• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.237-244
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• 2017

During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

• International Journal of Heart Failure
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• 제6권1호
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• pp.1-10
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• 2024

Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

• 대한흉부심장혈관외과학회:학술대회논문집
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• 대한흉부외과학회 1996년도 제 28차 추계학술대회 및 총회 대한흉부외과학회
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• pp.21-21
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• 1996

• International Journal of Vascular Biomedical Engineering
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• 제1권2호
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• pp.36-41
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• 2003

Both flow visualizations and computational fluid dynamics were performed to determine hemodynamics in a total cavopulmonary connection (TCPC) model for surgically correcting congenital heart defects. From magnetic resonance images, an anatomically correct glass model was fabricated to visualize steady flow. The total flow rates were 4, 6 and 8L/min and flow rates from SVC and IVC were 40:60. The flow split ratio between LPA and RPA was varied by 70:30, 60:40 and 50:50. A pressure-based finite-volume software was used to solve steady flow dynamics in TCPC models. Results showed that superior vena cava(SVC) and inferior vena cava(IVC) flow merged directly to the intra-atrial conduit, creating two large vortices. Significant swirl motions were observed in the intra-atrial conduit and pulmonary arteries. Flow collision or swirling flow resulted in energy loss in TCPC models. In addition, a large intra-atrial channel or a sharp bend in TCPC geometries could influence on energy losses. Energy conservation was efficient when flow rates in pulmonary branches were balanced. In order to increase energy efficiency in Fontan operations, it is necessary to remove a flow collision in the intra-atrial channel and a sharp bend in the pulmonary bifurcation.

• The Korean Journal of Physiology
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• 제20권2호
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• pp.175-183
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• 1986

Since it was proposed that vanadate may be an ‘ideal endogenous regulator of the $Na^+,\;K^+-ATPase$ activity (Cantley et at, 1979), vanadate has been a subject of intensive research and a variety of its physiological effects have been described (Nechay, 1984). In isolated guinea pig heart muscle vanadate shows a positive inotropic effect on ventricular muscle, while it induces a negative inotropic effect on atrial muscle. But its underlying mechanism has not been elucidated so far. Therefore, in this study the flux rates of calcium ion into and from guinea pig heart muscle were measured to throw some light on the underlying mechanism, because those rates have been known to be closely related to the cardiac contractility and the results are summarized as follows: 1) Calcium efflux rates from the intracellular $Ca^{++}$ pool (compartment 4) of both guinea pig left atrium and right ventricle were significantly reduced by vanadate and their pool sizes were significantly increased by vanadate. 2) The magnitude of calcium influx into left atrium was reduced by vanadate, While the magnitude of calcium influx into right ventricle was not affected by vanadate. From these results, it may be concluded that the positive inotropic effect of vanadate on the ventricular muscle was due to a reduced efflux rate of calcium ion and its negative inotropic effect on atrial muscle was resulted from a reduced influx of calcium ion.

• The Korean Journal of Physiology
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• 제13권1_2호
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• pp.1-12
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• 1979

To evaluate the present status of physical fittness of Korean long distance runners, body fat, pulmonary functions, maximal oxygen intake and oxygen debt were measured in 5 elite marathoners (A group), 6 college student runners (B group) and 3 middle school student runners (C group). After laboratory tests, full course marathon running was performed in 2 elite marathoners during which their heart rates were monitored continuously. The results are summerized as follows: 1) Total body fat in all three groups are in the range of 13-15% of their body weight. 2) In all three groups, average values of various pulmonary functions were within the normal limits, but those of tidal volume were higher and respiratory rate were lower in comparison to normal values. These phenomena may represent respiratory adaptations against training. The average resting oxygen consumptions in A,B and C were $322{\pm}23$, $278{\pm}14$ and $287{\pm}16$m1/min, respectively. 3) In all three groups, resting blood pressures were in the normal range, but the resting heart rate was slightly lower in groups A $(56{\pm}3\;beats/min)$ and B $(64{\pm}2\;beats/min)$ and higher in group C $(82{\pm}9\;beats/min)$ in comparison to normal values. These changes in cardiovascular functions in marathoners may also represent adaptive phenomena. 4) During treadmill running the minute ventilation and oxygen consumption of the runners increased lineally with work load in all three groups. When the oxygen consumption was related to heart rate, it appeared to be a exponential function of the heart rate in all three groups. 5) The average maximal heart rates during maximal work were $196{\pm}3$, $191{\pm}3$ and $196{\pm}5\;beats/min$ for groups A,B and C, respectively. Maximal oxygen intakes were $84.2{\pm}3.3\;ml/min/kg$ in group A, $65.2{\pm}1.1\;ml/min/kg$ in group B and $58.7{\pm}0.4\;ml/min/kg$ in group C. 6) In all three groups, oxygen debts and the rates of recovery of heart rate after treadmill running were lower than those of long ditsance runners reported previously. 7) The 40 km running time in 2 elite marathoners was recorded to be $2^{\circ}42'25'$, and their mean speed was 243 m/min (ranged 218 to 274 m/min). The heart rate appeared to increase lineally with running speed, and the total energy expenditure during 40 km running was approximately 1360.2 Calories. From these it can be speculated that if their heart rates were maintained at 166 beats/min during the full course of marathon running, their records would be arround $2^{\circ}15'$. Based on these results, we may suspect that a successful long distance running is, in part, dependent on the economical utilization of one's aerobic capacity.

