Kim, Joo Yeon;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
Journal of Chest Surgery
/
v.49
no.4
/
pp.258-263
/
2016
Background: The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position. Methods: This is a retrospective study of 33 patients (>20 years old) who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years) and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months). Results: Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were $80.0%{\pm}7.3%$ and $60.8%{\pm}10.1%$, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were $92.3%{\pm}5.2%$, $68.9%{\pm}10.2%$, and $50.3%{\pm}13.6%$, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were $91.7%{\pm}8.0%$, $41.7%{\pm}14.2%$, and $25.0%{\pm}12.5%$, respectively. Conclusion: Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis.
Ko, Yousang;Shin, Jeong Hwan;Lee, Hyun-Kyung;Lee, Young Seok;Lee, Suh-Young;Park, So Young;Mo, Eun-Kyung;Kim, Changhwan;Park, Yong Bum
Tuberculosis and Respiratory Diseases
/
v.80
no.1
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pp.27-34
/
2017
Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days). Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.
Journal of the Institute of Electronics Engineers of Korea SC
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v.45
no.3
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pp.59-67
/
2008
Due to the fast increase in cellular phone users, public interest on health effect of electromagnetic fields(EMFs) by cellular phonos is gradually increasing. Some EHS(electromagnetic hypersensitivity) patients complain of psycho-neurophysiological symptoms such as headaches, insomnia, memory loss resulting from RF radiation by CDMA cellular phones. However, EHS is difficult to diagnose and depends on the individual's subjective judgement. And we don't know clearly if the cause of EHS is uneasiness or real exposure. There have been various EHS volunteer studies on heart rate, blood pressure and subjective symptoms using GSM phones. But there are few studies on experimental case-control study investigating physiological parameters, subjective symptoms, and perception of EMFs. In this study, two volunteer groups of 17 self-declared EHS and 19 controls were exposed to both sham and real RF exposure by CDMA cellular phones for half an hour each. We investigated not only the physiological parameters such as heart rates, respiration rates and HRVs(hear rate variability), but also the perception of EMFs and subjective symptoms. As the results, EMF exposure did not have any effects on the subjective symptoms or physiological parameters for both groups. For the EMF perception, there was no evidence that EHS group perceived the EMFs correctly than the control group.
Journal of Korean Academy of Fundamentals of Nursing
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v.6
no.2
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pp.240-254
/
1999
The purpose of this study was to investigate the effect of exercise therapy and relaxation therapy on catecholamine and heart rate in people in white color jobs and to determine this information the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for stress patients. The subjects were divided into an exercise therapy group, a relaxation therapy group, and control group and the research design was a nonequivalent control group pretest-post test design(exercise therapy : n= 12, relaxation therapy : n=12, control group, the group without any treatment in exercise on relaxation therapy : n=12), The subjects in the exercise therapy group were given a particular intensity for each kp during 30min, bicycle ergometer which is using an LX PE training system before & after 4weeks of training. The exercise therapy that was used was Astrard load method which tested absolute exercise load of heart rate before & after four weeks, and resting heart rate was tested for exercise and relaxation therapy before, after four weeks, and at eight weeks. The results of each kp & absolute exercise load were calculated with the target rate formula(maximal heart rate-rest heart rate) x exercise intensity(%) + rest heart rate so the subjects could continue 60-70% exercise intensity for exercise therapy over eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy were trained at the following intensity for eight weeks(3times/week, 30min/day) to see changes in catecholamine & heart rates. After eight weeks, statistical analysis of exercise & relaxation therapy were carried out Two-way ANOVA and multiple range test(SNK : Student Newman Keul) were used. The results are as follows : 1. The change of epinephrine & norepinephrine in the exercise therapy, relaxation therapy, and control group was statistically significant at the .05 level after four weeks & eight weeks. Also, exercise therapy was statistically significant at .05 level over that of the control group after 4weeks. 2. The change of heart rate in relaxation therapy was statistically significant at the .05 level, and was statistically significant at the .05 level over that of the exercise therapy and control group. In conclusion, it is obvious that exercise therapy and relaxation therapy should be one of the most effective stress treatment and desirable nursing interventions methods for job stress in people in white color jobs.
