• Title/Summary/Keyword: circulatory type

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Exploring Differences in Surgical Outcomes Depending on the Arterial Cannulation Strategy for Acute Type A Aortic Dissection: A Single-Center Study

  • Tae-hong Yoon;Han Sol Lee;Jae Seok Jang;Jun Woo Cho;Chul Ho Lee
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.380-386
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    • 2024
  • Background: Type A aortic dissection (AD) and intramural hematoma (IMH) are critical medical conditions. Emergency surgery is typically performed under cardiopulmonary bypass immediately after diagnosis, which involves lowering the body temperature to induce total circulatory arrest. Selection of the arterial cannulation site is a critical consideration in cardiac surgery and becomes more challenging in patients with AD. This study explored the strengths and weaknesses of different cannulation methods by comparing each cannulation strategy and analyzing the reasons for patients' outcomes, especially mortality and cerebrovascular accidents (CVAs). Methods: This retrospective study reviewed the medical records of patients who underwent surgery for type A AD or IMH between 2008 and 2023, using the moderate hypothermic circulatory arrest approach at a single center. Results: Among the 146 patients reviewed, 32 underwent antegrade cannulation via axillary, innominate artery, aortic, or transapical cannulation, while 114 underwent retrograde cannulation via the femoral artery. The analysis of surgical outcomes revealed a significant difference in the total surgical time, with 356 minutes for antegrade and 443 minutes for retrograde cannulation (p<0.001). The mean length of stay in the intensive care unit was significantly longer in the retrograde group (5±16 days) than in the antegrade group (3±5 days, p=0.013). Nevertheless, no significant difference was found between the groups in the 30-day mortality or postoperative CVA rates (p=0.2 and p=0.7, respectively). Conclusion: Surgeons should consider an appropriate cannulation strategy for each patient instead of adhering strictly to a specific approach in AD surgery.

Trends in the Use of Oriental Medical Care Service and Treatment Satisfaction (지역주민의 한방의료 이용성향과 진료만족도)

  • Suh, Ho-Suk;Nam, Chul-Hyun;Kim, Jae-Don;Kim, Sung-Jin;Ryu, Jang-Gun;Jun, Bong-Chun;Kim, Mi-Ae
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.41-70
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    • 2007
  • The purpose of this study was to identify a tendency in patients who seek oriental medical service and factors influencing patient satisfaction. The study was conducted with 1,520 residents of a community during the period from February 5, 2005 through June 30, 2005 using a questionnaire. This study results are summarized as follows : 1. Of subjects who sought oriental medical service, 66.2% had musculoskeletal disorder and connective tissue disease, 18.9% had digestive tract disease, 16.4% had respiratory disease, 8.2% had endocrinemetabolic disease, 7.5% had circulatory disease and the remaining subjects had other diseases(p<0.001). 2. Of subjects who sought oriental medical service for the treatment of musculoskeletal disorder, 84.9% preferred acupuncture. Of those who had digestive tract diseases, 47.0% preferred packaged herbal medicine. Of those who had respiratory disease, 63.0% preferred packaged herbal medicine. 3. Acupuncture was the most often sought by subjects with musculoskeletal disorder. Packaged herbal medicine was sought by subjects with respiratory disease, digestive tract disease, endocrine-metabolic disease or circulatory disease. Tablet-type herbal medicine was sought by subjects with musculoskeletal disorder or digestive tract disease. Combined therapy was sought by subjects with musculoskeletal disorder, digestive tract disease, hematopoietic disease or immune disorder. 4. The level of satisfaction with oriental medical service was higher in subjects with circulatory disease, subjects with digestive tract disease, subjects with neurological disorder and subjects with musculoskeletal disorder in descending order. Of total subjects, 39.4% experienced side effects of oriental medical care, 38.1% experienced side effects of herbal medicine. About 51.9% considered the price of herbal medicine costly while 23.2% considered it reasonable. 5. Subjects' knowledge of herbal medicine was measured as $29.2{\pm}3.83$ out of 42 scores or 69 out of 100 points, indicating a low knowledge level. Subjects' knowledge was influenced by occupation, religion, side effects, sex, age, residence area, the type of insurance. These variables explained 15.2% of the variance. 7. Of total subjects, 56.8% were satisfied with oriental medical service. Patient satisfaction varied with occupation, religion, the type of insurance, health state and treatment outcomes. These variables explained 37.3% of the variance. Conclusion : The majority of subjects were satisfied with oriental medical service. However, oriental medical care are not widely used to treat all kinds of diseases while its use skews to a small categories of diseases. It is therefore necessary for the government and oriental medical service providers to develop new therapy approaches for the treatment of a broader range of diseases.

