• 한국임상수의학회지
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• 제19권1호
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• pp.95-99
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• 2002

A 6-month-old, intacted male dog was admitted to Seoul Animal Medical Center. The referring veterinarian suspected that the patient might have congenital cardiac problem. It was diagnosed with patent ductus arteriosus(PDA) based on the physical examination, auscultation, radiography, electrocardiography and ultrasonogrphy. After surgical ductus closure, there were improved clinical conditions through by alleviation of atrial fibrilation and left heart enlargement.

• The Korean Journal of Physiology
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• 제23권2호
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• pp.339-350
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• 1989

Electrophysiological effects of ammonia was studied in the isolated superfused sinus node and atrial muscle cells of the rabbit heart. No significant changes were observed in the overshoot potential (05), maximum diastolic potential (MDP), and action potential amplitude (APA) of the sinus node cells following superfusion with 3.0 mM ammonia, fifty times upper limit of the normal human plasma level. However the action potential duration (APD) of sinus node cells were significantly prolonged after superfusion with 0.6 mM ammonia for 20 min or with 1.2 and 3.0 mM ammonia for 5 minutes. Ammonia in all the concentrations tested decreased the rate of spontaneous firing (RSF) from the sinus node cells. After superfusion of sinus node cells with 0.3 mM ammonia for 20 min, the RSF significantly decreased from 20 min to 25 min after onset of superfusion while a significant decrement in the RSF was observed from 7 min to 30 min following superfusion with 3.0 mM ammonia for S min. On the other hand, the effects of ammonia on the action potential of the rabbit atrial muscle cell were much similar to those on pacemaker cells except that the atrial cell was generally less sensitive to ammonia. The results suggest that ammonia may cause changes in the action potential of the rabbit cardiac cells by the direct action, and that the cardiac effects of ammonia are generally opposite to those of glycine.

• The Korean Journal of Physiology
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• 제23권2호
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• pp.291-299
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• 1989

Na and Ca effects on contracture were studied in order to estimate Na/Ca exchange ratio in the isolated atrial muscle of the rabbit. All experiments were performed in tris-buffered Tyrode solution which was being aerated with 100% $O_2\;and\;kept\;at\;37^{circ}C$. To load intracellular $Na^+,\;10{-6}M$ ouabain or K-free solution were used. Contractures were induced by brier exposure of atrial muscle to Tyrode solution containing various concentrations of Ca or of Na. The results obtained were as follows: 1 ) Increasing the extracellular Ca concentration, the amplitude of contracture also increased and was maximum at 8 mM Ca-Tyrode solution. 2) The relationship between extracellular Ca concentrations and relative amplitude of the contractures showed hyperbolic pattern. By using Hill plot, the line has the slope of 1 12 which means the number of Ca binding sites of the carrier in the cell membrane. 3) The amplitude of the contracture was maximum in 0 mM Na-Tyrode solution and decreased in dose dependent manner when the Na concentration increased. 4) When the relationship between extracellular Na concentrations and the amplitude of contractures was expressed as dose-response curve, the curve showed sigmoid pattern. The line with the slope of 2.82 was obtained by using Hill plot. 5) From above all the results, it is suggested that exchange ratio of Na and Ca via Na/ca exchange system in the atrial muscle of rabbit could be 3:1 approximately.

• Journal of Yeungnam Medical Science
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• 제4권2호
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• pp.23-27
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• 1987

저자들은 1986년 5월부터 1987년 4월까지 건강 진단 목적으로 검사한 대구시내 국민학생 및 중학생의 심전도를 분석하여 다음과 같은 결론을 얻었다. 대상학생은 13,801명으로 남자 7,526명, 여자 6,275명이였다. 심전선도에서 이상소견을 보인 수는 145명(1.05%)으로 남자 98명, 여자 47명이였다. 심방 및 심실비대는 우심방비대 2명, 좌심방비대 5명, 우심실비대 35명(0.25%) 및 좌심실비대 16명(0.12%)이였다. 이소심박중 심방성 조기수축 12명(0.09%), 심실성 조기수축 8명(0.06%) 및 방실접합부율동 5명(0.04%)이였다. 정도장애 부정맥중 1도방실전도장애 21명(0.15%), 1형 2도방실전도장애 1명, 방실해리 1명, 우각전도차단 36명(0.26%), 좌각전도차단 1명 및 WPW증후군 2명이였다. 비특이적 ST, T변화가 3명이였고, 동성빈맥이 1명이였다.

• Journal of Chest Surgery
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• 제47권2호
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• pp.94-99
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• 2014

Background: Surgical repair of a partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) may be complicated by sinus node dysfunction or SVC obstruction. We modified the Warden procedure by using a right atrial auricular flap to decrease the occurrence of these complications. Methods: Between February 2005 and July 2012, 10 consecutive patients underwent a modified Warden procedure to correct PAPVC. The median patient age was 5.7 years. Eight patients (80%) had an atrial septal defect. To surgically correct the PAPVC, we made a U-shaped incision on the right atrial appendage and sutured the flap to the posterior wall of the SVC. The anterior wall was reconstructed with various patch materials. Results: No early or late deaths occurred, nor did any patient require early or late reoperation for SVC or pulmonary venous obstruction. No new arrhythmias appeared during follow-up, which was complete in all patients (mean, 29.5 months). Conclusion: Our modification of the Warden procedure seems to be effective and safe. This technique may lower the risk of SVC obstruction, pulmonary venous obstruction, and sinus dysfunction.

