• Journal of Chest Surgery
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• v.30 no.5
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• pp.501-505
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• 1997

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n= 11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization'due to bleeding, coronary artery dissection pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

• Korean Journal of Clinical Pharmacy
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• v.5 no.2
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• pp.61-69
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• 1995

Hyperlipidemia is a major predisposing factor of atherosclerosis and cerebrovascular accidents. In effort to develope a hypolipidemic drug from medicinal herb, We tested three prescriptions of traditional medicine for the lipid lowering effect on diet-induced hyperlipidemic rats. GyejI-Bokryung-Hwan, Ohyak-Sunki-San, and Shihoga-Yongol-Moryu-Tang were selected based on the comnon prescriptions for patients with hyperlipidemia-related diseases. Water extract from each prescriptions was made by the method used in the clinical setting, and administered intragastrically once a day, for 4 weeks. Fenofibrate and lovastatin were given by the same method as the control drugs. Blood levels of total cholesterol(TC), high density lipoprotein(HDL), low density lipoprotein (LDL), and triglyceride(TG) were measured before, 1, 2, 3, and 4 weeks after starting the drug administration. All of the traditional prescriptions did not show lipid lowering effect, while fenofibrate lower the blood cholesterol levels(TC;from 215mg/dl before to 182m41 at 4 weeks-point of drug administration, and LDL ;from 203mg/dl before to aut 161, and 163mg/dl at 3 and 4 week-point respectively). Oyak-Sunki-San increased the level of TC (from 283mg/dl to over 350mg/dl starting from the first week of drug administratin). Effects on TG variable in the cases of traditional medicines and control drug In conclusion, any of the three traditional medical prescriptions did not decrease the level of blood cholesterol.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.18-24
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• 2011

Background: We evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease. Material and Methods: From November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was $7.6{\pm}6.5$ years and follow-up duration was $22.7{\pm}12.3$ months. Results: There were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was $55.3{\pm}8.1%$ and ejection fraction of postoperative six month was $54.7{\pm}6.5%$. Left atrial size of preoperative and postoperative were $61.5{\pm}11.6\;mm$ and $53.1{\pm}8.4\;mm$ at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033). Conclusion: The Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.779-784
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• 2002

Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F＝12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

• Journal of Sasang Constitutional Medicine
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• v.9 no.2
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• pp.245-261
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• 1997

The investigation were carried out the 37 patient with cerebrovascular accidents who had been treated in Oriental Medical Hospital in Kyung Hee University and in KangNam Uy Lim, and the 10 examinees who had been worked in Medical Hospital in Kyung Hee University. The consitution which had discriminated by survey, which had discriminated by study on the morphological diagrammings, which had discriminated by the result of the impatient of hospital on a dosage of constitutial prescription. The Prostaglandin E2 in blood for 47 persons (37 patients & 10 examinees) was measured. The following results were obtained. 1.In the constitution which had discriminated by survey, in the value of Prostaglandin E2 in bood of ammong four constitutiens didn,t showed significant differance. 2.In the constitution which had discriminated by study on the morphological diagrammings, in the value of Prostaglandin E2 in bood of ammong four constitutiens didn,t showed significant differance. 3.In the constitution which had discriminated by the result of patient of hospital on a dosage of constitutial prescription, the value of Prostaglandin E2 in blood of among four constitutions didn,nt showed signicant differance. 4.In the constitution which had discriminated by colligated three methods(survey, morphological diagrammings,the result of patient of hospital on a dosage of constitutial prescription), the value of Prostaglandin E2 in blood of ammong four constituion didn,t showed significant differnce. 5.In the constitution which had discriminated by survey, a test of significance between the value of Prostaglandin E2 in blood of each constitution and the value of Prostaglandin E2 in blood of the others was conducted. Only the value of Prostaglandin E2 in blood between in the TAE-EUM-IN(太陰人) and the others of female showed significant differance. 6.In the constitution which had discriminated by study on the morphological diagrammings,a test of significance between the value of Prostaglandin E2 in blood of each constitution and the value of Prostaglandin E2 in blood of the others was conducted. Only the value of Prostaglandin E2 in blood between in the SO-EUM-IN(少陰人) and the others of male showed significant differance. 7.In the constitution whichhad discriminated by the result of patient of hospital on a dosage of constitutial prescription,a test of significance between the value of Prostaglandin E2 in blood of each constitution and the value of Prostaglandin E2 in blood of the others was conducted. Only the value of Prostaglandin E2 in blood between in the TAE-EUM-IN(太陰人) and the others of male showed significant differance. 8.In the constitution which had discriminated was the colligated three methods(survey,morphological diagrammings,the result of patient of hospital on a dosage of constitutial prescription),a test of significance between the value of Prostaglandin E2 in blood of each constitution and the value of Prostaglandin E2 in blood of the others didn,t showed significant differnce. In this connected study is inadequete at present. But if the study is done persistently,the analysis of various ingredient in the body enables objectification in differentiation of four types of physical constitution as the supplemental method.