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The Study on Electrocardiographic Changes after Mitral Valvular Replacement (승모판막 수술에 따른 심전도 변화)

  • Yeo, Seung-Dong;Im, Seung-Pyeong
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.421-427
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    • 1991
  • Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

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Coronary Artery Bypass Rrafts in Two Renal Transplanted Patients (신장이식환자의 관상동맥우회로술 -2례 보고-)

  • Jin, Ung;Yoon, Jeong-Seob;Jo, Keon-Hyon;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.48-51
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    • 1994
  • Doing CABG in patient with renal transplantation requires special concern to keep and preserve renal function safely during and after operation. We experienced two cases of CABG for treatment of myocardial ischemia. who underwent renal transplantation 2 and 3 years ago respectively. The first patient received single reversed saphenous vein graft at LAD and second one received double saphenous vein graft at LAD and OMI. Peri & postoperative urinary volume and renal function test were comparable with preoperative status in both cases. Although abnormal lipid metabolism due to long term use of immunosuppressive regimen act a causative role in development and progression of coronary artherosclerosis in renal transplantation patient, CABG can be done safely with some precaution including maintenance of adequate mean blood pressure and blood level of immunosupressive regimen during cardiopulmonary bypass.

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Estimating Human Exposure to Benzo(a)pyrene through Multimedia/Multiroute Exposure Scenario (다매체/다경로 노출을 고려한 benzo(a)pyrene의 총 인체 노출량 예측)

  • Moon Ji Young;Yang Ji Yeon;Lim Young Wook;Park Seong Eun;Shin Dong Chun
    • Environmental Analysis Health and Toxicology
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    • v.18 no.4
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    • pp.255-269
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    • 2003
  • The objective of this study was to estimate human exposure to benzo (a)pyrene through multimedia/multi-pathway exposure scenario. The human exposure scenario for benzo(a)pyrene was consisted of 12 multiple exposure pathways, and the multipathway human exposure model based on this scenario constituted. In this study, the multipathway human exposure model was used to estimate the concentrations in the exposure contact media, human intake factors and lifetime average daily dose (LAD $D_{model}$) of benzo(a)pyrene in the environment. Sensitivity analysis was performed to identify the important parameters and Monte-Carlo simulation was undertaken to examine the uncertainty of the model. The total LAD $D_{model}$ was estimated to be 5.52${\times}$10$^{-7}$ mg/kg-day (2.06${\times}$10$^{-7}$ -8.65${\times}$10$^{-7}$ mg/kg-day) using the multipathway human exposure model. The inhalation dose accounted for 78% of the total LADD, whereas ingestion and dermal contact intake accounted for 20.2% and 1.8% of the total exposure, respectively. Based on the sensitivity analysis, the most significant contributing input parameter was benzo (a)pyrene concentration of ambient air. Consequently, exposure via inhalation in outdoor/indoor air was the highest compared with the exposure via other medium/pathways.

Development of Message Oriented Middleware for Operational Flight Program in Avionics (항공전자 비행운영프로그램을 위한 메시지 기반 미들웨어 개발)

  • Kim, Jong-Moon;Kim, Ki-Il
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.2
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    • pp.299-305
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    • 2016
  • It is require to design the next generation avionics system while considering applicability under open architecture where standerd communication module is used. In this situation, if the existing schemes cannot guarantee new requirement, new system development is demanded. In this paper, we present design, implementation, and testing procedure for message based middleware to support operational flight program on avionics. System architecture include mission computer (MC) and large area display (LAD) over standard socket communication based on reliable Ethernet. Finally, experimental results demonstrate that the proposed middleware can guarantee real-time with 20msec as well as reliability requirements with no lost packet.

Blood Compatibility of Hollow Fiber Membranes Treated by Plasma Polymerization (플라즈마 중합 처리된 중공사 막의 혈액 적합성)

  • Lee, Sam-Cheol;Kwon, O-Sung
    • Membrane Journal
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    • v.15 no.3
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    • pp.233-240
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    • 2005
  • Surface modification of polypropylene hollow fiber membranes was performed in order to develop blood-compatibility biomaterials for use in the blood contacting surfaces and oxygenation membranes of a lung assist device (LAD), important medical device even more useful. Blood compatibility of materials was determined by using anticoagulation blood and evaluating formation of blood clots on their surfaces as well as activation of plasma coagulation cascade, platelet adhesion, and aggregation. It was verified that the number of platelets on the silicone coated fibers was significantly lower than that on untreated fiber membrane, indicating improved blood compatibility. It was also found that the polypropylene hollow fiber membranes using plasma treatment exhibited suppression of complement activation in blood compatibility test.

