• Journal of Chest Surgery
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• v.24 no.4
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• pp.421-427
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• 1991

Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

• Clinical and Experimental Pediatrics
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• v.55 no.1
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• pp.24-28
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• 2012

Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

• The Korean Journal of Pharmacology
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• v.14 no.1_2
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• pp.41-46
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• 1978

The effects of sodium taurocholate(STC) and sodium deoxycholate(SDC) on cardiac function were examined by using isolated atria of rabbit and guinea pig and heart of anesthetized frog. Also the antiarrythmic action of STC and SDC on atrial arrhythmias induced by epinephrine or ouabain was studied. The results were following. The cholates exhibited a slight decrease in rate and contractile amplitude of the isolated rabbit atria. The cholates abolished partially the spontaneous arrhythmic occurring in isolated rabbit and guinea pig atria but no effect on the atrial arrhythmia induced by ouabain and epinephrine was observed. Concomitant administration of cholates with ouabain produced a marked prolongation of atrial arrhythmia in comparison to that of ouabain alone in both isolated rabbit and guinea pig atria. The cholates exhibited a marked prolongation in ventricular arrhythmia and cardiac arrest time in comparison to that of ouabain treatment. However, the combined treatment with cholates and ouabain produced a slight prolongation in comparison to that of ouabain alone in the heart of anesthetized frog. The above results suggest that cholates have a slight antiarrythmic effect on the heart but this effectiveness is different from those of propranolol that is non-selective antiarrhythmic drug.

• Proceedings of the Korean Biophysical Society Conference
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• 2003.06a
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• pp.25-25
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• 2003

Atrial myocytes have two functionally separate $Ca^{2+}$ release sites: those in peripheral sarcoplasmic reticulum (SR) adjacent to the $Ca^{2+}$ channels of surface membrane and those in central SR not associated with $Ca^{2+}$ channels. Study on the spatio-temporal properties of focal $Ca^{2+}$ releases (“sparks”) occurring spontaneously in central and peripheral sites of voltage-clamped rat atrial myocytes, using rapid two-dimensional (2-D) confocal $Ca^{2+}$ imaging revealed that peripheral and central sparks were similar in size and release time (~300,000 $Ca^{2+}$ ions for=12 ms), but significantly larger and longer than ventricular sparks. Both sites were resistant to Cd$^{2+}$ and inhibited by ryanodine. Peripheral sparks were brighter and flattened against surface membrane, had ~5-fold higher frequency, ~2 times faster diffusion coefficient, and dissipated abruptly. Central sparks, in contrast, occurred less frequently, were elongated along the cellular longitudinal axis, and dissipated slowly. Compound sparks (composed of 2-5 unitary focal releases) aligned longitudinally, occurred more frequently at the center.at the center.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.1
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• pp.33-41
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• 2004

We developed a cardiac cell model to explain the phenomenon of mechano-electric feedback (MEF), based on the experimental data with rat atrial myocytes. It incorporated the activity of ion channels, pumps, exchangers, and changes of intracellular ion concentration. Changes in membrane excitability and $Ca^{2+}$ transients could then be calculated. In the model, the major ion channels responsible for the stretch-induced changes in electrical activity were the stretch-activated channels (SACs). The relationship between the extent of stretch and activation of SACs was formulated based on the experimental findings. Then, the effects of mechanical stretch on the electrical activity were reproduced. The shape of the action potential (AP) was significantly changed by stretch in the model simulation. The duration was decreased at initial fast phase of repolarization (AP duration at 20% repolarization level from 3.7 to 2.5 ms) and increased at late slow phase of repolarization (AP duration at 90% repolarization level from 62 to 178 ms). The resting potential was depolarized from -75 to -61 mV. This mathematical model of SACs may quantitatively predict changes in cardiomyocytes by mechanical stretch.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.331-336
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• 1983

Cor triatriatum is a rare congenital malformation of the heart, in which a septum stretches in a transverse or oblique plane through the left atrium, thus separating it into two compartments. The upper one connects with the pulmonary veins, and the lower one connects with the left ventricle. Due to the rarity of, and great difficulty in-diagnosing, cor trlatrlatum, data On the surgery of this disease are of necessity very limited and so accurate pre-operative diagnosis was very difficult to make. `We experienced a case of the cyanotic congenital heart disease which was diagnosed as a large atrlal septal defect with streaming venous blood from inferior vena cava to left atrium through atrial septal defect in August, 1982. We found that there were transverse septum in the left atrium through atrlal septal defect, the pulmonary venous drainage were located in the upper chamber of the left atrium, and the lower chamber was connected with the left atrial appendage, mitral valve and `left ventricle. But our case had not any opening in this transverse septum and the right atrium was connected with the upper chamber of the left atrium through the upper part of the atrlal septal defect, and was communicated with the lower chamber of the left atrium through the lower part of the atrlal septal defect. We excised the transverse septum and repair this atrial septal defect with Woven Dacron patch accompanying with the drainage of coronary sinus to right atrium. The post-operative course was not eventful and he was discharged with good result on the post-operative 8th day, and has been in good .condition up to now for longer than 10 months.

