• Title/Summary/Keyword: 심장혈관계

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Relationship Between Body Position and Peripheral Pulse Arrival Time In Man (인체에서 체위변화와 말초맥파도달시간의 관계)

  • 허재택;허기영;정동근
    • Journal of Biomedical Engineering Research
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    • v.22 no.2
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    • pp.133-138
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    • 2001
  • 동맥계에서 맥파의 전달속도는 혈관의 긴장도에 따라 결정된다. 동맥혈관의 긴장도는 혈압에 의존적이며 순간적인 혈압의 증가에 따른 혈관긴장도의 변화는 순환기계의 질병을 야기할 수 있다. 본 연구에서는 말초맥파를 이용한 동맥 긴장도 평가 방법의 유용성을 밝히기 위하여 말초맥파 도달시간을 체위에 따라 측정하고, 체위 변화에 따른 정수압 변화와 말초맥파도달시간의 관계를 관찰하였다. 말초맥파도달시간의 측정은 심전도의 QRS파 피크로부터 말초에서 나타나는 광전용적맥파의 최대기울기점까지 시간을 측정하였다. 생체 신호를 아날로그-디지털 변환하여 PC에서 매번 심장주기마다 맥파도달시간을 분석하였으며 결과는 스플라인 보간법을 사용하여 그래프로 결과를 제시하였다. 소프트웨어는 C++을 사용하여 windows 환경에서 운용하였다. 앙아위에서 말초맥파도달시간은 233.38$\pm$1.84 ms이었으며 서있는 자세에서는 226.77$\pm$2.16 ms로 유의하게 감소하였다. 앙아위의 자세에서 손을 수직으로 들어올림에 따라 말초맥파도달시간은 각도에 비례하여 증가하는 특성을 보였다. 이러한 실험결과는 말초맥파도달시간이 동맥계의 일시적인 압력 변화에 매우 민감하게 반응하는 것을 제시하였으며, 고혈압 및 동맥경화가 있는 환자에서 예후를 판단하는 방법으로 유용하게 사용될 것이라 사료된다.

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Cerebrovascular Complications after Coronary Bypass Surgery. (관상동맥우회술 후 발생한 뇌혈관계 합병증)

  • Jin, Ung;Kim, Young-Doo;Yoon, Jeong-Seob;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.869-875
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    • 2000
  • 배경: 뇌혈관계 합병증은 관상동백우회술 후 발생하는 사망률 중 10% 이상을 차지하는 치명적인 질환이다. 최근들어 고령 환자, 고혈압, 당뇨병 등이 병발하고 고 위험군에 대한 수술이 증가하면서 뇌혈관계 합병증은 오히려 증가하고 있다. 본 연구는 관상동맥우회술을 받은 환자의 의무기록을 조사하여 관상동맥우회술 후 발생되는 뇌혈관계 질환의 위험 인자를 밝히고자 한다. 대상 및 방법: 1991년 3월부터 1999년 7월 사이에 관상동맥우회술을 받은 185명을 조사하여, 뇌혈관계 합병증의 위험 인자들을 통계적으로 검증하였다. 결과: 뇌혈관계 합병증의 유병율은 7.57%(14명)였으며 이중 5예는 사망하였다. 동 기간 중 전체 사망은 11예이므로 사망자의 45.5%가 뇌혈관계 합병증으로 사망한 것이다. 통계적의의가 있는 뇌혈관계 합병증 위험 인자로는 수술 후 부정맥(p=0.0064), 기왕의 뇌혈관계 병력(p=0.0090), 체외순환시간(p=0.0181), 대동맥의 동맥경화(p=0.03575) 및 당뇨병(p=0.0452) 등이었다. 경동맥협착이 동반되어 경동맥 혈관내막 절제술(carotid endarterectomy)을 동시에 시술한 경우는 2예였으나, 뇌혈관계 합병증은 발생하지 않았다. 75세 이상의 고령환자는 3명이었으며 모두 뇌혈관계 합병증은 발생하지 않았다. 결론: 관상동맥우회술 후 발생하는 뇌혈관계 질환과 통계적으로 유의한 위험요인은 수술 후 부정맥, 뇌혈관이상의 기왕력, 체외순환시간, 대동맥궁의 동맥경화, 당뇨 등이었다.

