• Journal of Chest Surgery
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• v.36 no.11
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• pp.799-811
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• 2003

Background: The aim of this study is to define the cardioprotective effects (hemodynamic, cytochemical and ultrastructural of the newly developed Histidine-Tryptophan-Ketoglutarate (HTK) cardioplegia compared to DelNido cardioplegia. Material and Method: Seventy-nine isolated rat hearts were divided into three groups on the basis of techniques of cardioplegia infusion. Twenty-eight hearts (Group 1) were flushed with cold DelNido cardioplegia with every 40 minutes for 2 hours. Twenty-seven hearts (Group 2) were flushed with cold HTK cardioplegia for once during the 2 hours. Twenty-four hearts (Group 3) were flushed with cold HTK cardioplegia with every 40 minutes for 2 hours. Heart rate, left ventricular developed pressure (LVDP), changes of + dp/dt max, coronary flow, and rate-pressure product value were measured at pre-ischemic, post-reperfusion 15 minutes, 30 minutes, and 45 minutes for hemodynamic study. Aspartate aminotransferase (AST), lactate dehydrogenase (LD), creatine kinase (CK), CK-MB, troponin-I, myoglobin, and lactate were measured at pre-ischemic and post-reperfusion 45 minutes for cytochemical parameters. Mitochondrial scores were counted in 3 cases from each group for ultrastructural assessment. Result: In hemodynamic study, there were no significant differences among group 1, group 2, and group 3. However, the decrease values of heart rate in group 2 and 3 exhibited significantly lower values than in group 1. In cytochemical study, there were no significant differences among group 1, group 2, and group 3. However, the increase values of lactate in group 2 and 3 exhibited significantly lower values than in group 1. In ultrastructural assessment, the mean myocardial mitochondria scores in group 1, group 2, and group 3 were 2.14$\pm$0.10, 1.52$\pm$0.57, and 2.10$\pm$0.16. Conclusion: HTK solution provides adequate myocardial protection with some advantages over DelNido solution in isolated rat hearts.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.211-215
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• 1995

전기유압식 좌심실 보조장치에서 모터 전류 파형을 정보로 하여 작동기의 이완기 속도를 조절함으로써 좌심방으로부터 유입되는 혈류량을 조절하는 알고리즘을 개발하였다. 전기 유압식 좌심실 보조장치에서는 혈액의 유입이 능동적으로 이루어지므로, 좌심방 함몰로 인한 심근 손상 및 외부 공기 유입으로 인한 색전증을 방지하기 위해 유입혈류량을 현재 좌심방 내의 상태에 따라 적절히 조절해 주어야 한다. 좌심방 내의 혈액량 정도는 혈액을 유입해내는 작동기의 이완기 동작 시에 소모되는 에너지 크기에 반영되고, 작동기를 구동하는 모터에 들어가는 전류의 크기는 작동기에 공급되는 에너지에 비례하므로, 이 전류 파형의 정보들을 통해 좌심방 내의 상태를 추정해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 이상 유무를 판단한 뒤 이에 따라 작동기의 이완기 속도를 조절하는 알고리즘을 개발하여 모의순환장치 실험을 통해 그 실효성을 검증한 결과를 정리하였다.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 1995.10b
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• pp.387-392
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• 1995

전기 유압식 좌심실 보조장치에서 모터 전류 파형을 정보로 하여 작동기의 이완기 속도를 조절함으로써 좌심방으로부터 유입되는 혈류량을 조절하는 알고리즘을 개발하였다. 좌심실 보조장치(Left Ventricular Assist Device, LVAD)는 허혈성 심장질환 등으로 좌심실 의 혈액 박출 기능이 저하된 환자에게 시술하여 정상 상태의 심박출량을 유지할 수 있도록 하는 보조 혈액 박출 기능이이다. 전기 유압식 좌심실 보조장치에서는 혈액의 유입이 능동 적으로 이루어지므로, 좌심방 함몰로 인한 심근 손상 및 외부 공기 유입으로 인한 색전증을 방지하기 위해 유입혈류량을 현재 좌심방내의 상태에 따라 적절히 조절해 주어야 한다. 좌 심방 내의 혈액량 정도는 혈액을 유입해 내는 작동기의 이완기 동작 시에 소모되는 에너지 크기에 반영되고, 작동기를 구동하는 모터에 들어가는 전류의 크기는 작동기에 공급되는 에 너지에 비례하므로, 이전류 파형의 정보들을 통해 좌심방내의 상태를 추정해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 정보들을 통해 좌심방 내의 상태를 추정 해 볼 수 있다. 본 논문에서는 퍼지로직을 적용하여 모터 전류 파형의 이상 유무를 판단한 뒤 에에 따라 작동기의 이완기 속도를 조절하는 알고리즘을 개발하여 모의순환장치 실험을 통해 그 실효성을 검증한 결과를 정리하였다.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.101-109
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• 2005

