• Journal of Chest Surgery
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• v.27 no.9
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• pp.738-745
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• 1994

In order to evaluate the myocardial injury in cardiac valvular and coronary surgery, variables of creatine kinase[CK], myocardial band of CK[CK-MB], lactate dehydrogenase[LDH], aspartate aminotrasferase[AST] were measured in the preoperative[Preop], the operation day[POD0], and the first[POD1], third[POD3], fifth[POD5], seventh[POD7], ninth[POD9] day after operation in 29 patients. The subjects were divided into two groups according to the diseases: group V [valvular disease, n=16] and group C[coronary artery disease, n=13]. Each group was subdivided into two subgroups according to the duration of aortic crossclamping time[ACT]; group VI[ACT 120min, n=7] and group VII[ACT>120min, n=9]; group CI[ACT 120min, n=6] and group CII[ACT>120min, n=7]. The results were as followed 1. The values of CK between group V and group C had no significant difference. The values of CK in group CII were significantly greater than those in group CI and the values of CK in group VII were significantly greater than those in group VI. 2. Percentages of CK-MB between groups had no significant difference. 3. The serum levels of LDH in group V were significantly greater than those in group C. The serum levels of LDH in group VII were significantly greater than those in group VI. 4. The serum levels of AST in group VII were significantly greater than that in group VI. We were concluded that myocardial injury was more related with the duration of aortic cross clamping time rather than the type of diseases.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.713-723
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• 1989

In order to assess the correlation of the myocardial damage and the duration of cardiopulmonary bypass, measurement of creatine kinase [CK], lactate dehydrogenase [LDH], asparatate aminotransferase [AST], and MB band of CK [CK-MB] were carried out on the first, third, fifth, seventh, and ninth day in 44 patients following open heart surgery [POD 1,3,5,7,9]. And the patients were divided into three groups according to the duration of aortic cross clamp time [ACT]: Group I [ACT< 60 minutes. n=19], Group II [60 minutes < ACT< 90 minutes, n=7] and Group III[90 minutes > ACT, n=18]. 1. The leakage of CK in total patients increased to the highest level at POD 1, with rapid decrease and recovery at POD 7. The leakage of CK in Group III were greater than in Group I from POD 1 to POD 3 [P < 0.01]. The recovery time of CK level was shorter in Group I [POD 3] than in Group II and III [POD 7]. 2. The serum levels of LDH in total patients increased to the highest level at POD 1, with slow recovery until POD 9. The levels of LDH in Group III were higher than in Group I until POD 9 [P < 0.005]. The levels of LDH in Group I and II recovered but not in Group III. 3. The serum levels of AST in total patients increased to the highest level at POD 1, with rapid decrease and recovery at POD 7. The levels of AST in Group III were greater than in Group I from POD 1 to POD 5 [P < 0.05]. The recovery time of AST level was shorter in Group I and II [POD 5] than in Group III [POD 7]. 4. The positive cases for CK-MB in 36 patients were 22 [61.1 %] as a whole, 5[41.6%] in Group I, 4[57.1 %] in Group II, 13[76.4 %] in Group III at POD 1, and a case in each group at POD 3, and only a case in Group Ill at POD 5. It is concluded that the myocardial injury was closely related with the duration of cardiopulmonary bypass in open heart surgery.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.291-297
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• 1998

Sternal fractures, once thought of as an uncommon phenomenon, have occurred with an increasing frequency, paralleling the incidence of motor vehicle accidents. The tremendous force necessary to cause sternal fracture and this bone's prominent position overlying major intrathoracic and mediastinal structures, have important implications in the assessment and treatment of patients. This evaluation is based on the review of 72 patients of traumatic sternal fracture treated at the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital during the last 4 years from March 1993 to February 1997. The frequency was 12.2% of nonpenetrating chest trauma and average age was 43.2 years old. Automobile accidents(84%) and sternal body fractures(95.8%) with anterior displacements(19.4%) was the most common cause and fracture site. Increase of cardiac isoenzymes was more frequent and higher in sternal fracture than chest contusion but there was no relationship between the time to take normalization of them and the mode of trauma.