High potassium cardioplegia is a widely accepted procedure to enhance myocardial protection from ischemic injuries associated with open heart surgery. Maintaining optimum osmolarity of the cardioplegic solution is one of the required conditions for an ideal cardioplegic solution Albumin is an frequently added component for maintaining optimum osmolarity of clinically used cardioplegic solutions. But the source of albumin is human blood so that the supply is limited and the cost of manufacturing is relatively high. Recently there are moves to minimized the use of blood product for fear of blood-associated infections or immunological disorders. In this experiment, we substituted mannitol or glucose for albumin added to the cardioplegic solution which has been used at the Wonju Medical College, To determine whether addition of mannitol or glucose instead of albumin in the cardioplegic solution can produce satisfactory myocardial protection during ischemia, three different groups of isolated rat heart perfused by modified Langendorff technique were studied. Wonju Cardioplegic Solution was selected as a standard high potassium[18mEq/L of K+] cardioplegic solution. Three kinds of cardioplegic solution were made by modifying the composition maintaining the same osmolarity[339$\pm$1mOsm/Kg] Isolated rat heart were perfused initially with retrograde nonworking mode and then changed to working mode. After measuring the heart rate, systolic aortic pressure, aortic flow, coronary flow, ischemic arrest by aorta cross clamp and cardioplegia was made maintaining the temperature of water jacket at 10oC. The heart was rewarmed and reperfused after 60min of ischemic arrest with intermittent cardioplegia at the 30min interval. The time to return of heart beat and the time required to get. Regular heart beat were observed after reperfusion. The recovery rate of the functional variables-heart rate, systolic aortic pressure, aortic flow, coronary flow and cardiac output were calculated and compared among the three groups of different cardioplegia-albumin, mannitol, and glucose. The wet weight and dry weight was measured and the water content of the heart as figured out for comparison. The time to return of heart beat was fastest in the albumin group, The functional recovery rates were best in the albumin group also. In the above conditions, albumin was the best additive to the cardioplegic solution compared to the mannitol or glucose.
Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
Journal of Chest Surgery
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v.49
no.6
/
pp.427-434
/
2016
Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.
Objective : Distal anterior cerebral artery (DACA) aneurysms are fragile and known to have high risks for intraoperative premature rupture and a relatively high associated morbidity. To improve surgical outcomes of DACA aneurysms, we reviewed our surgical strategy and its results postoperatively. Methods : A total of 845 patients with ruptured cerebral aneurysms were operated in our hospital from January 1991 to December 2005. Twenty-three of 845 patients had ruptured DACA aneurysms which were operated on according to our surgical strategy. Our surgical strategy was as follows; early surgery, appropriate releasing of CSF, appropriate surgical approach, using neuronavigating system, securing the bridging veins, using temporary clipping and/or tentative clipping, meticulous manipulation of aneurysm, and using micro-Doppler flow probe. Twenty of 23 patients who had complete medical records were studied retrospectively. We observed the postoperative radiographic findings and checked Glasgow Outcome Scale score sixth months after the operation. Results : Nineteen DACA aneurysms were clipped through a unilateral interhemispheric approach and one DACA aneurysm was clipped through a pterional approach. Postoperative radiographic findings revealed complete clipping of aneurysmal neck without stenosis or occlusion of parent arteries. In two patients, a residual neck of aneurysm was visualized. Seventeen patients showed good recovery, one patient resulted in moderate disability, while 2 patients died. Conclusion : With our surgical strategy it was possible to achieve acceptable surgical morbidity and mortality rates in patients with DACA aneurysms. Appropriate use of tentative clipping, temporary clipping and neuro-navigating systems can give great help for safe approach and clipping of DACA aneurysm.
