• Childhood Kidney Diseases
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• v.5 no.1
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• pp.9-14
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• 2001

Purpose : This study was undertaken to investigate clinical aspects of nutcracker syndrome in children including sexual distribution, age of onset, the ratio of peak flow velocity between the narrowed and dilated portions in the left renal vein and prevalence of hematuria or proteinuria. Materials and Method : The subjects included 30 patients diagnosed with nutcracker syndrome using Doppler sonography from September 1999 to January 2001 in Severance Hospital, Department of Pediatric Nephrology. The diagnostic criteria for nutcracker syndrome was a peak flow velocity of ratio is more than 5.0. Results : Patients consisted of 14 males and 16 females. The mean age was 9.19${\pm}$2.31 years old and the ratio of peak flow velocity was 8.52${\pm}$2.24. Age of onset us higher in males 9.68${\pm}$2.82 year old than in females, 8.76${\pm}$1.72 year old respectively(P<0.05). But there was no difference in the ratio of peak flow velocities ; 8.45${\pm}$2.31 in the male group , 8.58${\pm}$2.25 in the female group(P>0.05). There was no difference in the age of onset and the ratio of peak flow velocity between patients with hematuria and without hematuria. Among patients with nutcracker syndrome, 24 cases of hematuria, 3 cases of proteinuria only, and 3 cases of hematuria with proteinuria. Conclusion : In children of school age, early diagnosis of nutcracker syndrome and consistent follow up is worthy of consideration, especially ill the prevention of sequelae. (J. Korean Soc Pediatr Nephrol 5 : 9-14, 2001)

• Korean Journal of Veterinary Research
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• v.12 no.1
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• pp.37-50
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• 1972

Another comparison of alveolar gas pressures, in a continuously rebreathing dog lung, with pulmonary arterial (mixed venous) blood, again showed alveolar pressures to be the higher for $CO_2$ and usually $O_2$ (positive ${\Delta}Pco_2$, and ${\Delta}Po_2$). ${\Delta}Pco_2$ was almost invariably positive, it was independant of time and of plasma pH changes produced by acid or bicarbonate infusion, but proportional to blood $CO_2$ level. It was seemingly little affected by the distribution or magnitude of blood flow nor did it result from failure of $CO_2$ equilibrium within the blood, but it did rise with carbonic anhydrase inhibition. ${\Delta}Po_2$ was more variable and sometimes negative, particularly at low blood flow rates. It seemed in dependant of time, and plasma pH changes, apart from an inverse relationship with that resulting from $CO_2$ changes. It existed despite considerable potential for gas exchange, and was unaffected by inhibition of the $CO_2$ reactions.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.41-46
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• 2002

The Fourier transform arteriography (FTA) exploits the periodic variation of arterial flow velociety of arterial flow velocity in stnchronized with cardiac cycles. This technique is intrinsically unique compared to other modern techniques. This technique separates the arteries from the veins using the pulsatile arterial flow without using the presaturation RF pulses. Therefore, it has less RF deposition and is free from the dark band artifacts that can arise from retrograde flow and curved arteries. Furthermore, it is free from the artifacts induced by eddy currents. However, there are some drawbacks such as a single projection view and the saturation of arteries at the end of an imaging slab. These drawbacks are circumvented by applying recently developed techniques. The fast gradient switching capability of modern MRI systems enabled us to incorporate dual projection views into the conventional FTA sequence without increasing the repetition time. In addition, signals from the distal arteries were enhanced by use of a ramped RF pulse and therefore the distal arteries were less saturated. By use of the FTA sequence with dual projection views and the ramped RF pulse, we acquired the sagittal and coronal projection views of femoral arteriograms simultaneously with more enhanced signals of distal arteries than the conventional FTA.

• Journal of Biomedical Engineering Research
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• v.21 no.4
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• pp.391-401
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• 2000

Flow through compliant tubes with linear taper in wall thickness is numerically simulated by finite element analysis. For verification of the numerical method, flow through a compliant stenotic vessel is simulated and the results are compared to the existing experimental data. Steady two-dimensional flow in a collapsible channel with initial tension is also simulated and the results are compared with numerical solutions from the literature. Computational results show that as cross-sectional area decreases with the reduction in downstream pressure, flow rate increases and reaches the maximum when the speed index (mean velocity divided by wave speed) is near the unity at the point of minimum cross-section area, indicating the flow limitation or choking (flow speed equals wave speed) in one-dimensional studies. for further reductions in downstream pressure, flow rate decreases. The flow limitation or choking consist of the main reasons of waterfall effect which occurs in the airways, capillaries of lung, and other veins. Cross-sectional narrowing is significant but localized. When the ratio of downstream-to-upstream wall thickness is 2, the area throat is located near the downstream end. As this ratio is increased to 3, the constriction moves to the upstream end of the tube.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.49-54
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• 1994

