• Journal of Chest Surgery
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• v.3 no.2
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• pp.73-90
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• 1970

Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

• Proceedings of the KOSOMBE Conference
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• v.1993 no.11
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• pp.110-113
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• 1993

An in vitro experiment under laminar non-pulsatile blood flow and an acute canine ex vivo femoral A-V series shunt experiment were undertaken to investigate the effectiveness of saline perfusion through pores of porous tubes to prevent formation of mural thrombus. PS/SBR porous tubes were used for the in vitro experiment. Commercially obtained ePTFE porous tubes were etched by sodium naphthalenide, and the etched tubes were used for the ex vivo experiment. According to the results of the in vitro experiment, mural thrombus on the surface of the porous tribe could be prevented by the saline perfusion. Adhered blood cells decreased semi-logarithmically with increased perfusion rate (up to $0.022\;ml/min-cm^2$) of isotonic saline solution. According to results of the ex vivo experiment, mural thrombus decreased with increased perfusion rate (upto $0.060\;ml/min-cm^2$).

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1679-1682
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• 2008

Pulsatile Extracorporeal Membrane Oxygenation(ECMO) can mitigate the heart load and raise the patient's blood perfusion. But If the ECMO pulsate the blood flow during the systolic period, It can burden to the patient's heart. To avoid the heart injury, we have to consider the relation between output of ECMO, hemodynamic states and heart movement. To raise the efficacy of the pulsatile ECMO, we investigated the coronary perfusion, cardiac muscle tension and hemodynamic states during the ECMO perfusion by using the mathematical model of human blood circulatory system and ECMO. The outflow data of the pulsatile ECMO(T-PLS, Bioheartkorea, Korea) was obtained in vitro experiments. According to the phase and pumping rate of the ECMO, the heart's load and coronary perfusion could be adjusted to the proper levels. The results of the human- ECMO lumped parameter model showed that the synchronizing operation of the pulsatile ECLS can be helpful at stabilizing the patient's hemodynamic states.

• Macromolecular Research
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• v.9 no.4
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• pp.197-205
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• 2001

Platelet adhesion onto elastic polymeric biomaterials was tested in vitro by perfusing human whole blood at a shear rate of 100 sec$\^$-1/ for possible verification of mechanisms of initial platelet adhesion perfusion of blood on the polymeric substrates was performed after treatments either with or without pre-adsorption of 1% blood plasma, and either with or without residence of the protein-preadsorbed substrate in phosphate buffered solution. The surfaces employed were elastic polymers such as poly(ether urethane urea), poly(ether urethane), silicone urethane copolymer, silicone rubber and poly(ether urethane) with the anti-calcifying agent hydroxyethane bisphosphate. Each polymer surface treated was exposed in vitro to the dynamic, heparinized whole blood perfused for upto 6 min and the surface area of platelets initially adhered was measured by employing in situ epifluorescence video microscopy. The blood perfusion was performed on the surfaces treated at the following three different conditions: directly on the bare surfaces, after protein pre-adsorption and after residence in buffer for 3 days of the surfaces protein pre-adsorbed for 2 h. The effects of blood plasma pre-adsorption on the initial platelet adhesion was surface-dependent. The amount of the adsorbed fibrinogen and the surface coverage area of the adhered platelets were dependent on the surface conditions whether substrates were bare surfaces or protein pre-adsorbed ones. To test an effect of possible morphological (re)orientations of the adsorbed proteins on the initial platelet adhesion, the polymeric substrate pre-adsorbed with 1% blood plasma was immersed in phosphate buffered solution for 3 days and then exposed to physiological blood perfusion. The surface area of the platelets adhered on these surfaces was significantly different from that of the surfaces treated with protein pre-adsorption only. These results indicated that platelet adhesion was dependent on the surface property itself and pre-treatment conditions such as blood perfusion without any pre-adsorption of proteins, and blood perfusion either after protein pre-adsorption or after subsequent substrate residence in buffer of the substrate pre-adsorbed with proteins. Understanding of these results may guide for better designs of blood-contacting materials based on protein behaviors.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.246-253
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• 1988

