• Title/Summary/Keyword: 과관류

Search Result 205, Processing Time 0.024 seconds

Usefulness of $^{201}Tl$ Myocardial Perfusion SPECT in Prediction of Left Ventricular Remodeling following an Acute Myocardial Infarction (급성심근경색 후 발생하는 좌심실 재구도 예측에 대한 $^{201}Tl$ 심근관류 SPECT의 운용성)

  • Yoon, Seok-Nam;Park, C.H.;Hwang, Kyung-Hoon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.34 no.1
    • /
    • pp.30-38
    • /
    • 2000
  • Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.

  • PDF

Study on Myocardial Protective Effect of L-arginine (L-Arginine의 흰쥐 적출심근보호 효과에 관한 연구)

  • 이인성;이헌재
    • Journal of Chest Surgery
    • /
    • v.29 no.10
    • /
    • pp.1076-1080
    • /
    • 1996
  • The results about the myocardial protection of recta of the nitric oxide precursor L-arginine upon reperrusion injury after ischemia are diverse. These diversities may be model dependent. Experiments were designed and performed to investigate myocardial protection effects according to the concentration of L-arginine. The Isolated rat hearts were subjected in a 30 minutes oi normothermic ischemia and reperfused for 30 minutes with reperfusate containing 0, 1, 2, 3, 4 moil L-arginine. After 30 minutes of reperfusion, group with 1 and 2 mM/L L-arginine showed a trend of better recovery in left ventricular systolic function(left ventricular developed pressure, positive maximum dpfdt), diastolic function(negative maximum dpfdt) and coronary flow compared to control group(reperfusate no L-arginine). Recovery was impaired with a higher concentration, and at 4 moil L-arginine r covery was worse than control(p (0, 05). These results suggest that optimal concentration of L-arginine Is Important or the recovery of myocardial and endothelial function after ischemia and reperfusion.

  • PDF

Variations in The Size of The Ischemic Myocardium Due to Differences in The Normal File (Normal File의 차이에 따른 심근 관류결손 크기의 변화)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Heo Jae-Kyeong;Iskandrian Abdulmasshi S.
    • The Korean Journal of Nuclear Medicine
    • /
    • v.26 no.1
    • /
    • pp.49-57
    • /
    • 1992
  • 혈관확장제 투여에 의한 약물부하 심근스캔시는 운동부하 심근스캔시와 비교하여 심박출량과 관상 동백 혈류의 증가정도가 달라서 심근내 T1-201의 농도가 달라진다. 그러므로 부하 심근관류스캔의 정량적 판독시에 각각의 부하에 특이적인 Normal file을 사용하지 않으면 이러한 심근내 T1-201 농도의 차이로 인하여 관류 결손의 크기가 다르게 나타날 수 있으리라 추측할 수 있다. 본 연구는 좌전하행지의 유의한 협착이 있는 34명의 단일 혈관 관상동맥 환자에서 이러한 가정이 실제적으로 어떻게 나타나는가를 조사하였다. 환자들은 adenosine 140ug/kg/min을 정맥주사하고 T1-201 SPECT를 실시하였다. 관류결손의 크기는 답차운동부하 T1-201 스캔을 실시한 정상인에서 구한 Normal File (File-ex)과 adenosine T1-201 스캔의 Normal File (File-ad)을 각각 이용하여 만든 극성지도에서 구한 adenosine 심근스캔의 관류결손의 범위지수(extent score)와 중증도지수(severity score)로 표시하였고, 이들의 값을 비교하여 아래의 결과를 얻었다. File-ex로 구한 관류결손의 범위지수는 $19{\pm}13%$였고 File-ad로 구한 범위는 $11{\pm}10%$였다(차이 $8.1{\pm}1.6%$, p=0.0001), 중증도지수는 File-ex를 사용하였을 때 $582{\pm}479$였고 File-ad를 사용하였을때는 $310{\pm}309$였다(차이 $272{\pm}49$, p<0.0001). $50\sim70%$의 중등도의 내경 협착이 있었던 20명의 환자에서는 범위지수는 File-ex와 File-ad에서 각각 $17{\pm}10$$7{\pm}7%$(p=0.001)였고, 70% 이상의 내경 협착이 있었던 14명에서의 범위 지수는 각각 $24{\pm}16$$18{\pm}10%$ (p=0.03)로 모두에서 File-ex를 사용하였을때의 값이 컸다. 이와 같은 성적으로 보아 T1-201 스핀에서 관류결손의 정도를 정량적으로 첨가할 시에는 부하에 특이적인 Normal File을 사용하여야 관류 결손의 정도를 정확하게 추출할 수 있다는 사실을 알 수가 있다. 즉 dipyridamole이나 adenosine부하경사에서 운동부하의 Normal File을 사용하면 관류결손의 정도가 과대평가 된다는 것이다.