Postoperative brain damage is one of most serious complications of cardiopulmonary bypass (CPB). To prevent brain damage during CPB, adequate cerebral perfusion for cerebral oxygen demand should be maintained. This study monitored jugular venous oxyhemoglobin saturation ($SjO_2$), which reflects the overall balance of cerebral oxygen supply and demand, intermittently in 10 patients undergoing cardiac surgery. At the initiation of CPB, in spite of a significant decrease in mean arterial pressure, $SjO_2$ did not change, and it was stable during the hypothermic period of CPB. But a significan reduction in $SjO_2$ was observed during the rewarming period, and $SjO_2$ had an inverse linear correlation with esophageal temperature. Furthermore, the percent decrease of $SjO_2$ was related to rewarming speed. Therefore, therapeutic approaches for $SjO_2$ desaturation include slower rewarming, increasing cerebral blood flow, decreasing the cerebral metabolic rate for oxygen, increasing oxygen content, and increasing perfusion flow rate.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.177-177
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• 1993

뇌모세혈관내피세포로 구성된 혈액-뇌관문(BBB)은 tight junction으로 구성되어 있을뿐만 아니라 fenestra가 없는 등 BBB가 가진 특성으로 인해 물질 수송에 장벽역할을 하기 때문에 주로 중추신경계 질환시의 약물요법에 많은 제한이 따른다. 따라서 뇌로의 효율적인 약물 송달방법에 대해 많은 연구가 진행중에 있는데 본 연구에서는 BBB의 hyperosmotic opening법을 이용하여 뇌로 잘 수송되지 않는 약물의 뇌송달 방법에 대해 연구하고자 하였다. 먼저 수용성으로 인해 BBB 에 잘 통과하지 않는 물질로 신장 및 뇌영상 촬영시 사용되는 방사성 의약품이 Tc-DTPA를 이용하여, hyperosmotic opening법에 의한 뇌투과 증가정도를 검토하였으며, 실험방법이 확립됨에 따라 뇌암의 항암요법을 위해 뇌로의 투과가 적은 항암제(5-Fluorouracil, 5-FU)의 뇌송달에 대해 본 방법을 적용하여 검토하였다. 실험동물로는 S.D.계 웅성 랫트를 사용하였으며, 실험방법은 다음과 같이 하였다. 랫트의 좌측 외경동맥(left external carotid artery)에 혈류의 역방향으로 혈관 분지점에서 1-2mm 전까지 PE-50 catheter를 삽입하고, 1.6 molal L－(＋)－ arabinose 고장액(1580mOsm)을 0.12ml/sec의 일정한 속도로 30초간 infusion함으로 BBB를 opening 한 다음, 5분 후에 Tc-DTPA를 대퇴 정맥으로 주사하여 0, 10, 30초, 1, 1.5, 2, 3, 4, 5, 7 및 10분 간격으로 대퇴동맥에 설치한 카테타로부터 혈액을 채취하고 마지막 혈액을 취한 후 즉시 단두하여 뇌를 적출하였다. 채취한 뇌를 액체질소에 담근 후 tissue Tek으로 고정하고 autoradiography를 하기 위한 slice와 농도측정을 위해 필요한 부위를 취한 후 감마카운터로 Tc-DTPA의 brain각 부위별 및 혈장농도를 측정하였다. 뇌조직중 혈액부피의 측정은 Tc-albumin를 이용하여 구하였다. 같은 방법으로 5-FU에 대한 실험도 행하였고, 이때 각 혈장 및 조직중의 5-FU함량은 HPLC로 하였다.

