• Korean Circulation Journal
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• v.52 no.1
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• pp.1-33
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• 2022

In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.

• The Korean Journal of Physiology and Pharmacology
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• v.23 no.5
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• pp.305-310
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• 2019

The physiomic approach is now widely used in the diagnosis of cardiovascular diseases. There are two possible methods for cardiovascular physiome: the traditional mathematical model and the machine learning (ML) algorithm. ML is used in almost every area of society for various tasks formerly performed by humans. Specifically, various ML techniques in cardiovascular medicine are being developed and improved at unprecedented speed. The benefits of using ML for various tasks is that the inner working mechanism of the system does not need to be known, which can prove convenient in situations where determining the inner workings of the system can be difficult. The computation speed is also often higher than that of the traditional mathematical models. The limitations with ML are that it inherently leads to an approximation, and special care must be taken in cases where a high accuracy is required. Traditional mathematical models are, however, constructed based on underlying laws either proven or assumed. The results from the mathematical models are accurate as long as the model is. Combining the advantages of both the mathematical models and ML would increase both the accuracy and efficiency of the simulation for many problems. In this review, examples of cardiovascular physiome where approaches of mathematical modeling and ML can be combined are introduced.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.428-432
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• 2010

A 67 years old male patient was admitted with back pain that had recurred from 6 months previously. Eleven years previously, he underwent stent grafting at the descending thoracic aorta for a chronic Stanford type B aortic dissection. The preoperative computed tomography showed aortic dissection from the origin of the left subclavian artery to the bifurcation of the abdominal aorta, and there was a type I endoleak at the proximal portion of the stent graft and aneurysmal dilatation of the descending aorta. A hybrid endovascular repair was successfully performed, and this involved debranching and rerouting the aortic arch vessels under extracorporeal cardiopulmonary bypass and then this was followed 13 days later by stenting in the ascending aorta, the aortic arch and the descending aorta. The postoperative computed tomography showed complete exclusion of the type I endoleak. After discharge, he has been followed up for 8 months without any problems.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.255-259
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• 1993

The efficacy of the autotransfusion system is a reducing the need of intraoperative and postoperative transfusion in cardiovascular surgery. Between January 1990 and December 1991, we experienced 23 cases of autotransfusion using Haemonetic Cell Saver in cardiovascular surgery [Experimental group]. Another 13 cases which were taken similiar operations without Cell Saver during same period [Control group]. The amounts of blood transfused are 4.23 1.84 units in Control group, 2.82 1.84 units in Experimental group. Postoperatively, both groups showed decreased platelet counts, mild prolongation of prothrombin and partial thromboplastin time compred to preoperative value [P<0.001], but there were no significant differences between two group [P=NS]. Plasma hemoglobin was markedly increased in Experimental group compared with Control group [p<0.05]. In Experimental group, amount of average processed blood by Cell Saver was 700ml of which composition was hemoglobin 17mg/dl, hematocrit 50.0%, RBC 5,590,000/ml, WBC 7500/ml, and platelet 40,000/ml. The culture of the processed blood revealed no growth of the organisms. Conclusively, Cell Saver autotransfusion system is a simple, safe, and cost effective method especially in the cases associated with massive bleeding. However, it requires familiarity with system, gentle manipulation of suction tip, and careful selection of candidates to obtain maximal benefits .

