• Journal of Chest Surgery
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• v.43 no.3
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• pp.246-253
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• 2010

Background: Our objective was to review the long-term prognosis of patients with preoperative mild to moderate ischemic mitral regurgitation who underwent off-pump coronary artery bypass grafting. Material and Method: We prospectively followed 1,000 consecutive and systematic off-pump coronary artery bypass grafting patients who were operated on between September 1996 and March 2004; follow-up was achieved for 97%. Sixty-seven patients (6.7%) had mild to moderate ischemic mitral regurgitation at the time of surgery. Operative mortality, actuarial survival and major adverse cardiac event free survival were compared to assess the effect of ischemic mitral regurgitation. Result: Average follow-up was $66{\pm}22$ months. Patients with ischemic mitral regurgitation were older (p<0.001), had lower ejection fractions (p<0.001) and more comorbidities. Significantly more female patients presented with ischemic mitral regurgitation (p=0.002). There was no significant difference in operative mortality and perioperative myocardial infarction in ischemic mitral regurgitation patients (p=0.25). Eight-year survival was decreased in ischemic mitral regurgitation patients ($39.6{\pm}11.8%$ vs $76.7{\pm}2.2$, p<0.001). However, after correcting for risk factors, mild to moderate ischemic mitral regurgitation was not found to be a significant independent risk factor for long-term mortality (p=0.42). Major adverse cardiac event free survival at 8 years was significantly lower in ischemic mitral regurgitation patients ($53.12{\pm}12%$ vs $77{\pm}2%$, p<0.001). After correction for risk factors, ischemic mitral regurgitation remained a significant independent cause of major adverse cardiac events (HR: 2.31), especially congestive heart failure and recurrent myocardial infarction. Conclusion: In our series, patients with preoperative mild to moderate ischemic mitral regurgitation had a higher prevalence of preoperative risk factors than patients without ischemic mitral regurgitation. They had comparable perioperative mortality and morbidity, but, in the long term, were found to be at elevated risk for recurrent cardiac events.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.573-581
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• 2011

This study was done to examine the risk factors between controls group and acute brain infarction patients group, and to compare high risk group with low risk group through NIHSS(National Institutes of Health stroke scale). We compared the risk factors between acute brain infarction patients group(N=180) and controls group(N=93). And according to risk factors, we analyzed 1st NIHss, after 3 weeks improved extent within acute brain infarction patients group. The results were as follows. 1. Among the risk factors, HTN, DM, the blood levels of HCY were significantly higher and the blood levels of HDL-C was significantly lower in patients group than controls group. 2. In scale analysis according to risk factors, 1st NIHss were significantly higher in Hypo-HDL-cholesterolemia, Obesity, High-Homocysteine, HTN, DM, previous CVA history group than low risk group within acute brain infarction patients group. 3. In after 3 weeks improved extent analysis according to risk factors, improved extent were lower in Hyperlipidemia, HTN, DM, previous cardiac history, older age group than low risk group within acute brain infarction patients group. The above results suggest that significant risk factors of acute brain infarction, and shows the High risk group that had risk factor of brain infarction recognized from the former research tends to have higher 1st NIHss. Also the High risk group tends to have lower improved extent, but the results are not statistically significant. Furthur research on subject is needed.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.204-212
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• 1982

The presence of left atrial thrombus in mitral stenosis has been reported to be associated with several factors. These are age, sex, presence of atrial fibrillation, episodes of congestave heart failure, calcification of mitral valve, embolic episode, etc. Since none of these single factor has been always related to the presence of left atrial thrombus, related risk factors to left atrial thrombosis were studied in patients with mitral stenosis using chi square test. We had operated on 191 cases of mitral valvular heart disease from Jan. 1978 to June 1981 at Severance Hospital, Yunsei University College of Medicine. The left atrial thrombi were present in 41 cases among 191 cases of mitral valvular heart disease and it was present in 31 cases among 89 cases of pure mitral stenosis. Only 10 cases among 74 cases of mitral stenoregurgitation had left atrlal thrombi, whereas no left atrlal thrombus was found in patients with pure mitral regurgitation. Related risk factors studied herein were sex, episodes of congestive heart failure, atrial fibrillation, pulmonary capillary wedge pressure, mitral valve area calculated by Gorlin and Gorlin`s formula cardiac output and left atrial dimension by echocardiogram. In this study presence of atrial fibrillation was deemed to be one of the most potential risk factors and other factors of age, duration of symptoms, episode of embolization, calclfication of mitral valve, associated aortic and tricuspid valve disease, ejection fraction of left ventricle by cineangiocardiogram and echocardiogram were not significantly related to the presence of left atrlal thrombi in a statistical viewpoint.

