• Title/Summary/Keyword: 과관류

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Comparative Analysis of $\alpha$-STAT and pH-STAT Strategies During Deep Hypothermic Circulatory Arrest in the Young Pig (초저체온 순환정지시 $\alpha$-STAT와 pH-STAT 조절법의 비교분석 -어린돼지를 이용한 실험모델에서-)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Won, Tae-Hee;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.553-559
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    • 1998
  • Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management($\alpha$-stat versus pH-stat). This study aims to compare $\alpha$-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below $20^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below $20^{\circ}C$, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either $\alpha$-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming. Results & Conclusion: Cooling time was significantly shorter with $\alpha$-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.

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The Effect of Early IASP and Reperfusion Therapy in Patient of Post MI Cardiogenic Shock (Post MI Cardiogenic Shock 환자에서 조기 IABP 및 Reperfusion Therapy의 효과)

  • Lee, Jong-Suk;Kim, Min-Kyeung;Kim, Woong;Kim, Hyung-Jun;Bae, Jun-Ho;Park, Jong-Sean;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.31-38
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    • 2000
  • Background: We sought to examine the use and outcomes of early intraaortic balloon counterpulsation(IABP) combined with early reperfusion therapy in patients presenting cardiogenic shock complicated acute myocardial infarction. The usc of IABP in patients with cardiogenic shock is widely accepted. However there is not ample information on the use of this technique in patients with cardiogenic shock who arc treated with reperfusion therapy in Korea. Materials and Methods: Twenty-eight patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and the late IABP group (insertion after 12 hours). We compared In-hospital mortality between the two groups (early IABP group vs late IABP group). Results: Two groups showed no significant difference in clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortalities in the early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the two groups(p<0.05). Conclusion: IABP appears to be useful in patients presenting cardiogenic shock unresponsive medical therapy. Early IABP insertion and early reperfusion therapy may reduce in-hospital mortality rates of post-MI cardiogenic shock patients.

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The Role of GADD45 ${\beta}$ in Acute Myocardial Injury (급성 심근 손상에서 GADD45 ${\beta}$의 역할)

  • Cho, Suk-Ki;Hong, Jong-Myeon;Lee, Hak-Mo;Oh, Byong-Chul;Lee, Jae-Woong;Lee, Jeong-Ryul
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.25-33
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    • 2008
  • Background: A critical shortage of donor organs has necessitated an investigation of new strategies to increase the availability of additional organs available for human transplantation. We investigated the amount of apoptosis and expression of GADD45 ${\beta}$ in two groups, a GADD45 ${\beta}$-transfected group and untransfected group. Material and Method: The experimental groups consist of a control group (normal H9C2 cell line) and GADD45 ${\beta}$-transfected group. After injury of the each group, we evaluated the expression of GADD45 ${\beta}$ and the level of apoptosis in each group. Result: There was a significant increase in the expression of GADD45 ${\beta}$ in the GADD45 ${\beta}$-transfected group at 1 hour, 2 hours, and 3 hours after stimuli as compared with the control group. The amount of cardiac myoblast cell line apoptosis was significantly lower in the GADD45 ${\beta}$-transfected group as compared with the control group. The concentration of annex in in the GADD45 ${\beta}$-transfected group was significantly lower than that of the control. group after cell. injury. Conclusion: Transfection of a rat myoblast cell line with the GADD45 ${\beta}$ gene results in. decreased susceptibility to cell injury of human serum.

Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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Chemo-Mechanical Analysis of Bifunctional Linear DGEBA/Linear Amine (DDM, DDS) Resin Casting Systems (DGEBA/방향족 아민(DDM, DDS) 경화제의 벤젠링 사이의 관능기 변화가 물성 변화에 미치는 영향에 대한 연구)

  • 명인호;정인재;이재락
    • Composites Research
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    • v.12 no.4
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    • pp.71-78
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    • 1999
  • To determine the effect of chemical structure of linear amine curing agents on thermal and mechanical properties, standard epoxy resin DGEBA was cured with diaminodiphenyl methane (DDM), diaminodiphenyl sulphone (DDS) in a stoichiometrically equivalent ratio. From this work, the effect of aromatic amine curing agents. In contrast, the results show that the DGEBA/DDS cure system having the sulfone structure between the benzene rings had higher values in the conversion of epoxide, density, shrinkage (%), glass transition temperature, tensile modulus and strength, flexural modulus and strength than the DGEBA/DDM cure system having methylene structure between the benzene rings, whereas the DGEBA/DDM cure system presented higher values in the maximum exothermic temperature, thermal expansion coefficient, and thermal stability. These results are caused by the relative effects of sulfone group having strong electronegativity and methylene group having (+) repulsive property and stem from the effect of the conversion ratio of epoxide group. The result of fractography shows that the each grain size of the DDM/DGEBA system with feather-like structure is larger than that of the DDS/DGEBA system.

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A Case of Isolated Right Pulmonary Artery Agenesis (고립성 우측 폐동맥 형성부전증 1례)

  • Kim, Do Youn;Lee, Jae Sung;Kim, Young;Chang, Yoon Soo;Kim, Hyung Jung;Kim, Tae Hoon;Ahn, Chul Min
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.489-493
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    • 2004
  • Unilateral pulmonary artery agenesis is a rare congenital anomaly usually associated with other cardiovascular anomalies such as tetralogy of Fallot or septal defect. Unilateral pulmonary artery agenesis without other coexisting cardiovascular abnormality (isolated unilateral pulmonary artery) is extremely rare and often asymptomatic until adulthood. In these patients, diagnostic clue is found in a plain chest roentgenogram, showing a hyperlucent contracted hemithorax. We have recently experienced a case of isolated right pulmonary artery agenesis, which was diagnosed by chest dynamic CT, perfusion scan, echocardiogram and 3-dimensional reconstruction cardiac CT angiography in a 50-year old female who had suffered from mild dyspnea on exertion and improved with conservative treatment. We report this case with a brief review of the relevant literature.

Study on the Change of Catecholamine, Arginine Vasopressin and V1 Vasopressin Receptor Release in the Stressed Rat Brain

  • Kim, Tae-Gyun;Kim, Jee-Hee;Kim, Seung-Hee;Kang, Seog-Youn;Ki, Kyung-Chung;Huh, Young-Buhm;Lee, Song-Deuk
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.04a
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    • pp.85-85
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    • 1997
  • 스트레스가 유발된 랫드의 대뇌에서 Vasopressin-catecholamine pathway의 활성도를 알아보기 위해 면역화학염색법으로 vasopressin 호르몬의 분비와 catecholamine의 생성변화를 tyrosine hydroxylase (TH) 효소의 발현변화로 규명하고, arginine vasopressin (AVP)과 V1 vasopressin receptor의 유전자 발현변화를 in situ hybridization 방법을 이용하여 살펴보았다. 수컷 SD rat를 7시간동안 stress cage에 넣어 16$\pm$1$^{\circ}C$의 물에 수침구속 스트레스를 준 후 대조군과 함께 관류고정하여 brain을 적출하였다. Brain의 hypothalamus 부위를 중심으로하여 동결절편하여 면역조직화학 염색과 in situ hybridization을 시행하였다. TH 면역조직화학 염색에서 대뇌의 줄무늬체 부위의 꼬리조가비핵에서와 시상하부 부위의 내측등쪽시상하부와 흑색질부위에서 스트레스군이 대조군에 비해 TH 면역염색성이 증가되어 관찰되었으나 시상하부 부위의 시삭위핵, 뇌실주위핵, 뇌실옆핵에서는 두 군간의 큰 면역염색성의 차이는 보이지 않았다. AVP 면역조직화학 염색에서는 시삭위핵에 많은 수의 AVP 양성 신경세포체들이 밀집되어 있으며 뇌실옆핵에서는 스트레스군에서 AVP 면역염색성이 약간 증가되어 관찰되었으나 신경섬유의 분포양상은 비슷하였다. 중간융기에서는 모두 강한 염색성의 신경섬유들이 관찰되어 두 군간에 큰 차이는 없었다. AVP 유전자에 대한 in situ hybridization 결과 시삭위핵의 신경세포에서 AVP mRNA 양성반응을 관찰할 수 있었으나 다른 시상하부핵에서는 관찰할 수 없었으며, V1 vasopressin receptor에 대한 in situ hybridization 결과는 두 군의 대뇌에서 모두 양성반응을 관찰할 수 없었으며 V1 vasopressin receptor 유전자의 조직별 발현정도와 스트레스에 의한 발현량 조절을 관찰할 필요가 있다고 사료된다.

