• Journal of Chest Surgery
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• v.37 no.1
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• pp.11-18
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• 2004

Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1169-1179
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• 1992

To determine the period and degree of full recovery of postoperative pulmonary function, the author performed seiral pulmonry function test with spirometry at preoperative period and 1st, 2nd, 3rd, 4th, 6th and 8th postoperative week in 64 patients who underwent chest surgery form 1990. 1. to 1990. 8. at Dep. of Thoracic & Cardiovascular surgery, Pusan National University Hospitcal, Pusan, Korea 28 patients underwent lung resection[Group A], 14 patients mediastinal and other thoracic surgery[Group B], and 22 patients heart surgery with cardiopulmonary bypass[Group C]. Al of them recovered normally and discharged without any complications. Their serial changes of pulmonary function test were compaired and its results was as follows; l. Over all mean recovery time of restrictive ventilatory function tests[ie, VC, ERV, IC, FEF1, FVC, FEF200-1200, MVV] were 4th & 6th postoperative week, and that of obstructive ventilatory function tests[ie., EFE25-75%, Vmax50] were 2nd postoperative week. 2. In patient who underwent lung resection surgery[Group A], FEF1 recovered in 4th~6th postoperative week and its ratio to preoperative value was 70% in pneumonectomy, and 75% in lobectomy. FVC recovered in 4th~6th postoperative week and its ratio to preoperative value was 65% in pneumonectomy, and 80% in lobectomy. MVV was recovered in 4th~8th postoperative week and recovery ratio was 80%, FEF200-1200 was recovered at 4th~6th postoperative week and its recovery ratio was 70%, FEF25-75% and Vmax50 was recovered in 2nd~4th postoperative week and recovered nearly to preoperative level. 3. In patient who underwent mediastinal and other thoracic surgery[Group B], FEV1 and FVC and recovered in 4th~6th postoperative week and the recovery ratio of FVC in blebectomy was 90%. MVV reached preoperative level in 4th~8th postoperative week. FEF200-1200, FEF25-75% and Vmax50 were recovered in 2nd~4th postoperative week and the recovery of FEF25-75% and Vmax50 in blebectomy was prominant. 4. In patient who underwent heart surgery[Group C], FEV1 and FVC were recovered in 4th~6th postoperative week. The recover ratio of FEF25-75% and Vmax50 was delaied to 6th~8th postoperative week From the above results we concluded that the recovery time of posoperative restrictive ventilatory disorder was 4th postoperative week and pulmonary complication would possibly occure during that period. So more intensive observations will be needed.

• Journal of Korea Society of Digital Industry and Information Management
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• v.6 no.1
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• pp.69-81
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• 2010

Physical manifestations of aging due to the lack of exercise include the slowing down of motor learning, cardiopulmonary degradation, and the increasing difficulty to adapt to the environment. Aging is manifested with the lack of aerobic exercise work, decrease in muscular endurance, decline in skeletal and muscular strength, flexibility and agility, and the decrease in reaction speed and balance. Added to those are aging-related physiological changes, including the reduction of muscle bulk, increased body fat, decrease in total body water and basic metabolic rate as activities are reduced, and a decrease in cell and Lean Body Mass (LBM). These changes are known to cause problems. Interest and participation in appropriate physical activities among the elderly is needed to help them increase stamina, avoid diseases, maintain a clear intellect, and basically enable the elderly to live their daily lives as easy as possible. Therefore, physical activities are necessary for the elderly to enhance health-related factors. Special exercises should be performed for the enhancement of muscle function, muscle endurance, flexibility, agility, and balance. An accurate measurement of cardio-respiratory endurance and stamina through basic physical and cognitive characteristics of older adults is also required to ensure safety. Also, the development of a more scientific resistance exercise prescription system for the elderly is desperately needed.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.355-360
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• 1979

