In search for a method of evaluating the cardiopulmonary function. 74 male and 33 female volunteers ages 18~25 were subjected to this study. The subjects walked on a treadmill at speed of 2,4,6 and 8km/hr with 0,5,10,15,20 and 25% grade of inclination, respectively, for a measurement of heart rate and oxygen-pulse. Heart rate was measured every 5 seconds at resting state and during walking by telemetric method using Heart Checker 108 System (Senoh Co., Japan). Oxygen concentration was measured by Douglas bag method collecting expired air for 5 minutes at rest, and for 2 minutes at the end of each walking exercise. Oxygen concentration in an expired air was analyzed with Orzat gas analyzer and expressed in terms of STPD. Oxygen-pulse was defined as an amount of oxygen consumed at every heart at a cellular level. The followings were the results obtained from this study. 1. Mean values of oxygen-pulse at resting state was 3.1+/-0.11 ml/beat in male and 2.5+/-0.87 ml/beat in female, respectively. 2. Mean values of oxygen-pulse during treadmill walking were increased in proportion with the load of exercise, namely, the speed and grade of inclination, from minimum of 7.1 ml/beat upto maximum of 18.2 ml/beat in male and from minimum of 4.2 ml/beat upto maximum of 12.7 ml/beat in female. 3. Both linear and logarithmic regressional relationships between oxygen-pulse and speed of walking and grade of inclination were observed in both sexes. Predicted values of oxygen-pulse by logarithmic regressional formula on speed and on grade of inclination were better coincided with the measured values than those predicted by the linear regressional formula.
Female ; Heart ; Heart Rate ; Humans ; Linear Models ; Male ; Oxygen ; Volunteers ; Walking*

BACKGROUND: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. MATERIAL AND METHOD: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery (CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. RESULT: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6% (9 of 137) with the mortality of 3.9% (5 of 128) for elective operation, and 44.4% (4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men (4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. CONCLUSION: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.
Acute Kidney Injury ; Arrhythmias, Cardiac ; Cerebral Infarction ; Coronary Artery Bypass* ; Coronary Vessels* ; Female ; Hospitalization ; Humans ; Male ; Mortality* ; Myocardial Infarction ; Obesity ; Pneumonia ; Retrospective Studies ; Risk Factors* ; Sex Distribution ; Stroke Volume ; Transplants ; Ventilators, Mechanical ; Wound Infection

BACKGROUND: There are some previous reports about partial D in Korea. However, the frequency of the partial D in Korea is still unknown. In this study, subtypes of partial D were analyzed by the use of various commercially available anti-D reagents. METHODS: We collected 273 cases determined as RhD negative by RhD typing using the tube method with monoclonal IgM/IgG anti-D reagent (Bioscot. Livingston, UK) from 80,062 cases that were screened between January 2004 and August 2007. The cases were divided into three periods (I, II, III), according to the manufacturers and numbers of anti-D reagents used. A weak D test was performed by using the tube method with various anti-D reagents. The cases with different reactivity between anti-D reagents were determined as partial D, and further analyzed the subtypes by reactivity patterns according to the target epitope of anti-D reagents. An additional test using the ID-Partial D Typing Card (DiaMed, Cressier, Switzerland) was conducted during period III. RESULTS: Five cases showed reactivity patterns of weak D and 16 cases showed reactivity patterns of partial D. Ten cases of partial D were typed as DVI and three cases were typed as DFR. During period III, five cases were typed as DVI and one case was typed as DFR. These results were different from the results obtained with the use of the ID-Partial D Typing Card. CONCLUSION: DVI, which is the most common subtype of partial D, is also common in Korea. Therefore, RhD typing and a weak D test should be performed using combined anti-D reagents that enable the differentiation of DVI from other subtypes.
Indicators and Reagents* ; Korea

Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.
Aged ; Cor Triatriatum* ; Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Vessels* ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Mitral Valve ; Pulmonary Veins ; Thoracic Surgery

BACKGROUND: Median sternotomy remains the standard approach used by surgeons for most intracardiacscar we have tried to use alternative skin incision (bilateral subm-ammary skin incision) to median sternal skin incision, In this study we have tried to compare different postoperative results of wound between two different skin incisional methods. MATERIAL AND METHOD: Between June 1997 and June 1998, a bilateral subma-mmary skin incision combined with v operations but the residual scar is cosmetically unsatisfactory. To avoid an unsightly midline ertical sternotomy was performed in 21 pediatric female patients (submammary group)to repair acyanotic congenital heart disease. after the period we carried out a retrograde sion controls in whom there were 23 pediatric patients (control group). RESULT: Patients' age ranged from 14 to 96 months(mean 38.2 months) Mean duration of subcutaneous drains using Hemovac which was used only in the patients of submammary group was 4.2 days and total amount of the drained effusion was 51.1 ml. Postoperative wound complications included wound eruption in one patient wound disruption in one patient and skin necrosis in 3 patients in submammary group and included wound disruption in 4 patients in controls. mean duration required for wound healing was 15,5 days in submammary group versus 10.4 days in controls. The mean scar length was 12.5 cm in submammary group versus 11.3 cm in controls. The average follow-up was 8.2 months in submammary group versus 9.0 months in controls. In submammary group 3 patients parents(14.3%) were pleased with their cosmetic results of wound scar but 8(38.1%) were dissatisfied. Among the 23 patients in control group 8(34.8%) were pleased but 8(34.8%) complained ofunhappiness with the scar.
Cicatrix ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; Heart* ; Humans ; Necrosis ; Skin* ; Sternotomy* ; Thoracic Surgery* ; Wound Healing ; Wounds and Injuries*

No abstract available.

