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Contrast Media in Abdominal Computed Tomography: Optimization of Delivery Methods

  • Joon Koo Han;Byung Ihn Choi;Ah Young Kim;Soo Jung Kim
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.28-36
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    • 2001
  • Objective: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. Materials and Methods: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concentrations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocellular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. Results: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. Conclusion: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.

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Performance Evaluation of High Strength Lattice Girder by Structural Analyses and Field Measurements (구조해석과 현장계측에 의한 고강도 격자지보재의 성능 평가)

  • Lee, Jeo-Won;Min, Kyong-Nam;Jeong, Ji-Wook;Roh, Byoung-Kuk;Lee, Sang-Jin;Ahn, Tae-Bong;Kang, Seong-Seung
    • The Journal of Engineering Geology
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    • v.30 no.3
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    • pp.237-251
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    • 2020
  • This study examined structural analysis of supports in tunnel and displacement and underground stress of tunnel by measurement, in order to evaluate the performance of high-strength lattice girders developed as a substitute for H-profiles. According to the three-dimensional nonlinear structural analysis results of the tunnel support, the load and displacement relationship between the H-profiles and the high-strength lattice girders showed almost the same behavior, and the maximum load of the high-strength lattice girders were 1.0 to 1.2 times greater than the H-profiles. By the results of the three-dimensional tunnel cross-section analysis of the supports, the axial force was occurred largely in the lower left and right sides of the tunnel, and showed a similar trend to the field test values. In the results of the measurement of the roof settlement and rod extension, the final displacement of the steel arch rib (H-profile) and high-strength lattice girder section in tunnel was converged to a constant value without significant difference within the first management standard of 23.5 mm. According to the results of underground displacement measurement, the final change amount of the two support sections showed a slight displacement change, but converged to a constant value within the first management standard of 10 mm. By the results of measurement of shotcrete stress and steel arch rib stress, the final change amount of the two support sections showed a slight stress change, but converged to a constant value within the first management standard of 81.1 kg/㎠ and 54.2 tonf.

Study on the Elimination of Heavy Metal Pollutants in the Soil by Vascular Plant in the River Area (하천유역의 관속식물을 이용한 토양내의 중금속 오염원 제거에 관한 연구)

  • 강경홍;김인성
    • Journal of Korea Soil Environment Society
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    • v.1 no.2
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    • pp.23-34
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    • 1996
  • The biological magnification of Pb, Cu, Zn and Fe in vascular plant, Persicaria thunbergii, Trapa japonica and Nymphoides peltata natually grown at the river and riverside and relationship between the concentration of heavy metals in these vascular plants and in the soil were investigated in the Chonju river, Chonju city. The biological magnification values of these metals in P thunbergii were founded as follows ; Pb, Cu, Zn and Fe were 80.4~254.6$mu\textrm{g}$/g, 284.6~688.4$mu\textrm{g}$/g, 635.5~1979.4$mu\textrm{g}$/g and 1160.0~3590.9$mu\textrm{g}$/g respectively. In the case of T. japonica, Pb, Cu, Zn and Fe were 107.8~306.0$mu\textrm{g}$/g, 282.7~963.0p$mu\textrm{g}$/g, 1328.3~3546.$mu\textrm{g}$/g and 656.8~9944.0$mu\textrm{g}$/g and in N. peltata, 140.1~ 193.9$mu\textrm{g}$/g, 187.7~327.3$mu\textrm{g}$/g, 1126.6~1723.6$mu\textrm{g}$/g and 611.7~1914.6$mu\textrm{g}$/g respectively. The amount of the biological magnification of heavy metals in the leaf, stem and root of these plants was generally increased in the sequence of leaf

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Wintering Population Change of the Cranes according to the Climatic Factors in Cheorwon, Korea: Effect of the Snow Cover Range and Period by Using MODIS Satellite Data (기후요인에 의한 철원지역 두루미류 월동개체수 변화 - MODIS 위성영상을 이용한 눈 덮임 범위와 지속기간의 영향 -)