Echocardiographic Findings after Mitral Valve Replacement (승모판막치환수술 전후 심장초음파 소견의 변화에 관한 연구)

  • 이상진
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.656-663
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    • 1994
  • Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

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Minimally Invasive Coronary Artery Bypass without Extracorporeal Circulation - One case report - (심폐바이패스없이 제한적 전흉부개흉술로 시행한 관상동맥우회술 1례)

  • 서필원;김삼현;이상민;김영권;박이태
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1263-1266
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    • 1996
  • We have experienced a case of coronary artery bypass surgery without extracorporeal circulation through limited anterior thoracotomy. The lesion was a single vessel disease involving the take off of the left anterior descending artery(LAD) which showed tubular lesion with irregular contour and eccentric stenosis of more than 95% luminal narrowing. Percutaneous transluminal coronary angioplasty(PTCA) seemed to have moderate success rate and moderate complication rate. A segment of left internal mammary artery(LIMA) from the second rib down to the sixth rib was harvested through the bed of resected fourth costal cartilage. Anastomosis between LIMA and LAD was performed under beating condition. The patient was extubated in the operation room and showed excellent postoperative course without complications. The coronary angiography on the postoperative 7th day revealed good patency at the anastomosis site.

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Effectiveness of MDCT for the Followup of CABG Patients with LIMA to LAD and Saphenous Veins to Others (좌내흉동맥과 복재정맥편을 사용한 관상동맥우회로술 환자에서의 추적조사에서 MDCT의 유용성)

  • Kang Joon Kyu;Kim Hyung Tai;Park In Duk;Chung Young Mi;Lee Cheol Joo
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.410-414
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    • 2005
  • There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.

An Experimental Study on the Detection of Loosened Areas in a Ground cavity Using a Micro Penetration Test (초소형 관입시험기를 이용한 지반공동 주변지반의 이완영역탐지를 위한 실험적 연구)

  • Kim, Ho-Youn;Kim, Young-Ho;Park, Yoon-Suk;You, Seung-Kyong;Han, Jung-Geun
    • Journal of the Korean Geosynthetics Society
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    • v.18 no.4
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    • pp.299-306
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    • 2019
  • In this study, a model experiment that simulates the behaviour of the ground composed of several compacted layer was intended to measure the loosened area in the event of a ground cavity through a LAD (Loosened area detector). It was confirmed that the size of the cone diameter was affected by the ground composed of fine grain + granulated soil layered through the model soil. In order to select the appropriate cone type, a scale effect experiment was conducted. From the test results, a micro-cone was chosen for the most suitable indoor model experiment. In the case of applying LAD in this study, the loosening condition of the ground was determined by the rapid change in penetration resistance caused by the difference in the boundary surface and relative density due to the compaction of the ground for indoor model testing. The range of loosened area occurring in the cavity was estimated through the penetration resistance characteristics on the ground, and the failure area was identified through the reduction rate of penetration resistance in the loosening area.

Quantitative Analysis of Thallium-201 Myocardial Tomograms (Thallium-201 심근 단층영상의 정량적 분석)

  • Kim, Sang-Eun;Nam, Gi-Byoung;Choi, Chang-Woon;Choi, Kee-Joon;Lee, Dong-Soo;Sohn, Dae-Won;Ahn, Cu-Rie;Chung, June-Key;Lee, Myoung-Mook;Lee, Myung-Chul;Park, Young-Bae;Choi, Yun-Shik;Seo, Jung-Don
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.165-176
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    • 1991
  • The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age $55{\pm}7$ yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the % stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the "myocardial ischemic score" (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD ($\geq50%$ coronary stenosis by angiography) by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel deseases. Overall sensitivity was 97%. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70% for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCX lesions (kappa : 0.32). There were siginificant correlations between the MIS and SDE in LAD (rs=0.56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0.0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.

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