Background: In sudden cardiac arrest, the effective maintenance of coronary artery blood flow is of paramount importance for myocardial preservation as well as cardiac recovery and patient survival. The purpose of this study was to directly compare the effects of pulsatile and non-pulsatile circulation to coronary artery flow and myocardial preservation in cardiac arrest condition. Material and Method: A cardiopulmonary bypass circuit was constructed in a ventricular fibrillation model using fourteen Yorkshire swine weighing $25\~35$ kg each. The animals were randomly assigned to group I (n=7, non-pulsatile centrifugal pump) or group II (n=7, pulsatile T-PLS pump). Extra-corporeal circulation was maintained for two hours at a pump flow of 2 L/min. The left anterior descending coronary artery flow was measured with an ultrasonic coronary artery flow measurement system at baseline (before bypass) and at every 20 minutes after bypass. Serologic parameters were collected simultaneously at baseline, 1 hour, and 2 hours after bypass in the coronary sinus venous blood. The Mann-Whitney U test of STATISTICA 6.0 was used to determine intergroup significances using a p value of < 0.05. Result: The resistance index of the coronary artery was lower in group II and the difference was significant at 40 min, 80 min, 100 min and 120 min (p < 0.05). The mean velocity of the coronary artery was higher in group II throughout the study, and the difference was significant from 20 min after starting the pump (p < 0.05). The coronary artery blood flow was higher in group II throughout the study, and the difference was significant from 40 min to 120 min (p < 0.05) except at 80 min. Serologic parameters showed no differences between the groups at 1 hour and 2 hours after bypass in the coronary sinus blood. Conclusion: In cardiac arrest condition, pulsatile extracorporeal circulation provides more blood flow, higher flow velocity and less resistance to coronary artery than non-pulsatile circulation.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.111-117
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• 2001

배경: 심근 수축력과 더불어 전신저항은 개심술 후 적절한 심박출량을 유지하기 위한 매우 중요한 요인이다. 후부하의 변화를 비관혈적으로 평가할 수 있는지 알아 보고자 대동맥 혈류파형의 변화를 관찰하였다. 대상 및 방법: 개흉한 8마리의 잡견에서 연속파형 Doppler 심초음파를 이용하여 nitroprusside 단독 또는 epinephrine과의 병합투여 잔후로 상행 대동맥 혈류를 측정하였다. 결과: Nitroprusside의 투여로 동맥압과 전신저항은 약물의 투여량에 비례하여 감소함으로써(p<0.05 vs 기준치), 대동맥 혈류파형의 최고속도, 평균가속 및 분거리(속도시간적분$\times$심박동수)는 증가하였고, 가속시간은 짧아졌으며(p<0.05 vs 기준치), 가속시간/박출시간의 비는 변화가 없었다. Nitroprusside 투여로 인한 전신저항의 변화는 속도시간적분이나 Doppler 시간간격 지표보다는 최고속도(r=0.60, p=0.001)와 평균가속(r=0.52, p=0.003)과 상관관계가 있었다. Epinephrine과의 병합투여로 전신저항이 증가하지 않는 한 nitroprusside 단독투여에 비해서 최고속도, 평균가속 및 속도시간적분이 더 크게 증가했으나, 전신저항이 증가되면 이 Doppler 지표들은 감소하는 경향을 보였다. 결론: Doppler 심초음파를 이용하여 상행 대동맥 혈류파형의 최고속도와 평균가속을 연속적으로 측정함으로써 후부하의 변화를 비관혈적으로 평가할 수 있으리라 생각된다.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.468-475
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• 2005

Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. Material and Method: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. Result: The heart rates after ligation and after cannula insertion were $239.1\pm61.7,\;235.8\pm58.0bpm$ respectively, and they were statistically significantly slower than that of before ligation, $277.6\pm40.3bpm\;(p=0.017,\;p=0.007\;respectively)$. QRS sizes before ligation, after ligation, and after cannula insertion were $3.6\pm3.3mm,\;2.8\pm3.3 mm,\;and\;2.4\pm2.2mm,$respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from $2.11\pm0.17kHz,\;1.25\pm0.22kHz\;to\;0.83\pm0.15kHz,\;0.38\pm0.11kHz$(p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were $0.61\pm0.05kHz\;and\;0.33\pm0.05 kHz$ respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. Conclusion: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1055-1065
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• 1996

