• Journal of the Institute of Electronics Engineers of Korea SC
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• v.46 no.6
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• pp.44-49
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• 2009

EAS (electronic article surveillance) systems have increased rapidly for article surveillance. In this paper, the strength of the EMF (electromagnetic fields) of EAS systems were measured. Pacemaker and ICD were investigated for inappropriate response resulting from EM (electromagnetic) EAS systems. The strength of EMF and the response of pacemaker and ICD were measured in the inner left side, outer right sides and the center of gates of the 6.3 kHz and 14.25 kHz EAS systems at a height of 130cm. As the result, EMF of the EAS system using 14.25 kHz was stronger than that of 6.3 kHz. AU interferences were observed only for 14.25 kHz, and the noisy ECG was found in three static positions on the pacemaker. The ICD resulted in noise reversion and VF (ventricular fibrillation) both static and moving positions by the EMP of 14.25 kHz EAS system. Therefore, it is necessary to post a message warning radiation of EMF from every EAS systems and possible risk of pacemakers and ICDs.

• Fire Science and Engineering
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• v.27 no.4
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• pp.61-67
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• 2013

This study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of outof- hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC. The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrest was in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed (4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases, pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call to hospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency medical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-ofhospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.162-168
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• 2012

Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.52-62
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• 1991

The toxic effect of azalea extract, expecially on cardiovascular system, is relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups : In group as preliminary study ; 4cc of normal saline was administered intravenously(N) ; 0.7gm/kg and 1.0gm/kg of azalea extract was administered respectively in the same route, volume(A1, A2) ; atropine was administered intravenously(A) ; after pretreatment with atropine(0.04mg/kg) to block parasympathetic system, azalea extract was injected like the above groups(AA1, AA2) ; normal saline, 0.7gm/kg and 1.0gm/kg of azalea extract were administered respectively with 0.2cc(1 : 1000) epinephrine(E0,E1,E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes : RR interval, QTc interval, maximal systolic and diastolic pressure drop with occuring time and presence of significant arrhythmia. The results were as follows : 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epineprine and Azalea extract was not noted by the effect of epineprine itself. 5. The ST change by 0.7gm/kg, 1.0gm/kg of Azalea extract was revealed in 1 case(14.0%), 7 case(100%), respectively. 6. Most of all cases with arrhthymia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epineprine, except one case by Azalea extract(1.0gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we cann't be absolutely exclusive of actions of autonmic nervous system, especially parasympathetic nervous system.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.659-666
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• 2007

Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.523-529
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• 2002

Background: Previous reports present that the early results of coronary artery bypass grafting (CABG) has been improving with the accumulation of surgical experience. We conducted a retrospective analysis of the patients who received CABG to evaluate the recent results of CABG. Material and Method: Between January 1996 and August 2001, 154 patients underwent CABG at Hanyang University Hospital. There were 47 patients(group I) who were operated between 1996 and 1998, and 107 patients(group II) who were operated thereafter. The preoperative diagnosis, operative procedure, mortality, and complications were analyzed retrospectively. Result: There were 35 males and 12 females in group I, and 78 males and 29 females in group II, which shows similar ratio of sexes between the two groups. The average age of patients for group I and group II was $55.9{\pm}6.2$ years and $61.0{\pm}8.0$ years, respectively, showing a significant increase in group II(p<0.05). The average left ventricular ejection fraction(LVEF) for group I and group II was $54.6{\pm}11.8$% and $56.9{\pm}13.0$%, respectively. The number of patients who had previous MI in group I and group II were 13 patients(27.7%) and 14 patients(13.1%), respectively, which shows a significant difference (p<0.05). All procedures were performed using the cardiopulmonary bypass(CPB) and moderate systemic hypothermia. Myocardial protection was achieved using intermittent hypothermic ischemia under ventricular fibrillation state or cold crystalloid cardioplegic solution for most of group I patients, whereas cold blood cardioplegic solution was used for group II patients. The mean CPB times for group I and group II were $149.2{\pm}48.7$ minutes and $113.1{\pm}30.6$ minutes, respectively. The mean aortic cross clamp times for group I and group II were $81.3{\pm}26.5$ minutes $72.2{\pm}23.9$ minutes, respectively. These figures show that CPB and aortic cross clamp times were significantly reduced in group II(p<0.05). The use of the left internal thoracic artery(LITA) was increased from 42%(20/47) for group I to 81% (87/107) for group II. The mean number of grafts also significantly increased from $2.5{\pm}0.6$ for group I to $3.0{\pm}1.1$ for group II(p<0.05). Intra-aortic balloon pump(IABP) was applied in 7 cases in group I and 17 cases in group II. Of these, 28.6%(2/7) and 52.9%(9/17) were broadly applied preoperatively in patients with LVEF<40% or congestive heart failure. The operative mortalities for group I and II were 10.6%(5/47) and 0.9%(1/107), respectively, which shows significant decrease for group II(p.0.05). Conclusion: This report suggest that CABG using CPB can recently be performed more safely in virtue of the accumulation of surgical experience with reduction in CPB and aortic cross clamp times and improved surgical techniques and myocardial protection. And we think that the optimal treatment of patients with left ventricular dysfunction associated with congestive heart failure and the extended application of IABP, especially have contributed to the reduction of operative mortality and morbidity.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.600-606
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• 2007

Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.680-684
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• 2005

Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1147-1158
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• 1998

Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.475-481
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• 2010

Background: We evaluated mid-term results of mitral annuloplasty using a flexible band and a completely rigid ring for mitral valve repair in patients with degenerative mitral regurgitation (MR). Material and Method: From January 2004 to September 2008, 71 patients (M:F=36:35, $55{\pm}13$ years) underwent mitral valve repair with mitral annuloplasty for degenerative MR. Ring annuloplasty was done using a Cosgrove-Edwards flexible band (Group I, n=43) or a Carpentier-Edwards classic ring (Group II, n=28). There were no differences in preoperative characteristics of the participants. Average duration of follow-up was 36 months (range: 2~69 mos). Result: There was no in-hospital mortality. Postoperative morbidity, which included atrial fibrillation (n=7) and low cardiac output syndrome (n=5) in groups I and II were similar. There was one late death in group II. The proportion exhibiting freedom from recurrent mitral regurgitation ($\geq$moderate) at 4 years in Groups I and II were, respectively, 94.5 and 91.8%, (p=0.695). Left ventricular ejection fraction decreased in the early postoperative period ($7{\pm}2$ days) and recovered by last follow-up ($25{\pm}16$ mos; p=0.002). The pattern was similar in groups I and II (p=0.905). Re-operation was performed in 3 patients (1 in Group I and 2 in Group II, p=0.316). Four-year event-free survival (free of adverse valve-related events) was 95.2% for Group I and 92.6% for Group II; this difference was not significant, p=0.646). Conclusion: The type of technique used in mitral annuloplasty to repair the mitral valve repair after degenerative MR did not affect mid-term clinical and functional results.