An in vitro model providing with a recirculating perfusion apparatus using an isolated canine heart and its autogenous blood, which was prepared for study of myocardial protection method. This apparatus was easily used by quick connect system and maintained well heart function for about 2 hours. The Langendorff perfusion was initiated for a 10 minute period by introducing perfusate at 37` into the aorta from aortic reservoir located 100 cm above the heart. The isolated perfused working canine heart model was a left heart preparation in which oxygenated perfusion medium [at 37K] entered the cannulated left atrium at a constant flow rate [900ml/ min] under 20 mmHg overflow system and was spontaneously ejected[no electrical pacing] via an cannula against a hydrostatic pressure of 80 cm H2O. During this working period, various indices of cardiac function were measured. The cardiac functions were stable for over 2 hours with perfusion of Krebs-Henseleit solution and autologous blood[1:1] mixture in volume and maintained heart rate ]]3-122/bpm peak systolic pressure 109-113 mmHg, cardiac output 900 ml / min and left atrial mean pressure 8-9 mmHg. In this model, the efficiency of myocardia] protection could be easily measured by means of functional, enzymatic, biochemical and ultrastructural assessment. And also, we believe this model to be a useful assessment screening model of recovery state after long duration of myocardial preservation of donor heart without difficult transplantation procedures.

• Journal of Chest Surgery
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• v.4 no.2
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• pp.69-80
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• 1971

Total body perfusion using Rygg-Kyvsgaard Heart-Lung-Machine, Mark IV, Polystan was attempted in the dogs by the hemodilution method with total prime of buffered Hartman's solution and under hypothermia. The first of all, the functions of Rygg--Kyvsgaard Heart-Lung-Machine and the effects of the hemodilution perfusion by buffered Hartman's solution was studied. At the same time the changes of blood pressure, oxygen consumption, and influence on the blood pictures were observed before, during, and in 1-3 days after perfusion. Hemodilution rates were the average 74. 22cc/Kg(the ranges of 67 to 81 cc/Kg) and perfusion flow rates were maintained in the mean 62. 6cc/Kg/min., Although it was possible to check up to 87 cc/ Kg/min. The total body perfusion continued for 60-80 minutes. Hypothermia was employed between $36^{\circ}C$ and $32^{\circ}C$ of the rectal temperature. Arterial pressure was ranged approximately between 68mmHg and 149mmHg, but generally, it was maintained over 80mmHg. Venous pressure was measured between 6.5cm $H_2O$and 11.5cm $H_2O$. Optimum oxygenation can be expected when oxygen flow into the disposable bubble oxygenator was maintained approximately at 3.5 L/min .. Inthis way, the oxygen contents were measured in the mean value of 13.11${\pm}$O.56 vol. % of arterial blood and 8.67+1.08 vol.% of venous blood(P${\pm}$0.86 vol.% in arteriovenous oxygen difference and 2. 97${\pm}$0.62cc/Kg in oxygen consumption were calculated. According to these dates, it is as plain as pikestaff that excellent oxygenation and good tissue perfusion was accomplished. Erythrocyte, hemoglobin and hematocrit were decreased about 38% during extracorporeal circulation and these were not recovered until 1-3 days after perfusion. These decrease was resulted from relatively high degree of hemodilution rate and no blood transfusion to compensate during these experimental studies. The platelets were also decreased about 76% during perfusion, but on the contrary, it was increased progressively after perfusion and in 1-3 days after perfusion was returned to the control level. Leucocyte were also decreased during perfusion, but it was increased progessively after perfusion and in 1-3 days after perfusion exceed the control level. This increase was resulted from postoperative infection of the wound, but its analysis were not changed significantly.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2018.05a
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• pp.188-192
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• 2018

Surgery to increase cerebral blood flow is one of the treatment methods of cerebral infarction. However, invasive methods, such as surgery, may result in postoperative complications or side effects. In order to supplement this invasive method, non-invasive devices have been introduced that use human blood pressure to pressurize the extremities to increase cerebral blood flow. However, the problem of poor speed and accuracy was raised. In this paper, the perfusion index of each arm was measured by applying pressure to both arms using Blood Oxygen Level Sensor to improve the accuracy of measurement and measurement time. The pressure applied to the arm by 75% of the moment when it falls to the leg and the pressure calculated by using the pressure value obtained from the arm. Like the existing blood pressure measuring cerebral blood flow increasing device, the blood flow can be increased by more than 20% and the measurement time can be shortened, so that it can be selectively used for the patient with cerebral infarction.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.299-314
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• 1977

