• Journal of Pharmacopuncture
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• v.19 no.3
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• pp.197-206
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• 2016

Introduction: This study aims to investigate the effects of acupuncture stimulation on the radial artery's pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties. Methods and analysis: This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz ($SE_{10-30Hz}$) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine. Discussion: The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery. Ethics and dissemination: This study was approved by the Institutional Review Board (IRB) of Kyung Hee University's Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization's (WHO's) Registry Network.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.123-130
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• 2003

Background: In order to develop the acute heart failure model for the animal experiment of the pneumatic ventricular assist device, we decided to use young pig whose coronary artery distribution is almost the same as humans and also very cheap in price. The purpose of this study is to develop stable, reproducible acute ischemic heart failure model in swine using coronary artery ligation method. Material and Method: Five young pigs whose weights are the same as adult humans are under experiment. Each pig was under endotracheal intubation and connected to a mechanical ventilator. Through left lateral thoracotomy, we exposed the heart and induced ischemic heart failure by coronary artery ligation. The ligation began at the distal part of the left anterior descending coronary artery. After 5 minutes of initial ligation we reperfused the artery and then re-ligated. Before and after each ligation-reperfusion procedure we assessed the left ventricular end-diastolic pressure, arterial pressure, and cardiac index. We also measured left ventricular end-diastolic dimension, end-systolic dimension, fractional shortening, ejection fraction using intraoperative epicardial echocardiography. After appropriate heart failure was established with sequential (from distal part of LAD to proximal location) ligation-reperfusion-ligation procedure, we inserted the ventricular assist device and operated. Result: We established stable acute ischemic heart failure in 3 of 5 young pigs with this sequential ligation-reperfusion-ligation procedure, and could maintained 50% less ejection fraction before the procedure according to intraoperative epicardial echocardiography. We also observed no ventricular arrhythmia usually associated with simple coronary artery ligation in large animals and no cardiac arrest associated with ventricular arrhythmia or myocardial stunning. In pathologic specimen, we observed scattered ischemic myocardium in all around the ischemic field induced by coronary artery ligation. Conclusion: Under the concept of ischemic preconditioning, we developed safe and reproducible acute ischemic heart failure model in swine using sequential coronary artery ligation-reperfusion-ligation method.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.329-335
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• 2002

Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.168-179
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• 2007

Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.69-76
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• 1996

Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.101-108
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• 2011

Purpose: Cardiopulmonary resuscitation (CPR) prevents tissue necrosis of the brain and cardiac muscle in the cardiac arrest patient and requires exact skills in order to increase survival rate. Through comparison of the training effects of feedback manikin and non-feedback manikin, this study present the effective CPR device to CPR instructors. Method: This CPR course for 80 students by using Resusci Anne $SkillReporter^{TM}$ (RASR; Laerdal Medical, Stavanger, Norway) and Actar 911 $Squadron^{TM}$ (A911; Vital Signs, New Jersey, USA) held on December 22, 2009. Thirty seven students and two assistants were placed in one laboratory, there were five RASR manikins which provide the LED performance indicator, not the metronome. Forty two students and two assistants were placed in the other laboratory, there were 20 A911 manikins which don't provide any feedback indicator. Chest compression scores and ventilation compression scores obtaining from two groups were analysed statistically by using independent t-test. Results: Chest compression scores, average depth (mm) was 37.5 in RASR and 41.80 A911 (p=.004), too depth (#) was 2.8 in RASR and 19.4 A911 (p=.005), average number per min (#/min) was 64.4 in RASR and 68.2 A911 (p=.038), wrong hand position (#/min) was 10.9 in RASR and 30.8 A911 (p=.040). Four items that showed better scores in group RASR had statistically significant difference. Ventilation compression scores, percent correct (%) was 40.6 in RASR and 20.6 A911 (p<.001), number correct (#) was 4.7 in RASR and 2.1 A911 (p=.002), too fast (#) was 0.9 in RASR and 2.9 A911 (p=.003), average volume (ml) was 536.5 in RASR and 707.1 A911 (p=.011). Also, three items that showed better scores in group RASR had statistically significant difference. Conclusions: Regarding the positive effect of CPR training feedback, comparison between the real-time visual feedback manikin (RASR) and the non-feedback manikin (A911) showed that RASR had better results than A911 in chest compression except average number per min (it means that we need harder chest manikin) and ventilation. Verification of the training effect in the real world such as CPR outcomes is also necessary. A proper application of manikin in training circumstances and research on retention of CPR skills will be needed.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.138-146
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• 2024