  • Yoo, Seung-Hwa;Lee, Ki-Sup;Jung, Hwa-Young;Kim, Hwa-Jung;Hur, Wee-Haeng;Kim, Jin-Han;Park, Chong-Hwa
    • Korean Journal of Ecology and Environment
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    • v.48 no.3
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    • pp.176-187
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    • 2015
  • In this study, we hypothesized that the size of wintering crane population would change due to the climate factors. We assumed that wintering population size would differ by climate values in January, which is the coldest period in year. Especially, White-naped cranes were able to choose wintering site between Cheorwon and other alternative place where snow coverage had low influence, differing from Red crowned cranes. For this reason, we predicted the population size of White-naped cranes would fluctuate according to the extent of snow coverage in Cheorwon. Therefore we used snow coverage data based on MODIS and climate data from KMA (Korea Meteorological Administration) that are generally used. We analyzed the crane's population size in Cheorwon in January from 2002 to 2014. The temperature in the Cheorwon increased from 2002 to wintering period in 2007~ 2008 and went down, showing the lowest temperature in 2011~ 2012. With this phenomenon, warmth index showed the similar pattern with temperature. Amount of newly accumulated snow (the amount of snow that fallen from 0:01 am to 11:29 pm in a day) was low after 2002, but rapidly increased in 2010~ 2011 and 2011~ 2012. The area of snow coverage rapidly declined from 2002 to 2005~ 2006 but suddenly expanded in wintering period in 2009~ 2010 and 2010~ 2011. Wintering population size of the White-naped cranes decreased as snow coverage area increased in January and the highest correlation was found between them, compared to the other climatic factors. However, the number of individuals of Red crowned cranes had little relationship with general climate factors including snow cover range. Therefore it seems that population size of the Red crowned crane varied by factors related with habitat selection such as secure roosting site and area of foraging place, not by climatic factors. In multiple regression analysis, wintering population of White-naped cranes showed significant relationship with logarithmic value of snow cover range and its period. Therefore, it suggests that the population size of the White-naped crane was affected by snow cover range n wintering period and this was because it was hard for them to find out rice grains which are their main food items, buried in snow cover. The population size variation in White-naped cranes was caused by some individuals which left Cheorwon for Izumi where snow cover had little influence on them. The wintering population in Izumi and Cheorwon had negative correlation, implying they were mutually related.

Clinical Analysis on the Closed Thoracostomy -2341 cases (폐쇄식 흉강 삽관술에 대한 임상적 고찰)

  • Kim, Cheon-Seog;Kim, Yeun-Gue;Park, Jin;Lee, Kyong-Woon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.991-1000
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    • 1997
  • Closed thoracostomy with UWSD* which is the most utilized procedure in chest surgery applies general thoracic disorders, trauma and after-thoracic surgery. The University hospital was involved on operating 2341 cases of closed thoracostomy with UWSD except chest tubing after-thoracic surgery for a full six years from January, 1991 to December, 1996. The rate of men and women out of the total 2341 cases was 3.5 : 1, the distribution by age showed that men were 36.6 $\pm21.0$ years old, women were $47.0\pm20.2$ years old and so that the total were 40.0 $\pm$ 20.5 years old. As for indication, spontaneous, secondary and traumatic pneumothorax were the most common, in addition to hemothorax hemopneumothorax, hydrothorax, hydropneumothorax, empyema, chylothorax. The most indwelling period of chest tubing is between eight and fourteen days for 974 cases and the average is 13.7 $\pm$ 6.3 days, The average drainage amount immediately after thoracostomy was 537 $\pm$ 88m1, and in 694 cases(46.0%), the drain amount was 201 ~ 500 ml. The rate of right and left tubing was 52.4 47.6, in 2071 cases(88.5%), the thoracostomy was the first chance and 2210 cases(94.4%) were treated with a single tube drainage. Almost all the patients complained of tube site pain, besides tube site infection, intercostal neuralgia, loss of tube function by the pleural adhesion, intrathoracic infection, incomplete reexpansion of defective lung, hemorrhage caused by the rupture of a blood vessel, subcutaneous emphysema, lung parenchymal rupture, diaphragmatic and intraabdominal trauma, reexpansionary pulmonary edema of one side lung and cellulitis were relapsed. 84.6% of all patients recovered with only clo ed thoracostomy and the rest of patient needed additional some necessary managements and so on to have successful results. There were two deaths(0.1%), caused by reexpansionary pulmonary edema, the cellulitis were complicated by thoracostomy with UWSD on an empyema patients to come to death(due to sepsis). t UWSD = under water seal drainage

