients and heart-boiling. (1) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, depend on God, have positive thoughts and another's strong support, they experience release by positive reaction to the intense-grief. (2) If patients have the experience of dialysis, have a short term admission to hospital, are weak in heart-boiling, do not depend on God, have negative thoughts, and have few supports from others, they experience attachment to heart-boiling though a negative reaction. (3) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, do not depend on God, and have negative thoughts, they experience attachment to heart-boiling through negative reaction in spite of support from another. (4) If patients have the experience of dialysis, have a long term admission into hospital, are strong in heart-boiling and satisfaction is low, but they have positive thoughts, then they experience acceptance and harmony through the positive reaction to heart-boiling. The results of this study are expected to help the way nurses care for patients who have had a kidney graft from another.

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심장 상태와 발음간의 연관성 분석을 위한 성대 진동의 변화율 추출 (Change Rate Extraction of Vocal Fold Vibration for Heart Conditional and Pronunciation of Correlative Analysis)

  • 김봉현;조동욱
    • 한국통신학회논문지
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    • 제35권2B호
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    • pp.191-196
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    • 2010
  • 흡연, 당뇨, 비만 및 스트레스 등에 의한 심장 질환이 증가됨에 따라 이로 인한 사망률이 늘어나면서 심장 질환은 현대 사회에서 조기 진단의 필요성을 제시하고 있는 실정이다. 특히 심장 질환에 대한 사람들의 무지와 무관심 때문에 발병율이 급격히 증가하고 있다. 따라서 이와 같은 심장 질환에 대한 사회적 현상을 해결하기 위해 본 논문에서는 동의보감에서 제시하고 있는 심장 상태에 대한 진단 이론을 기반으로 심장 질환의 조기 진단에 필요한 객관적 출력 변수를 설계하였다. 특히 심장 질환에 따른 발음의 부정확성을 입증하기 위해 성대의 진동 변화율을 추출하여 실험 집단간의 비교, 분석을 수행하였다. 이를 위해 본 논문에서는 표준어를 구사하는 성인 남성 중에서 심장 질환을 앓고 있는 환자들과 심장에 이상이 없는 정상인들로 피실험자 집단을 구성하고 이들의 음성을 수집하여 성대 진동의 변화율에 대한 비교, 분석을 통해 심장 질환에 대한 조기 진단 방법을 제안하였다.

Heart Sound Recognition by Analysis of wavelet transform and Neural network.

  • Lee, Jung-Jun;Lee, Sang-Min;Hong, Seung-Hong
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2000년도 ITC-CSCC -2
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    • pp.1045-1048
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    • 2000
  • This paper presents the application of the wavelet transform analysis and the neural network method to the phonocardiogram (PCG) signal. Heart sound is a acoustic signal generated by cardiac valves, myocardium and blood flow and is a very complex and nonstationary signal composed of many source. Heart sound can be discriminated normal heart sound and heart murmur. Murmurs have broader frequency bandwidth than the normal ones and can occur at random position of cardiac cycle. In this paper, we classified the group of heart sound as normal heart sound(NO), pre-systolic murmur(PS), early systolic murmur(ES), late systolic murmur(LS), early diastolic murmur(ED). And we used the wavelet transform to shorten artifacts and strengthen the low level signal. The ANN system was trained and tested with the back- propagation algorithm from a large data set of examples-normal and abnormal signals classified by expert. The best ANN configuration occurred with 15 hidden layer neurons. We can get the accuracy of 85.6% by using the proposed algorithm.

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SAMD4B, a novel SAM-containing protein, inhibits AP-1-, p53- and p21-mediated transcriptional activity

  • Luo, Na;Li, Guan;Li, Yongqing;Fan, Xiongwei;Wang, Yuequn;Ye, Xiangli;Mo, Xiaoyan;Zhou, Junmei;Yuan, Wuzhou;Tan, Ming;Xie, Huaping;Ocorr, Karen;Bodmer, Rolf;Deng, Yun;Wu, Xiushan
    • BMB Reports
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    • 제43권5호
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    • pp.355-362
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    • 2010
  • The sterile alpha motif (SAM) is a putative protein interaction domain involved in a wide variety of biological processes. Here we report the identification and characterization of a novel gene, SAMD4B, which encodes a putative protein of 694 amino acids with a SAM domain. Northern blot and RT-PCR analysis showed that SAMD4B is widely expressed in human embryonic and adult tissues. Transcriptional activity assays show SAMD4B suppresses transcriptional activity of L8G5-luciferase. Over-expression of SAMD4B in mammalian cells inhibited the transcriptional activities of activator protein-1 (AP-1), p53 and p21, and the inhibitory effects can be relieved by siRNA. Deletion analysis indicates that the SAM domain is the main region for transcriptional suppression. The results suggest that SAMD4B is a widely expressed gene involved in AP-1-, p53- and p21-mediated transcriptional signaling activity.

