• Journal of Chest Surgery
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• v.51 no.2
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• pp.109-113
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• 2018

Background: Low cardiac output syndrome (LCOS) after cardiac surgery usually requires inotropes. In this setting, critical illness-related corticosteroid insufficiency (CIRCI) may develop. We aimed to investigate the clinical features of CIRCI in the presence of LCOS and to assess the efficacy of steroid treatment. Methods: We reviewed 28 patients who underwent a rapid adrenocorticotropic hormone (ACTH) test due to the suspicion of CIRCI between February 2010 and September 2014. CIRCI was diagnosed by a change in serum cortisol of <$9{\mu}g/dL$ after the ACTH test or a random cortisol level of <$10{\mu}g/dL$. Results: Twenty of the 28 patients met the diagnostic criteria. The patients with CIRCI showed higher Sequential Organ Failure Assessment (SOFA) scores than those without CIRCI ($16.1{\pm}2.3$ vs. $11.4{\pm}3.5$, p=0.001). Six of the patients with CIRCI (30%) received glucocorticoids. With an average elevation of the mean blood pressure by $22.2{\pm}8.7mm\;Hg$ after steroid therapy, the duration of inotropic support was shorter in the steroid group than in the non-steroid group ($14.1{\pm}2.3days$ versus $30{\pm}22.8days$, p=0.001). Three infections (15%) developed in the non-steroid group, but this was not a significant between-group difference. Conclusion: CIRCI should be suspected in patients with LCOS after cardiac surgery, especially in patients with a high SOFA score. Glucocorticoid replacement therapy may be considered to reduce the use of inotropes without posing an additional risk of infection.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1117-1123
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• 1988

Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.594-598
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• 2002

Amiodarone is an iodinated benzofuran derivative that has been proved effective in the control of supraventricular and ventricular arrhythmias refractory to other antiarrhythmic drugs. In patients treated with amiodarone, subsequent surgical intervention is a common clinical scenario, but unfortunately we do not have definite data about complications due to amiodarone after cardiac surgery. Some reports have shown that amiodarone treatment can be associated with a state of $\alpha$-adrenergic and $\beta$-adrenergic receptor blockade, which requires more pacing and epinephrine infusion for perioperative hemodynamic support. And some reports have also identified a severe form of ARDS in patients on amiodarone therapy which was associated with siginificant morbidity and mortality. We exprienced a patient who expired after mitral valve replacement due to amiodarone-induced ARDS; therefore, we report this case with a brief literature.

• Fashion & Textile Research Journal
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• v.20 no.2
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• pp.219-225
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• 2018

The purpose of this study is to make an ideal dummy for adult Maltese with proper investigation of its character and direct measurement of dog body-shape. The results of the study are as follows; First, there were 6 factors to affect the characteristics of Maltese body in the analysis, which are size of body, leg shape, chest shape, leg thickness, body length, length between fore-legs. In the cluster analysis with the 6 factors there were two types of Maltese body. Type 1 has body characteristics with large body, thick leg, and small distance between front legs. Type 2 has average size of all factors including body size, leg thickness, and length between fore-legs. Second, type 2 was selected as a representative one to make a dummy reflected body shape of characteristics because it took 67.71% from entire considered factors and has average value in the measured size. The first dummy pattern was planned by copying the surface area of the representative body shape with the method of surgical tape. A dummy of single body with trunk and legs was made using 30's cotton cloth, polyester inside batting, compressed form PVC and metallic wire on the joint of trunk and legs to support dummy shape. The second pattern was made by correcting size difference of the pattern and adding the pattern of neck covering plate, metal magnetic button was inserted on the center of joint area of trunk and legs to make detachable legs for easy slip on and off the pet's wear.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.247-252
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• 1997

Ten acute and chronic in vivo studies were utilized to develop a pneumatic ventricular assist device (VAD) as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial funct on after cardiac surgery. Two sizes of blood pump of 70cc for adult patients and 34cc for pediatric patients were implanted in the animals. Ventricle of the blood pump was made from the polyurethaae to enhance antithrombogenecity. The VAD was implanted between the left atrium and the descending aorta. Average flow rate was 2.38 L/min for adult and 0.41 L/min for pediatric VAD at the rate of 60 bum. The duration of support ranged from 1 to 26 hours. The most frequent complication was bleeding. Main causes of death were heart failure and respiratory failure. The device function was good for short term use. Studies to date suggest that, with further refinement, a reliable long term VAD that will have clinical application can be developed.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.20-27
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• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

• Journal of Multimedia Information System
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• v.6 no.4
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• pp.293-302
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• 2019

