• Journal of Chest Surgery
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• v.45 no.5
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• pp.301-307
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• 2012

Background: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. Materials and Methods: One hundred and thirteen patients (male:female=35:78, mean age=$66.7{\pm}9.9$ years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. Results: Sixty-five patients (47.5%) received the RBC transfusion (mean $2.2{\pm}3.2$ units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (<75 minutes) and total operation time (<5.5 hours, p <0.05). Conclusion: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.421-429
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• 2021

Objective: The purpose of this study was to examine the effect of personalized complex aerobic training programs using wearable device on cardiovascular and respiratory functions in community based female elderly. Design: One group pre-post intervention study. Methods: Twenty-one older female participants lived in 'D' city were included. The personalized complex aerobic training program using wearable devices was applied to all participants for 4 weeks, 3 times a week, 30 minutes for per session. The participants' blood pressure, heart rate, oxygen saturation, respiration rate, submaximal exercise stress test, pulmonary function test and respiratory muscle strength test were evaluated before and after the complex training program. Results: After intervention, resting diastolic blood pressure, resting systolic blood pressure and the systolic blood pressure after submaximal exercise stress test were significantly decreased over time (p<0.05), and the submaximal exercise stress test duration were significantly increased over time (p<0.05). The maximal inspiratory pressure (MIP) was significantly increased compare to before the intervention (p<0.05). Conclusions: This study showed that personalized complex training program using wearable device can provide personalized exercise intensity according to cardiopulmonary function that give feedback, and these interventions have a significant effect on improving the cardiovascular and respiratory system functions of the female elderly in the community dwelling.

• Journal of Chest Surgery
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• v.52 no.2
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• pp.78-84
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• 2019

Background: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of $6.8{\pm}5.4years$ (4.2 years). Methods: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. Results: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial b leeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5-78.5) to 31.0 (25.7-37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63-2.00) to 0.50 (0.50-1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. Conclusion: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.140-147
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• 2021

Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

• Journal of Veterinary Science
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• v.23 no.4
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• pp.53.1-53.9
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• 2022

Background: Problems associated with using inhalational anaesthesia are numerous in veterinary anaesthesia practice. Decreasing the amount of used inhalational anaesthetic agents and minimising of cardiorespiratory disorders are the standard goals of anaesthetists. Objective: This experimental study was carried out to investigate the sparing effect of intravenous tramadol, lidocaine, dexmedetomidine and their combinations on the minimum alveolar concentration (MAC) of sevoflurane in healthy Beagle dogs. Methods: This study was conducted on six beagle dogs. Sevoflurane MAC was determined by the tail clamp method on five separate occasions. The dogs received no treatment (control; CONT), tramadol (TRM: 1.5 mg kg^-1 intravenously followed by 1.3 mg kg^-1 h^-1), lidocaine (LID: 2 mg kg^-1 intravenously followed by 3 mg kg^-1 h^-1), dexmedetomidine (DEX: 2 ㎍ kg^-1 intravenously followed by 2 ㎍ kg^-1 h^-1), and their combination (COMB), respectively. Cardiorespiratory variables were recorded every five minutes and immediately before the application of a noxious stimulus. Results: The COMB treatment had the greatest sevoflurane MAC-sparing effect (67.4 ± 13.9%) compared with the other treatments (5.1 ± 25.3, 12.7 ± 14.3, and 40.3 ± 15.1% for TRM, LID, and DEX treatment, respectively). The cardiopulmonary variables remained within the clinically acceptable range following COMB treatment, although the mean arterial pressure was higher and accompanied by bradycardia. Conclusions: Tramadol-lidocaine-dexmedetomidine co-infusion produced a remarkable sevoflurane MAC-sparing effect in clinically healthy beagle dogs and could result in the alleviation of cardiorespiratory depression caused by sevoflurane. Cardiorespiratory variables should be monitored carefully to avoid undesirable side effects induced by dexmedetomidine.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.374-386
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• 2023

Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

• Journal of Ginseng Research
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• v.48 no.4
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• pp.405-416
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• 2024

