• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.74-79
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• 1996

This paper describes a methodology for the development of models of discrete event system(DES). The methodology is based on transformation of continuous state space into discrete one to homomorphically represent dynamics of continuous processes in discrete events. This paper proposes a formal structure which can couple DES models within a framework. The structure employs the DEVS formalism for the DES models. The proposed formal structure has been applied to develop a DEVS model for the human cardiovascular system. For this, the cardiac cycle is partitioned into a set of phases based on events identified through VisSim simulation in the CS of the electrical analog model. VisSim is the simulation tool of visual environment for developing continuous, discrete, and hybrid system models and performing dynamic simulation. For each phase, a CS of the electrical analog model for the cardiovascular system has been simulated by VisSim 2.0. To validate this model, first develop the DEVS model, then simulate the model in the DEVSIM++ environment. It has same simulation results for the data obtained from the CS simulation using VisSim. The comparison shows that the DEVS model represents dynamics of the human heart system at each phase of cardiac cycle.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.792-795
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• 2009

Pulmonary sequestration is a relatively rare malformation. Infection with common pyogenes is a frequent complication in this disease. We report here on a case of intralobar sequestration that was infected with Mycobacterium tuberculosis in the absence of any other site of tuberculous infection. A 40-year man presented with a small amount of hemoptysis, and the man had been previously diagnosed with bronchiectasis 3 years ago. Chest computerized tomography revealed bronchiectasis with pneumonia in the left lower lobe and there was a large feeding artery from the thoracic aorta. A lobectomy of the left lower lobe was conducted via thoracotomy and the final pathologic examination confirmed pulmonary tuberculosis limited to the intralobar sequestrated lung. The patient underwent anti-tuberculous chemotherapy from the postoperative $7^{th}$ day and he was discharged without any adverse event.

• The Korea Journal of Herbology
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• v.24 no.2
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• pp.49-56
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• 2009

Objectives : Inflammation is important event in the development of vascular diseases including hypertension, atherosclerosis, and restenosis. Bodusan (BDS) was a traditional Korean herbal medicine and widely used in treatment of gastrointestinal complaint and stomach ulcer. The aim of this study was to determine whether BDS and its components inhibit production of nitrite, PGE2 and proinflammatory cytokines in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages. Methods : Cytotoxic activity of BDS and its components on RAW 264.7 cells was using 5-(3caroboxymcrophages. eth-oxyphenyj)-2H-tetra-zolium inner salt (MTS) assay. The nitric oxide (NO) production was measured by Griess reagent system. And proinflammatory cytokines were measured by ELISA kit. The levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression were detected by western blot. Results : Our results indicated that BDS and its components significantly inhibited the LPS-induced NO and PGE2 production. Moreover. BDS and its components inhibited iNOS and COX-2 expression accompanied by an attenuation of TNF-${\alpha}$, IL-11${\beta}$, IL-6 and MCP-1 formation in macrophages. Conclusions: These results indicate that BDS and its components have potential as an anti-inflammatory agent.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.675-679
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• 2005

Background: Clinical reports on replacement of all three (AV + MV + TV) valves are rare. Material and Method: From January 1992 to December 2003, 38 patients received triple valve replacement (aortic, mitral, tricuspid) at Yonsei Cardiovascular Center. Mean age of patients was $49.5\pm10.7 (28\~69)$ years, and 24 patients $(63.1\%)$ were female. Rheumatic valve disease was the most common cause of operation (n=37). Preoperative New York Heart Association functional class were II in 4, III in 24 and IV in 10. Fifteen patients (group 1) received triple valve replacement at their first operation. Twenty three patients (group 2) received one or more operations before tricuspid valve replacement (TVR). Seven patients received tricuspid valve annuloplasty at first operation and received TVR later. Result: Six patients died at hospital after operation $(15.8\%)$ and all these patients were in group 2. All patients in group I survived and were discharged. Three patients $(9.4\%)$ died during follow up periods. Most of the survivors had improved functional class (I in 22, II in 8, III in 1, IV in 1). During follow up period, there were 4 valve related complications. The 10-year survival rate was $68.8\%$ and survival rate for free from valve related event at 10 years was $85.5\%$. Conclusion: After triple valve replacement, most patients showed improvement of symptoms. And during follow up period, valve related complications and survival were acceptable. Therefore, if indicated, triple valve replacement is recommended before the patients' conditions get worse.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.232-236
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• 1978