• Journal of Biomedical Engineering Research
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• v.40 no.2
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• pp.62-67
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• 2019

The purpose of this study was to evaluate the performance of deep neural network model in order to determine whether there is a risk factor for coronary artery disease based on the cardiac variation parameter. The study used unidentifiable 297 data to evaluate the performance of the model. Input data consists of heart rate parameters, which are SDNN (standard deviation of the N-N intervals), PSI (physical stress index), TP (total power), VLF (very low frequency), LF (low frequency), HF (high frequency), RMSSD (root mean square of successive difference) APEN (approximate entropy) and SRD (successive R-R interval difference), the age group and sex. Output data are divided into normal and patient groups, and the patient group consists of those diagnosed with diabetes, high blood pressure, and hyperlipidemia among the various risk factors that can cause coronary artery disease. Based on this, a binary classification model was applied using Deep Neural Network of deep learning techniques to classify normal and patient groups efficiently. To evaluate the effectiveness of the model used in this study, Kernel SVM (support vector machine), one of the classification models in machine learning, was compared and evaluated using same data. The results showed that the accuracy of the proposed deep neural network was train set 91.79% and test set 85.56% and the specificity was 87.04% and the sensitivity was 83.33% from the point of diagnosis. These results suggest that deep learning is more efficient when classifying these medical data because the train set accuracy in the deep neural network was 7.73% higher than the comparative model Kernel SVM.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.416-421
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• 2012

A 10-year-old 4-kg spayed female Chihuahua with severe congestive heart failure was referred for surgical treatment. Through several examinations, the dog was diagnosed as severe mitral regurgitation (MR) and moderate TR. Because of the poor prognosis associated with continuation of medical management, surgical repair of the mitral valve was considered as the treatment option for the dog. The mitral valve repair was performed undergoing cardio pulmonary bypass (CPB) circuit. However after mitral repair, the dog was died without recovery from anesthesia. Many risk factors associated with failure of cardiac surgery are included CPB management, hypothermia, organ dysfunction, hemorrhage, hypotension, electrolyte & acid base imbalance, and infection. Although the dog is died from the operation, it is an important to reveal the factors of failure in veterinary clinic. From the case report, causes of failure of mitral valve repair can be considered from the failure of oxygenation and gas exchange by hypothermia and serious hypotension with low heart rate by low cardiac output syndrome (LCOS). Through the several considerations from this case, it is known that coming cardiac surgery for mitral valve repair is required to be more careful for successful operation. Further it can be brought to increase success rate in further operation.

• Journal of the Korean Applied Science and Technology
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• v.37 no.2
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• pp.162-172
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• 2020

The purpose of this study was to investigate the improvement effect of 5% mung bean (phaseolus aureus L.) on the blood glucose and lipid metabolism function of streptozotocin (STZ, 45 mg/kg body weight)-induced diabetic rats. Seven-week-old male rats were divided into four groups (n=6), and fed experimental diets containing mung bean meal [basal diet+5% mung bean (BM), basal diet+STZ+5% mung bean (SM)], and control (BD), BS groups (basal diet+STZ). The results of this study, mung bean diet groups (BM, SM) in lipid composition evidenced the significantly reduction of serum total cholesterol, low density lipoprotein-cholesterol (LDL-cholesterol), atherosclerotic index (AI), cardiac risk factor (CRF), triglyceride (TG), phospholipid (PL), free cholesterol, cholesteryl ester, uric acid, blood glucose, non esterified fatty acid (NEFA), and elevation of high density lipoprotein-cholesterol (HDL-cholesterol). The serum albumin/globulin ratio (A/G ratio) was increased in mung bean supplementation diet than STZ-induced diabetic rats (p<0.05). Concentrations of sodium (Na) and chlorine (Cl) in sera were lower in the mung bean diet than diabetic group. Total calcium (T-Ca), phosphorus (Pi) and potassium (K) concentrations in sera were higher in the BM, SM and BD groups than BS group. In vivo experiments with Sprague-Dawley rats showed that ingestion of mung bean (phaseolus aureus L.) were effective in blood glucose and lipid composition.