In the past, there was a theory that influenza wasn't transmitted directly from birds but was infected to humans via swains. Recently, molecular level research has progressed, and it was confirmed that the avian influenza virus can directly infected to human lung and intestinal epithelial cells. Three pandemicsin the past 100 years were also infected to humans directly from birds. In view of such scientific background, we are developing a method for screening sick birds by monitoring the physiological characteristics of birds in a contactless manner with sensors. Here, the movement of respiratory muscles and abdominal muscles under autonomic innervation was monitored using a magnet and Hall sensor sewn on the thoracic wall, and other multimedia devices. This paper presents and discusses the results of experiments involving continuous periodic noise discovered during flight experiments with a data logger mounted on a Japanese pheasant from 2012 to 2015. A brief summary is given as the below: 1. Magnet and Hall sensor sewn to the left and right chest walls, bipolar electrocardiograms between the thoracic walls, posterior thoracic air sac pressure, angular velocity sensors sewn on the back and hips, and optical reflection of LEDs (blue and green) from the skin of the hips allow observation of periodic vibrations(fasciculations) in the waves. No such analysis has been reported before. 2. These fasciculations are presumed to be derived from muscle to maintain and control air sac pressure. 3. Since each muscle fiber is spatially Gaussian distributed from the sympathetic nerve, the envelope is assumed to plot a Gaussian curve. 4. Since avian trunk muscles contract periodically at all time, we assume that the sympathetic nerve dominates in their control. 5. The technique of sewing a magnet to the thoracic wall and measuring the strength of the magnetic field with a Hall sensor can be applied to screen for early stage of avian influenza, with a sensor attached to the chicken enclosure.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.381-386
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• 2015

Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

• The Research Journal of the Costume Culture
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• v.21 no.1
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• pp.81-92
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• 2013

Many women feel pain in their breasts while running due to an excessively large degree of breast movement. Therefore, most sports bras pursue a reduction in breast movement. The purpose of this study is to investigate the breast movement reduction effect of a selection of sports bra designs according to the intensity of the sport and the breast size of the wearer. The study measured differences in the vertical movement of the nipple with 4 types of sports bras and 3 exercise speeds(4km/h, 7km/h, and 10km/h). Subjects included women in their 20s with bra sizes of either B cup(n=3) or C cup(n=3). The results of the study are as follows. Breast movement differed according to running speed and breast size; breast movement significantly increased starting with jogging speed(7km/h), and the C-cup group had a larger degree of vertical movement than the B-cup group. A superior effect on breast movement during jogging(7km/h) and sprinting(10km/h) was observed differently by bra cup sizes. To C-cup group, encapsulation-style sports bra, which provides horizontal support across the upper breast and padding inside the shoulder strap and bra cup to ease impact was most effective and next effective style was the compression-style bra with a princess line to cover the breasts solidly. Most style sports bra were effective in the B-cup group. Besides aforementioned encapsulation-style sports bra, the compression-style bra with a band, which presses the breasts against the chest wall, reduced breast movement effectively.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1254-1260
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• 1992

Rupture of the posterior left ventricular wall following mitral valve replacement is a rare but fatal complication. Over a 10 year period from August 25 1980 to November 27 1990, we have experienced 6 such patients among 884 cases of mitral valve replacement with 4 deaths and 2 survivors. One patient had a type I rupture and another a type II rapture with the remaining four patients having suffered type III ruptures. All of the ruptures were dis covered intraoperatively enabling prompt reinstitution of the cardiopulmonary bypass and subsequent cardioplegic arrest prior to repair. Overzealous removal of calcified valve leaflets seemed to be responsible for the single type I rupture, and untethering of the so called ventricular loop appeared to be the main mechanism responsible for the type III ruptures. The single type II rupture that had occurred seemed to have been caused by inadvertent laceration of the papillary muscle with resultant rupture of the posterior LV wall at the base of the papillary muscle. Among the type III ruptures, 2 patients required intraaortic balloon pump[IABP] support only for mechanical assistance and 1 patient required both the IABP and the Biomedicus LV assist device for successfull weaning following repair of the LV rupture Another patient with a type II rupture also required the circulatory assistance of both the IABP and the bio-medicus LV assist device for weaning from the bypass. Attention to meticulous technical considerations such as avoiding over aggressive removal of heavily calcified valvular tissue, preservation of as much mural leaflet tissue and chordal stuctures as possible seemed helpful in preventing this catastrophic complication from occurring. Fusion and fibrous stricture of the chordal structures appeared particularly conducive to the type II ruptures as a result of the increased susceptibility to papillary injury during operation.