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Studies on the Polyethylenimine-Polymethylenepolyphenylene Isocyanate Backbone Chelating Resin Synthesis for the Trace Heavy Metals Enrichment and Analysis(II) : Rubeanic Acid Loaded Carboxymethylated Polyamine-Polyurea Resin (미량 중금속의 농축 및 정량을 위한 폴리에틸렌이민-폴리메틸렌폴리페닐렌 이소시안에이트에 토대한 킬레이트 수지의 합성에 관한 연구(II) : 루빈산이 결합된 카르복시메틸화된 폴리아민-폴리우레아 수지)

  • Chung, Yong Soon;Lee, Kang Woo;Hwang, Jongyoun;Lim, Kwang Soo
    • Analytical Science and Technology
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    • v.6 no.5
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    • pp.435-442
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    • 1993
  • Carboxymethylated polyamine-polyurea resin loaded with rubeanic acid (RCCPPI resin) was obtained by 1 step chemical reaction between chlorocarboxymethylated polyamine-polyurea(CCPPI) resin as matrix polymer and rebeanic acid. This resin was confirmed with infrared spectrometry, elemental analysis, and thermal analysis(DSC). The adsorption characteristics of the heavy metal's on the resin were studied by measuring distribution coefficient($K_d$) with changing pH of the solutions and frontal chromatography. The enrichment, recovery, and analysis of trace heavy metals, such as cadmium, cerium, copper, nikel, lead, and zinc, in the presence of high concentrations of sodium, calcium, and acetate salts was possible quantitatively by a column packed with the resin at each optimum pH. Preconcentration factors were more than 25. To elute the adsorbed heavy metals on the resin, 0.025M EDTA solution(pH 9.0) was used.

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Duplex Sonography in Subclavian Steal Syndrome Treated by Stent Insertion (이중초음파검사상 빗장밑혈류빼앗김증후군이 관찰된 환자에서의 스텐트 삽입 후 추적)

  • Han, Minho
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.370-374
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    • 2018
  • Subclavian steal syndrome is a type of obstructive artery disease caused by severe stenosis and occlusion of a left proximal subclavian artery or brachiocephalic trunk. The resulting vertebro-basilar insufficiency symptoms are due to retrograde blood flow from the contralateral vertebral and basilar arteries into the low-pressure ipsilateral upper extremity vessels. For that reason, patients usually experience dizziness or arm ischemic symptoms. Neurointervention is an effective treatment for ischemic stroke, including the subclavian artery stenosis. This paper reports a patient with subclavian steal syndrome who had a vertebral artery Doppler waveform change in duplex sonography and a 12 mmHg difference in interarm systolic blood pressure. A stenotic lesion of the subclavian artery was treated effectively by inserting a precise stent. The follow up examination showed that the vertebral artery Doppler waveform change disappeared and recovered and that the 12 mmHg difference in interarm systolic blood pressure decreased to 5 mmHg after treatment.

Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis (가와사끼병 환아에서 발생한 거대관상동맥류 내 혈전의 성공적 용해요법과 장기 치료 및 경과 1례)

  • Moon, Su Jung;Lee, Su Ya;Na, Kyong Hee;Park, Sun Young;Kim, Eun Young;Kim, Kyoung Sim;Kim, Yong Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.302-307
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    • 2003
  • The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.