• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.689-699
• /
• 1996

An animal experiment was designed for the evaluation of in vivo performance of the newly developed electrohydraulic type ventricular assist device and its influence on the left ventricular function during pal- satile left ventricular assist. Eight adult sheep were incorporated into the study and data were collected from seven sheep. Total as- sist time ranged from 69 minutes to 7 days. The performance of the device was satisfactory both in asyn- chr nous and synchronous mode within the range of given native heart rate. More than 4 liters of device output could be reached within the range of normal left atral pressure without development of negative pressure in the left atrium. Moderate to severe degree of hemolysis was noted as evidenced by significant increase of plasma free hemoglobin level after 3 days of left ventricular support along with the presence of the small amount of thrombi around the floating disc type polymer valve apparatus reflecting that further study and refinement of the device need to be done in regard of biocompatibility and thromboresistance. The hemodynamics showed increase in heart rate (p < 0.05), cardiac output and left ventricular minute work (p < 0.05) after placement of the device at the flow rate of 2.0∼2.5 Llmin. The left atrial pressure, left ventricular pressure and LV dpldt were decreased after the device placement(p < 0.05). The endocardial viability ratio and oxygen contents of the mixed ven us blood and coronary venous blood were all increased (p < 0.05) after the device placement suggesting effective unloading of the left ventricle was accomplished. The myocardial perfusion was thought improved in synchronous counterpulsation as suggested by sig- nificant increase in endocardial viability ratio and coronary venous blood oxygen content in synchronous assist mode comparing with asynchronous mode.

• Proceedings of the KOSOMBE Conference
• /
• v.1992 no.11
• /
• pp.141-145
• /
• 1992

심부전 환자의 심근회복을 도울 수 있는 장비인 전기유압방식 좌심실보조기를 개발하였다. 좌심실보조기는 혈액펌프, 압력펌프, 제어기로 구성되어 있으며, 혈액펌프에 내장된 혈액주머니는 동물실험을 위하여 50 ml의 크기로 제작하였다. 좌심실보조기의 성능평가를 위하여 최대 박출량을 측정하고 있으나 실험실에서 측정된 간은 동물 실험에서 관찰되는 것보다 일반적으로 증가된 박출량을 보이게 된다. 이는 생체에서는 좌심방의 체적이 박동 주기에 따라 변하여 좌심실보조기가 받아들일 수 있는 유효 혈액량이 변하는 반면, 모의순환장치에서는 좌심방을 단순 저장고로 사용하기 때문에 좌심방의 박동주기에 따른 체적변화를 감안하지 못하여 생기는 것이다. 본 실험에서는 모의순환 장치에 체적변화 가능한 100ml 크기의 좌심방을 연결하여 좌심방으로 들어오는 혈류량이 제한된 동물실험 상황을 모방하였다. 좌심실보조기의 제어방식중 수측기 이완기 비율(SD 비율)변화에 따른 좌심방 음압발생효과를 관찰한 결과 SD 비율을 40 %로 유지하면 행정거리가 클때도 좌심실의 음압발생을 줄일 수 있는 것을 관찰하였다.

• The Korean Journal of Pharmacology
• /
• v.30 no.3
• /
• pp.321-330
• /
• 1994

The protective effect of 'ischemic preconditioning (PC)' on ischemia-reperfusion injury of heart has been reported in various animal species, but without known mechanisms in detail. In an attempt to investigate the cardioprotective mechanism of PC, we examined the effects of PC on the myocardial oxidative injuries and the oxygen free radical production in the ischemia-reperfusion model of isolated Langendorff preparations of rat hearts. PC was performed with three episodes of 5 min ischemia and 5 min reperfusion before the induction of prolonged ischemia (30 min)-reperfusion(20 min). PC prevented the depression of cardiac function (left ventricular pressure x heart rate) observed in the ischemic-reperfused heart, and reduced the release of lactate dehydrogenase during the reperfusion period. On electron microscopic pictures, myocardial ultrastructures were relatively well preserved in PC hearts as compared with non-PC ischemic-reperfused hearts. In PC hearts, lipid peroxidation of myocardial tissue as estimated from malondialdehyde production was markedly reduced. PC did not affect the activity of xanthine oxidase which is a major source of oxygen radicals in the ischemic rat hearts, but the myocardial content of hypoxanthine (a substrate for xanthine oxidase) was much lower in PC hearts. It is suggested from these results that PC brings about significant myocardial protection in ischemic-reperfused heart and this effect may be related to the suppression of oxygen free radical reactions.