Mitral and aortic valve replacement with tricuspid annuloplasty was undertaken in 5 patients out of 38 valvular surgery between the period from Jan. 1977 to May 1979 in the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital. All were male patients with age ranging from 18 to 42 years, and preoperative evaluation revealed one case in Class IV, and four cases in Class III according to the classification of NYHA. Preoperative diagnosis was confirmed by routine cardiac study including retrograde aorto- and left ventriculography, and there were two cases with MSi+ASi+Ti, two cases with MSi+Ai+Ti, and one case with Mi+Ai+Ti. Double valve replacement was performed under the hypothermic cardiopulmonary bypass with total pump time of 247 min. in average ranging from 206 min. to 268 min. During aortic valve replacement, left coronary perfusion was done in the first two cases, and cardiac arrest with cardioplegic solution proposed by Bretschneider was applied in the remained three cases. Starr-Edwards, Bjork-Shiley prosthetic valves and Carpentier-Edwards tissue valve were replaced in the aortic area, and Carpentier-Edwards and Angell-Shiley tissue valves were replaced in the mitral area with each individual combination [three prosthetic and two tissue valves in the aortic, and five tissue valves in the mitral area respectively]. Postoperative recovery was uneventful in all cases except one case with hemopericardium, which was managed with pericardiectomy on the postoperative 10th day in good result. Follow-up after double valve replacement of the all five cases for the period from 6 months to 33 months revealed satisfactory adaptation in social activity and occupation with cardiac function of Class I according to the classification of NYHA In all five cases.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1049-1056
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• 1990

The OXYREX hollow fiber membrane oxygenator developed by joint work of KIST and Green Cross Medical company has been evaluated by experimental investigation and clinical application, In this oxygenator gas exchanges occur through small pores of 0.1pm size which are distributed on 70% of surface of polypropylene hollow fiber. The Oxyrex membrane oxygenator consists of 36 thousand hollow fibers and it has 3.3m2 of gas exchange surface. The Oxyrex membrane oxygenator has unique blood flow path: blood enters the oxygenator passes between the hollow fibers and exits through outlet ports, that provides low transmembrane pressure drop. In the animal experiment and in vitro investigations of Oxyrex oxygenator, it showed low transmembrane pressure difference, effective heat exchanger performance, stable gas transfer function and less blood trauma. The Oxyrex oxygenator been used from March, 1990, to October, 1990, in 40 patients undergoing open heart operations. In the clinical applications of Oxyrex, adequate oxygenation[PaO2, 283$\pm$70mmHg] and carbon dioxide removal[PaCO2, 27\ulcorner6mmHg]were maintained under the condition of FiO2: below 0.6, Hct; 25%, perfusion flow; 2.4 L/min, gas flow: 2.1 L/min. During maximum 365 minutes of cardiopulmonary bypass[CPB] time period, the Oxyrex oxygenator maintained stable condition of PaO2, PaCO2 respectively and it also kept low plasma hemoglobin level. The complement proteins C3 and CH50 were not significantly changed pre to post CPB. There were no complications related to the oxygenator during and after the CPB.

• The Journal of Korean Physical Therapy
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• v.13 no.1
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• pp.107-114
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• 2001

Recently the number of elderly have been increasing at a rapid pace in Korea. Accompanying this aged society are numerous health problems. Whit this in mind health-promotion behaviors such as physical activity. good nutrition and stress management are vitally important to the elderly in reducing the risk of Health problems, maintaining health and improving the overall quality of life. Health promotion programs for the elderly must be developed. The purpose of th is study was to determine influential cognitive factors on health-promotion behaviors and the effects of previously implemented Health promotion programs. For this, previous studies were reviewed and analyzed. The results were as follows. 1. Cognitive factors on health-promotion behaviors were internal locus of control, perceived health status, self-efficacy, concerns about health, social support, attending social activities. 2. Components of health promotion programs were exercise and health education. Exercise was performed in most programs. The effects of exercise programs were improved flexibility, muscle strength. balance, cardiopulmonary function and elevated ability of daily living, perceived health status, quality of lift and a decrease depression. The results strongly suggest that complex health promotion programs should be developed. Health promotion programs need to include exercise, health education, health counseling and social activities. We have to consider cognitive factors on health-promotion behaviors.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.885-891
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• 1995