  • PDF

Ischemia-Reperfusion : Mechanism of Microvascular Dysfunction (허혈-재관류 : 미세혈관 기능 장애의 기전)

  • Park, Jae Hong
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.3
    • /
    • pp.295-301
    • /
    • 2002
  • 미세혈관의 모든 분절(세동맥, 모세혈관, 세정맥)에 있는 내피세포의 기능은 허혈-재관류(ischemia-reperfusion)에 노출시 장애가 발생하게 되는데, 세동맥에서는 혈관확장 능력이 떨어지고, 모세혈관에서는 체액 여과 및 백혈구에 의한 혈관의 막힘(leukocyte plugging)이 증가되며, 세정맥에서는 백혈구-내피세포 접착(leukocyte-endothelial cell adhesion)과 단백의 혈관 외 누출이 증가한다. 활성 산소(reactive oxygen species)와 nitric oxide의 생산의 불균형은 이들 반응을 촉진시키며, 심혈관 질환의 위험 인자인 hypercholesterolemia, 당뇨병, 고혈압 등은 I/R에 대한 미세혈관 반응을 더욱 악화시킨다.

뇌혈류 자가조절과 내인성 $K^{+}$ channel 개방물질에 대한 연구

  • 홍기완
    • Proceedings of the Korean Society of Applied Pharmacology
    • /
    • 1993.04a
    • /
    • pp.85-85
    • /
    • 1993
  • 뇌동맥계는 일과성 저혈압에 반응하여 혈관확장이 야기되고, 혈압 상승시에는 혈관수축이 일어남으로서 뇌혈류가 일정하게 조절된다. 이러한 자가조절은 뇌손상 등의 병적 상태에서 야기된다. 연구의 목적은 \circled1 Cromakalim, CGRP(calcitonin-gene related peptide), 및 substance P에 의하여 뇌연막동맥의 직경이 어떻게 변동하는가를 관찰하고 \circled2 이들 신경성 peptide의 작용에 대하여 $K^{+}$ 통로 개방 봉쇄제인 glibenclamide의 전처치 효과를 검색하고 \circled3 Capsaicin 전처치가 뇌혈류 자가조절에 어떻게 영향을 미치는가를 검색하였다. 그 결과는 다음과 같다. 1. 뇌혈류 자가조절은 대퇴동맥을 통한 사혈에 의하여 혈압하강을 일으킬 때 뇌연막 동맥은 이완하였고, reservoir내의 혈액을 체내로 주입함로서 혈압반전을 일으켰을 때는 혈관 수축이 일어났다. 2. 연막동맥은 glibenclamide (1~3$\mu$M)의 관류에 의하여는 영향을 받아니하였다. 3. 혈압변동에 따른 혈관직경의 변화를 회기직선으로 분석하였다. Glibenclamide 1과 3$\mu$M의 전처치 관류에 의하여 혈압하강에 따른 혈관 이완경사도와 혈압반전에 따른 혈관수축 경사도가 대조군에 비하여 현저히 약화되었다. 4. Cromakalim (0.1-30$\mu$M)의 각 농도를 대뇌표면에 관류시 연막동맥의 기초직경은 약물농도에 의존하여 증가되었고, 이는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었다. 5. CGRP (0.1~100 nM)와 substance P (0.1~10nM)도 용량에 의존하여 혈관이완을 일으켰다. 전자는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었으나 후자는 영향을 받지 아니하였다. 6. Capsaicin(50 nmol: intracisternally) 주사에 의하여 뇌혈류자가조절의 변동이 초래되었다. 이상의 결과들을 종합하면 CGRP가 혈압변동에 의하여 반사적으로 유리되고, 이는 glibenclamide-sensitive $K^{+}$ 통로에 작용하는 것으로 시사된다.

