• Journal of Chest Surgery
• /
• v.30 no.2
• /
• pp.131-136
• /
• 1997

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prosnosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively: The results were as follows : 1. Serum triiodothyronine(73) reached to its nadir(30.05 $\pm$ 17.5ng/dl, p(0.001) at 10 minutes after the start of CPB and remained low(p(0.05) throughout the study period. 2. Serum thyroxine(74) concentr tion slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(W4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37 $\pm$ 0.81u1U/m1, p(0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum 73 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum 73 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.

• Journal of the Korean Crystal Growth and Crystal Technology
• /
• v.12 no.5
• /
• pp.234-239
• /
• 2002

The spinel was calcined at temperatures in the range of $1000^{\circ}C$ to $1300^{\circ}C$ with $100^{\circ}C$ interval to evaluate the effect of calcination temperature on mechanical properties of spinel-glass dental composites. Although the average particle size of spinel calcined at temperatures from $1000^{\circ}C$ to $1200^{\circ}C$ was within 2.8~3.0 $\mu\textrm{m}$, the spinel calcined at $1300^{\circ}C$ was 4.66 $\mu\textrm{m}$ due to abnormal grain growth. Shrinkage and pore size of the spinel preform decreased and increased, respectively, as calcination temperature increased, indicating that the calcination temperature was significant to the powder compaction and the densification of the composites as a result of particle size and distribution. The optimum strength and the fracture toughness of the composite calcined at $1200^{\circ}C$ were 284$\pm$40 MPa, 2.5$\pm$0.1 MPaㆍ$m^{1/2}$ respectively. Optical experimental results showed that transmittance of the spinel-glass composite in the visible region was twice higher than that of the alumina-glass composite, suggesting that the spinel-glass composites possessed better aesthetic properties for all-ceramic dental crown application.

• Journal of Conservation Science
• /
• v.21
• /
• pp.49-58
• /
• 2007

Among the treatment results of test samples of the antique lacquer-ware, the treatment with PEG#3,350 40% solution displayed excellent effect with low shrinkage ratio; in weight gain the treatment with Sucrose 19%+Glycerin 1%(t-butanol 5% in water) solution showed consistent increase. However during the impregnation process of Sucrose, the weight of the testing samples decreased by dehydration because the inner part of the test samples and the treatment solution showed concentration gradient. Therefore, we concluded longer impregnation period should be necessary to prevent dehydration. Since both higher and lower molecular weight treatment chemicals could penetrate into the wood of the lacquer-ware, air drying and conditioning after impregnation treatment with high concentration chemicals would be possible, as well as vacuum freeze-drying.

• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.53-57
• /
• 1999

We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.24 no.10
• /
• pp.1341-1347
• /
• 2020

Legacy studies for classifying arrhythmia have been studied in order to improve the accuracy of classification, Neural Network, Fuzzy, Machine Learning, etc. In particular, deep learning is most frequently used for arrhythmia classification using error backpropagation algorithm by solving the limit of hidden layer number, which is a problem of neural network. In order to apply a deep learning model to an ECG signal, it is necessary to select an optimal model and parameters. In this paper, we propose parameter extraction based on AR and arrhythmia classification through a deep learning. For this purpose, the R-wave is detected in the ECG signal from which noise has been removed, QRS and RR interval is modelled. And then, the weights were learned by supervised learning method through deep learning and the model was evaluated by the verification data. The classification rate of PVC is evaluated through MIT-BIH arrhythmia database. The achieved scores indicate arrhythmia classification rate of over 97%.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1329-1336
• /
• 1996

From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.

• Journal of Chest Surgery
• /
• v.38 no.11 s.256
• /
• pp.761-772
• /
• 2005

Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.

• Journal of Chest Surgery
• /
• v.39 no.12 s.269
• /
• pp.891-899
• /
• 2006

Background: This study is to evaluate the safety of ATS valve by examining the clinical results of ten-years experience. Material and Method: From July 1995 to March 2005, we reviewed 305 patients with ATS valve implantation. Mean age was $49.8{\pm}11.7$ years and 140(45.6%) males were included. Etiologies were rheumatic diseases in 207 cases(67.4%), degenerative changes in 57 cases(18.6%), valve dysfunction in 23 cases(7.5%) and infective endocarditis in 14 cases(4.6%). AVR was performed in 72 patients(23.5%), MVR in 156 patients (50.8%), DVR(AVR+MVR) in 63 patients(20.5%) and TVR in 16 patients(5.2%). Result: There were 9 operative mortalities(2.9%). Follow up period was $56.5{\pm}34.0(0{\sim}115)$ months and 96.4% patients were followed up with 9 late deaths. Five and ten years survival rates were $94.9{\pm}1.3%,\;91.2{\pm}2.3%$ using Kaplan-Meier's methods. Valve related event free survival rates in 5 and 10 years were $90.8{\pm}2.0%$ and $86.9{\pm}3.2%$. There were 16 anticoagulation-related hemorrhages, 6 thromboembolisms, 3 prosthetic valve endocarditis and 1 paravalvular leakage. NYHA class improved after operation(p<0.05). Postoperative echocardiography showed significant decrease in LA size, LVEDD and IVESD(p<0.01). Patients with 19 and 21 mm valve showed significantly higher transvalvular pressure gradient in aortic position(p<0.001, p<0.001). Conclusion: ATS valve showed good hemodynamic results with few valve related complications and thus can be used with acceptable risk.

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.165-174
• /
• 2009

Background: With the advances of cardiac surgery, the demand for an artificial prosthesis has increased, and this has led to the development and utilization of diverse alternative materials. We conducted this research to improve an artificial prosthesis by examining the changes of the physical qualities, the pressure related tensile strength, the change in elasticity and the thermostability of a xenograft valve (porcine) and pericardium (bovine, porcine) based on the type of fixation liquid we used. Material and Method: The xenograft valves and pericardium were assigned into three groups: the untreated group, the fixed with glutaraldehyde (GA) group and the glutaraldehyde with GA+solvent such as ethanol etc. group. The surgeons carried out each group's physical activities. Each group's uniaxial tension and elasticity was measured and compared. Thermostability testing was conducted and compared between the bovine and porcine pericardium fixed with GA group and the GA+solvent group. Result: On the physical activity test in the surgeon's hand, no significant difference between the groups was sensed on palpation. For suture and tension, the GA+solvent group was slightly firmer than the low GA concentration group. In general, the circumferential uniaxial tension and elasticity of the porcine aortic and pulmonary valves were better in the fixed groups than that in the untreated group. There was no significant difference between the GA and GA+solvent groups (p>0.05). Bovine and porcine pericardium also showed no significant difference between the GA group and the GA+solvent group (p>0.05). When comparing between the groups for each experiment, the elasticity tended to be stronger in most of the higher GA concentration group (porcine pulmonary valve, porcine pericardium). On the thermostability testing of the bovine and porcine pericardium, the GA group and the G+solvent group both had a sudden shrinking point at $80^{\circ}C$ that showed no difference (bovine pericardium: p=0.057, porcine pericardium: p=0.227). Conclusion: When fixing xenograft prosthetic devices with GA, adding a solvent did not cause a loss in pressure-tension, tension-elasticity and thermostability. In addition, more functional solvents or cleansers should be developed for developing better xenografts.

• Journal of Chest Surgery
• /
• v.30 no.3
• /
• pp.287-292
• /
• 1997

.Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.