• Journal of Chest Surgery
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• v.42 no.5
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• pp.576-587
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• 2009

Background: The up-regulation of the nitric oxide (NO)-cGMP pathway might be involved in the change of vascular reactivity in rats 3 days after they suffer acute myocardial infarction. However, the underlying mechanism for this has not been clarified. Material and Method: Acute myocardial infarction (AMI) was induced by occluding the left anterior descending coronary artery (LAD) for 30 min (Group AMI), whereas the sham-operated control rats were treated similarly without LAD occlusion (Group SHAM), The concentration-response relationships for phenylephrine (PE), KCl, acetylcholine (Ach) and sodium nitroprusside (SNP) were determined in the endothelium intact E(+) and endothelium denuded E(-) thoracic aortic rings from the rats 3 days after AMI or a SHAM operation. The concentration-response relationships of PE in the E(+) rings from the AMI rats were compared with those relationships in the rings pretreated with nitric oxide synthase (NOS) inhibitor $N{\omega}$-nitro-L-arginine methyl ester (L-NAME) or the cyclooxygenase inhibitor indomethacin. The plasma nitrite/nitrate concentrations were checked via a Griess reaction. The cyclic GMP content in the thoracic aortic rings was measured by radioimmunoassay and the endothelial nitric oxide synthase (eNOS) mRNA expression was assessed by real time PCR. Result: The mean infarct size (%) in the rats with AMI was $21.3{\pm}0.62%$. The heart rate and the systolic and diastolic blood pressure were not significantly changed in the AMI rats. The sensitivity of the contractile response to PE and KCl was significantly decreased in both the E(+) and E(-) aortic rings of the AMI group (p<0.05). L-NAME completely reversed these contractile responses whereas indomethacin did not (p<0.05). Moreover, the sensitivity of the relaxation response to Ach was also significantly decreased in the AMI group (p<0.05). The plasma nitrite and nitrate content (p<0.05), the basal cGMP content (p<0.05) and the eNOS mRNA expression (p=0.056) in the AMI rats were increased as compared with the SHAM group. Conclusion: Our findings indicate that the increased eNOS activity and the up-regulation of the NO-cGMP pathway can be attributed to the decreased contractile or relaxation response in the rat thoracic aorta 3 days after AMI.

• The Korean Journal of Pharmacology
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• v.22 no.2
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• pp.96-104
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• 1986

Higenamine, dl-1-( 4-hydroxybenzyl)-6, 7-dihydroxy-1 ,2, 3 ,4-tetrahydroisoquinoline has been synthesized and evaluated for hemodynamic actions using rabbits under pentobarbital anesthesia. Concentration-related fall of mean blood pressure was observed, where diastolic blood presure was significantly lowered at 10 ug/kg/min or above (p<.05), while the systolic blood pressure was slightly increased or unaffected, thereby, causing increment of pulse pressure. No significant change was occured in heart rate, however, carotid artery blood flow was significantly (p<.05) increased. These actions were inhibited with pretreatment of 0.3 mg/kg of propranolol, beta-adrenoceptor antagonist, 5 minutes before infusion of higenamine indicating that higenamine compete with propranolol for the so-called beta adrenergic receptor. As comparison, the same procedure was applied to isoproterenol as well, where typical antagonism of propranolol against isoproterenol was shown. From these findings the vasodilating and diastolic blood pressure lowing effects could be explained in terms of cardiac beta stimulating action, however, dopamine receptor activation could not be excluded because no significant changes observed in chronotropism.

• The Korean Journal of Pharmacology
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• v.31 no.1 s.57
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• pp.39-51
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• 1995

The roles of ${\beta}-adrenoceptor$ were well known in hyperthyroidal heart, but not with ${\alpha}-adrenoceptor$. So we studied the effects of phenylephrine on membrane potential, intracellular sodium activity ($a^{i}_{Na}$), twitch force, and intracellular pH ($pH_i$) by continuous intracellular recordings with ion-selective and conventional microelectrodes in the papillary muscles of hyperthyroid guinea pig heart. ${\alpha}_1-adrenoceptor$ stimulation by phenylephrine (10^{-5}\;or\;3{\times}10^{-5}M$) produced the following changes: variable changes in action potential duration, a hyperpolarization ($1.5{\pm}0.1mM$) of the diastolic membrane potential, an increase in $a^{i}_{Na}\;(0.4{\pm}0.15mM)$, a stronger positive inotropic effect ($220{\pm}15%$), an increase in $pH_i\;(0.06{\pm}0.002\;unit)$. These changes were flocked by prazosin and atenolol. This indicated that the changes in membrane potential, $a^{i}_{Na}$ twitch force, and $pH_i$ are mediated by a stimulation of the ${\alpha}_1-adrenoceptor$. Ethylisopropylamiloride ($10^{-5}$) also blocked the increase in $a^{i}_{Na}$ and twitch force. On the other hand, strophanthidin, tetrodotoxin, $Cs^+$ or verapamil did not block the increase in $a^{i}_{Na}$ and twitch force. Thus, it was suggested that ${\alpha}_1-adrenoceptor$ stimulation increased $a^{i}_{Na}\;and\;pH_i$ by stimulation of $Na^{+}-H^{+}$ exchange, thereby allowing intracellular alkalinization and $a^{i}_{Na}$ increase. These results were very different from euthyroidal heart which showed ${\alpha}_1-adrenoceptor$-induced decrease in $a^{i}_{Na}$ and initial negative inotropic effect. From the above results, it was concluded that ${\alpha}_1-adrenoceptor$ had a important role in hyperthy-roidal heart.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.57-61
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• 2012