• Physical Therapy Korea
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• v.9 no.2
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• pp.107-113
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• 2002

This study was conducted to determine the effects of deep breathing exercise and ankle exercise on blood flow velocity in the femoral vein. Sixteen healthy male students were recruited from Yonsei University, at Wonju. The blood flow velocities in the femoral vein were measured under three different conditions: resting, deep breathing, and ankle exercise. All subjects were given a 5-minute relaxing time in supine position prior to the study. Using a doppler ultrasound with a 8 MHz probe, the peak blood flow velocities were collected in a twenty-second-period at each condition. The subjects took a rest in between trials for the blood flow to return to its resting levels. The result showed a significant difference in peak blood flow velocities under those three conditions (p<.001). The peak blood flow velocity was highest in ankle exercise condition. The peak blood velocity was significantly higher in deep breathing condition compared with the resting condition. As a result, it is revealed that not only the muscular contractions but also the deep breathing exercises induced facilitating effects of venous return. Either of the exercise methods can be recommended to prevent blood stasis in patients with risk of deep vein thrombosis after cardiac or lower extremity surgery.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.874-882
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• 1999

배경: 체외순환 후의 부종현상 및 이에 따른 여러 장치의 기능 저하를 방지하기 위하여, 최근에 체외 순환 이탈 후 환자의 혈액을 짧은 시간에 관류하여 여과해 주는 변형 초여과법의 사용이 늘고 있다. 이에 대한 긍정적인 임상결과들의 보고도 있으나, 다른 한편 체외 순환 후 염증반응을 포함한 폐손상의 기전에 혈구 성분의 영향이 보고되고 있는 바, 변형 초여과법의 효과, 특히 폐 조직에 대한 영향을 밝혀 보고자 하였다. 대상 및 방법: 몸무게 15에서 22 Kg(평균 16.5$\pm$0.5)의 16 쌍의 잡견을 이용한 정소성 심장이식, 실험에서, 통상적인 인공심폐기 작동군과 인공심폐기 작동 후 변형 초여과 관류를 시행한 군으로 무작위 구분하였다. 변형초여과법은 체외순환 정지 후에 대동맥관에서 나온 혈류를 Roller pump를 거쳐 Amicon Diafilter 초여과 관에 150 mL/m 정도의 속도로 10~15 분 정도 관류시켜 정맥관을 통하여 우심방에 직접 주입하였다. 혈액 채취 및 폐생검은 심폐기 시작 전과 정지 직후, 그리고 변형초여과 시행 군은 초여과 완료 직후에, 대조군은 심폐기 정지 10~15분 후에 각각 시행하였다. 혈류역학 측정요소는 동맥압, 우심방압, 좌심방압 등이었으며, 혈액 검사 항목은 동맥혈 가스분석, 혈색소 농도, 헤마토크릿, 백혈구 수, 혈소판 수, 혈중 단백 성분, 알부민 성분 등이었다. 폐 생검 조직으로는 냉동 건조법을 이용한 수분 함유량을 측정하였고, 광학 및 전자현미경으로 관찰을 하였다. 결과: 변형 초여과 군에서 혈중 혈색소 농도는 수술전 10.3$\pm$1.7 mg/dL, 심폐기 정지 직후 6.3$\pm$1.7 mg/dL, 초여과 직후는 8.3$\pm$2.8 mg/dL의 변화를(p=0.0078, 0.0117), 혈중 총 단백질의 농도 변화는 4.3$\pm$0.9, 3.1$\pm$1.5, 4.1$\pm$1.6 mg/dL, 혈중 알부민의 농도는 1.9$\pm$0.5, 1.4$\pm$0.7, 1.8$\pm$0.8 mg/dL로서, 각각 초여과법의 시행 전후에 유의한 증가를 가져왔고(p=0.0280, 0.0277), 폐조직의 수분 함유량의 변화는 수술전 75.1$\pm$8.6%, 심폐기 정지 직후 82.8$\pm$6.0%, 초여과 직후 77.88%를 보인 반면, 대조군에서는 각각 74.7$\pm$4.9, 82.1$\pm$5.9, 82.3$\pm$5.1%의 변화를 보였다. 미세 구조의 관찰에서, 폐포의 내포세피의 융합 기저막층과 미토콘드리아에서의 부종은 변형 초여과 후에 급격히 감소하였으나, 미토콘드리아내 크리스티의 파괴성 변화와 막성 파괴 성향이 초여과 후에 심화되게 관찰되었고, 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 폐조직 내의 백혈구는 심폐기 작동 후에 그 수에 있어서 증가하였으며 백혈구의 괴변, 탈과립 정도도 심폐기 작동 후 및 초여과 후에 증가한 소견을 보였다. 결론: 변형 초여과법은 인공 심폐기 후의 혈색소 농도 및 혈중 단백질 농도의 복원에 효과가 있었으며 변형 초여과 관류후 폐의 미세 조직내에서 부종의 급격한 감소 등을 관찰할 수 있었다.

• 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.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.255-261
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• 1999

Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.