• Proceedings of the KOSOMBE Conference
• /
• v.1997 no.11
• /
• pp.575-578
• /
• 1997

Myocardial blood low (MBF) in human can be noninvasively quantified using dynamic N-13 ammonia PET and two-compartment tracer kinetic model. In this study, factor analysis was used to extract the "pure" blood-pool time-activity curves (TACs) and to generate actor images. ive human N-13 ammonia PET dynamic studies were obtained. Three actors and their corresponding actor images were extracted rom each study. The accuracy of MBF estimated by the actor analysis (FA/FA MBF) was examined by comparing to the values estimated using the conventional ROI method (ROI/ROI MBF). MBF obtained by the actor analysis linearly correlated with MBF obtained by the ROI method (slope=0.98, r=0.91). Input unctions obtained by the two methods agreed well. In conclusion, MBF can be measured accurately and noninvasively with dynamic N-13 ammonia PET imaging and actor analysis. This method is simple and acurate and can measure MBF without blood sampling, ROI drawing nor spillover correction.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.16 no.3
• /
• pp.507-513
• /
• 2002

Jaeumgenby-tang(JGT) have been used in oriental medicine for many centries as a a therapeutic agent of vertigo caused by deficiency of qi and blood. The effects of JGT on the regional cerebral blood flow(rCBF), mean arterial blood pressure(MABP) and cardiac muscle contractile force(CMF) is not known. The purpose of this Study was to investigate effects of JGT on the rCBF, MABP, CMF and mechanism of JGT induced changed rCBF, MABP, CMF. The changes of rCBF, MABP and CMF were determinated by Laser-Doppler Flowmetry(LDF). The results were as follows; JGT extract was increased rCBF, MABP and CMF in a dose-dependent, specially JGT extract was significantly increased rCBF and MABP. Pretreatment with propranolol was significantly inhibited JGT induced increase of rCBF but pretreatment with indomethacin and methylene blue were accelerated JGT induced increase of rCBF. Pretreatment with propranolol and indomethacin were inhibited JGT induced increase of MABP, but pretreatment with methylene blue was accelerated JGT induced increase of MABP. Pretreatment with propranolol was significantly inhibited JGT induced increase of CMF but pretreatment with indomethacin and methylene blue were accelerated JGT induced increase of CMF. This results suggest that JGT increased rCBF by increasing MABP and CMF and the action of JGT is mediated by adrenergic β-receptor.

• Journal of Chest Surgery
• /
• v.35 no.12
• /
• pp.862-870
• /
• 2002

The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.329-334
• /
• 2008

Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

• Journal of Chest Surgery
• /
• v.33 no.7
• /
• pp.531-540
• /
• 2000

Baclgrpimd; Recent studies have suggested that the cardioprotective effect of ischemic preconditioning(IP) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G) is closely related to glycogen depletion and attenuation of intracellular acidosis. In the present study, the authors tested this hypothesis by perfusion isolated rabbit hearts with glucose(G)-free perfusate. Material and Method; Hearts isolated from New Zealand white rabbits(1.5~2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IP(IP group, n=13) or without IP(ischemic control group, n=10). IP was induced by single episode of 5 min global ischemia and 10 min reperfusion. In the G-free preconditioned group(n=12), G depletion was induced by perfusionwith G-free Tyrode solution for 5 min and then perfused with G-containing Tyrode solution for 10 min; and 45 min ischemia and 120 min reperfusion. Left ventricular functionincluding developed pressure(LVDP), dP/dt, heart rate, left ventricular end-distolic pressure(LVEDP) and coronary flow (CF) were measured. Myocardial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific peptide and PKC isozymes were analyzed by Western blot with monoclonal antibodies. Infarct size was determined by staining with TTC(tetrazolium salt) and planimetry. Data were analyzed by one-way analysis of variance (ANOVA) and Turkey's post-hoc test. Result ; In comparison with the ischemic control group, IP significantly enhanced functional recovery of the left ventricle; in contrast, functional significantly enhanced functional recovery of the left ventricle; in contrast, functional recovery were not significantly different between the G-free preconditioned and the ischemic control groups. However, the infarct size was significantly reduced by IP or G-free preconditioning(39$\pm$2.7% in the ischemic control, 19$\pm$1.2% in the IP, and 15$\pm$3.9% in the G-free preconditioned, p<0.05). Membrane PKC activities were increased significantly after IP (119%), IP and 45 min ischemia(145%), G-free [recpmdotopmomg (150%), and G-free preconditioning and 45 min ischemia(127%); expression of membrane PKC isozymes, $\alpha$ and $\varepsilon$, tended to be increased after IP or G-free preconditioning. Conclusion; These results suggest that in isolated Langendorff-perfused rabbit heart model, G-free preconditioning (induced by single episode of 5 min G depletion and 10 min repletion) colud not improve post-ischemic contractile dysfunction(after 45-minute global ischemia); however, it has an infarct size-limiting effect.