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Hearing Loss in the Workers Exposed to Organic Solvents and Noise (유기용제와 소음에 폭로된 근로자들의 청력 손실)

  • 김영기;이용환
    • Journal of Life Science
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    • v.9 no.2
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    • pp.136-145
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    • 1999
  • The purpose of this study was to evaluate the effect of organic slovents and noise on hearing loss. We selected organic solvents exposed group of 32 cases, noise exposed group of 31 cases, both noise and solvent exposed group of 31 cases, and control group of 53 cases and studied the relation between exposure level of noise and organic solvents and degree of hearing loss. The results were as follows. The subjects under investigation were exposed to noise and organic solvents under threshold limit values and the amount of urinary hippuric acid excretion were also under biological exposure indices. In case of noise, both noise and organic solvents exposed group and noise exposed group were more exposed than organic solvents exposed group(p<0.05). When urinary hippuric acid excretion were concerned, both noise iud organic solvents exposed group and organic solvents exposed group showed higher values than noise exposed group(p<0.05). In comparison of mean auditory threshold values by frequency, on the air conduction test, both noise and organic solvents exposed group showed significantly higher hearing loss than noise exposed group in 500Hz of right ear, 500 and 2000Hz of left ear(p<0.05). Forty-three cases among 147 subjects were regarded as hearing loss group and average age(42.6years) of hearing loss group was higher than normal groups average age of 38.0 years. Urinary hippuric acid excretions of hearing loss group were significantly higher than normal group(p<0.05). Thirty-eight percent(12cases) of noise exposed group, 40.6 $\%$(13cases) of organic solvents exposed group, 51.6 $\%$(16cases) of both noise and organic solvents exposed group, and 3.8 $\%$(2cases) of unexposed group were regarded as hearing losers. Exposed groups showed higher incidence of hearing loss than unexposed group but there were no significant differences among the exposed groups. The variables showing significant correlation with hearing loss were age and the amount of hippuric acid in urinary excretion. When age were adjusted for the purpose of seeing the effects of hearing losses due to organic solvent, urinary excretion of hippuric acids was the only variable with significant correlation with hearing loss (p<0.05). When odds ratio to hearing loss between control and exposed groups was considered, noise exposed group showed 6.1 times (95 $\%$ CI: 3.3-8.7), organic solvents exposed group showed 7.4 times (95 $\%$ CI: 3.5-14.6) and both noise and organic solvents exposed group showed 17.2 times(95% CI: 5.6-31.8) higher values than unexposed group(p<0.01). Above results suggest that health screening test of hearing loss is also needed in organic solvents exposed workers.

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Use of Undiluted Potassium Solution in Intermittent Antegrade Warm Blood Cardioplegia (IAWBC) (간헐적 전방온혈심정지액에서 희석되지 않은 고농도 포타슘의 사용)

  • 백완기;손국희;김영삼;윤용한;김혜숙;임현경;이춘수;김광호;김정택
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.660-664
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    • 2004
  • Background: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. Material and Method: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4 : 1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. Result: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346$\pm$597 mL in dilutedplegia (mean$\pm$standard deviation, and 28$\pm$9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21$\pm$4% in dilutedplegia and 24$\pm$3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250$\pm$810 mL, 1689$\pm$548 mL) than in microplegia (959$\pm$410 mL, 1461$\pm$784 mL; p<0.05). Conclusion: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.

Effect of orthodontic force on the amount of tooth movement and root resolution in rat (교정력이 흰쥐의 치아이동량과 치근흡수에 미치는 영향)