• Journal of the Korean Applied Science and Technology
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• v.36 no.1
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• pp.47-58
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• 2019

This study aimed to investigate the improvement effect of turmeric (Curcuma longa L.) on the lipid component, protein and electrolyte concentration in dyslipidemic rats. Sprague-Dawley rats (24 male) were divided into four groups, namely the ND (normal-nondyslipidemic diet), NT (normal-nondyslipidemic diet+5% turmeric), DD (control-dyslipidemic diet), and DT groups (dyslipidemic diet+5% turmeric). Rats were sacrificed at the end of 5 weeks after experiment diet. In this study, turmeric diet (NT, DT) groups in lipid composition as evidenced from the significantly reduction of serum total cholesterol, low density lipoprotein-cholesterol (LDL-cholesterol), atherosclerotic index (AI), cardiac risk factor (CRF), triglyceride (TG), phospholipid (PL), free cholesterol, cholesteryl ester, blood glucose and non esterified fatty acid (NEFA), and elevation of high density lipoprotein-cholesterol (HDL-cholesterol) (p<0.05). The serum globulin concentration was significantly decreased (p<0.05), and the albumin concentrations were increased in turmeric diet than dyslipidemic rats. Concentrations of sodium (Na) and chlorine (Cl) in sera were lower in the DT group than DD group. Concentrations of total calcium (T-Ca), phosphorus (Pi) and potassium (K) in sera were higher in the ND, NT and DT groups than DD group. Therefore, it was concluded that the 5% turmeric diet used in the condition of this study had a beneficial effect on dyslipidemia.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.108-114
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• 2011

Background: Homograft cardiac valves and valved-conduits have been available in our institute since 1992. We sought to determine the long-term outcome after right ventricular outflow tract (RVOT) reconstruction using homografts, and risk factors for reoperation were analyzed. Materials and Methods: We retrospectively reviewed 112 patients who had undergone repair using 116 homografts between 1992 and 2008. Median age and body weight at operation were 31.2 months and 12.2 kg, respectively. The diagnoses were pulmonary atresia or stenosis with ventricular septal defect (n=93), congenital aortic valve diseases (n=15), and truncus arteriosus (N=8). Mean follow-up duration was $79.2{\pm}14.8$ months. Results: There were 10 early and 4 late deaths. Overall survival rate was 89.6%, 88.7%, 86.1% at postoperative 1 year, 5 years and 10 years, respectively. Body weight at operation, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were identified as risk factors for death. Forty-three reoperations were performed in thirty-nine patients. Freedom from reoperation was 97.0%, 77.8%, 35.0% at postoperative 1 year, 5 years and 10 years respectively. Small-sized graft was identified as a risk factor for reoperation. Conclusion: Although long-term survival after RVOT reconstruction with homografts was excellent, freedom from reoperation was unsatisfactory, especially in patients who had small grafts upon initial repair. Thus, alternative surgical strategies not using small grafts may need to be considered in this subset.

• The Korean Journal of Health Service Management
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• v.7 no.3
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• pp.71-82
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• 2013

Arterial stiffness(AS) is an important pathologic state of vascular injury. This study was carried out to elucidate the effect of physiological variables on brachial-ankle pulse wave velocity(BAPWV), index of AS. Four hundred adults(volunteers) participated in this study. Body indices, biochemical, cardiac and inflammatory markers, and right(Rt)- and left(Lt)-BAPWV were measured. Body mass index(BMI), Rt- and Lt-BAPWV, glucose, triglyceride, alkaline phosphatase(ALP), gamma-glutamyl transferase(GGT), creatinine, uric acid, troponin-I(TNI), NT-proBNP and high sensitivity C-reactive protein(hs-CRP) levels were higher than the reference value of each variable. Rt- and Lt-BAPWV were directly correlated with age, body weight, BMI, glucose, ketone, aspartate aminotransferase, alanine aminotransferase, ALP, GGT, total cholesterol, low density lipoprotein, lipoprotein(a), apolipoprotein-B, blood urea nitrogen, heart rate, TNI, creatine kinase, CK-MB, lactic dehydrogenase, myoglobin, hs-CRP, lipase, reumatoid factor, fibrinogen and D-dimer (P<0.05, P<0.01, P<0.001 or P<0.000, respectively), but inversely associated with total bilirubin, uric acid, apolipoprotein-A1 and GFR (P<0.05). These observations suggest that a variety of physiological variables may influence BAPWV, resulting in increased risk or prevention of cardiovascular and/or cerebrovascular attacks. Therefore, physiological variables affecting BAPWV should be regularly controlled.