• Biomedical Science Letters
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• v.10 no.3
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• pp.237-243
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• 2004

In recent, many cardiac centers have preferred off-pump coronary artery bypass grafting (CABG) to on-pump CABG to prevent the adverse effects of cardiopulmonary bypass. The present study was performed to prove beneficial effects of off-pump CABG. Sixty adult patients scheduled for elective CABG were randomly assigned to On-pump group (n=30) or Off-pump group (n=30). Arterial blood samples were drawn before and after the operation (Pre-OP and Post-OP, respectively) for measuring CBC, prothrombin time, activated thromboplastine time, blood gas analysis, creatine kinase-MB (CK-MB) level, and lactate dehydrogenase (LDH) level. Perioperative parameters including heparin and protamine usages, complications, blood components usages, blood loss, ventilation and ICU-staying time, and hospitalization were also evaluated. Platelet count at Post-OP was high in Off-pump group whereas CK-MB and LDH levels were low compared with On-pump group. Off-pump group had significantly lower heparin and protamine usages, lower total leukocyte count, higher hematocrit and hemoglobin levels, less blood loss, lower usages of blood components, shorter ventilation and ICU-staying time, and lower incidence of pleural effusion than On-pump group. Other variables did not significantly differ between two groups. These results showed that Off-pump CABG was a satisfactory technique with less inflammatory reaction, less cardiac damage, less postoperative complications, and less cost.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.48-55
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• 1995

The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was $0.01{\pm}0.02{\mu}g/L$ in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 ${\mu}g/L$. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardial infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5849-5855
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• 2012

Objective: The purpose of this study was to determine pretreatment effects of moderate-term endurance training before the various dosages (10 and $20{_{mg.kg}}^{-1}$) of DOX on a heat shock protein ($HSP_{70kda}$) and cardiotoxicity in heart tissue. Methods: Forty-eight male rats were randomly assigned to nontraining (NT) and training (T) groups and three subgroups; $DOX{_{10mg.kg}}^{-1}$ and $DOX{_{20mg.kg}}^{-1}$ and saline treatment. The training program included treadmill running between 25-39 min/day and 15-17 m/min, 5 days/wk for 3 wk. Result: DOX administration, in particularly with $20{_{mg.kg}}^{-1}$, caused up-regulation of oxidants and cardiac damage (MDA, CK, CPK-MB and CK/CPK-MB) and down-regulation of cardioprotection ($HSP_{70}$, SOD) markers, as compared to NT+saline group. Pretreatment effect of treadmill running endurance exercise in the presence of DOX with $10{_{mg.kg}}^{-1}$ caused a significant increase in $HSP_{70}$, SOD and a significant decrease in MDA and insignificant decrease in CK, CPK-MB and CK/CPK-MB, in comparison $T+DOX_{10}$ with $NT+DOX_{10}$ group. However, there was no significant difference between $T+DOX{_{10mg.kg}}^{-1}$ and $T+DOX{_{20mg.kg}}^{-1}$ in the aforesaid markers. Conclusion: Dox-induced cardiotoxicity is related to oxidative stress. Our study suggests that pretreatment with endurance exercise may be considered as a potentially useful strategy to improve myocardial tolerance against single dose DOX-induced oxidative damage.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.429-437
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• 1991

