• Journal of Chest Surgery
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• v.11 no.4
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• pp.422-427
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• 1978

Alterations in the serum and urine potassium were studied in twenty patients who underwent open heart surgery in National Medical Center during the period from Jan.1978 to June 1978. There were twelve cases congenital heart disease and eight acquired heart disease. Rigg-Kyvsgaad mark IV roller pump and Polystan bubble oxygenator were used in all patients. Hemodilution was carried out by priming the oxygenator with Hartmann`s solution. Measurements were made of the serum electrolyte, gas analysis and twenty four hour urine electrolytes. During the bypass, the serum potassium decreased Significantly from 4.2?.47 to 3.6?. 72 mEq. per liter. [p<0.05] Fifty seven miliequivalant of potassium chloride were added during operation-urine potassium was higher in the diuretic group than in the non diuretic group. Plasma potassium level in the diuretic group was more significantly reduced than nondiuretic group. In this series large amount of urine potassium loss was noted on the day of operation, the first and second post operative day.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.203-210
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• 1988

The clinical experience with the activated clotting time[A.C.T.] for the control of heparin and protamine therapy during cardiopulmonary bypass in 40 patients between April, 1987 and September, 1987 is reviewed retrospectively. All of patients used with cold blood potassium cardioplegia for myocardial protection under standard cardiopulmonary bypass, priming and perfusate techniques respectively. This study was divided into 2 groups of patients followed by cardiopulmonary bypass time. Twenty patients, within 60 minutes of cardiopulmonary bypass time[group A] were compared with twenty patients, from 60 to 120 minutes of cardiopulmonary bypass time[group B]. Using blood cardioplegia for myocardial protection, Author observed wide variation of A.C.T. in individual response to initial heparinization[2mg /kg] and no requirement of additional heparin during cardiopulmonary bypass until 120 minutes. Total heparin amount during cardiopulmonary bypass was not related to body weight and body surface area in the both groups. After cardiopulmonary bypass, amounts of protamine for neutralization of heparin were more required in group B.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.281-288
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• 1983

Heparinization is an essential step in extracorporeal circulation for open heart surgery. But wide individual variation to heparin effect sometimes makes it difficult to anticoagulate safely or neutralize appropriately. Because the conventional set protocol of heparinization did not consider this individual variation, a new method of control of heparinization was proposed by Dr. Brian Bull in 1974. We compared the group in which a conventional set protocol was used [Control group] with the other in which a new protocol modified from that of Bull was used [ACT group], on the aspects of the dosages of heparin and protamine administered and postoperative bleeding. Our conventional protocol [Control group] consisted of: 1. Initial heparin was given at dose of 350U/Kg into the right atrium prior to bypass. 2. Additional heparin was given every hour during E.C.C., as much as a half of the Initial dose. 3. 600U of heparin was mixed into every 100ml. of priming solution. 4. The protamine dose was calculated by totalling the units of heparin given to the patient and giving 1 .8mg. of protamine per 100 units of heparin. ACT protocol [ACT group] consisted of: 1. Initial heparinization was same as that of conventional protocol. 2. ACT`s were checked before [A point] and 10 minutes after initial heparinization [B point]. With these 2 points, a dose response curve was drawn. 3. Heparin for the priming solution was same as in control group. 4. Every 30 minutes during E.C.C., ACT`s were checked with Hemochron [International Technidyne Corp.]. ACT between 450 and 600 seconds was regarded as safety zone. If ACT checked at a time was below 450 seconds, heparin dose was calculated on the dose-response curve to lengthen ACT to 480 seconds and was given into the oxygenator. 5. About 10 minutes before the term of E.C.C., ACT was checked to estimate the blood heparin level at the time. Then, protamine dose was calculated at dose of 1.Stag per 100 units of heparin. The calculated dose of protamine was mixed into 50 to lO0ml of 5% Dextrose Water and dripped intravenously during the period of 15 minutes. Compared these two groups mentioned above, results were obtained as follows: 1. Mean value of normal ACT checked with Hemochron on 30 preoperative patients was 124 seconds [range 95-145 sec.]. 2. Doses of heparin and protamine given to the patient were decreased in ACT group as much as 32.2% and 62.2% respectively. 3. Postoperative bleeding and transfusion were also decreased in ACT group in 60.5% and 67.1% respectively. 4. Our modified dose-response curve did not cause any problems in the control of heparinization. 5. Initial heparinization [Heparin 350U/Kg] was sufficient for the most patients until 60 minutes under extracorporeal circulation. 6. We used 1.5mg of protamine to neutralize 100 units of heparin. But smaller dose of protamine may be sufficient for appropriate neutralization.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.37 no.2
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• pp.134-140
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• 1992

