• Title/Summary/Keyword: 혈관상태

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뇌혈류 자가조절과 내인성 $K^{+}$ channel 개방물질에 대한 연구

  • 홍기완
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.85-85
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    • 1993
  • 뇌동맥계는 일과성 저혈압에 반응하여 혈관확장이 야기되고, 혈압 상승시에는 혈관수축이 일어남으로서 뇌혈류가 일정하게 조절된다. 이러한 자가조절은 뇌손상 등의 병적 상태에서 야기된다. 연구의 목적은 \circled1 Cromakalim, CGRP(calcitonin-gene related peptide), 및 substance P에 의하여 뇌연막동맥의 직경이 어떻게 변동하는가를 관찰하고 \circled2 이들 신경성 peptide의 작용에 대하여 $K^{+}$ 통로 개방 봉쇄제인 glibenclamide의 전처치 효과를 검색하고 \circled3 Capsaicin 전처치가 뇌혈류 자가조절에 어떻게 영향을 미치는가를 검색하였다. 그 결과는 다음과 같다. 1. 뇌혈류 자가조절은 대퇴동맥을 통한 사혈에 의하여 혈압하강을 일으킬 때 뇌연막 동맥은 이완하였고, reservoir내의 혈액을 체내로 주입함로서 혈압반전을 일으켰을 때는 혈관 수축이 일어났다. 2. 연막동맥은 glibenclamide (1~3$\mu$M)의 관류에 의하여는 영향을 받아니하였다. 3. 혈압변동에 따른 혈관직경의 변화를 회기직선으로 분석하였다. Glibenclamide 1과 3$\mu$M의 전처치 관류에 의하여 혈압하강에 따른 혈관 이완경사도와 혈압반전에 따른 혈관수축 경사도가 대조군에 비하여 현저히 약화되었다. 4. Cromakalim (0.1-30$\mu$M)의 각 농도를 대뇌표면에 관류시 연막동맥의 기초직경은 약물농도에 의존하여 증가되었고, 이는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었다. 5. CGRP (0.1~100 nM)와 substance P (0.1~10nM)도 용량에 의존하여 혈관이완을 일으켰다. 전자는 glibenclamide (1$\mu$M) 전처치 관류에 의하여 억제되었으나 후자는 영향을 받지 아니하였다. 6. Capsaicin(50 nmol: intracisternally) 주사에 의하여 뇌혈류자가조절의 변동이 초래되었다. 이상의 결과들을 종합하면 CGRP가 혈압변동에 의하여 반사적으로 유리되고, 이는 glibenclamide-sensitive $K^{+}$ 통로에 작용하는 것으로 시사된다.

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Treatment of Vasodilatory Shock after Cardiac Surgery : Low Dose Arginine Vasopressin Therapy - Three cases report - (개심술후 발생한 Vasodilatory Shock의 치료 : Arginine Vasopressin의 소량투여요법 - 3례 보고 -)

  • 이교준;김해균;정은규;김도형;강두영;이응석
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.227-230
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    • 2002
  • The vasodilatory shock after cardiopulmonary bypass is defined as the condition involving severe and persistent form of hypotension, tachycardia, normal or increased cardiac output and decreased systemic vascular resistance. Because of the unsuccessful response to infusion of fluids or catecholamine vasopressors, a sustained systemic shock state occurs and results in a high morbidity and mortality. We successfully treated this syndrome of 3 patients after open heart surgery with low dose of arginine vasopressin(AVP). Therefore, we report these cases with a review of related articles.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

The Analysis of Pulse Wave Velocity of Jeju female divers (제주 해녀의 맥파전도속도 분석)

  • Lee, Han-Young
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.515-521
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    • 2015
  • In this study, we tried to analyze arterial stiffness of Jeju female divers who diver into cold water without the assistance of oxygen. For this purpose we measured pulse wave velocity and ankle-brachial index of Jeju female divers and same aged females who didn't have any cardiovascular risk for comparing the vascular stiffness. The results were the following : First, the light-femoral pulse wave velocity of Jeju female divers was significantly lower than normal women of the same ages. Second, Jeju female divers's ABI showed higher tendency than normal same aged women. These result showed that Jeju female divers' body had been completed for adaptation to low temperature and high pressure water environment through a long-term immersion activities in old age, as well as due to higher physical activity levels of Jeju female divers peripheral vascular resistance was not reduced.