• Korean Journal of Pharmacognosy
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• v.15 no.4
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• pp.188-193
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• 1984

It was previously indicated that 'Samulanshintang' had been examined for effects of the anticonvulsive, antipyretic, analgesic, sedative and antispasmodic actions. In order to investigate the effect on the cardiovascular system and anemic rabbits induced by phenlhydrazine HCl, pharmacological studies have been carried out with extract. The results of this investigation were summarized as follows: The relaxation of bronchial smooth muscle and antihistamine action were recognized. Antihypertensive and vasodilating actions due to vascular smooth muscle relaxation were noted in frogs and rabbits. 'Samulanshintang' lowered the rate of anemia induced by phenylhydrazine and rapidly recovered from the anemia state.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.100-106
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• 2016

Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

• Integrative Medicine Research
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• v.3 no.4
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• pp.204-210
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• 2014

The aim of this review was to understand the effects of ${\beta}$-adrenergic stimulation on oxidative stress, structural remodeling, and functional alterations in the heart and cerebral artery. Diverse stimuli activate the sympathetic nervous system, leading to increased levels of catecholamines. Long-term overstimulation of the ${\beta}$-adrenergic receptor (${\beta}AR$) in response to catecholamines causes cardiovascular diseases, including cardiac hypertrophy, stroke, coronary artery disease, and heartfailure. Although catecholamines have identical sites of action in the heart and cerebral artery, the structural and functional modifications differentially activate intracellular signaling cascades. ${\beta}AR$-stimulation can increase oxidative stress in the heart and cerebral artery, but has also been shown to induce different cytoskeletal and functional modifications by modulating various components of the ${\beta}AR$ signal transduction pathways. Stimulation of ${\beta}AR$ leads to cardiac dysfunction due to an overload of intracellular $Ca^{2+}$ in cardiomyocytes. However, this stimulation induces vascular dysfunction through disruption of actin cytoskeleton in vascular smooth muscle cells. Many studies have shown that excessive concentrations of catecholamines during stressful conditions can produce coronary spasms or arrhythmias by inducing $Ca^{2+}$-handling abnormalities and impairing energy production in mitochondria, In this article, we highlight the different fates caused by excessive oxidative stress and disruptions in the cytoskeletal proteome network in the heart and the cerebral artery in responsed to prolonged ${\beta}AR$-stimulation.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.265-271
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• 2015

Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

• Journal of the Korean Institute of Intelligent Systems
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• v.13 no.2
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• pp.222-230
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• 2003

Once the medical knowledge-based system has been developed, it is essential to investigate the knowledge sources of the system because knowledge sources can affect the performance of the system in great deal. This paper presents the method and the results of the reliability test done on the medical knowledge-based system CLINAID. A knowledge source tested is Cardiovascular body system data used in CLINAID. The reliability test will be done by investigating structural relationships revealed by fuzzy relational method between the components of the knowledge sources of individual body systems using syndromes as its main component. These partitions are going to be compared with the syndromes elicited from the medical experts. This paper also reports the outcome of the computations using 7 implication operators performed on Cardiovascular body system data.

• Journal of Community Nutrition
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• v.1 no.1
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• pp.33-38
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• 1999

Since binge eating is known to be related to increased risk of body weight fluctuations, it may be associated with increased health risks. This study was conducted to investigate the risks of binge eating on the cardiovascular system of female university students in Korea. Sixty-five female university students who were interested in a weight control program were recruited from a university campus. After personal interviews were conducted using a semi-structured questionnaire, 36 individuals were classified as binge eaters and 29 as non-binge eaters according to modified criteria of the proposed DSM-IV by the American Psychiatric Association(APA). All subjects participate in anthropometric and clinical measurements to evaluate the level of obesity and cardiovascular risks. Binge eating subjects showed no significant differences in obesity index compared to non-binge eating subjects. However, they had a higher level of low-density lipoprotein (LDL) cholesterol and a higher atherogenic index. They also showed close correlations with general obesity and cardiovascular risk factors. Body mass index(BMI) was the main explanatory index related to cardiovascular risk factors according to the stepwise regression analysis. Furthermore, obese binge subjects had higher levels than non-obese binge subjects or non-binge subjects for total cholesterol, LDL-cholesterol, triacylglycerols, atherogenic index, and systolic blood pressure. The findings strongly suggest that obese young women having binge eating episodes might display a greater risk for cardiovascular disease tan that shown for obese non-binge eating women.