Geft is dispensable for the development of the second heart field

  • Fan, Xiongwei;Hou, Ning;Fan, Kaiji;Yuan, Jiajia;Mo, Xiaoyang;Deng, Yun;Wan, Yongqi;Teng, Yan;Yang, Xiao;Wu, Xiushan
    • BMB Reports
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    • 제45권3호
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    • pp.153-158
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    • 2012
  • Geft is a guanine nucleotide exchange factor, which can specifically activate Rho family of small GTPase by catalyzing the exchange of bound GDP for GTP. Geft is highly expressed in the excitable tissue as heart and skeletal muscle and plays important roles in many cellular processes, such as cell proliferation, migration, and cell fate decision. However, the in vivo role of Geft remains unknown. Here, we generated a Geft conditional knockout mouse by flanking exons 5-17 of Geft with loxP sites. Cre-mediated deletion of the Geft gene in heart using Mef2c-Cre transgenic mice resulted in a dramatic decrease of Geft expression. Geft knockout mice develop normally and exhibit no discernable phenotype, suggesting Geft is dispensable for the development of the second heart field in mouse. The Geft conditional knockout mouse will be a valuable genetic tool for uncovering the in vivo roles of Geft during development and in adult homeostasis.

인공심장판막의 개발 및 동물실 (Development and Animal Tests of Artificial Heart Valves)

  • 이재영
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.458-472
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    • 1987
  • A heart supplies bloods of about 15, 000 liters to each human organ in a day. A normal function of heart valves is necessary to this act of heart. The disease of heart valve develops to a narrowness of a closure, resulting in an abnormal circulation of bloods. In an attempt to eliminate the affliction of heart valves, the operation method to repair with artificial heart valves has been developed and saved numerous patients over past 30 years. This replacement operation has been performed since early 1960`s in Korea, but all the artificial heart valves used are imported from abroad with very high costs until recent years. The artificial heart valve using pyrolytic carbon has been developed at KAIST, which was proved to be stable in the mechanical performance and durability. Therefore, the in viva performance of this valve was examined through animal tests. The artificial heart valves used in this study are tilting disc type valves, in which the disc were made of graphite coated with pyrolytic carbon and the cages were made of titanium. In viva testings of these valves were performed in 12 dogs, in which right ventriculo-pulmonary arterial [Croup I] or inter-aortic [Croup IV] valved conduit was implanted using polytetrafluoroethylene conduits containing KAIST valve and aortic valve [Group II] or pulmonary valve [Croup III] was replaced by a KAIST valve with a 21mm or 19mm tissue annulus diameter. In group I and II, pre-and post-operative transvalvular pressure gradient was measured and compared with other prosthetic valves. During post operative period laboratory examination was performed including hemoglobin, hematocrit, red cell count, white cell, lactic acid dehydrogenase and platelet. The eight surviving dogs were sacrificed and autopsy was performed at 2, 6, and 8 weeks. KAIST valve has low transvalvular gradient and relatively high orifice area. Average ventriculo-aortic peak systolic transvalvular gradient was 14 mmHg in 21 mm valve and 19 mmHg in 19 mm valve. The valve has slight intravascular hemolysis effect. Thrombogenic effect of low polishing quality and eddy currents around small orifice is high. The valve has vulnerability of disc movement. These animal tests suggest that the improvement of the heart valve design, surface polishing state and prescription methods.

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심박변이도의 운동부하 의존성 (Work Load Dependency of Heart Rate Variability (HRV))

  • 권정훈;김철승;엄광문
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2006년도 춘계학술대회 논문집
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    • pp.641-642
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    • 2006
  • The purpose of this work is to investigate the effect of work load on heart rate variability (HRV) which is widely used marker of the autonomic nervous system activity. Average heart rate, rating of perceived exertion, and the power spectrum of heart rate variability were investigated in seven healthy males during exercise at various work loads. The subjects were divided into two groups according to the average heart rate during exercise, group 1 with lower heart rate and group 2 with higher heart rate. HF component showed decrease followed by increase with workload. Accordingly, the LF/HF ratio showed increase followed by decrease with workload. The peak in LF/HF ratio of group 1 was at the lower workload than that of group 2.

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