• Journal of Chest Surgery
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• 제53권5호
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• pp.270-276
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• 2020

Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

• Journal of Electrical Engineering and Technology
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• 제12권1호
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• pp.346-355
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• 2017

Atrial fibrillation (AF) and Congestive heart failure (CHF) are increasingly widespread, costly, deadly diseases and are associated with significant morbidity and mortality. In this study, we analyzed three statistical methods for automatic detection of AF and CHF based on the randomness, variability and complexity of the heart beat interval, which is RRI time series. Specifically, we used short RRI time series with 16 beats and employed the normalized root mean square of successive RR differences (RMSSD), the sample entropy and the Shannon entropy. The detection performance was analyzed using four large well documented databases, namely the MIT-BIH Atrial fibrillation (n=23), the MIT-BIH Normal Sinus Rhythm (n=18), the BIDMC Congestive Heart Failure (n=13) and the Congestive Heart Failure RRI databases (n=25). Using thresholds by Receiver Operating Characteristic (ROC) curves, we found that the normalized RMSSD provided the highest accuracy. The overall sensitivity, specificity and accuracy for AF and CHF were 0.8649, 0.9331 and 0.9104, respectively. Regarding CHF detection, the detection rate of CHF (NYHA III-IV) was 0.9113 while CHF (NYHA I-II) was 0.7312, which shows that the detection rate of CHF with higher severity is higher than that of CHF with lower severity. For the clinical 24 hour data (n=42), the overall sensitivity, specificity and accuracy for AF and CHF were 0.8809, 0.9406 and 0.9108, respectively, using normalized RMSSD.

• The Korean Journal of Physiology and Pharmacology
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• 제2권6호
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• pp.743-752
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• 1998

The atrial acetylcholine-activated $K^+\;(K_{ACh})$ channel is gated by the pertussis toxin-sensitive inhibitory G $(G_K)$ protein. Earlier studies revealed that ATP alone can activate the $K_{ACh}$ channel via transphosphorylation mediated by nucleoside-diphosphate kinase (NDPK) in atrial cells of rabbit and guinea pig. This channel can be activated by various agonists and also modulated its function by phosphorylation. ATP-induced $K_{ACh}$ channel activation (AIKA) was maintained in the presence of the NDPK inhibitor, suggesting the existence of a mechanism other than NDPK-mediated process. Here we hypothesized the phosphorylation process as another mechanism underlying AIKA and was undertaken to examine what kinase is involved in atrial cells isolated from the rat heart. Single application of 1 mM ATP gradually increased the activity of $K_{ACh}$ channels and reached its maximum $40{\sim}50$ sec later following adding ATP. AIKA was not completely reduced but maintained by half even in the presence of NDPK inhibitor. Neither ADP nor a non-hydrolyzable ATP analogue, AMP-PNP can cause AIKA, while a non-specific phosphatase, alkaline phosphatase blocked completely AIKA. PKC antagonists such as sphingosine or tamoxifen, completely blocked AIKA, whereas PKC catalytic domain increased AIKA. Taken together, it is suggested that the PKC-mediated phosphorylation is partly involved in AIKA.

• Journal of Chest Surgery
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• 제31권8호
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• pp.816-819
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• 1998

점액종은 심장 종양의 가장 흔한 형태이며 주로 좌심방에서 발견된다. Carney 등에 의하면가 족성을 가지 며 점액종(심장, 피부, 유방), 반점상의 피부 색소침착와 내분비성 질환이 동반된 증후군을 점액종 증후군 이라 명명하였다. 저자들은 얼굴과 좌완에 피부병변이 있고 좌심방과 우측 유두에서 점액종이 발견되고 가 족력이 있는 19세 여자를 Carney 증후군을 가진 가족성 심방 점액종으로 진단하여 좌심방 중격과 승모판에 부착된 점액종을 성공적으로 절제하였다. 심장 점액종의 가족성이 있는 동일 가족 구성원은 증상이 발현되 지 않더라도 심장 점액종을 발견하기 위해 선별적 심방초음파 검사가 주기적으로 실시되어야하며 재발과 다 발성병변이므로 수술시 종양의 완전 절제와 수술후 추적검사가 필요하다.

• International Journal of Vascular Biomedical Engineering
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• 제2권1호
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• pp.11-16
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• 2004

Both flow visualizations and computational fluid dynamics were performed to determine hemodynamics in a total cavopulmonary connection (TCPC) model for surgically correcting congenital heart defects. From magnetic resonance images, an anatomically correct glass model was fabricated to visualize steady flow. The total flow rates were 4, 6 and 8L/min and flow rates from SVC and IVC were 40:60. The flow split ratio between LPA and RPA was varied by 70:30, 60:40 and 50:50. A pressure-based finite-volume software was used to solve steady flow dynamics in TCPC models. Results showed that superior vena cava(SVC) and inferior vena cava(IVC) flow merged directly to the intra-atrial conduit, creating two large vortices. Significant swirl motions were observed in the intra-atrial conduit and pulmonary arteries. Flow collision or swirling flow resulted in energy loss in TCPC models. In addition, a large intra-atrial channel or a sharp bend in TCPC geometries could influence on energy losses. Energy conservation was efficient when flow rates in pulmonary branches were balanced. In order to increase energy efficiency in Fontan operations, it is necessary to remove a flow collision in the intra-atrial channel and a sharp bend in the pulmonary bifurcation.