In order to test the hypothesis that the pulmonic valve, when used to replace the aortic root as a pulmonary autograft, will remain a viable anatomical structure and will grow and develop normally along with the host, we performed aortic valve replacement with the pulmonary autograft in 15 neonatal piglets. The weight of the donor was 9.3 $\pm$ 0.2 kg, the recipient 9.6 $\pm$ 0.3 kg. Measured diameters of pulmonic annulus were 14 $\pm$ 0.2 mm for autograft and 14.2 $\pm$ 0.2 mm for pulmonary artery homograft. Operation was performed under cardiopulmonary bypass with deep hypothermia [20oC at low flow perfusion [70 ml/kg/min . The mean operation time was 227 $\pm$ 10 min., bypass time 152$\pm$ 7.6 min. and aortic cross clamp time 73$\pm$ 4.6 min.. 9 piglets survived more than 12 hours. One survived 12 days and died of pneumonia and the latest one survived in good condition and sacrificed at postoperative 6th week for cardiac catheterization and pathologic examination that revealed the viability and growing of the pulmonary autograft. Currently we are able to complete the operation with good preservation of cardiac function, and our postoperative care has evolved to the extent that we are now confident enough of having an acceptable percentage of long term survivors to undertake a definite study in this regard.

• Clinical and Experimental Pediatrics
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• v.57 no.1
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• pp.19-25
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• 2014

Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt followed by repair. Early primary repair provides several advantages, including avoidance of shunt-related complications, early relief of hypoxia, promotion of normal lung development, avoidance of ventricular hypertrophy and fibrosis, and psychological comfort to the family. Because of advances in cardiopulmonary bypass techniques and accumulated experience in neonatal cardiac surgery, primary repair in neonates with TOF has been performed with excellent early outcomes (early mortality<5%), which may be superior to the outcomes of aortopulmonary shunting. A remaining question regarding surgical options is whether shunts can preserve the pulmonary valve annulus for TOF neonates with pulmonary stenosis. Symptomatic neonates and older infants have different anatomies of right ventricular outflow tract (RVOT) obstructions, which in neonates are nearly always caused by a hypoplastic pulmonary valve annulus instead of infundibular obstruction. Therefore, a shunt is less likely to preserve the pulmonary valve annulus than is primary repair. Primary repair of TOF can be performed safely in most symptomatic neonates. Patients who have had primary repair should be closely followed up to evaluate the RVOT pathology and right ventricular function.

• Journal of the Korean Society of Food Culture
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• v.31 no.1
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• pp.51-63
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• 2016

The aim of this study was to investigate food culture represented by the grain yard, water well, kitchen, and meat storage space which were depicted in the mural painting of An-Ak tomb No. 3. The mural paintings of An-Ak tomb No. 3 were compared with those of ancient Chinese tombs before the 4th century in order to understand their characteristics. Above all, the tomb murals describe the form and function of the stove (buttumak) as well as the cuisine using the cauldron (sot) and steamer (siru) in a very interesting manner. The meat storage space of An-Ak tomb No. 3 shows whole carcasses of animals such as roe deer, dog, and pig. However, Chinese murals show that while small animals such as soft-shelled turtle, fish, chicken, duck, pheasant, rabbit, etc. were stored as whole carcasses without being cut into pieces, large animals such as cows and pigs were slaughtered and each piece of their carcasses such as the head, thigh, meat loaf, and cardiopulmonary part was separately depicted. These tomb murals vividly describe the food culture of Koguryo and China before the 4th century.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.743-748
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• 1993

Alterations in thyroid function test results are frequently seen in patients with nonthyroidal illness & correlate with the severity of the illness & prognosis. We studied thyroid hormone changes in 14 patients received cardiopulmonary bypass[CPB]. All patients were biochemical euthyroidism preoperatively. TSH[Thyroid Stimulating Hormone] level reached its nadir[0.46 $\pm$ 0.11 ulU/ml, P<0.0005] at 12 hours after the start of CPB & showed elevating pattern to the preoperative level thereafter. FT4[Free Thyroxine] reached to its nadir[10.16$\pm$ 1.17 pmol/L, P<0.01] at POD[Post Operative Day] #4 & reached to the preoperative level at POD #7. Mean serum TSH & FT4 concentration were within normal limits[P>0.25] during CPB & thereafter. TT3[Total Triiodothyronine] reached to its nadir[38.6 $\pm$ 8.4 ng/dl, P<0.001] at 30 minutes after the start of CPB & remained low[P<0.05] throughout the study period. The patients whose recovery was uneventful[Group I] had higher serum TSH, TT3 levels[P<0.05] than who had complications or died[Group II]. Group I showed the elevating pattern of TSH, TT3 at POD #4, but Group II failed to show such elevating pattern. In Group I, FT4 was within normal limits[P>0.5] throughout the study period, and also within normal limits[P>0.1] in Group II.