• Journal of the Korean Institute of Telematics and Electronics
• /
• v.26 no.2
• /
• pp.132-139
• /
• 1989

We have designed a real-time Cardiac digital substraction angiography system (C-DSA) and tested the system for the diagnosis of Cardiac patients. The system was developed by interfacing a radiographic angiography system to a computerized motional image analysis system. This new cardiac DSA can perform the real time processing of averaging and subtraction of the 32 image frames to measure the volume changes of the left ventricle after elimination of motional artrifacts, caused by the heart contraction of beats per minute in average. Each frame has a resolution of 512 x 512 pixels and 256 gray levels. Two image data with maximal and minimal volume were moved to the interfaced IBM PC computer system by high speed computer link line for computation of the heart's contraction parameters. First, the boundary of the left ventricule was detected using a dynamic programming of the gray levels, and its volume was computered to determine the parameters, such as the maximal volume of end-diastolic volume (EDV), the minimal volume of end systolic volume (ESV), and ejection fraction (EF).

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4843-4846
• /
• 2013

Background: The infusion rate is considered to affect incidence and severity of infusion reactions (IRs) caused by protein formulations. Trastuzumab (TRS) is approved for 90-minute infusion as the initial dose followed by 30-minute infusion with 250 ml saline. In the study, we evaluated the safety of TRS intravenously administered over 30 minutes with 100 ml saline to reduce burden of patients, safety of infusion with 250 ml saline already being established. Materials and Methods: Women with HER2 positive breast cancer, ${\geq}18$ years and ${\geq}55%$ left ventricular ejection fraction (LVEF), were registered in the study. Patients received 8mg/kg of TRS 250 ml over 90 minutes followed by 6mg/kg of TRS 100ml over 30 minutes in a three-week cycle. Results: A total of 31 patients were recruited, 24 for adjuvant therapy and seven with metastases. The median age was 59 years (range 39 to 82). The total number of TRS doses ranged from 5 to 17 with the median of 15. Mild IR occurred in two patients at the first dose. However, no IR was observed after reducing to 100 ml saline. No decrease of LVEF, increase of serum brain natriuretic peptide or any other adverse events were reported. Conclusions: Intravenous infusion of TRS with 100 ml saline over 30 minutes in breast cancer patients can be considered safe based on results from the study. It can be given on an outpatient basis as with the currently recommended dilution in 250 ml saline.

• Investigative Magnetic Resonance Imaging
• /
• v.21 no.1
• /
• pp.20-27
• /
• 2017

Purpose: To evaluate quantification results of single breath-hold (SBH) magnetic resonance (MR) cine imaging compared to results of conventional multiple breath-hold (MBH) technique for left ventricular (LV) function in patients with cardiac arrhythmia. Materials and Methods: MR images of patients with arrhythmia who underwent MBH and SBH cine imaging at the same time on a 1.5T MR scanner were retrospectively reviewed. Both SBH and MBH cine imaging were performed with balanced steady state free precession. SBH scans were acquired using temporal parallel acquisition technique (TPAT). Fifty patients ($65.4{\pm}12.3years$, 72% men) were included. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass, and LV regional wall motion were evaluated. Results: EF, myocardial mass, and regional wall motion were not significantly different between SBH and MBH acquisition techniques (all P-values > 0.05). EDV, ESV, and SV were significant difference between the two techniques. These parameters for SBH cine imaging with TPAT tended to lower than those in MBH. EF and myocardial mass of SBH cine imaging with TPAT showed good correlation with values of MBH cine imaging in Passing-Bablok regression charts and Bland-Altman plots. However, SBH imaging required significantly shorter acquisition time than MBH cine imaging ($15{\pm}7sec$ vs. $293{\pm}104sec$, P < 0.001). Conclusion: SBH cine imaging with TPAT permits shorter acquisition time with assessment results of global and regional LV function comparable to those with MBH cine imaging in patients with arrhythmia.

• The Korean Journal of Nuclear Medicine
• /
• v.17 no.2
• /
• pp.25-33
• /
• 1983

Left ventricular wall motion was observed with EKG gated cardiac blood pool scan in 71 various cardiac diseases and 10 normal controls to evaluate its diagnostic and clinical significance in them. 1) In the presence of left ventricular dysfunction, visual evaluation of the left ventricular wall motion was useful to determine whether it was due to localized or diffuse abnormalities. In cardiomyopathy, marked left ventricular dilatation and severe hypokinesia were noted. 2) In myocardial infarction, regional wall motion abnormalities well represented the location of infarcted areas in majority of cases. Patients with inferior wall infarction had smaller decrease of the left ventricular ejection fraction and wall motion grade than anterior or combined groups. In whom persistent left ventricular failure was present, wall motion analysis with gated cardiac scan provided valuable information for the detection of ventricular aneurysms. 3) Evaluation of the left ventricular wall motion and its grading provided a reliable estimate of the left ventricular function. In conclusion, visual evaluation of left ventricular wall motion and its grading provided valuable information for analyzing the characteristics of regional and global left ventricular dysfunction.

• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.238-241
• /
• 2017

Background: We investigated the difference in right ventricle (RV) volume and ejection fraction (EF) according to the pulmonary valve (PV) annular extension technique during Tetralogy of Fallot (TOF) total correction. Methods: We divided patients who underwent the procedure from 1993 to 2003 into two groups according to PV extension technique (group I: PV annular extension, group II: no PV annular extension) during TOF total correction. We then analyzed the three segmental (RV inlet, trabecular and outlet) and whole RV volume and EF by cardiac magnetic resonance imaging (MRI). Results: Fourteen patients were included in this study (group I: 10 patients, group II: four patients; male: nine patients, female: five patients). Cardiac MRI was conducted after a 16.1 years TOF total correction follow-up period. There was no statistical difference in RV segmental volume index or EF between groups (all p>0.05). Moreover, the total RV volume index and EF did not differ significantly between groups (all p>0.05). Conclusion: The RV volume and EF of the PV annular extension group did not differ from that of the PV annular extension group. Thus, PV annular preservation technique did not show the surgical advantage compared to PV annular extension technique in this study.

• Biomedical Science Letters
• /
• v.17 no.2
• /
• pp.113-122
• /
• 2011

Several studies have reported a relation between serum levels of uric acid and a wide variety of cardiovascular conditions. But, the relationship between serum levels of uric acid and coronary artery disease (CAD) is still controversial. The present study was retrospectively designed to investigate whether CAD can be stratified by the level of uric acid and there are the relationships between preoperative levels of uric acid and perioperative biochemical markers in fifty-adult patients that underwent coronary artery bypass grafting surgery (CABG) and twenty-normal subjects. They were divided into the control, the unstable angina (UA-group) and the myocardial infarction group (MI-group). In preoperative levels of uric acid, the MI-group was higher than control and the UA-group. The MI-group had significantly higher correlations than the UA-group between preoperative levels of uric acid and left ventricular ejection fraction, cardiac markers (creatine kinase, lactate dehydrogenase and brain natriuretic peptide), renal markers (blood urea nitrogen and creatinine) or total leukocyte levels. At postoperative periods, the MI-group had higher relationships of uric acid with aspartate aminotransferase, blood urea nitrogen or creatinine levels. Although there was not statistically significant, the UA-group tended to have higher correlation coefficients than the MI-group between preoperative levels of uric acid and intensive care unit-stay (ICU), or postoperative mechanical ventilation time. These results reflect that increased levels of serum uric acid may be a tool for the diagnosis of coronary heart disease and may be considered as a good predictor in assessing the cardiac and renal functions in patients with myocardial infarction or unstable angina at the preoperative period. However, further studies should be performed in a large patient population.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.63-68
• /
• 1996

Background; Epidural analgesia for controlling labor pain has recently gained world-wide popularity. However, many patients scheduled for continuous epidural analgesia voice concern over harmful effects to their fetus and other possible complications such as hemodynamic changes, back pain and neurologic sequelae etc. The aim of this study was to evaluate the hemodynamic changes with and without epidural block as a measure to determine the safety of epidural analgesia during labor and delivery. Methods: Twenty healthy subjects were divided equally into two groups(Group 1 without epidural block, and Group 2 with epidural block) and serial hemodynamic measurements were taken in all subjects with transcutaneous impedence cardiography. The epidural catheter was inserted at the level of $L_{3,4}$ in Group 2 and analgesia was maintained using 0.25% bupivacaine mixed with fentanyl. Results: Cardiac output increased slightly with cervical dilatation in both groups, but no significant differences were found between the two groups. Similarly, no significant differences were found in blood pressures between the two groups. Stroke volume and end-diastolic volume indices were slightly decreased in group 1 and slightly increased in group 2. However, there were no significant differences between the two groups. The ejection fraction was nearly constant and ranging 56~59%. Conclusion: We concluded epidural analgesia for labor and delivery is a safe technique for the parturients since results indicated no significant differences in hemodynamic changes, as compared to the control group.