This experiment was undertaken to assess the effect of nitric oxide, isosorbide dinitrate, and sodium nitroprusside, which are known to increase coronary flow by vasodilation and to improve the cardiac function of an ischemic heart The experiment was carried out to investigate the effect of nitric oxide on the coronary artery of an ischemic rat myocardium using isolated constant pressure Langendorfr system. The experimental parameters were lactate and CK-MB for the frozen myocardium and coronary flow. the quantity of coyonary flow, left ventricular developed pressure (LVDP), and dp/dt. The experimental groups were decided as control group (Group I), nitric oxide group (Group II), Iso orbide dinitrate group (Group III) and sodium nitroprusside group (Group IV). Statistical analysis was performed using repeated measured analysis of variance and 2tudent t-test The results were as follows: 1 . The lactic acid contents of group II and IV were less than other groups for the frozen myocardium at preischemic state (p< 0.0025), whereas the determined coronary flows were higher. 2. In the ratio of produced lactic acid between the preischemia and reperfusion for the coronary flow, group II and IV exhibitrod less value than others (p< 0.005). 3. Group II and III were less than others in the coronary flow for the quantity of CK-MB, but or the frozen myocardium, group II and IV were less. 4. Group II and IV showed higher coronary flow compared to others throughout entire experimental period (p< 0.005). 5. Group II was highest at the preischemic state for the left ventricular developed pressure. 6. The +maximal dp/dt of group II was highest compared to others. 7. Group I exhibi ed the highest recovery rate of coronary flow between prelschemla and reperfusion. 8. The(-dp/dt)1(+dp/dt) ratio was 116%, 100%, 100%, and 55% for the 4 groups, respectively And the recovery rate of total dp/dt was 34%, 67%, 51%, and 76% for the four groups, respectively.

• Journal of Korea Multimedia Society
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• v.6 no.3
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• pp.444-454
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• 2003

An analysis of heart movement is to estimate a role which supplies blood in human body. We have constructed a left ventricle myocardium model and mathematically evaluated the motion of myocardium. The myocardial motility was visualized using some parameters about cardiac motion. We applied the myocardium model in the gated myocardium SPECT image that showed a cardiac biochemical reaction, and analyzed a motility between the gated myocardium SPECT image and the myocardium model. The myocardium model was created of the based on three dimensional super-ellipsoidal model that was using the sinusoidal function. To express a similar form and motion of the left ventricle myocardium, we calculated parameter functions that gave the changing of motion and form. The LSF algorithm was applied to the myocardium gated SPECT image data and the myocardium model, and finally created a fitting model. Then we analyzed a regional motility direction and size of the gated myocardium SPECT image that was constructed on a fitting model. Furthermore, we implemented the Bull's Eye map that had evaluated the heart function for presentation of regional motility. Using myocardium's motion the evaluation of cardiac function of SPECT was estimated by a contraction ability, perfusion etc. However, it is not any estimation about motility. So, We analyzed the myocardium SPECT's motility of utilizing the myocardium model. We expect that the proposed algorithm should be a useful guideline in the heart functional estimation.

• The Korean Journal of Pharmacology
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• v.17 no.1 s.28
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• pp.9-15
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• 1981

Aconiti tuber butanol fraction, which is isolated from the chloroform insoluble and water soluble extract of Aconitum volubile, has been recently known to have a potent positive inotropic effect in the isolated cardiac muscle preparations of various animals. The positive inotropic mechanism of Aconiti tuber butanol fraction, in relation with the external calcium, was studied using the isolated cat papillary muscle. The positive inotropic effect was dependent on the calcium concentration in the nutrient medium, and a synergistic relation could be demonstrated between Aconiti tuber butanol fraction and the external calcium. The inotropic effect of $10^{-4}g/ml$ of Aconiti tuber butanol fraction was equivalent to that of 0.06mM of calcium in the medium. After the treatment with a calcium influx inhibitor, Verapamil$(2{\pm}10^{-7}-10^{-6}M)$, the contractile force of the papillary muscle was markedly inhibited. In these preparations, Aconiti tuber butanol fraction restored the decreased contractility in a dose-dependent manner. It was suggested that the positive inotropic effect of Aconiti tuber butanol fraction might be related with the stimulating action on the calcium influx through the slow inward calcium channels in the cardiac cell membrane. In contrast with digitalis cardiac glycoside, Aconiti tuber butanol fraction infused intravenously into the anesthetized rabbit decreased the systemic arterial blood pressure and increased the carotid blood flow, but produced no prominent changes in the heart rate.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.35-42
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• 2004

Background: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were peformed. This study was performed to investigate whether V-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. Material and Method: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. Result: left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizations by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal blanches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. Conclusion: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.