• Journal of Chest Surgery
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• 제35권11호
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• pp.831-834
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• 2002

감염된 심박조율기의 부분적 제거 후에 발생되는 재감염율은 51%에서 77%에 이르기 때문에 심박조율기의 어느 부위라도 감염이 된다면 모든 심박조율기의 하드웨어는 제거되어야 한다. 심폐기 가동하에서 감염된 심박조율기를 제거하는 것은 감염과 증식물의 확산 뿐만 아니라 기계적 손상을 방지 할 수 있다. 저자 등은 좌쇄골하 정맥에서 심장내로 이동된, 감염된 경정맥 심박조율기 도관에 의해 발생한 심내막염의 1예를 보고 한다. 심장내로 이동된 심박조율기 도관과 증식물이 부착된 전극은 심폐우회를 이용하여 제거하였다.

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.113-116
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• 2014

A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

• 한국섬유공학회:학술대회논문집
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• 한국섬유공학회 2003년도 가을 학술발표회 논문집
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• pp.55-58
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• 2003

Segmented polyurethanes have been widely used for various commercial and experimental blood-contacting and tissue-contacting applications such as vascular prostheses, blood pumps, heart valves, pacemaker lead wire insulation, catheters, artificial hearts, and cardiac assist devices due to their generally favorable physical and mechanical properties, as well as fairly good biocompatibility and antithrombogenicity characteristics. (omitted)

• 대한중풍순환신경학회지
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• 제23권1호
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• pp.41-54
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• 2022

Brady-arrhythmia is defined as an arrhythmia in which the heart rate slows to less than 60 beats per minute. Brady-arrhythmia reduces cardiac output and causes changes in blood flow. As a result, dizziness occurs because not only ischemia occurs in the central nervous system, but also blood flow in major organs decreases. The insertion of an artificial pacemaker is known as almost the only treatment alternative for patients with brady-arrhythmia with symptoms. This study reports a case of 85 year old male diagnosed with brady-arrhythmia complaining presyncope type of dizziness. The patient underwent complex Korean medicine treatments by herbal medicine, acupuncture and moxibustion. The daily average value of pulse rate, K-DHI score, NRS score and the patient's subjective expression of symptoms were used as evaluation tools. This study suggested a significant improvement in symptoms through complex Korean medicine treatments without the use of anti-arrhythmic drugs or insertion of an artificial pacemaker in the patient with brady-arrhythmia complaining dizziness.

• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.198-203
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• 2015

The purpose of the study is to examine the effects of pacemaker location on cardiac pumping efficacy theoretically. We used a three-dimensional finite element cardiac electromechanical model of canine ventricles with models of the circulatory system. Electrical activation time for normal sinus rhythm and artificial pacing in apex, left ventricular free wall, and right ventricular free wall were obtained from electrophysiological model. We applied the electrical activation time maps to the mechanical contraction model and obtained cardiac mechanical responses such as myocardial contractile ATP consumption, stroke work, stroke volume, ejection fraction, and etc. Among three artificial pacing methods, left ventricle pacing showed best performance in ventricular pumping efficacy.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 2012년도 한국컴퓨터종합학술대회논문집 Vol.39 No.1(D)
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• pp.369-371
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• 2012

Wireless sensor networks have taken immense interest in healthcare systems in recent years. One example of it is in an in vivo sensor that is deployed in critical and sensitive healthcare applications like artificial retina, cardiac pacemaker, drug delivery, blood pressure, internal heat calculation, glucosemonitoring etc. In vivo sensor nodes exhibit temperature that may be very dangerous for human tissues. However, existing in vivo thermal aware routing approaches suffer from hotspot creation, delay, and computational complexity. These limitations motivate us toward an in vivo virtual backbone, a small subset of nodes, connected to all other nodes and involved in routing of all nodes, -based solution. A virtual backbone is lightweight and its fault-tolerant version allows in vivo sensor nodes to disconnect hotspot paths and to use alternative paths. We have formulated the problem as m-connected k-dominating set problem with minimum temperature cost in in vivo sensor network. This is a combinatorial optimization problem and we have been motivated to use evolutionary approach to solve the problem.

• 수면정신생리
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• 제5권1호
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• pp.1-11
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• 1998

Chronobiology is the area of medicine that is, how time-related event shape our daily biologic responses and apply to any aspect of medicine with regard to altering pathophysiology and treatment response. In mammals, there are several evidences that prove suprachiasmatic nuclei(SCN) is the major circadian pacemaker and the circadian rhythm influences so many biological aspects of an living organism such as rest-activity, thermoregulation, reproduction, and endocrine system. In case of human beings, there had been little information of circadian system. That may be due to the experimental, technical difficulties to study but also to the fact that human has the more complex environments that may alter the circadina rhythm like the artificial light, many socio-cultural aspects and so forth. However, several reports of these days indicate human's circadian system is composed of two or more circadian oscillators and SCN is the major circadian oscillator among them like the other mammals. Free-running circadinan period of mankind is about 24 hours rather than about 25 hours, and rest-activity rhythm is polymodal like other species. In addition to that, human may have capcities to change the circadian rhythm as the seasonal changes of daynight schedule. In this article, the author will summarize recent progress of anatomy and physiology of the circadian clock mechanism in humans.

• Journal of Chest Surgery
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• 제31권4호
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• pp.398-401
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• 1998

단극유도의 심박조율기를 가진 56세 여자환자에서 관상동맥 우회로술과 승모판 치환술을 시행하였다. 이러한 단극유도 심박조율기는 심근 외의 전자기의 간섭에 대한 감수성이 높으므로 개심술시 전기소작기의 전기파에 의해 심박조율기의 조율기능이 억제될 수 있으며, 수술후 제세동기 사용할 때 영구 심박조율기에 전기 충격이 갈 수 있다. 따라서 대동맥 차단 감자를 해제한 후 심실세동없이 정상 심박동을 유도해야 한다. 본 환자에서 임시형 심방실 유도를 거치하고 임시형 심박조율기로 조율하여 심장리듬과 심기능을 유지시키면서 전기소작기를 사용할 수 있었으며, 대동맥 차단 중 전행성 및 역행성으로 혈성심정지액을 투여하고 대동맥 차단감자를 해제하기 직전에는 온혈심정지액과 온혈의 순차적인 역행성 주입으로 자연적인 심장리듬을 회복시킴으로써 제세동기 사용을 배제할 수 있었다.

• Journal of Korean Biological Nursing Science
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• 제23권4호
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• pp.298-307
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• 2021

Purpose: This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. Methods: This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher's exact test, and logistic regression analysis using SPSS/WIN 23.0. Results: Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m² (Odds ratio [OR]= 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). Conclusion: These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.