Beta hydroxytrimethylammonium butyrate[L-carnitine] is highly concentrated in myocardium and it is essential substance for transfer of fatty acids into the mitochondria. We respect that L-carnitine has protective action to myocardium during ischemia. I studied coronary flow and CK - MB isoenzyme of coronary effluent of Langendorff`s isolated rat heart model. As a control group 5 Sprague-Dowley species rat hearts were connected to Langendorff`s isolated rat heart model and perfused for 30 minutes with Kreb-Henseleit buffer solution. After cessation of perfusion for 30 minutes they were reperfused for 30 minutes. In experimental group 10 Sprague-Dowley species rat hearts were perfused with 10mmole /L of L-carnitine contained in Kleb-Henseleit buffer solution. In equilibrium state, coronary flow was 1.7 times greater in experimental group. During reperfusion, both group showed equally decreased flow amount of about 60% of that of equilibrium state. CK-MB isoenzyme level of perfused coronary fluid showed no significant difference in equilibrium state. In reperfusion. CK-MB isoenzyme levels of control group were 17.61$\pm$8. 68U/L at 25 minutes, 23.32$\pm$4.15U /L at 30 minutes; and in experimental group, 13.63$\pm$6. 08U/L at 15 minutes and 13.6$\pm$8.41U /L at 30 minutes respectively. Those values in both states showed significantly lower CK-MB level in experimental group. In conclusion, L-carnitine prevent ischemic myocardial damage during ischemic and reperfusion state of Langendorff`s isolated rat hearts and also I suggest the L-carnitine act potent coronary vasodilator during preischemic and postischemic states of rat hearts.

• Journal of Chest Surgery
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• v.33 no.9
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• pp.707-715
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• 2000

Background: Cold blood cardioplegic solution has been used to protect myocardium during open heart surgery with the hypothesis stating that it provides more oxygen supply to myocardium compared to crystalloid caridoplegic solution. We repeatedly infused cold blood cardioplegic solution to achieve myocardial protection. We biopsied a small portion of papillary muscle of patients with mitral valve replacement or double valve replacement during aortic cross-clamp time and evaluated the method of myocardial protection through the observation of changes in ultrastructure. We then analysed the relationship between changes in ultrasructure and peak postoperative CK-MB value and SGOT value. Material and method: We report observation on changes of myocardial ultrastructure, postoperative CK-MB and SGOT, and electrocardiogram in 31 patients who underwent cardiac operation. There were 11 males and 20 females, and they ranging in age from 28 to 69 years(mean score was 2.08$\pm$0.560, it was 2.37$\pm$0.558 at 40 minutes, and it was 2.36$\pm$0.523 at 70minutes. Mitochondrial score increased significant at 40 minutes. Mean value of postoperative peak CK-MB and SGOT were 37.3$\pm$17.061IU, 144.5$\pm$125.5IU respectively. We were not able to find any new Q were in EKG after the operation. There was no significant relationship between myocardium mitochondrial score and mean value of postoperative peak CK-MB and SGOT. Conclusion: In conclusion, with this study the cold blood cardioplegic solution was incomplete in preserving ultrastructure of myocardium even with satisfactory results in serum enzyme and EKG evaluation.

• The Korean Journal of Physiology and Pharmacology
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• v.18 no.5
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• pp.419-423
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• 2014

The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n＝7) and non-elite athlete group (NEG: n＝8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.735-741
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• 2004

Blood cardioplegia is known as an established cardioplegic solution during open heart surgery. Recently, the Histidine-Tryptophan-Ketoglutarate (HTK) solution has been introduced as a cardioplegia in Korea. This study was designed to compare the myocardial protective effect between the cold blood cardioplegia (CBC) and HTK solution. Material and Method: Forty patients who underwent valve surgery or coronary artery bypass surgery were randomly divided into CBC group (n=20) and HTK group (n=20). The perioperative hemodynamic and clinical data were analyzed. The concentration of CK-MB, Troponin 1 and Lactate from coronary sinus and radial arterial blood were compared for the evaluation of the myocardial damage. The postoperative serial CK-MB levels were measured. Result: The characteristics of preoperative patients were similar in two groups. The hemodynamic parameters and postoperative clinical data were also similar between the two groups. There were no statistical significances between the CBC and HTK group in the difference of biochemical markers: Δ CK-MB (15.3$\pm$26.0 vs 19.3$\pm$14.3), ΔTro-1 (2.4$\pm$4.9 vs 2.0$\pm$2.20), ΔLac (1.6$\pm$1.0 vs 1.9$\pm$2.5). The serial CK-MB levels were not significantly different between the two groups. Conclusion: These results suggested that the myocardial protective effect of HTK solution was similar to cold blood cardioplegia during open heart surgery.