Purpose: The multi-gated cardiac blood pool scan is to evaluate the function of left ventricle (LV) and usefully observe a value of ejection fraction (EF) for a patient who is receiving chemotherapy. To calculate LVEF, we should adjust an angle of left anterior oblique (LAO) view to separate both ventricles. And by overlapped ventricles, it is possible to affect LVEF. The purpose of this study is to investigate and compare quantitative indices by changing an angle of LAO view. Materials and methods: We analyzed the 49 patients who were examined by multi-gated cardiac blood pool scan in department of nuclear medicine at Asan Medical Center from June to September 2011. Firstly, we acquired "Best septal" view. And then, we got images by addition and subtraction of angle for LAO view to anterior and lateral. We compared three LAO views for 20 people by 5 degrees and 39 people by 10 degrees. And we analyzed quantitative indices, EF, end diastole and end systole counts, by automated and manual region of interest (ROI) modes. Results: Firstly, we analyzed quantitative indices by automated ROI mode. In case of 5 degrees, the averages of EF are $61.0{\pm}7.5$, $62.1{\pm}7.1$, $60.9{\pm}6.7%$ ($p$=0.841) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $62.4{\pm}9.5$, $62.3{\pm}10.8$, $61.6{\pm}.9.3%$ ($p$=0.938) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Secondly, we analyzed quantitative indices by manual ROI mode. In case of 5 degrees, the averages of EF are $62.8{\pm}7.1$, $63.6{\pm}7.5$, $62.7{\pm}7.3%$ ($p$=0.903) in LAO, LAO $-5^{\circ}$ and LAO $+5^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). In case of 10 degrees, the averages of EF are $65.5{\pm}9.0$, $66.3{\pm}8.7$, $63.5{\pm}.9.3%$ (p=0.473) in LAO, LAO $-10^{\circ}$ and LAO $+10^{\circ}$ respectively. And there is no difference in end diastole and end systole counts ($p$<0.05). Conclusion: When an image is nearly "Best septal" view, the difference of LAO angle would not affect to change LVEF. Although there was no difference in quantitative analysis, deviations could happen when to interpret wall motion qualitatively by reading physicians.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.287-292
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• 1997

.Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.1-6
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• 1996

We developed an experimental model of brain death using dogs. Brain death was induced by increasing the intracranial pressure (ICP) gradually by continuous Infusion of saline through an epidural Foley catheter in 5 mongrel dogs (weight, 18~22kg). Hemodynamic and electrocardiographic changes were evaluated continuously during the process of brain death and obtained the following results. 1. The average volume and time required to induce brain death was 4.8$\pm$1.0ml and 143.0$\pm$30.9minutes respectively. 2. There was a steady rise of the ICP after starting the constant infusion of saline, and ICP rised continuously until the brain death (122.0$\pm$62.5mmHg). After reaching to the maximal value (125.0$\pm$47.7mmHg) at 30 minutes after brain death, the ICP dropped and remained approximately constant at the slightly higher level than the mean arterial pressure (MAP). 3. MAP showed no change until the establishment of brain death and it declined gradually. The peak heart rate reached to 172.6$\pm$35.3/min at 30 minutes after the brain death. 4. Even though the body temperature and all hemodynamic variables, such as cardiac output, mean pulmonary arterial pressure, left ventricular (LV) end-diastolic pressure and LV maximum + dp/dt, were slightly greater than those of basal state, at the point of brain death, there was no statistically significant change during t e process of brain death. 5. There was no remarkable arrhythmias during the experiment except ventricular premature beats which was observed transiently in one dog at the time of brain death. Hemodynamic changes in the brain death model induced by gradual ICP increment were inconspicuous, and arrhythmias were rarely seen. Hyperdynamic state, which was observed at the point of brain death in another brain death model caused by abrupt ICP increase, was not observed.

• The Korean Journal of Pharmacology
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• v.22 no.2
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• pp.105-114
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• 1986

This study was undertaken to search for a new antiarrhythmic agent in natural plants. Extracts of Buxus microphylla var. koreana Nakai have been used as folk remedies of several diseases, including malaria and venereal disease, but any study on the pharmacological actions of this plant has not yet been carried out and its active ingredients have not been identified. In our laboratory, we isolated buxuletin (nonalkaloid) and cyclobuxine D (steroidal alkaloid) from Buxus microphylla var. koreana Nakai and reported their pharmacological actions: diuretic effects of buxuletin in rabbits and hypotensive effect of cyclobuxine D in rats. In the present study, we investigated the effect of cyclobuxine D on isolated frog heart and heart rate in urethane anesthetized rats. In order to clarify the mechanism of bradycardic effect of cyclobuxine D, we examined the changes of the ECG parameters (PR, QRS and R ${\alpha}$ T interval) produced by intravenous injection of cyclobuxine D in anesthetized rats. Cyclobuxine D depressed the contractile force in isolated frog heart and exerted a dose-dependent bradycardic effect in anesthetized rats. Intracerebroventricular injection of cyclobuxine D caused a fall in blood pressure and an increase in heart rate, but those effects were not significant. Cyclobuxine D prolonged the PR interval and RaT interval (${\alpha}$ Tindicates the apex of T), but was without significant effects on the duration of the QRS complex and PRc in urethane anesthetized rats.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.131-136
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• 1997

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prosnosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively: The results were as follows : 1. Serum triiodothyronine(73) reached to its nadir(30.05 $\pm$ 17.5ng/dl, p(0.001) at 10 minutes after the start of CPB and remained low(p(0.05) throughout the study period. 2. Serum thyroxine(74) concentr tion slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(W4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37 $\pm$ 0.81u1U/m1, p(0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum 73 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum 73 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.

• 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.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.659-666
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• 2007

Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.