Surgical Management of Giant Aneurysm of Intracranial Artery Under Circulatory Arrest -one case report- (총순환정지를 이용한 두개강내 거대동맥류 치험 1례)

  • 홍종면;김오곤;이석재;홍장수;민경수;김상태;임승운;송우익
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.80-83
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    • 1999
  • Complete circulatory arrest with profound hypothermia has been an indispensable adjunct to the safe management of selected giant intracranial aneurysms. For the conduct of cardiopulmonary bypass, there are usually two kinds of methods, open and closed chest methods. We could manage one case of huge intracranial aneurysm that was successfully operated under circulatory arrest using the closed chest method, especially with percutaneous insertion of arterial and venous cannulas for cardiopulmonary bypass.

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Stimulatory Efect of Cinnamomum cassia Extract on Angiogenesis Through Regulation of VEGF (VEGF 조절을 통한 육계 추출물의 신생혈관 형성 촉진 작용)

  • Ko, Jeong-Min;Lee, Sang-Hoon;Baek, Yong-Hyeon;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.153-162
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    • 2009
  • 목적 : 한의학 분야에서 육계(CCE: Cinnamomum cassia)는 혈류 순환이 저하된 상태에 널리 쓰이는 약재이다. 이 연구에서는 CCE와 그 활성 혼합물인 cinnamic acid가 in vitro와 in vivo에서 발휘하는 신생혈관 형성 작용에 대해 알아보고자 한다. 방법 : CCE와 CA의 신생혈관형성 작용을 알아보기 위하여 Human unbilical endothelial cells(HUVECs)와 Bovine arterial endothelial cells(BAECs) 그리고 Matrigel assay를 이용하였다. 결과 : In vitro에서 CCE와 그 활성 혼합물은 HUVEC 증식, 이동, 모세혈관-유사 관 형성을 유도한다. CCE에서의 25-50% 증가(1 또는 10ng/ml 용량에서)는 CA에서 증식과 유사하게 나타났다. HUVEC에서는 증식이 뚜렷하게 나타났으나 BAEC에서는 증식이 뚜렷하게 나타나지 않아 증식 효과는 내피세포의 기원에 따라 다른 것으로 나타났다. BAEC는 CCE와 CA에서 증식은 보이지 않았지만 이동과 모세혈관-유사 관 형성 또는 분화를 보였다. 또한 CCE와 CA는 HUVEC에서 VEGF 발현과 Flk-1/KDR 발현을 각각 2.2배와 2.5배 증가시켰다. 결론 : CCE와 그 활성 혼합물은 in vivo와 in vitro에서 혈관 내피세포의 VEGF 발현을 통하여 신생혈관 형성 작용을 유도하며 이는 앞으로 다른 한약 추출물의 신생혈관형성 촉진 작용 연구에 모델을 제시할 것으로 보인다.

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Primary Intracardiac Hemangioma -1 case report- (원발성 심장 혈관종 -1례 보고-)

  • 임상현;장병철;이문형;조상호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.735-738
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    • 1998
  • Intracardiac hemangiomas are very rare primary cardiac tumor and there have been at least 37 reports of surgically resected cardiac hemangiomas. Most cardiac hemangiomas are asymptomatic. In symptomatic patients, symptoms are related to the location of tumor and outflow tract obstruction or obstruction of inferior and/or superior vena cava. Sudden death may occur due to conduction disturbances. The principle of treatment is surgical resection, and the prognosis is dependent upon the size, location and multiplicity of the tumor. A 40 year old man was admitted due to chest contusion and was found to have an intracardiac mass during echocardiographic examination. The mass was successfully removed and pathologic examination showed benign hemangioma. The patient was recovered uneventfully in postoperative period and was followed up for 1 year without evidence of recurrence.

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Detection of Retinal Vessels of Fundus Photograph Using Hessian Algorithm (안저 영상에서 헤이지안 알고리즘을 이용한 혈관 검출)

  • Kang, Ho-Chul;Kim, Kwang-Gi;Oh, Whi-Vin;Hwang, Jeong-Min
    • Journal of Korea Multimedia Society
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    • v.12 no.8
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    • pp.1082-1088
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    • 2009
  • Fundus images are highly useful in evaluating patients' retinal conditions in diagnosing eye diseases. In particular, vessel regions are essential in diagnosing diabetes and hypertension. In this paper, we used top-hat filter to compensate for non-uniform background. Image contrast was enhanced by using contrast limited adaptive histogram equalization (CLAHE) method. Hessian matrix was next applied to detect vessel regions. Results indicate that our method is 1.3% more accurate than matched filter method. Our proposed method is expected to contribute to diagnosing eye diseases.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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