• Journal of Chest Surgery
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• 제57권4호
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• pp.390-398
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• 2024

Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

• 수면정신생리
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• 제10권1호
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• pp.5-11
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• 2003

Sleep apnea syndrome is a common clinical disorder characterized by intermittent cessation of airflow at nose and mouth during sleep. The clinical significance of this syndrome is that it is one of the most common causes of excessive daytime sleepiness. It can also cause neuropsychiatric, cardiovascular, and cerebrovascular complications. The standard for diagnosis of sleep apnea syndrome is nocturnal polysomnography. Because polysomnography is a time-consuming and expensive test, many efforts have been made to replace polysomnography with a simpler system of monitoring, but no method has yet been approved as a definitive investigation method. The goals of treatment for this syndrome are to eliminate excessive daytime sleepiness and to reduce the risk of possible cardiovascular complications. Continuous positive airway pressure is the most definite and widely accepted treatment for achieving these goals. Other treatments such as surgical treatment, oral appliances, and behavioral therapy may be useful for selected patients who are mildly affected.

• 한국인터넷방송통신학회논문지
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• 제10권2호
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• pp.129-134
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• 2010

통계청에 따르면 심혈관 등의 성인병 질환으로 연 600~800명이 사망하는 것으로 나타나고, 고혈압, 동맥경화증, 심장병, 뇌졸중 등은 혈액의 흐름에 장애가 생겨 발생하는 심혈관계질환으로 오늘날 성인병의 주종을 이루고 있는 사망률이 높은 질병으로 구분된다. 또한 사망한 심혈관질환자 중 올바른 응급처치를 했더라면 생존했을 환자가 약 40%를 차지하고 있어 응급상황 발생 시 신속한 대응이 요구된다. 따라서 본 논문에서는 AdaBoost알고리즘의 weak classifier를 결합하여 strong classifier를 생성하는 방법을 통하여 효과적인 분석으로 심전도를 측정할 수 있도록 하고, 심혈관 질환자에게 발생한 응급상황을 빠른 시간 내에 관리 데스크에 전달할 수 있는 시스템을 제안하였다. 이에 따라 심전도 센서를 기반으로 측정한 데이터를 ZigBee통신으로 단말기에 전송하고 응급 상황을 판정하여 관리데스크에 긴급경보와 모니터링을 제공함으로써 신속한 의료서비스 제공이 가능하도록 하였다.

• 대한의용생체공학회:의공학회지
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• 제35권4호
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• pp.87-94
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• 2014

Recent technological advances have increased interest in personal health monitoring. Electrocardiogram(ECG) monitoring is a basic healthcare activity and can provide decisive information regarding cardiovascular system status. In this study, we developed a capacitive ECG measurement system that can be included within a cloth mattress pad. The device permits ECG data to be obtained during sleep by using capacitive electrodes. However, it is difficult to detect R-wave peaks automatically because signals obtained from the system can include a high level of noise from various sources. Because R-peak detection is important in ECG applications, we developed an algorithm that can reduce noise and improve detection accuracy under noisy conditions. Algorithm reliability was evaluated by determining its sensitivity(Se), positive predictivity(+P), and error rate(Er) by using data from the MIT-BIH Polysomnographic Database and from our capacitive ECG system. The results showed that Se = 99.75%, +P = 99.77%, and Er = 0.47% for MIT-BIH Polysomnographic Database while Se = 96.47%, +P = 99.32%, and Er = 4.34% for our capacitive ECG system. Based on those results, we conclude that our R-peak detection method is capable of providing useful ECG information, even under noisy signal conditions.

• 센서학회지
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• 제29권3호
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• pp.162-171
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• 2020

The incidences of cardiovascular diseases are rapidly increasing worldwide. The electrocardiogram (ECG) is a test to detect and monitor heart issues via electric signals in the heart. Presently, detecting heart disease in real time is not only possible but also easy using the myDAQ data acquisition device and LabVIEW. Hence, this paper proposes a system that can acquire ECG signals in real time, as well as detect heart abnormalities, and through light-emitting diodes (LEDs) it can simultaneously reveal whether a particular waveform is in range or otherwise. The main hardware components used in the system are the myDAQ device, Vernier adapter, and ECG sensor, which are connected to ECG monitoring electrodes for data acquisition from the human body, while further processing is accomplished using the LabVIEW software. In the Results section, the proposed system is compared with some other studies based on the features detected. This system is tested on 10 randomly selected people, and the results are presented in the Simulation Results section.

• 한국멀티미디어학회논문지
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• 제22권2호
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• pp.242-249
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• 2019

Old people and patients with cardiovascular disease could die of a heart attack in the bath with heated water for a long time. Various researches have been studied to prevent these accidents from happening such as measuring the ECG signal when taking bath. However, these devices are hard to use and the higher price is not easily accepted by the public. In this paper, a low-cost and use-friendly, real time high precision water temperature monitoring device to prevent heart attack in the bath was developed. The device with waterproof design that lets the device can float on the surface of the water, and an accurate way to make water temperature measurement method was proposed by this paper that is immerging the sensor into water with 4cm depth to measure the temperature of underwater. The manufactured device was conducted to two experiments; one was to verify the basic functions of the device, and another one was for compare the proposed device with commercial products for monitoring the water temperature in the bathtub. As the experimental results shown, the proposed device has stable performance for the water temperature measurement and communicating with laptop in wireless.