Purpose To evaluate whether the image quality of chest radiographs obtained using a camera-type portable X-ray device is appropriate for clinical practice by comparing them with traditional mobile digital X-ray devices. Materials and Methods Eighty-six patients who visited our emergency department and underwent endotracheal intubation, central venous catheterization, or nasogastric tube insertion were included in the study. Two radiologists scored images captured with traditional mobile devices before insertion and those captured with camera-type devices after insertion. Identification of the inserted instruments was evaluated on a 5-point scale, and the overall image quality was evaluated on a total of 20 points scale. Results The identification score of the instruments was 4.67 ± 0.71. The overall image quality score was 19.70 ± 0.72 and 15.02 ± 3.31 (p < 0.001) for the mobile and camera-type devices, respectively. The scores of the camera-type device were significantly lower than those of the mobile device in terms of the detailed items of respiratory motion artifacts, trachea and bronchus, pulmonary vessels, posterior cardiac blood vessels, thoracic intervertebral disc space, subdiaphragmatic vessels, and diaphragm (p = 0.013 for the item of diaphragm, p < 0.001 for the other detailed items). Conclusion Although caution is required for general diagnostic purposes as image quality degrades, a camera-type device can be used to evaluate the inserted instruments in chest radiographs.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.265-270
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• 1976

Implantation of a permanent pacemaker is a widely accepted procedure for the patient with complete heart block.As a result of these device, the prognosis for patients with Adams-Stokes syndrome caused by complete A-V block and other cardiac arrhythmia have become much more optimistic. Permanent pacemaker implantation by means of a transvenous approach has made the operative risk much less and the procedure simpler. However, a number of complications have been reported in the literature regarding transvenous endocardial pacemaker implantation during the last a decade. The patient presented in this paper is a 26-year old girl who was implanted with a permanent pacemaker at 14 years of age because of a congenital A-V block. Following first exchange of pulse generator, the electrode (lead) was fractured, so that by the pulse generator, a change to the transvenous technique of implantation was made, After this, there were episodes of recurrent wound infection on three occasions, even though the site of pulse generator implantation was exchanged to the contralateral side of chest wall, massive doses of antibiotics were administered and sensitivity tests for coagulase positive staphylococcal infection were performed. Though there was no definite evidence of blood stream infection by blood culture, we decided not to use the transvenous technique and not to implant the pulse generator in the chest wall because the venous system and the entire anterior chest wall appeared to be diseased or contaminated by virulent pyogenic organisms. Finally this intractable systemic and local wound infection was successfully controlled by myocardial lead implantation via a subxiphoid approach and implantation of the pulse generator far down in the abdominal wall. The causes and routes of recurrent wound infection and possible blood born infection in this particular patient are still obscure. We strongly believe that myocardial pacemaker implantation is much safer than transvenous endocardial pacemaker implantation & myocardial pacemaker implantation is a definite method for controlling such an intractable wound infection. following transvenous pacemaker implantation.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.21 no.7
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• pp.1379-1385
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• 2017

Virtual training is a kind of training that proceeds as if it were a real situation. In recent years, there has been a growing demand for experiencing a situation in which a virtual reality technology has not been experienced directly in the real world due to the rapid development of the technology. Especially, safety education is very necessary in Korea where safety accidents are caused by many disasters. Therefore, simulation of disaster response training using virtual reality is more urgent than ever. Although the automatic defibrillator is the medical device that is most needed to rescue patients with cardiac arrest, few people know how to use it. Therefore, there are very few cases where the use of automatic defibrillators has saved the patient's life in Korea. The proposed Automated External Defibrillator virtual training system enables immersive and experiential training in real situations and effective training at low cost.

• Progress in Superconductivity
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• v.10 no.2
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• pp.139-143
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• 2009

We have fabricated a low-noise 61-channel axial-type first-order gradiometer system for measuring fetal magnetocardiography(MCG) signals. Superconducting quantum interference device(SQUID) sensor was based on double relaxation oscillation SQUID(DROS) for detecting biomagnetic signal, such as MCG, magnetoencphalogram(MEG) and fetal-MCG. The SQUID sensor detected axial component of fetal MCG signal. The pickup coil of SQUID sensor was wound with 120 ${\mu}m$ NbTi wire on bobbin(20 mm diameter) and was a first-order gradiometer to reject the environment noise. The sensors have low white noise of 3 $fT/Hz^{1/2}$ at 100 Hz on average. The fetal MCG was measured from $24{\sim}36$ weeks fetus in a magnetically shielded room(MSR) with shielding factor of 35 dB at 0.1 Hz and 80 dB at 100 Hz(comparatively mild shielding). The MCG signal contained maternal and fetal MCG. Fetal MCG could be distinguished relatively easily from maternal MCG by using independent component analysis(ICA) filter. In addition, we could observe T peak as well as QRS wave, respectively. It will be useful in detecting fetal cardiac diseases.