BACKGROUND: Twelve patients with acyanotic tetralogy of Fallot (TOF), characterized by the combination of a malaligned ventricular septal defect (VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. MATERIALS AND METHODS: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months (mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. RESULTS: The preoperative mean right ventricle to pulmonary artery (RV-PA) pressure gradients were 52.3 mmHg on 2D-echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients (50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients (mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. CONCLUSIONS: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.
Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Chylothorax ; Diagnosis ; Heart ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemorrhage ; Humans ; Oxygen ; Postoperative Complications ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Tetralogy of Fallot*

BACKGROUND: Esophageal surgery in esophageal cancer has low curative resection rate and its resut has not improved even after the extended lymphnode dissection. To evaluate the effectiveness of cervical lymph node dissection, we compare the node of cervical lymph node metastasis in patients esophageal cancer. MATERIALS AND METHODS: We studied a series of 32 patients who underwent operation for thoracic esophageal carcinoma at our institution. The 25 patient who underwent curative surgery were divided into two groups. Both groups A and B underwent transthoracic esophagectomies with mediastinal and abdominal lymphadenectomies only, but group B also underwent bilateral lower neck node dissection. RESULTS: The rate of operative complications did not differ significantly between two groups. No operative and hospital mortalities were noted in either group. However, the mean anesthetic time was significantly longer in group B (mean: 90 minutes). Neck node metastasis was revealed in 27% of group B. CONCLUSIONS: Therfore, neck node dissection is meaningful for surgical treatment of the thoracic esophageal carcinoma. The longterm survival rate should be compared later.
Esophageal Neoplasms ; Esophagectomy ; Hospital Mortality ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neck* ; Neoplasm Metastasis ; Survival Rate

BACKGROUND: There is room for doubt that the reference intervals currently used in many hospitals or health institutions in Korea are appropriate, because some scientists do not agree that the selections of reference individuals were valid universally. If we adopt the inappropriate reference intervals in the decision making of examinees' health status, we are liable to lead to false-negatives or false-positives. METHODS: We selected 555 healthy and 2,134 unhealthy adult samples who took medical check-up at an institution between 2000 and 2004 through semi-stratified random sampling method. Disease groups were divided into 7 subgroups: hepatic, gastrointestinal, obesity, circulatory, endocrine, urogenital and others. RESULTS: Through parametric and non-parametric methods, we produced new reference intervals and compared the newly developed intervals with current ones. Some reference values should be adjusted newly; ALT-male < or =33 IU/L, ALT-female < or =22 IU/L, AST < or =28 IU/L, cholesterol < or =198 mg/dL, triglyceride-male < or =172 mg/dL, triglyceride-female < or =133 mg/dL, fasting blood sugar 65-101 mg/dL. CONCLUSIONS: In order to reduce the rate of false-positives or false-negatives, we suggest that reference ranges of some items might be reestablished or adjusted according to gender through the further studies on current reference ranges.
Adult* ; Blood Glucose ; Cholesterol ; Decision Making ; Fasting ; Humans ; Korea ; Obesity ; Reference Values*

BACKGROUND: Hemostatic function is regarded to be preserved after an off-pump coronary artery bypass grafting (CABG), compared to conventional CABG, and the preserved hemostatic function may increase thrombotic occlusion of the graft. We studied the changes of hemostatic variables in patients undergoing off-pump CABG, and compared to those of on-pump CABG. MATERIAL AND METHOD: We studied the changes of coagulation function in 11 patients who underwent off-pump CABG (group I), and compared them with those of 11 patients who underwent on-pump CABG and Dor procedure (group II). Coagulation status was evaluated by thromboelastography and blood coagulation test preoperatively, postoperative 1st day, 2nd day, 3rd day, and 5th day, respectively. RESULT: Among the variables measured by thromboelastography (such as r time, k time, alpha angle, and MA value) and blood coagulation test (such as factor VII, protein S, protein C, antithrombin III, activated protein C resistance test, plasminogen, D-dimer, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and fibrinogen), there were significant differences in the MA value, alpha angle, and platelet counts between the two groups. MA values were 140+/-72% and 153+/-98% in group I, and 87+/-27% and 78+/-28% in group II, at postoperative 3rd and 5th days, respectively (p<0.05). alpha angle was 122+/-92% in group I and 69+/-23% in group II at postoperative 3rd day (p=0.09). Platelet count was 63+/-55% in group I and 33+/-13% in group II at postoperative 3rd day (p<0.05). CONCLUSION: Patients who underwent off-pump CABG showed increased coagulability during postoperative periods, compared to those who underwent on-pump CABG. Our data suggest that aggressive perioperative anticoagulation therapy is warranted in patients undergoing off-pump CABG.
Activated Protein C Resistance ; Antithrombin III ; Blood Coagulation Tests ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Factor VII ; Humans ; Partial Thromboplastin Time ; Plasminogen ; Platelet Count ; Postoperative Period ; Protein C ; Protein S ; Prothrombin Time ; Thrombelastography ; Transplants