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Development of Accident Models by Collision Type at Roundabout (충돌유형별 회전교차로 사고모형 개발)

  • Park, Byung Ho;Beak, Tae Hun
    • Journal of the Korean Society of Safety
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    • v.31 no.3
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    • pp.136-142
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    • 2016
  • This study deals with traffic accident of roundabout by collision type. In pursuing the above, this study gives particular attention to developing the appropriate models using Tobit model. The main results are as follows. First, three Tobit models (by collision type) which are statistically significant(their $R^2$ values are 0.858, 0.918 and 0.859) are developed. Second, t-test results show that there are no differences between the predicted and actual values. Finally, such the common variable as traffic volume, and such the specific variables as diameter of central island, the number of circulatory roadway, approach width and average of the number of approach are adopted in this study.

Correlation between Hyungsang Medicine and GCM Types (형상의학과 GCM 체형의 상관성)

  • Hwang Won Duek;Kang Sung Ho;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.680-687
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    • 2004
  • A study on the correlation between four GCM types and Dam and Bangkwang types of Hyungsang medicine comes to the following conclusions : GCM I type is closely related to Bangkwang type in Hyungsang medicine. GCM II type corresponds to Dam type. In terms of obesity and emaciation, GCM I type is related to obesity and GCM II type to emaciation. In terms of Right and Left, GCM I type is more active in Left, GCM II type in Right. In terms of movement, GCM I and II types are kinetic and GCM III and IV types are static. In terms of Front and Back, the disease of GCM I type usually appears on Back but the treatment starts on Front. In GCM II type, disease mainly occurs on Front but the treatment starts on Back. GCM I type is susceptible to an alimentary disease and constitutionally predisposed to damp-phlegm in Hyungsang medicine. GCM II type is easily affected by a circulatory illness and very vulnerable to heat with blood deficiency and depression and stagnation of Ki.

The Using Status and Effectiveness of Sasang Constitutional Herbal Prescription (사상체질 처방 활용 현황 및 유효 질환 조사)

  • Jang, Eun-Su;Yoo, Jong-Hyang;Kim, Yun-Young;Park, Ki-Hyun;Lee, Si-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.1
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    • pp.87-97
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    • 2011
  • 1. Objectives: We aimed to derive using status of Sasang Constitutional herbal prescription and good effective one in specific disease. 2. Methods: We sent Questionnaire to 463 oriental medical doctor listed Korea Sasang Constitutional medicine from 2009 years. 10 to 11 and got back 191 questionnaire, which consisted of sex, age, clinical duration, working type, using status and effectiveness of Sasang Constitutional herbal prescription. 3. Results: - Digestive tract disease was especially most effective field, and circulatory, the endocrine, dermatology, psychopathy, urogenital disease went in order in western disease. - Spleen disease was especially most effective field, and the heart and circulatory, neuropsychiatry, lung, liver, psychopathy, gynecology disease went in order in oriental medicine pathology. - Chungshimyenja-tang was effective to neuropsychiatry and heart disease in Taeeumin, Hyangsayangwi-tang to disease related digestive system, Palmulgunja-tang to gynecology disease in Soeumin, Dockhalgiwhang-tang to diet disorder, Yanggeuksanwha-tang to heart and psychologic disease in Soyangin. 4. Conclusions: Constitutional prescription effected on special pathological symptom support weaken organ, and these result will help to make treatment standard and support clinical study of constitutional medicine.

The Effect of Jakamchotang(炙甘草湯) on Isolated rat herts under langendorff apparatus (자감초탕(炙甘草湯)이 재관류장치하에서 흰쥐의 적출심장(摘出心臟)에 미치는 영향(影響))