• Proceedings of the Korean Operations and Management Science Society Conference
• /
• 2003.05a
• /
• pp.21-27
• /
• 2003

분산컴퓨팅, 다자간 협업, 대용량 고품질의 컨텐츠 교환을 지원하는 P2P는 차세대 인터넷의 핵심 어플리케이션이 될 것이다. 본래 인터넷의 근본이었던 IP 라우팅도 P2P 방식이었다. 장비가 다양해지고, PC가 증가하게 됨에 따라 동적 IP를 사용하거나, 하나의 IP를 여러 사람이 공유하여 사용하는 복잡한 방식을 취하기 시작했다. 그러나 새로운 IP 주소들이 충분히 공급될 수 있다면, 하나의 장치 당 하나의 주소 체제가 다시 각광을 받게 될 것이고, 지금처럼 불규칙적인 동적 IP 주소를 활용하지 않아도 될 것이다. 그런 의미에서 IPv6는 풍부한 주소자원을 각 단말에 부여할 수 있어, IPv16 기반의 P2P 구축은 P2P의 성능을 최적화하는 방법이 될 것이다. 현재 P2P는 콘텐츠 공유 및 전달, 네트워크/장치(하드디스크, CPU) 리소스 공유, 다자간 원격협업, 검색, 호스팅 및 프로젝트 관리 등 다양한 방법으로 활용되고 있다. 2000년경부터 대두되기 시작한 P2P 애플리케이션은 지난 2년 동안 급속하게 늘어났으며, 특히 인터넷 사용자들은 컨텐츠를 공유/전달할 목적으로 P2P를 많이 사용하고있다. 그러나 컨텐츠의 공유에 있어 MP3, 동영상, 이미지의 전달 및 공유에 그치고 있어, P2P를 기업 환경에서 지식공유 및 전달을 위한 시스템으로 활용하는 경우는 아직 미약하다. 그러므로 본 논문에서는 조직 내에서 정보활용 능력을 제고하기 위한 방안으로 P2P 시스템을 정보 공유 시스템으로 팔용하고, P2P의 성능을 최적화 할 수 있는 IPv6 기반의 개발 방안을 제안하고자 한다. 본 IPv6 기반의 정보 공유 P2P는 IPv6 전문가 그룹을 통해 시범적으로 적응하는 것으로 시작해, 학교 및 연구소를 통한 정보지식 공유 그리고 기업 정보화 솔루션으로 활용 될 수 있다.을 제시한다. 이렇게 함으로써 최대한 고객 납기를 만족하도록 계획을 수립할 수 있게 된다. 본 논문에서 제시하는 계획 모델을 사용함으로써 고객 주문에 대한 대응력을 높일 수 있고, 계획의 투명성으로 인한 전체 공급망의Bullwhip effect를 감소시킬 수 있는 장점이 있다. 동시에 이것은 향후 e-Business 시스템 구축을 위한 기본 인프라 역할을 수행할 수 있게 된다. 많았고 년도에 따른 변화는 보이지 않았다. 스키손상의 발생빈도는 초기에 비하여 점차 감소하는 경향을 보였으며, 손상의 특성도 부위별, 연령별로 다양한 변화를 나타내었다.해가능성을 가진 균이 상당수 검출되므로 원료의 수송, 김치의 제조 및 유통과정에서 병원균에 대한 오염방지에 유의하여야 할 것이다. 확인할 수 있었다. 이상의 결과에 의하면 고농도의 유기물이 함유된 음식물쓰레기는 Hybrid Anaerobic Reactor (HAR)를 이용하여 HRT 30일 정도에서 충분히 직접 혐기성처리가 가능하며, 이때 발생된 $CH_{4}$를 회수하여 이용하면 대체에너지원으로 활용 가치가 높은 것으로 판단된다./207), $99.2\%$(238/240), $98.5\%$(133/135) 및 $100\%$ (313)였다. 각각 두 개의 요골동맥과 우내흉동맥에서 부분협착이나 경쟁혈류가 관찰되었다. 결론: 동맥 도관만을 이용한 Off pump CABG를 시행하여 감염의 위험성을 증가시키지 않으면서 영구적인 신경학적 합병증을 일으키지 않았고 좋은 혈관 개존율을 보여주었다. 따라서 동맥 도관을 이용한 Off pump CABG는 관상동맥의 협착의 정도에 따라 효율적으로 시행 시 좋은 임상결과를 얻을 수 있을 것으로 생각된다.였다. 그러나 심근 기능이나

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