Carrot(Daucus carota L.) seeds (CV Danver 126) were primed and then separated by density differences to improve both the percentage and time of radicle emergence. Seeds for priming were soaked in aerated distilled water for 2 days (water imbibed), 25% solution of polyethylene glycol(PEG) 6000 for 6 or 10 days, salt solution of 0.2M KNO$_3$＋0.1M $K_2$HPO$_4$ for 6 or 10 days, or mixed with Agro-Lig with 90% moisture content for 6 days and 70% moisture content for 6 or 10 days (SMP) at 2$0^{\circ}C$, respectively. The greatest embryo growth and the highest radicle emergence were observed from the seeds treated SMP with 90% moisture content for 6 days among the primed treatments. After the SMP treatment, the seeds were separated into density classes with a float-sink procedure using aqueous solution of Maltrin 600 with 0.02/cm$^3$ density increments. The lower density classes of the carrot seeds, the more embryo growth, the higher and the faster rates of radicle emergence were exhibited in order from 1.06 to 1.14 density classes of the carrot seeds treated SMP.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.1-9
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• 1976

The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.53-61
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• 1999

Newley developed dentin bonding system which contains self-etching primer performed the removing of smear layer and etching procedure at once. So, it make possible more simple and shorter working time, the stronger bonding strength than conventional dentin bonding system. Cavities were prepared in the buccal and lingual surface of 30 extracted primary molars, and randomly assigned into three equal groups of 10 each. All cavities were filled with Z-100 composite resin following manufacturer's specifications after priming of three different dentin bonding system. Specimens stored for 7 days in 37 degree C water, thermocycled for 1000 cycles between 5 degree C and 55 degree C, immersed in 50% silvernitrate solution for 24 hours, and embedded in resin before being sectioned longitudinally. Data were analyzed by t-test and ANOVA. Mac-Bond II and Clearfil Linear-Bond II showed less microleakage at the occlusal and gingival margins compared to Scotchbond Multi Purpose. All dentin bonding systems showed significantly less microleakage at the occlusal margins compared to the gingival margins. But, there were no significantley difference between each group.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.921-926
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• 1989

The Free fatty acid [FFA] induced massive erythrocyte crenation has been reported in patients undergoing extracorporeal circulation[EGG], suggesting that the crenated cells impair microcirculatory flow and tissue oxygenation during and after the operation. Effect of albumin administration on erythrocyte crenation was examined in 24patients undergoing open heart surgery at the department of Thoracic and Cardiovascular Surgery in the Kyung Hee University Medical Center Between January, 1989 and August, 1989: 8 patients of 24 patients [group A] were given 50 gm albumin, another 8 patients of 24 patients [group B] were g en 26 gm of albumin and the other 8 patients of 24 patients [group C] were not given any albumin as a part of the priming solution. Erythrocyte crenation was almost completely prevented in the patients given 50 gm albumin. Crenated erythrocytes d urging ECC were 3.6* 0.4 % [mean\ulcornerD] of all erythrocytes and 3.1*0.6% after ECC. This was significantly lower than in patients without albumin administration [64.2*9.5% during ECC and 28.7*1.9% after ECC]. But the effect was less striking in the patients given 25 gm albumin, 37.8* 12.0 % during ECC and 27.8*3.9 % after ECC. Maintaining an adequate level of plasma albumin is important in preventing erythrocyte crenation during ECC, improving microcirculatory flow in patients undergoing open heart surgery.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.240-245
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• 1988