  • Moon, Hyung-Kun;Moon, Sang-Kwan;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.340-354
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    • 1997
  • Background : The stenosis of the coronary artery results in a decrease in the myocardial oxygen supply, ischemia and infarction. Jakamchotang as a drug of liquid is generally regarded to have the effect of arrythmia, palpitation from Heart disease and promoting the flow of Ki and Blood. Methods : The purpose of this experimental study is to find whether Jakamchotang is effective or not in curing ischemia in isolated perfused rat hearts and to measure the degree of its curing effect. In this study, under the Langendorff apparatus, ischemia was induced in isolated Sprague-Dawley rat hearts by ceasing the perfusion for 20 minites. Subjects were divided into a normal saline orally administered group(control group), an Jakamchotang orally 100mg administered group (sample A), an Jakamchotang orally 300mg administered group (sample B), and an Jakamchotang injection perfused group(sample C). The heart rates, left ventricular pressure, myocardial dilatation/contraction, cardiac perfusion flow and cardiac ezyme(LDH, CPK) of the four group were measured and compared in order to assess the influence of Jakamchotang on isolated perfused rat hearts recovering abillity from ischemia and infarction. results : 1. Heart rates were increased significantly in Jakamchotang orally 100mg administered group, Jakamchotang orally 300mg administered group and Jakamchotang injection perfused group on perfusion and reperfusion(p<0.01). 2. Left ventricular pressure were increased significantly in Jakamchotang orally 100mg administered group and 300mg administered and Jakamchotang injection perfused group(p<0.01) in comparison with control group on perfusion, but every group did not significant on reperfusion. 3. While there were no differances in each group's abillities of myocardial dilatation, the ability of myocardial constriction of Jakamchotang 100mg administered group only on perfusion was significantly greater than that of control group(p<0.05). 4. CBF was no significant on perfusion and reperfusion in comparison with control group(N.S.) 5. LDH was not significantly decreased on perfusion, but significactly decreased in Jakamchotang orally 100mg administered group, Jakamchotang orally 300mg administered group on reperfusion. 6. CPK was significantly decreased in Jakamchotang orally 100mg administered group, 300mg administered and Jakamchotang injection perfused group on perfusion(p<0.01), but was not significantly in Jakamchotang 300mg administered group only on reperfusion(P<0.05) Conclusion : According to the result above, Jakamchotang have an effect to recover in the isolated perfused rat hearts. Especially, the effect of Jakamchotang in orally adminstered group is greater than that of Jakamchotang injection perfused group on preischemia. The followings are the two important results of this study: First, the effect of Jakamchotang used traditionally on heart disease was proved statistcally under the Langendorff apparatus. Second, on the basis of this study, the effect of other type medications on myocardial ischemia can be evaluted in further studies.

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Particle Trajectory Visualization in Electrostatic Precipitator (정전집진기내의 입자궤적 가시화)

  • 박석주;김상수
    • Transactions of the Korean Society of Mechanical Engineers
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    • v.18 no.12
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    • pp.3270-3275
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    • 1994
  • Particle trajectory visualization using laser sheet was performed to investigate the corona wind flow interactions in the one-wire and two-wire type electrostatic precipitators. The corona wind generated by corona discharge was not negligible, and strong flow interactions took place owing to the induced circulatory cells. In the case of one-wire type, as the applied voltage was increased and the cross-section mean velocity was decreased, the effect of corona wind became active. In the case of two-wire type, if upstream discharge voltage was relatively higher than downstream discharge voltage, the effect of upstream corona wind was reduced.

Surgical correction of Total anomalous pulmonary venous drainage of cardiac type. - 3 cases - (Cardiac type 총폐정맥 이상환류증 수술치험 3)

  • 김삼현
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.323-327
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    • 1987
  • Majority of patients with total anomalous pulmonary venous drainage [TAPVD] have severe symptoms within the first few months of life. And early in the experience with correction of TAPVD, hospital mortality was high, especially in infant. In Sejong General Hospital, we operated on 3 infants with TAPVD of cardiac type. Repair was performed under the conventional cardiopulmonary by pass in one case and by the total circulatory arrest in other 2 cases. Interatial septum between enlarged coronary sinus opening and interatrial septal defect was excised and the coronary sinus was radically unroofed to make wide opening between left atrium and common pulmonary venous channel. The defect in atrial septum was closed with redundant pericardial patch. Postoperative courses were uneventful except transient dysrrhythmia of A-V dissociation. They are doing well on follow up check.

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Performance Evaluation of Side Channel Type Regenerative Blower (사이드채널형 재생블로워의 성능평가)

  • Lee, Kyoung-Yong;Choi, Young-Seok
    • 유체기계공업학회:학술대회논문집
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    • 2005.12a
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    • pp.378-383
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    • 2005
  • The performances of side channel type regenerative blowers were evaluated by the blower performance test, 1-D performance prediction and CFD. The performance prediction method was modified using the results of the performance test and CFD and applied to the design of the new regenerative blowers. The major geometric parameters such as channel height, channel area and expansion angle were decided from the performance prediction method for the improved models and the predicted results were compared with CFD and experimental data. Both of the modified models showed improved efficiency at the operating condition. Especially, model3 could be possible to reduce operating rotating speed, that is benefit to noise performance, because of the high head performance at the design point. The CFD results showed that the performance of the regenerative blower was influenced by the secondary circulatory flow in the channel.

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Short-term Mechanical Circulatory Support with Centrifugal Pump in Cardiac Arrest or Cardiogenic Shock - Report of 5 cases- (심정지 혹은 심인성 쇼크에서 원심성 펌프를 이용한 단기목표의 기계적 순환 보조)

  • 양희철;성기익;뱍계현;전태국;박표원;양지혁;이영탁
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1003-1009
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    • 2004
  • Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.