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Experimental Endotoxin-Induced Disseminated Intravascular Coagulation in Rat Model (쥐 모델에 있어 내독소에 의한 실험적인 범발성 혈관내 응고증)

  • Seok- Cheol Choi;Jai-Young Kim;Jin-Bog Koh;Won-Jae Lee
    • Biomedical Science Letters
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    • v.3 no.2
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    • pp.83-88
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    • 1997
  • In septic patients, disseminated intravascula. coagulation (DIC) occurs frequently and is a pathologic condition associated with a variety of critical illness. DIC may complicate the already complex clinical situations and contribute to the high mortality. Nevertheless, its pathogenic mechanisms are not completely elucidated. Present study was prospectively designed to understand the pathogenetic mechanisms involved in the development of DIC. 15 rats were subjected to study and according to the aim, they were divided into three groups: group I, control (not treated-endotoxin, n=5); group II (12 hours after endotoxin injection, n=5); group III (24 hours after endotoxin injection, n=5). Experimental DIC was induced in rats by a bolus injection of endotoxin (1mg/kg, E. coli serotype 055:B5). Blood was collected by direct puncture of the heart. Platelet count, fibrinogen and plasminogen concentration, antithrombin III, D-dimer and complement components (C3 and C4) were measured in all subjects. In group II and III, there were apparent signs of DIC, including thrombocytopenia, decreased fibrinogen (but increase in group III), reduced C3 and antithrombin III, and elevated D-dimer. These data indicated that endotoxin might induce the activation of several pathways such as coagulation, fibrinolytic and complement cascade, causing DIC and subsequent multiple organ failures. Ultimately, the increased knowledge of the various pathogenetic mechanisms of coagulation activation and fibrinolysis in endotoxin-induced DIC may have prophylactic or therapeutic implications.

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Construction of Ultrasound Pulsed Doppler Velocimeter (펄스 초음파 도플러 속도계의 제작에 관한 연구)

  • 현석봉;김수용;이재수
    • Progress in Medical Physics
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    • v.5 no.1
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    • pp.25-39
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    • 1994
  • To measure the velocity of heart wall and local flow transctaneously in blood vessels, we have developed a single channel 3.1 MHz pulsed ultrasonic Doppler velocity meter. Ultrasound pluse width and repetition frequency (PRF) used in the velocity meter is 1 ${\mu}$sec 6kHz reapectively, and the Doppler shift of the backscattered echo signal is sensed in a phase detector by coherent demodulation method. From the output of the phase detector, the Doppler signal corresponding to the mean velocity of acoustic wave scatterers over a small region is obtained by using a range gate, sample holder and band-pass filter. Mean frequency of Doppler signal is estimated by zero-crossing counter and the instantaneous velocity of scatters is displayed as a function of time. It is possible to estimate velocity profile, volume flow and flow acceleration of vessels in man if the number of channels and range resolution in increased.

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Effects of Extruded Job s-tear Cereal on Lipid Metabolism in High Fat Fed Rats (압출성형된 율무 시리얼 식이가 고지방섭취 흰쥐의 지질대사에 미치는 영향)

  • 김병용;강병선;원혜진;함영태;김혜경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.2
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    • pp.252-256
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    • 2000
  • Coronary heart disease (CHD) is caused by elevated blood lipids and the death rate from CHD is continuously increasing in recent years. In Korea, death rate from CHD is more than 30%. Recently, it has been reported that Job's tear decreaseds blood cholesterol level. However, most of the reports used Job's tear itself. Therefore, we have examined the effect of extruded Job's-tear cereal on blood and liver lipid levels in rats fed with a high fat diet for 5 weeks. The energy intake and body weight gain were higher in Job's tear cereal group (JFD) than in high fat fed group(HFD). Blood triglyceride concentration was significantly reduced in JFD group (p<0.05). And Atherogenic Index was decreased about 20% in JFD suggesting favorable effect of Job's-tear cereal on hyperlipidemia. Liver lipids levels were not affected by Job's-tear cereal.

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Extralobar Pulmonary Sequestration located in Right Oblique Fissure with Unusual Vascularture - A Case of Report - (우측 폐엽간에 위치한 비정상 혈관구조를 가진 외엽형 폐격리증 - 1례 보고 -)

  • 윤찬식;정재일;김재욱;윤영철;이홍섭;이혜경
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.502-505
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    • 2001
  • Pulmonary sequestration is an abnormal lung tissue that does not communicate with tracheobronchial tree, and that receives blood supply from anomalous arteries. Pulmonary sequestration is divided into two anatomical forms, intralobar and extralobar. Extralobar pulmonary sequestration is usually located between the diaphragm and the lower lobe and has systemic arterial supply and venous drainage, and most patients are diagnosed in their infancy. We report an extralobar pulmonary sequestration located between the right upper lobe and the lower lobe in a 48-year-old female adult, which has anomalous blood supply from the right pulmonary artery and venous drainage directly into the left atrium.