Background: Hypoxic pulmonary hypertension (HPH) is the main pathological change in vascular remodeling, a complex cardiopulmonary disease caused by hypoxia. Some research results have shown that ginsenoside Rg1 (Rg1) can improve vascular remodeling, but the effect and mechanism of Rg1 on hypoxia-induced pulmonary hypertension are not clear. The purpose of this study was to discuss the potential mechanism of action of Rg1 on HPH. Methods: C57BL/6 mice, calpain-1 knockout mice and Pulmonary artery smooth muscle cells (PASMCs) were exposed to a low oxygen environment with or without different treatments. The effect of Rg1 and calpain-1 silencing on inflammation, fibrosis, proliferation and the protein expression levels of calpain-1, STAT3 and p-STAT3 were determined at the animal and cellular levels. Results: At the mouse and cellular levels, hypoxia promotes inflammation, fibrosis, and cell proliferation, and the expression of calpain-1 and p-STAT3 is also increased. Ginsenoside Rg1 administration and calpain-1 knockdown, MDL-28170, and HY-13818 treatment showed protective effects on hypoxia-induced inflammation, fibrosis, and cell proliferation, which may be associated with the downregulation of calpain-1 and p-STAT3 expression in mice and cells. In addition, overexpression of calpain 1 increased p-STAT3 expression, accelerating the onset of inflammation, fibrosis and cell proliferation in hypoxic PASMCs. Conclusion: Ginsenoside Rg1 may ameliorate hypoxia-induced pulmonary vascular remodeling by suppressing the calpain-1/STAT3 signaling pathway.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5943-5949
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• 2012

This study aimed to identify the effects of Basic Life Support course for healthcare providers on the knowledge and attitude of the health science college students. The study was a quasi-experimental design with a non-equivalent pre-post test. The subjects included 140 health science college students from a D college in D city. BLS course for healthcare providers was given to the experimental group from August 3 to August 29, 2010. The knowledge and attitude of cardiopulmonary resuscitation were measured. The data were analyzed with ${\chi}^2$ test, Fisher's exact test, independent t-test, paired t-test and ANCOVA using the SPSS/PC 12.0 win. For the CPR knowledge, a significant increase was observed in the experimental group (F=47.227, p<.001). For the CPR attitude, the experimental group were significantly increased compared to the control group (F=40.204, p<.001). The study showed that BLS Course for Healthcare Providers has positive effects on CPR knowledge and attitude for the health science college students. Subject related to CPR through the division of health science needs to be recommended and systemic and standard educational programs should be developed.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.29-37
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• 2005

This study was prospectively designed to determine the physiologic effects of normothermic CPB and to compare its influences with hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for el­ective cardiac surgery were randomly assigned to moderate hypothermic (hypothermic group nasopharyngeal tem­perature $26\~28^{\circ}C,\;n=18)$ ornormothermic (normothermic group, nasopharyngeal temperature > $35.5^{\circ}C\;n=18)$ CPB. Arterial blood samples were taken before CPB (Pre-CPB), 10 minutes after the start of CPB (CPB-10), and imme­diately after CPB stop (CPB-off) for determining total leukocyte counts, neuron-specific enolase (NSE), interleukin-6 (IL-6), endothelin-1 (ET-1), cortisol, troponin I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, blood urea nitrogen (BUN), and the pulmonary index $(Pi,\;PaO_{2}/FiO_{2}),$Other parameters such as urine output, mechanical ventilating period, ICU-staying period, postoperative complications and hospitalized days were also evaluated. Result: Total leukocyte counts, increased rate in NSE, in IL-6 and in cortisol at CPB-10 and CPB-off were significantly higher in normothermic group than in hyphothermic group. Urine output during CPB was lower in normothermic group than in hyphothermic group. The duration of mechanical ventilation, ICU-stay, and hospitalization were longer in normothermic group than in hyphothermic group. Conclusion: These findings sug­gested that normothermic CPB caused higher inflammatory and stress responses than hypothermic CPB during car­diac surgery using cold crystalloid cardioplegia. However, further studies with large number of cases should be carried out to validate this hypothesis.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.471-478
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• 1997

Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.