The experimental study for extracorporeal preservation of the heart-lung preparation by autoperfusion system was performed in 10 dogs. Under intravenous Pentothal endotracheal anesthesia bilateral thoracotomies were performed. A 24F cannula connected to a plastic reservoir bag located 100 cm above the level of the heart was introduced into the aortic arch. Left subclavian, innominate artery, and descending aorta were ligated and divided. Both vena cavae were ligated and divided after the bag was half filled with blood. A 24F catheter inserted into right atrium and connected to the plastic bag in order to keep constant the preload. The thoracic trachea was intubated and the lungs were ventilated. The heart-lung preparations were removed en bloc and floated in a $34^{\circ}C$ bath of Hartmann solution. The preparations were observed for from 2 hours to 8 hours, with the average of 5.2 hours. Hemodynamic and hematologic variables were measured during preharvest and autoperfusion. The pH revealed severe respiratory alkalosis due to very low $PaCO_2$ during autoperfusion ; $PaO_2$ remained constant for 130-140 mmHg; $A-aDO_2$ increased markedly. The static inspiratory pressure [SIP] at late autoperfusion [6hr] increased significantly as compared with at early autoperfusion [2hr]. There was no difference between white blood cell counts from right atrium and those of left atrium. Heart rates remained constant for 110-120/min; cardiac outputs maintained to approximately 0.6L/min; mean aortic pressures, 75 mmHg; mean pulmonary arterial pressures, 15-18 mmHg; mean right atrial pressures, 9-13 mmHg; mean left atrial pressures, 12 mmHg lower than those of right atrium. Serum Na maintained with normal range during autoperfusion; K increased significantly; Ca decreased progressively. Hemoglobin and hematocrit decreased significantly during autoperfusion. The study demonstrated that stable hemodynamics could be maintained throughout the experiment and the preparation of the lung seemed to be inadequate, especially after 3-4 hours, such as high $A-aDO_2$, increased SIP, and scattered atelectasis and edema in their gross appearances.
Repetitive movement, inadequate working posture, overuse of force, physical contact with sharp edge, vibration and temperature were well known risk factors of WMSDs (Work-related Musculoskeletal Disorders). Many researchers have investigated the relationship between inadequate working postures and incidences of WMSDs of the upper extremities, whereas relatively few researchers have tried to evaluate workload associated with the lower-body postures. The effects of lower-limb postures including various knee flexion angles on the subjective discomfort, heart rate and EMG of lower-limb muscles were investigated in this study. Thirty graduate students were asked to maintain thirteen different body postures, and heart rate and EMG data of five muscle groups (electro spine, biceps femoris, vastus medialis, gastrocnemius and tibialis anterior) from each posture were collected during fifteen minutes sustaining tasks. All participants were also asked to report their discomfort ratings of body parts. Results showed that high subjective discomfort ratings and heart rates were reported at the postures of knee angles of $60^{\circ}$ and $90^{\circ}$, whereas low discomfort ratings were founded at the postures of chair heights with 20cm, 40cm, and sitting with crossed legged. The change of median frequency for each muscle group during fifteen minutes tasks was investigated for each body posture to evaluate the relationship between muscle fatigue and body posture. It was found that the trends of changes of median frequency were different based on muscle group as well as lower-limb body posture from this study.
Kim, Ji-Hwan;Kim, Byoung-Soo;Park, Seong-Sik;Lee, Yong-Jae;Keum, Na-Rae;Bae, Hyo-Sang
Journal of Sasang Constitutional Medicine
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v.28
no.2
/
pp.123-131
/
2016
Objectives We observed what effects of Paced Breathing(PB) in specific respiration rate have on heart rate variability (HRV) according to Sasang Constitution.Methods HRV of 72 healthy participants in sitting position was recorded while they carried out usual breathing, 0.2Hz, 0.1Hz, and 0.05Hz PB each 5 minutes in consecutive order. Five minute of relaxation was permitted between each breathing. Finally, HRV indices were statictically analyzed of 32 participants (SOEUM: 11, SOYANG: 10, TAEEUM: 11) after data out of accord with respiration rate or outliers were excluded.Results and Conclusions According to respiration rates, there was no statistical significance of HRV among Sasang Constitution. Regardless of Sasang Constituion, 0.2Hz PB increased mean heart rate and decreased natural logarithmic low frequency(lnLF) oscillation of HRV without the change of natural logarithmic high frequency(lnHF), while 0.1Hz PB increased lnLF and standard deviation of N-N interval(SDNN), and slightly decreased lnHF without the change of mean heart rate. 0.05 Hz PB also showed the same effect as 0.1Hz PB, but was impracticable.
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