• The Korean Journal of Zoology
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• v.35 no.3
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• pp.263-270
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• 1992

Responses of immunoreactive atrial natriuretic peptide (ir-ANP) to environmental temperature were studied in the freshwater catfish, Silums usotus, acclimated at various temperatures for one week. According to increase in environmental temperature, plasma sodium and chloride concentrations, and osmolality were significantly increased, while hematocrit showed a marked decrease. When the catfishes frere acclimated at cold $(3^{\circ}C)$ or warm $(18^{\circ}C)$ temperatures, ir-ANP contents in the atrium and bulbus arteriosus were significantly lower than those at $9^{\circ}C.$ However, ventricular contents of ir-ANP urere not different among the three groups.Levels of plasma ir-ANP in the catfish increased in response to the increment of acclimated temperature. On the basis of these results, we suggest that the environmental temperature may modulate synthesis and secretion of ir-hUP in the fish. We also suggest that changes of plasma ir-ANP levels may be associated with the control of body fluid homeostasis.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.124-128
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• 2018

Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.

• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.151-157
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• 2013

Purpose: Warfarin is the most widely used anticoagulant drug for preventing cardiovascular diseases after ischemic stroke and thromboembolism related to atrial fibrillation, artificial heart valves, deep vein thrombosis, and pulmonary embolism. Warfarin is commonly used in combination with other drugs such as diuretics in order to treat the comorbidity. Although several warfarin-diuretics interactions have been reported, the results are conflicting. Therefore, the initial aim of this study was to identify the effects of diuretics on the warfarin response in patients with atrial fibrillation. Methods: One hundred forty six patients with atrial fibrillation who were on anticoagulation therapy with warfarin and maintained INR levels of 2-3 for three consecutive times were followed up, retrospectively. Stable warfarin doses and INR per stable warfarin dose were compared according to age, gender, comorbidity, and concurrent medication. The stable warfarin dose was defined as the maintenance dose of warfarin of the measured patient whose INR was within the target INR range more than 3 times consecutively. Results: The differences of stable warfarin doses in patients with ($3.22{\pm}1.21$ mg/day) and without ($3.58{\pm}1.14$ mg/day) diuretics were marginally significant (P=0.069). On the other hand, stable warfarin doses were $2.97{\pm}1.10$ mg/day in patients with thiazide (n=36) and $3.58{\pm}1.14$ mg/day in patients without diuretics (n=82), which was statistically significant (p=0.009). INR values per stable warfarin dose in patients with diuretics and thiazide were $0.84{\pm}0.31$ and $0.90{\pm}0.34$, respectively, which were statistically different from those without diuretics ($0.72{\pm}0.21$, P=0.010 and P=0.006, respectively). Age, gender, and concurrent use of thiazide diuretics were found to have significant influence on the warfarin response from multivariate analysis. Conclusion: Our study showed that the concurrent use of thiazide diuretics could increase the response of warfarin in patient with atrial fibrillation. Therefore, clinicians should be aware that warfarin dose needs to be adjusted when it is used with thiazide diuretics concomitantly.

• The Korean Journal of Physiology
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• v.23 no.1
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• pp.43-49
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• 1989

Effects of atrial natriuretic peptide (ANP) on the development of hypertension in 2-kidney, 1-clip (2-K, 1-C) rats were examined. In one group of rats, ANP infusion (500 ng/hr, iv) started immediately after clipping the renal artery. Another group of rats with one kidney-clipped was without ANP infusion and served as a control. Blood pressure was measured on days 4, 7, and 10 following clipping the renal artery. Upon the last blood pressure measurement finished, blood sample was collected by decapitation to measure plasma renin activity (PRA), and both kidneys were taken to weigh and to measure renin content. The ANP-infused group showed an attenuation of increases in blood pressure compared to the non-infused control group. PRA was lower in the ANP-infused group than in the non-infused group. Cortical renal renin content (RRC) of the clipped kidneys was not different between ANP-infused and non-infused groups. The clipped kidneys showed a higher RRC and weighed less than the non-clipped contralateral kidneys within each group. In contrast, sham-clipped rats did not show significant changes in any of the parameters examined regardless of whether ANP was infused or not. These results demonstrate that chronic ANP infusion does not prevent but does attenuate the development of hypertension in 2-K, 1-C rats. It is suggested that ANP plays a role in the long-term regulation of blood pressure, at least in part, by antagonizing the renin-angiotensin-system.