• Journal of Chest Surgery
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• 제49권6호
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• pp.427-434
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• 2016

Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2007년도 춘계학술대회B
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• pp.2941-2946
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• 2007

A model of the cardiovascular system coupling cell, hemodynamics and autonomic nervecontrol function is proposed for analyzing heart mechanics. We developed a comprehensive cardiovascular model with multi-physics and multi-scale characteristics that simulates the physiological events from membrane excitation of a cardiac cell to contraction of the human heart and systemic blood circulation and ultimately to autonomic nerve control. Using this model, we delineatedthe cellular mechanism of heart contractility mediated by nerve control function. To verify the integrated method, we simulated a 10% hemorrhage, which involves cardiac cell mechanics, circulatory hemodynamics, and nerve control function. The computed and experimental results were compared. Using this methodology, the state of cardiac contractility, influenced by diverse properties such as the afterload and nerve control systems, is easily assessed in an integrated manner.

• Journal of Chest Surgery
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• 제50권5호
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• pp.399-402
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• 2017

We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.

• Journal of Chest Surgery
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• 제46권1호
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• pp.60-62
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• 2013

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.

• 한국소음진동공학회논문집
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• 제26권6_spc호
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• pp.674-679
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• 2016

According to the conventional studies on the noise and cardiovascular effect, railway noise is better associated with hypertension and adverse cardiovascular events than road traffic noise. But the underlying mechanisms remain unclear. We investigated the hypothesis that exposure to acute railway noise would the unfavorable effect of cardiovascular and autonomic system in healthy young subjects. Using a randomized, sham-controlled cross-over design, ten subjects were assigned to receive either an exposure to high speed train noise (84 dB) for 30 minutes or a control condition (non noise), separated by two days. Blood pressure, heart rate, augmentation index and heart rate variability as indices of cardiovascular and autonomic system function were measured at baseline, during, and recovery from two trials. The results show that exposure to acute railway noise significantly increased diastolic blood pressure and augmentation index, which may cause of adverse cardiovascular effects.

• Physical Therapy Rehabilitation Science
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• 제10권4호
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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.

• 한국응용과학기술학회지
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• 제40권6호
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• pp.1340-1349
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• 2023

Despite its profound impact on athletic performance, the significance of heart rate recovery (HRR) has been insufficiently addressed in the filed of sports science, particularly in the context of weightlifting characterized by brief and intense exertions involving heavy weights. Serving as a valuable indicator of autonomic nervous system and cardiovascular function, HRR assumes a pivotal role in weightlifting. This comprehensive review aims to delineate the specific demands for HRR in weightlifting, shedding light on the often overlooked cardiovascular considerations within training regimes focused on strength and power. The investigation scrutinizes the repercussions of HRR on weightlifting performance, seeking to elucidate how inadequate recovery intervals may result in physiological and psychological consequences. These consequences encompass a distorted perception of effort, disruption of coordination, compromised posture due to irregular breathing, and an overall decline in lifting capacity. The review systematically presents compelling evidence pertaining to heart rate response and recovery patterns during weightlifting, underscoring the critical importance of well-structured rest periods. Furthermore, the review delves into a comprehensive discussion of factors influencing HRR in weightlifting, encompassing variables such as sex, age, cardiovascular function, hydration, nutrition, and psychological aspects. Finally, a key emphasis is placed on the integration of effective HRR techniques into the training regimens of weightlifters, thereby ensuring sustained and optimized performance outcomes.

• Journal of Cardiovascular Imaging
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• 제31권4호
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• pp.191-199
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• 2023

BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.

• Journal of Cardiovascular Imaging
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• 제31권2호
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• pp.98-104
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• 2023

BACKGROUND: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT). METHODS: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|. RESULTS: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups. CONCLUSIONS: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.

• 대한한방내과학회지
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• 제26권2호
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• pp.353-359
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• 2005

Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.