  • Kim, Il-Gon;Kim, Kwang-Won;Yoon, Young-Jooh
    • The korean journal of orthodontics
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    • v.29 no.5 s.76
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    • pp.551-562
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    • 1999
  • This study was undertaken to investigate the relation between orthodontic force magnitude and the amount of tooth movement. And more light force application for reducing root resorption Twenty-four rats were divided into three experimental groups(A, B, C) based on force magnitude and application method. Springs of 50g force were applied to A group, springs of 100g force were applied to B group and springs of 25g force were applied to C group initially, and after 4 days springs of C group were changed to springs of 50g force. Two kinds of $sentally^{(R)}$(GAC U.S.A.) closed coil spring, 50g and 100g, were used. And we made 25g springs by heat treatment process of 50g springs. Each spring was inserted between the maxillary central incisor and the maxillary left first molar. Amounts of tooth movement were measured everyday by digital caliper($Digimatic^{(R)}$, Mitutoyo, Japan) under inhalation anesthesia for 15 days. After 15 days, all rats were sacrificed and histological samples were obtained with Hematoxyline-Eosin stain and Masson's trichrome stain. Following conclusion were made; 1. Group B showed the mean cumulative tooth movement of $2.19{\pm}0.41mm$ at 15th day, which was greatest among three groups, followed by group C($2.06{\pm}0.10mm$), group A($1.90{\pm}0.49mm$) respectively. however, there was no statistically difference among three groups. 2. All groups showed general tooth movement pattern and A, B, C group finished lag phase at 9th, 8th, 7th day, but there was no statistical significance. 3. Group A,B,C showed root resorption and especially group B showed the most severe root resorption and group C showed milder root resorption than other groups. According to the above results, large initial force with the development of a flirty widespread hyalinized zone may cause severe root resorption, so initial force should be applied lightly to reduce hyalinized area and eventually root resorption and then increased force will induce efficient tooth movement.

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Compare to Evaluate the Imaging dose of MVCT and CBCT (Tomotherapy MVCT와 Linac CBCT의 Imaging dose 비교평가)

  • Yoon, Bo Reum;Hong, Mi Lan;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.83-89
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    • 2014
  • Purpose : In case of the intensity modulated radiation therapy (IMRT) using Tomotherapy and linear accelerator (Linac), it was to compare and to evaluate the imaging dose of MVCT and CBCT that were performed daily for the correct set up of the patient. Materials and Methods : The human body model Phantom (Anderson rando Phantom, USA) was divided into the three parts as Head, Thorax, pelvis, and after GafChromic EBT3 film cut to the size of $0.5{\times}0.5cm2$.in the center of the recording area were situated on the ant, post, left, and right surface of the phantom and 2cm in depth from the ant, post, left, right, and center surface of the phantom, the surface dose and inner dose were measured repeatedly three times, respectively, using the tomotherapy (Hi Art) and the OBI of NovalisTx. The measured film calculated the output value by RIP version6.0 and then the average value of the dose was calculated by the one-way analysis of variance. Results : Using the human body model phantom, the results of MVCT and CBCT performance were that measurements of MVCT inner dose were showed $15.43cGy{\pm}6.05$ in the head, $16.62cGy{\pm}3.08$ in the thorax, $16.81cGy{\pm}5.24$ in the pelvis, and measurements of CBCT inner dose were showed $13.28{\pm}3.68$ in the head, from $13.66{\pm}4.04$ in the thorax, $15.52{\pm}3.52$ in the pelvis. The measurements of surface dose were showed in case of MVCT performance, $11.64{\pm}4.05$ in the head, $12.16{\pm}4.38$ in the thorax, $12.05{\pm}2.71$ in the pelvis, and in case of CBCT performance, $14.59{\pm}3.51$ in the head, $15.82{\pm}2.89$ in the thorax, $17.48{\pm}2.80$ in the pelvis, respectively. Conclusion : In case of Inner dose, the MVCT using MV energy showed higher than the CBCT using kV energy at 1.16 times in the head, at 1.22 times in the thorax, at 1.08 times in the pelvis, and in case of surface dose, the CBCT was higher than MVCT, at 1.25 times in the head, at 1.30 times in the thorax, at 1.45 times in the pelvis. Imaging dose was a small amount compared to the therapeutic dose but it was thought to affect partially to normal tissue because it was done in daily schedule. However, IMRT treatment was necessarily parallel with the IGRT treatment through the image-guide to minimize errors between planned and actual treatment. Thus, to minimize imaging dose that the patients receive, when planning the treatment, it should be set up a treatment plan considering imaging dose, or it must be performed by minimizing the scan range when shooting MVCT.

The Cox-Maze Procedure for Atrial Fibrillation Concomitant with Mitral Valve Disease (승모판막질환에 동반된 심방세동에서 Cox-Maze 술식)

  • Kim, Ki-Bong;Cho, Kwang-Ree;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.939-944
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    • 1998
  • Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.

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