This study was prospectively planned to realize the reduction of calcium ion in serum along with the cardiopulmonary bypass[CPB], to find out the cause of the reduction, and to verify the justification of the classical methods of calcium replacement. Nine patients with various open heart surgeries by CPB in 1987 wee selected at random. Calcium chloride was added as follows:: For each unit of ACD blood transfusion, 600mg of calcium chloride was added. In case of massive transfusion, 600 mg of calcium chloride was injected every 2 or 3 units of transfusion. On occasions such as weaning from CPB, or following defibrillation, or hypotension, weak myocardial contractility of the heart, calcium chloride was needed in an amount of 10 mg / kg. In ICU, calcium chloride was limited to use in low serum level or in emergency use. Total calcium decreased early bypass and progressively increased above the preoperative value during late bypass and three hours thereafter, Ionized calcium increased during late bypass and three hours following. Total and ionized calcium depicted similar patterns of change during open heart surgery. Decrease of the calcium at the early bypass was thought from reduction of total protein and alkalosis during bypass. Meanwhile, increase of both calciums during the end of surgery was presumably attributable to addition of calcium chloride in priming solution, injections of calcium chloride in the process of termination of bypass. We conclude that enough calcium was replaced by the classical methods of calcium supplement.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.46 no.4
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• pp.321-324
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• 2001

Tobacco seeds (Nicotiana tabacum L. cv KF109) were primed in the polyethylene glycol 6000(PEG) solution and then stored at 5 and $25^{\circ}C$ under 40, 60 and 80% relative humidity (RH) conditions for six months. The effect of storage temperature and humidity on mean germination time ($T_{50}$), longevity and germination of the primed tobacco seeds were compared. Untreated seeds (control) stored at $5^{\circ}C$ showed high germinability throughout the entire storage period and humidity, and a decline in germinability showed after 6 months at 60% RH and after 3 months at 80% RH when stored at $25^{\circ}C$, Primed seeds retained high germinability until 6 months at 60% RH and 3 months at 80% RH when stored at $5^{\circ}C$ but showed a significant decline in germinability after 3 months at 40% RH, and 1 months at 60% and 80% RH, respectively when stored at $25^{\circ}C$, Primed seeds were completely lost viability when stored at $25^{\circ}C$ under 60% RH for 6 months and under 80% RH for 3 months.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.473-479
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• 2009

Background: Retrograde autologous priming (RAP) is known to be useful in decreasing the need of transfusions in cardiac surgery because it prevents excessive hemodilution due to the crystalloid priming of cardiopulmonary bypass circuit. However, there are also negative side effects in terms of blood conservation. We analyzed the intraoperative blood-conserving effect of RAP and also investigated the efficacy of autotransfusion and ultrafiltration as a supplemental method for RAP. Material and Method: From January 2005 to December 2007, 117 patients who underwent isolated coronary artery bypass operations using cardiopulmonary bypass (CPB) were enrolled. Mean age was 63.9$\pm$9.1 years (range 36$\sim$83 years) and 34 patients were female. There were 62 patients in the RAP group and 55 patients in he control group. Intraoperative autotransfusion was performed via the arterial line. RAP was done just before initiating CPB using retrograde drainage of the crystalloid priming solution. Both conventional (CUF) and modified (MUF) ultrafiltrations were done during and after CPB, respectively. The transfusion threshold was less than 20% in hematocrit. Result: Autotransfusions were done in 79 patients (67.5%) and the average amount was 142.5$\pm$65.4 mL (range 30$\sim$320 mL). Homologous red blood cell (RBC) transfusion was done in 47 patients (40.2%) and mean amount of transfused RBC was 404.3$\pm$222.6 mL. Risk factors for transfusions were body surface area (OR 0.01, 95% CI 0.00 $\sim$ 0.63, p=0.030) and cardiopulmonary bypass time (OR 1.04, 95% CI 1.01 $\sim$ 1.08, p=0.019). RAP was not effective in terms of the rate of transfusion (34.5% vs 45.2%, p=0.24). However, the amount of transfused RBC was significantly decreased (526.3$\pm$242.3ml vs 321.4$\pm$166.3 mL, p=0.001). Autotransfusion and ultrafiltration revealed additive and cumulative effects decreasing transfusion amount (one; 600.0$\pm$231.0 mL, two; 533.3$\pm$264.6 mL, three; 346.7$\pm$176.7 mL, four; 300.0$\pm$146.1 mL, p=0.002). Conclusion: Even though RAP did not appear to be effective in terms of the number of patients receiving intraoperative RBC transfusions, it could conserve blood in terms of the amount transfused and with the additive effects of autotransfusion and ultrafiltration. If we want to maximize the blood conserving effect of RAP, more aggressive control will be necessary - such as high threshold of transfusion trigger or strict regulation of crystalloid infusion, and so forth.