  • PDF

Comparison of Pulsed Arterial Spin Labeling with Conventional Perfusion MRI in Moyamoya Disease Patient (모야모야병에서 펄스 동맥 스핀 표지 영상과 고식적인 관류자기공명영상의 비교)

  • Jo, Gwang-Ho;Bae, Sung-Jin
    • Journal of radiological science and technology
    • /
    • v.30 no.4
    • /
    • pp.427-433
    • /
    • 2007
  • This study was conducted to investigate the usefulness of PASL image technique through visual and quantitative assessment by dividing CBF image, conventional perfusion magnetic resonance image, anterior cerebral artery, middle cerebral artery and posterior cerebral artery into 6 territories both right and left in moyamoya disease. In visual assessment, the scope of decreased perfusion in the PASL CBF image and conventional perfusion MR CBF image agreed with the position of deficiency in the MR image. The quantitative assessment, showed that the scope and position of decreased perfusion accord with both in the PASL CBF image and the existing conventional perfusion MR CBF image but the assessment of measuring the quantity of perfusion according to signal intensity showed a little difference.

  • PDF

Effect of Cyclobuxine on Oxygen Free Radical Production and Cellular Damage Promoted by Arachidonate in Perfused Rat Hearts (허혈재-관류 적출심장에서 Arachidonic Acid에 의한 산소래디칼 생성 및 심근손상에 대한 Cyclobuxine의 영향)

  • Lee, Jong-Hwoa;Kwon, Jun-Tack;Cho, Byung-Heon;Park, Jong-An;Kim, Yu-Jae;Kim, Jong-Bae;Cha, Young-Deog;Kim, Chang-Ho
    • The Korean Journal of Pharmacology
    • /
    • v.28 no.2
    • /
    • pp.163-170
    • /
    • 1992
  • The present study was attempted to investigate the effect of cyclobuxine (a steroidal alkaloid) on generation of reactive oxygen metablite and myocardial damage promoted by an exogenous administeration of arachidonate in ischemic-reperfused hearts. Langendorff preparation of the isolated rat heart was made ischemic condition by reducing the flow rate to 0.5 ml/min for 45 min, and then followed by normal reperfusion (7 ml/min) for 5 min. The generation of superoxide anion was estimated by measuring the SOD-inhibitable ferricytochrome C reduction. The degree of lipid peroxidation in myocardial tissue was estimated from the tissue malondialdehyde (MDA) concentration using thiobarbituric acid method. The myocardial cell damage was observed by measuring LDH released into the coronary effluent. Sodium arachidonate $(0.1\;and\;1.0\;{\mu}g/ml)$ infused during the period of oxygenated reperfusion stimulated superoxide anion production dose-dependently. The rate of arachidonate-induced superoxide anion generation was markedly inhibited by cyclobuxine $(1.0\;and\;10\;{\mu}g/ml)$. The production of malondialdehyde was increased by infusion of arachidonate. This increase was prevented by superoxide dismutase (300 U/ml) and cyclobuxine $(1.0\;and\;10\;{\mu}g/ml)$. The release of LDH was increased by sodium arachidonate was also inhibited by superoxide dismutase and cyclobuxine. In conclusion, the present results suggest that cyclobuxine inhibits the production of reactive oxygen metabolite and myocardial damages which were promoted by an administeration of arachidonate during reperfusion of ischemic hearts.

  • PDF

The Correlation Analysis of Ejection Fraction: Comparison of $^{201}Tl$ gated Myocardial Perfusion SPECT and Echocardiography ($^{201}Tl$ 게이트 심근관류 SPECT 및 심초음파의 좌심실 구혈률 상관관계 비교)

  • Yoon, Soon Sang;Ryu, Jae Kwang;Cha, Min Kyung;Lee, Jong Hun;Kim, Sung Hwan
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.16 no.2
    • /
    • pp.49-56
    • /
    • 2012
  • Purpose : Gated myocardial perfusion SPECT provides not only myocardial perfusion status, but various functional parameters of left ventricle (LV). The purpose of this study was to analyze ejection fraction (EF) for correlation and difference between $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography depending on extent of perfusion defect, gender and LV volumes. Materials and Methods : From April 2011 to May 2012, we analyzed 291 patients (male:female =165:126; mean: $64.6{\pm}10.8$ years) who were examined both $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography at less than 7 days apart in our hospital. 101 patients showed perfusion defect and the rest of the people without any defect. We applied automatic analysis (Quantitative gated SPECT, QGS), and calculated EF, End-diastolic volume (EDV) and End-systolic volume (ESV) from Stress (G-Stress) and Rest (G-Rest) studies. And we analyzed the correlation and difference for EF between $^{201}Tl$ gated SPECT and echocardiography. Results : The correlation of LVEF among G-Stress, G-Rest and echocardiography was quite a good (G-Stress vs. G-Rest: r=0.909, G-Stress vs. echocardiography: r=0.833, G-Rest vs. echocardiography: r=0.825). And there were significant differences in EDV, ESV and EF in total patients (p<0.01). The normal group showed significant difference in EF (p<0.01) and the group with perfusion defect also demonstrated significant difference (a group with reversible defect: p<0.01, fixed defect: p<0.01) depending on extent of perfusion defect. We analyzed difference in normal group by gender. In normal group, there was no significant difference (p>0.05) in EF from men. However, there was a significant difference (p<0.01) from women. When we classified two groups by average size of EDV in Korean women, there was no significant difference in a group of above average size of EDV (p>0.05). Conclusion : When compared among Stress and Rest of $^{201}Tl$ gated SPECT and echocardiography, we confirmed that there was a good correlation for LVEF. But there were significant differences among three studies. And extent of perfusion defect, gender and LV volumes are independent determinants of the accuracy of LVEF. So, it is hard to compare and interchange quantitative indices among modalities. We should take additional researches to prove results of our study.