• Journal of Chest Surgery
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• 제31권9호
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• pp.873-876
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• 1998

개심수술에서 Aprotinin에 의한 ACT가 연장되는가를 알아보기 위해 서로 다른 표면 촉매제인 kaolin (K-ACT)과 celite(C-ACT)를 이용하여 동시에 측정 비교하였다. 개심수술을 받은 22명의 성인을 대상으로 하여 Hemocron 8000 system을 이용하여 동시에 ACT를 측정 하였는데 aprotinin과 heparin 투여 전(Phase I), Aprotinin투여 후 heparin 투여 전(Phase II), heparin투여 5분 후(Phase III), haparin투여 30분 후(Phase IV), heparin투여 60분 후(Phase V), heparin투여 90분 후(Phase VI), protamin투여 30분 후(Phase VII)에 각각 측정하였다. Phase I, II, III에 두 군간에 차이가 없었으나 heparin투여 30분 후에는 C-ACT가 928$\pm$400초 K-ACT가 572$\pm$159초였고 60분 후에는 C-ACT가 888$\pm$254초 K-ACT가 535$\pm$186초 90분 후에는 C-ACT가 686$\pm$141초 K-ACT가 484$\pm$54초로 K-ACT에 비해 C-ACT가 통계학적으로 의의있게 증가하였다. 그러나 protamin투여 후에는 C-ACT가 137$\pm$26초 K-ACT가 139$\pm$28초로 두군간에 차이가 없었다. 이상의 결과에서 aprotinin투여 후 ACT는 연장이 되는 것이 아니라 activator로 celite를 사용했기 때문인 것으로 생각된다. 결론적으로 aprotinin을 투여한 개심수술에서 정확한 ACT수준을 측정하기 위하여 celite activator보다 kaolin activator를 사용해야 하며 heparin은 보통용량을 투입하여야 할 것으로 생각된다.

• Journal of Multimedia Information System
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• 제8권1호
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• pp.1-10
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• 2021

Heart Rate is a crucial physiological parameter that provides basic information about the state of the human body in the cardiovascular system, as well as in medical diagnostics and fitness assessments. At present day, it has been demonstrated that facial video-based photoplethysmographic signal captured using a low-cost RGB camera is possible to retrieve remote heart rate. Traditional heart rate measurement is mostly obtained by direct contact with the human body, therefore, it can result inconvenient for long-term measurement due to the discomfort that it causes to the subject. In this paper, we propose a non-contact-based remote heart rate measuring approach of the subject which depends on the color intensity variation of the subject's facial skin. The proposed method is applied in two regions of the subject's face, forehead and cheeks. For this, three different algorithms are used to measure the heart rate. i.e., Fast Fourier Transform (FFT), Independent Component Analysis (ICA) and Principal Component Analysis (PCA). The average accuracy for the three algorithms utilizing the proposed method was 89.25% in both regions. It is also noteworthy that the FastICA algorithm showed a higher average accuracy of more than 92% in both regions. The proposed method obtained 1.94% higher average accuracy than the traditional method based on average color value.

• Journal of Chest Surgery
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• 제28권7호
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• pp.684-688
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• 1995

Hyperhidrosis, one of the abnormalities in autonomic nervous system, has been treated with dermatologic principles or thoracic sympathectomy via conventional axillary thoracotomy or dorsal spinal approach. But these techniques were rather ineffective or invasive. Recently, VATS is widely applied in thoracic surgical area, and hyperhidrosis is not the exception of these cases.From May 1993 to August 1994, 30 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic [T2, T3 sympathectomy with thoracoscopic surgery at Seoul National University Hospital. There were 20 men and 10 women and the mean age was 23.0 years.Mean operating time was 115 min and there was no thoracotomy conversion. Operative complications were anesthetic overdose in 1, Horner`s syndrome in 1, and small amount of residual pneumothorax in 6. Mean postoperative hospital stay was 2.3 days [range from 1 to 4 days and postoperative analgesics were required in 17 cases with a single dose.Sweating amount was measured in 12 patients, showing significantly decreased amount from 284.5 mg preoperatively to 18.9 mg postoperatively in 5 minutes [p=0.004 . There was no recurrence during mean 6 months follow up. Twenty two patients [73.3 % complained moderate compensatory hyperhidrosis on the trunk.In conclusion, all patients were greatly satisfied with those results including no more palmar sweating, less pain, better cosmetics, short hospital stay. In addition, recent use of sweating amount measurement and intraoperative temperature monitoring could make this technique more accurate, so we easily applied thoracoscopic sympathectomy with minimal risk.

• Journal of Chest Surgery
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• 제22권2호
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• pp.212-219
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• 1989

We utilized pulmonary artery pressure monitoring system in risky patients for preventing the postoperative pulmonary hypertensive crisis and for sampling the mixed venous blood. And this mixed venous blood oxygen saturation [MVSO2] or partial pressure [MVPO2]tells us many meaningful patients state. We selected 59 cyanotic congenital heart diseased patients, who were operated in our hospital from Nov. 1987 to Oct. 1988, in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital, who had pulmonary artery pressure monitoring catheter and who made us know their mixed venous oxygen condition. We found that there was no close relationship between MVPO2 and Cardiac Index [C.I.] during early postoperative period, but on the first and second day after operation the correlation coefficient was increased as r=0.35[p=0.008], r=0.78[p=0.0001]. So we concluded that the correlation between MVPO2 and C.I. was more reliable with time going as hemodynamic stabilization. And we experienced no survivors whose MVPO2 was under 20 torr, but that was not the only factor for death. From these results, we conclude that we can consider the MVPO2 [or MVSO2] representing C.I. after stabilized postoperative condition of the open heart surgery patients, but during early postoperative period, in addition to this MVPO2, we should do also apply other parameter such as urine output, arterial blood pressure, left atrial pressure and pulmonary arterial pressure for exact estimation of the patients status.