Twenty-two years old male was operated for spontaneous rupture of the esophagus. In the event of perforation, there is nothing to prevent wide spread dissemination, and a devastating necrotizing chemical insult occurrs which is rapidly complicated by anaerobic and aerobic infection which quickly jeopardizes the patient`s life, often with a fatal result. For these reasons and despite modern diagnostic aids, anesthetic and operative technics, and antibiotics, perforation of the esophagus is still an alarming accident. In this case, thoracotomy and surgical closure of the perforation resulted in satisfactory outcome except postoperative fistula, which healed spontaneously.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.925-929
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• 1992

Supravalvular aortic stenosis is relatively uncommon form of congenital heart disease and the most important lesion of this anomaly is various narrowing of the aortic lumen just above the sinus of Valsalva. We experienced a case of hourglass type of supravalvular aortic stenosis involving lcm from length from lcm above the sinus of Valsalva. The patient was associated with mental retardation, peculiar facies and dental anomaly. The diagnosis was confirmed preoperatively by retrograde left heart catheterization and left ventriculography. An incision was made in the ascending aorta and into the right coronary and noncornary sinus. Care was taken to protect the right coronary artery. A Y-shaped patch of Dacron was made to enlarge the stenotic portion of aorta. Postoperative pressure gradient between the aorta and left ventricle markedly reduced 36 mmHg in comparison with preoperative pressure gradient 150mmHg. The boy was discharged without any event.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.495-498
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• 1995

Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1263-1269
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• 1990

Two patients with uncorrectable cyanotic cardiac anomalies underwent total cavopulmonary shunt[modified Fontan operation]. Case I was a 14 years old male with dyspnea and cyanosis after birth. Aortogram showed TGA combined with overriding of aorta, pulmonary stenosis, complete atrioventricular septal defect, interruption of inferior vena cava, and situs inversus totalis. We had performed total cavopulmonary shunt using with 16 mm Gortex Graft in single atrium to bypass the hepatic vein to pulmonary artery. Postoperatively, patient sustained low PaCO2 and low cardiac output and then expired at 19th postoperative day. The cause of death of the patient would be low cardiac output. Case II was a 6 years old female with dyspnea and cyanosis after birth. Aortogram showed tricuspid atresia[Type IIb], transposition of great arteries, atrial septal defect, ventricular septal defect and pulmonary stenosis, We had performed total cavo-pulmonary shunt using intraatrial baffle[tunnel] with Goretex patch. The postoperative course of this patient was good without event.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.935-938
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• 1995

Two cases of severe caustic injury of the hypopharynx, esophagus, and stomach are presented. Restoration of digestive continuity was accomplished by retrosternal isoperistaltic interposition of the transverse and left colon on the post-injury 73rd and 66th day respectively. The upper oro-colon continuity was made by a cervical approach, a vertical incision at the posterior hypopharyngeal wall, and interrupted one-layer sutures using 3-0 Dacron suture materials. The distal continuity was made by colojejunostomy between the transposed colon and proximal jejunum. There was no event after the operation in both cases. The posterior vertical hypopharyngotomy and hypopharyngocolostomy at the early post-injury period may be the preferred procedure to obtain normal deglutition in patients with esophageal stricture associated with hypopharyngeal injury.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.543-548
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• 1986

Massive air embolism during cardiopulmonary bypass is uncommon but serious and often lethal complication. Following this catastrophic event, the immediate institution of retrograde arterial blood perfusion via superior vena cava was made to remove air emboli from cerebral circulation. This method was performed by removing the arterial perfusion line from aortic cannula and connecting it to superior vena caval cannula. Then, retrograde perfusion at a flow rate of 2Umin via superior vena cava was carried out for 3 minutes. After air returning from the aortic cannula was identified, each line was connected to the cannulae primarily. In 2 cases who had massive air emboli due to air pumping into arterial line, the postoperative complete recovery resulted from this technique, which was used in conjunction with other therapy postoperatively.