  • PDF

A Study on the Protective Effect of Antioxidants on Damage Induced by Liver Ischemia/Repefusion in a Rat Model (모델 랫드에 간 허혈/재관류로 유발된 손상에 대한 항산화제의 보호 효과에 관한 연구)

  • Ahn, Yong Ho;Seok, Pu Reum;Oh, Su Jin;Choi, Jin Woo;Shin, Jae-Ho
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.51 no.3
    • /
    • pp.370-378
    • /
    • 2019
  • The hepatic ischemic model has recently been widely used for the epidemiological study of ischemic reperfusion injury. This study was carried out to investigate the protective effect of vanillin, which is known to have antioxidant and anti-inflammatory effects, against hepatic and renal injury using an ischemia-reperfusion rat model, and we also investigated the mechanism related to vanillins' protective effect. The test material was administered at a concentration of 100 mg/kg for 3 days, followed by ligation of the liver for 60 minutes to induce ischemia reperfusion. As control groups, there was a negative control, sham control and ischemia-reperfusion-only ischemia reperfusion control, and the controls groups were compared with the drug administration group. In the vanillin group, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were significantly inhibited compared with the AST and ALT activities of the ischemia-reperfusion group, and histopathological examination showed significant reduction of both inflammation and necrosis. The malondialdehyde (MDA) and superoxide dismutase (SOD) levels were significantly different from the ischemia-reperfusion group. In conclusion, vanillin showed a hepatocyte protective action by alleviating the cellular inflammation and cell necrosis caused by hepatic ischemia-reperfusion, and vanillin mitigated inflammatory changes in the kidney glomeruli and distal tubules. The protective effect is considered to be caused by vanillin's antioxidant function. Further studies such as on cell death and possibly vanillin's same effect on damaged tissue will be necessary for clinical applications such as organ transplantation.

Development of Greenhouse Cooling and Heating Load Calculation Program Based on Mobile (모바일 기반 온실 냉난방 부하 산정 프로그램 개발)

  • Moon, Jong Pil;Bang, Ji Woong;Hwang, Jeongsu;Jang, Jae Kyung;Yun, Sung Wook
    • Journal of Bio-Environment Control
    • /
    • v.30 no.4
    • /
    • pp.419-428
    • /
    • 2021
  • In order to develope a mobile-based greenhouse energy calculation program, firstly, the overall thermal transmittance of 10 types of major covers and 16 types of insulation materials were measured. In addition, to estimate the overall thermal transmittance when the cover and insulation materials were installed in double or triple layers, 24 combinations of double installations and 59 combinations of triple installations were measured using the hotbox. Also, the overall thermal transmittance value for a single material and the thermal resistance value were used to calculate the overall thermal transmittance value at the time of multi-layer installation of covering and insulating materials, and the linear regression equation was derived to correct the error with the measured values. As a result of developing the model for estimating thermal transmittance when installing multiple layers of coverings and insulating materials based on the value of overall thermal transmittance of a single-material, the model evaluation index was 0.90 (good when it is 0.5 or more), indicating that the estimated value was very close to the actual value. In addition, as a result of the on-site test, it was evaluated that the estimated heat saving rate was smaller than the actual value with a relative error of 2%. Based on these results, a mobile-based greenhouse energy calculation program was developed that was implemented as an HTML5 standard web-based mobile web application and was designed to work with various mobile device and PC browsers with N-Screen support. It had functions to provides the overall thermal transmittance(heating load coefficient) for each combination of greenhouse coverings and thermal insulation materials and to evaluate the energy consumption during a specific period of the target greenhouse. It was estimated that an energy-saving greenhouse design would be possible with the optimal selection of coverings and insulation materials according to the region and shape of the greenhouse.