• Asian-Australasian Journal of Animal Sciences
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• 제18권8호
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• pp.1176-1181
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• 2005

This study investigated the effects of restricted suckling (RS) on some physiological and behavioural stress parameters compared to temporal weaning (TW). Twenty Brahman (Bos indicus) cow-calf pairs were assigned to one of two groups: Calves in the RS group were limited to suckle their dams once daily for 30 min during days 30 to 33, while calves in the TW group were removed from their dams during days 59 to 62 postpartum. Heart and respiratory rates, serum cortisol concentration and body temperature were registered in cows and calves. In addition, the number of steps was also registered in calves. All parameters were recorded 24, 48 and 72 h after the beginning of the two treatments, respectively. In TW calves, higher (p<0.05) cortisol concentration and number of steps were recorded in the 1st samples and 1$^{st}$ and 2$^{nd}$ observations, respectively. No difference was found in body temperature between treatments. However, respiration and heart rates differed in the 1$^{st}$ and 2$^{nd}$ observations, respectively. In general, a significant decrease (p<0.05) in these three parameters was observed over time. In cows, no differences were found in cortisol concentration or body temperature between treatments or with time. Heart and respiratory rates were lower (p<0.05) in the TW treatment only 24 h after beginning of treatment. It was concluded that (a) RS resulted in less behavioural and physiological indices of distress compared to TW in calves, although in general, differences were found only in some variables, mainly during the 1$^{st}$ day following start of the treatment, and there in a chance of age effects. (b) Cows were less affected than their young, regardless of the treatment applied.

• 전자공학회논문지SC
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• 제38권5호
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• pp.59-69
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• 2001

최근에 디지털 선호처리와 전자부품의 발달로 심음 분식에 관한 많은 연구가 진행되고 있다. 그러나 심음 인식, 특히 심음 한주기 전체에 대한 인식연구는 거의 없다. 본 논문에서 심음 전체 한주기에 대한 새로운 인식 방법을 제안하였다. 먼저 주성분 분석을 이용하여 훈련 셋트로 데이터베이스를 구축한다. 데이터베이스는 새로운 심음입력을 인식하는데 이용된다. 심음은 정상심음, 수축전 심잡음, 수축초기 심잡음, 수축 말기 심잡음, 이완 초기 심잡음, 이완 말기 심잡음， 연속적 심잡음으로 분류된다. 실험결과 새로운 인식 방법은 심음의 특징을 인식하는데 효과적이었다. 최대 인식률은 NO의 경우 71%, PS와 ES의 경우 80%, LS의 경우 78%, ED의 경우 87%, LD의 경우 60%, CM의 경우 20% 이었다. 현재의 결과가 실제적으로 심음을 인식하기에는 충분하지 못하였지만 선음 전체 주기를 대상으로 한 연구라는데 의의가 있으며 더 효과적인 데이터베이스를 구축함으로써 인식률을 개선할 수 있다.

• 한국정보전자통신기술학회논문지
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• 제2권3호
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• pp.23-29
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• 2009

심박수는 심장이 혈액을 전신에 보낼 때에 고동치는 속도, 즉 매 분당 박동수를 말하 며 성인남자의 경우 보통 1분동안 60~80회가 정상적이다. 심박수가 정상보다 적으면 서맥, 많으면 빈맥이라 하며 이 경우 여러 가지 질병에 걸릴 수 있으며 상황에 따라 사망에 이르기까지도 한다. 따라서 심박수는 건강한 생활에 매우 중요한 역할을 하고 있다. 본 연구에서는 ECG를 통하여 심박수를 자동 추출하는 방법에 관하여 연구하였다. 육안으로 측정한 심박수를 기준으로 첫째 ECG를 2차 미분을 이용하여 심박수를 추출하는 방법과 자기상관함수를 이용하여 심박수를 추출한 방법으로 구한 심박수를 비교하여 고찰 하였다. 실험 데이터는 MIT/BIH Database를 이용하였다.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.24.1-24.15
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• 2023

Background: The construction workers are vulnerable to fatigue due to high physical workload. This study aimed to investigate the relationship between overwork and heart rate in construction workers and propose a scheme to prevent overwork in advance. Methods: We measured the heart rates of construction workers at a construction site of a residential and commercial complex in Seoul from August to October 2021 and develop an index that monitors overwork in real-time. A total of 66 Korean workers participated in the study, wearing real-time heart rate monitoring equipment. The relative heart rate (RHR) was calculated using the minimum and maximum heart rates, and the maximum acceptable working time (MAWT) was estimated using RHR to calculate the workload. The overwork index (OI) was defined as the cumulative workload evaluated with the MAWT. An appropriate scenario line (PSL) was set as an index that can be compared to the OI to evaluate the degree of overwork in real-time. The excess overwork index (EOI) was evaluated in real-time during work performance using the difference between the OI and the PSL. The EOI value was used to perform receiver operating characteristic (ROC) curve analysis to find the optimal cut-off value for classification of overwork state. Results: Of the 60 participants analyzed, 28 (46.7%) were classified as the overwork group based on their RHR. ROC curve analysis showed that the EOI was a good predictor of overwork, with an area under the curve of 0.824. The optimal cut-off values ranged from 21.8% to 24.0% depending on the method used to determine the cut-off point. Conclusion: The EOI showed promising results as a predictive tool to assess overwork in real-time using heart rate monitoring and calculation through MAWT. Further research is needed to assess physical workload accurately and determine cut-off values across industries.