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Endovascular Aortic Balloon Clamping for Various Heart Disease (대동맥 내 풍선 차단법을 이용한 여러 가지 심장수술)

  • Choi, Jin-Ho;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.61-67
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    • 2008
  • Background: Conventional ascending aortic cross clamping is often limited. This study was carried out to evaluate the safety and efficacy of an endovascular aortic clamping technique with an intraaortic balloon catheter. Material and Method: From April 2004 to January 2007, surgery with endoaortic clamping was performed in seven patients. A retrograde access perfusion (RAP) catheter was used in six patients and a Pruitt's balloon catheter in two patients. The indication for the operation was a retrosternal pseudoaneurysm of the aortic root in six patients, diffuse calcification of the ascending aorta with aortic regurgitation in 2 patients and an atrial septal defect in one patient. Five patients had at least two prior cardiac surgeries. Result: Successful insertion of the catheter and endoaortic clamping was achieved in all patients. Conclusion: The endovascular aortic clamping technique with a balloon catheter was a useful alternative method for patients in whom conventional cardiac surgery was limited.

Results of Surgical Management in Patients with Cardiac and Arterial Manifestations of Behcet's Syndrome (심장 및 동맥계를 침범한 베체트씨 증후군 환자의 수술 후 결과)

  • 원종윤;장병철;이도연;박상준
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.36-42
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    • 2002
  • Background: To evaluate the efficiency of surgical treatment in patients with cardiac valvular and arterial involvement of Behcet's syndrome. Material and Method: 12 patients underwent surgical treatment due to the valvular heart diseases and the various arterial diseases associated with Behest's syndrome over 7 years; 6 with valvular heart disease, 1 with annuloaortic ectasia, 1 with ascending aortic aneurysm, 4 with pseudoaneurysms in abdominal aorta(n=2), carotid artery(n=1), and popliteal artery(n=1). All 12 patients had received valvular replacement(n=6) and the artificial(n=5) or autologous(n=1) graft interposition. We followed the results of these surgical treatments. Result: Operations were technically successful in all 12 patients and peri-operative complication was not demonstrated. However, 10 patients had recurrences; 6 with valvular dehiscence, 3 with pseudoaneurysm at anastostomosis site, and 1 with aorto-duodenal fistula. The duration of recurrence was 1 to 55 months(mean: 15.7$\pm$ 16.2 months). 7 patients underwent the second operation and among them, 4 patients showed repeated recurrences. Overall, 5 patients died 2 to 25 months after the operation(mean: 13.6 months), because of the bleeding at the anastomosis site Five patients did not present recurrence after the first(n=2) or the second operation(n=3) and their follow up duration was 5 to 60 months(mean: 45.8$\pm$41.7 months). Five patients received immune-suppressive therapy after the first(n=2) and second operation(n=3). Three did not shown recurrence for the 13, 29 and 33 months. Conclusion: Post-operative prognosis of arterial manifestation of Behcet's syndrome was not encouraging and if possible, other treatment strategy should be considered.

Spontaneous Pneumothorax due to Pulmonary Invasion in Multisystemic Langerhans Cell Histiocytosis (다체계 랑거한스 세포 조직구 증식증에 의해 발생한 기흉)

  • Cho, Kyu-Seok;Kim, Jung-heon;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.447-449
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    • 2010
  • Langerhans cell Histiocytosis can present as a single or multiple lesion and can affect one or several organ systems. A 41-year-old woman with a history of multisystemic Langerhans cell Histiocytosis invading lung and thyroid was admitted with left-sided spontaneous pneumothorax. Here we report a case of uncommon pulmonary Langerhans-cell Histiocytosis presenting with spontaneous pneumothorax as a multisystemic Langerhans cell Histiocytosis.

Magnetic Resonance Angiographic Evaluation as a Screening Test for Patients who are Scheduled for Cardiac Surgery (심장수술 대상자에서 선별 검사로서 두경부 MRA)

  • Suh, Jong-Hui;Choi, Si-Young;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.718-723
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    • 2008
  • Background: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. Material and Method: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. Result: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. Conclusion: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.