• Journal of Chest Surgery
• /
• v.30 no.6
• /
• pp.613-616
• /
• 1997

We present a case of 58-year-old (tamale with dilated cardiomyopathy(DCMP) in whom we performed left ventricular(LV) remodeling surgery(Batista operation) to reduce the left ventricle diameter and improve left ventricular unction. The patient was admitted September 1996 with heart failure NYHA class IV. There was severe orthopnea and peripheral edema. 2-D echocardiography(Echo) showed DCMP with the ejection fraction(EF) I5%, LV end diastolic dimension(LVEDD) 80mm, mitral regurgitation(MR) grade IV, tricuspid regurgitation ('m) grade ll. Preoperative cardiac output(CO) was 1.5/L/min and cardiac index(Cl) was 1.0 L/min/m2. We proceeded with LV remodeling surgery by resection a part of LV lateral wall between both papillary muscle, from the mitral annulus to the LV apex. Size of resected LV wall was 90 $\times$ 100 $\times$ 15 mm. At the mean time, mitral valve and tricuspid valve were repaired. Postoperative 2-D Echo showed the EF 37%, LVEDD 50 mna, trivial MR, no TR. CO was 3.SL/min and Cl was 2.3 L/min/m2. Her fuctional NYHA class was 1.

• Journal of Chest Surgery
• /
• v.34 no.4
• /
• pp.322-328
• /
• 2001

배경: 우심실 유출로 재건술후에는 폐동맥판막부전이 우심실기능에 나쁜 영향을 미친다. 이를 막기 위해 여러 재료로 판막을 제조하여 사용하는데 가피 형성이 적은 막형 ePTEE(expanded polytetrafluoroethylene, Goretex) 단엽판막의 효과를 알아보고자 연구를 시행하였다. 대상 및 방법; 1996년 3월부터 1997년 2월까지 우심실유출로 재건술을 시행받고 수술 1일까지 우심실 압력을 측정할 수 있었던 47명중 막형 Goretex단엽판막을 사용한 환자(비교군) 19명, 사용하지 않은 환자(대조군) 28명에서 단엽판막의 유용성을 조사하였다. 두 군간에는 나이, 체중 그리고 McGoon ratio 등에는 통계학적 차이가 없었다.(p>0.05) 이전의 수술은 대조군에서 19번, 비교군에서 22번을 시행하였다. 우심실 유출로에 대한 수술은 대조군에서 REV수술 2예, 우심실폐동맥 연결수술 8예, 우심실 유출로 재개건술 2예, 우심실 유출로에 대한 수술은 대조군에서 16예였으며, 비교군에서는 REV 수술 5예, Rastelli 씨 수술 6예, 재우심실 유출로 재건술 5예, 그리고 우심실 재건술 3예였다. 결과: 대동맥 차단 시간이나 총심폐순환시간에는 두군간의 차이는 없었다. 또한 수술직후와 수술후 1일째 측정한 우심실 압력 및 좌심방압력의 차이도 두군간에는 차이가 없었으며 수술후 7일째 시행한 심에코도 결과 ejection fraction., 우심실/ 좌심실 압력비 , 그리고 우심실 유출로의 압력차, 강심제 투여일수, 호흡기 사용 기간 등에서도 두군간의 차이는 없었으나 흉관 삽입기간이 비교군에서 의미있게 짧았다. 추적 조사 기간 중 비교군 1예에서 사망을 하였으나. Goretex 단엽판막에 의한 것은 아니였으며 심초음파검사상 우심실 유출로 압력차이나 재수술은 두군간에 차이는 없었으나 폐동맥 폐쇄부전은 비교군에서 의미 있게 낮은 것을 보이고 있다. 결론; 막형 Goretex 단엽판막의 조기성적은 우수하였으며 폐동맥 폐쇄분전의 정도를 적게 하는 효과를 보이나 앞으로 이들이 성장함에 따라 우심실 유출로에 폐쇄를 일으키는지는 계속적인 추적관찰이 요구된다.

• Journal of Chest Surgery
• /
• v.49 no.1
• /
• pp.9-14
• /
• 2016

Background: Tetralogy of Fallot (TOF) is a well-recognized congenital heart disease. Despite improvements in the outcomes of surgical repair, the optimal timing of surgery and type of surgical management of patients with TOF remains controversial. The purpose of this study was to assess outcomes following the repair of TOF in infants depending on the surgical procedure used. Methods: This study involved the retrospective review of 120 patients who underwent TOF repair between 2010 and 2013. Patients were divided into three groups depending on the surgical procedure that they underwent. Corrective surgery was done via the transventricular approach (n=40), the transatrial approach (n=40), or a combined atrioventricular approach (n=40). Demographic data and the outcomes of the surgical procedures were compared among the groups. Results: In the atrioventricular group, the incidence of the following complications was found to be significantly lower than in the other groups: complete heart block (p=0.034), right ventricular failure (p=0.027) and mediastinal bleeding (p=0.007). Patients in the atrioventricular group had a better postoperative right ventricular ejection fraction (p=0.001). No statistically significant differences were observed among the three surgical groups in the occurrence of tachycardia, renal failure, and tricuspid incompetence. The one-year survival rates in the three groups were 95%, 90%, and 97.5%, respectively (p=0.395). Conclusion: Combined atrioventricular repair of TOF in infancy can be safely performed, with acceptable surgical risk, a low incidence of reoperation, good ventricular function outcomes, and an excellent survival rate.