Clinical experience on 16 cases of open heart surgery under the extracorporeal circulation with mild or moderate hypothermia and partial hemodilution technique at the National Medical Center during the period from June 1976 to October 1977. Nine of sixteen were congenital heart disease and seven were acquired heart disease. The age of the patient ranged between 6 and 48 years. The body weight varied from 18.5kg to 60kg and body surface area 0. 79-1.70m2. The average priming volume of pump oxygenator was 2080 ml, which was consisted fresh ACD blood, buffered Hartmann`s solution, Mannitol, 50% dextrose in water and Vit. C. The average hemodilution rate was 27%. The average flow 2.3 L/min/m2 or 80 ml/min and the duration of perfusion varied from 31 min to 270 min with average of 107 min. The perfusion was carried out under the mild or moderate hypothermia using core cooling alone in 10 cases, core cooling and local myocardial cooling with $0-4^{\circ}C$ physiologic saline in 2 cases. From a hemodynamic point of view, the blood pressure dropped down around 80 mmHg after the initiation of perfusion follwed by increase to safety level and stable during the perfusion. The central venous pressure remained within normal limits. In most cases, hemoglobin and hematocrit decreased during and after the perfusion. Hemogiobin level was decreased, average of 20.6 %, hematocrit 18.6%, pletelets 55% postoperatively. Plasma hemoglobin increased moderately, from preperfusion average valve of 7.79 mg % to post-perfusion value of 54.7 mg %. Electrolytes changes during cardiopulmonary bypass showed definite hypokalemia but changes of Na, Ca were not definite. Arterial blood gas analysis during cardiopulmonary bypass suggested that the metabolic acidosis which was accompanied by respiratory alkalosis which was corrected postoperatively. As the opera tive complication, transient hemoglobinuria in 4 cases and neurological signs in 2 cases were all cured. There were 2 death cases and operative mortality rate was 12.5%.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.8
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• pp.1083-1089
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• 2018

Surgery to increase cerebral blood flow is one of the treatment methods of cerebral infarction. In order to supplement this invasive method, non-invasive devices have been introduced that use human blood pressure to pressurize the extremities to increase cerebral blood flow. However, the problem of poor speed and accuracy was raised. In this paper, the perfusion index of each arm is measured by applying pressure to both arms using Blood Oxygen Level Sensor to improve the accuracy of measurement and measurement time. The pressure applied to the arm is calculated by using the pressure value obtained from the arm. Like the existing blood pressure measuring cerebral blood flow increasing device, the blood flow can be increased by more than 20% and the measurement time can be shortened, so that it can be selectively used for the patient with cerebral infarction.

• Journal of Ginseng Research
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• v.26 no.3
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• pp.132-138
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• 2002

To study the effect of Korea red ginseng (KCG) on the skin and cerebral blood flow, we evaluated the change of skin perfusion rate and cerebral perfusion rate after the intravenous, intraperitoneal, and oral administration of crude saponin (CS) and saponin-free fraction (SFF) of KRG in the rats. The change of skin perfusion rate and cerebral perfusion rate was measured laser doppler flowmetry. The intravenous injections of CS or SFF of KRG and intraperitoneal injection of SFF of KRG did not change the relative skin and cerebral blood flow in the rats. When the rats were treated by the intraperitoneal injection of CS of KRG, relative cerebral blood flow was significantly increased with a time-dependent manner, however, relative skin blood flow was not influenced by the them. Oral administration of CS of KRG slightly increased skin blood flow in the rats. Also, the change of cerebral blood flow by transient bilateral carotid arterial clamp in the CS-treated rats was significantly decreased, compared with control groups. From the above results, it was suggested that Korea red ginseng have a increasing property of cerebral blood flow in the rats.