• Title/Summary/Keyword: CPB

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Rectal Temperature Maintenance Using a Heat Exchanger of Cardioplegic System in Cardiopulmonary Bypass Model for Rats (쥐 심폐바이패스 모델에서 심정지액 주입용 열교환기를 이용한 직장체온 유지)

  • Choi Se-Hoon;Kim Hwa-Ryong;Paik In-Hyuck;Moon Hyun-Jong;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.505-510
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    • 2006
  • Background: Small animal cardiopulmonary bypass (CPB) model would be a valuable tool for investigating path-ophysiological and therapeutic strategies on bypass. The main advantages of a small animal model include the reduced cost and time, and the fact that it does not require a full scale operating environment. However the rat CPB models have a number of technical limitations. Effective maintenance and control of core temperature by a heat exchanger is among them. The purpose of this study is to confirm the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. Material and Method: The miniature circuit consisted of a reservoir, heat exchanger, membrane oxygenator, roller pump, and static priming volume was 40 cc, Ten male Sprague-Dawley rats (mean weight 530 gram) were divided into two groups, and heat exchanger (HE) group was subjected to CPB with HE from a cardioplegia system, and control group was subjected to CPB with warm water circulating around the reservoir. Partial CPB was conducted at a flow rate of 40 mg/kg/min for 20 min after venous cannulation (via the internal juglar vein) and arterial cannulation (via the femoral artery). Rectal temperature were measured after anesthetic induction, a ter cannulation, 5, 10, 15, 20 min after CPB. Arterial blood gas with hematocrit was also analysed, 5 and 15 min after CPB. Result: Rectal temperature change differed between the two groups (p<0.01). The temperatures of HE group were well maintained during CPB, whereas control group was under progressive hypothermia, Rectal temperature 20 min after CPB was $36.16{\pm}0.32^{\circ}C$ in the HE group and $34.22{\pm}0.36^{\circ}C$ in the control group. Conclusion: We confirmed the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. This model would be a valuable tool for further use in hypothermic CPB experiment in rats.

Comparison of Inflammatory Response and Myocardial injury Between Normoxic and Hyperoxic Condition during Cardiopulmonary Bypass (체외순환 시 정상 산소분압과 고 산소분압의 염증반응 및 심근손상에 관한 비교연구)

  • 김기봉;최석철;최국렬;정석목;최강주;김양원;김병훈;이양행;조광현
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.524-533
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    • 2001
  • Background: Hyperoxemic cardiopulmonary bypass (CPB) has been recognized as a safe technique and is widely used in cardiac surgery. However, hyperoxemic CPB may produce higher toxic oxygen species and cause more severe oxidative stress and ischemia/reperfusion injury than normoxemic CPB. This study was undertaken to compare inflammatory responses and myocardial injury between normoxemic and hyperoxemic CPB and to examine the beneficial effect of normoxemic CPB. Material and method: Thirty adult patients scheduled for elective cardiac surgery were randomly divided into normoxic group (n=15), who received normoxemic CPB (about Pa $O_{2}$ 120 mmHg), and hyperoxic group (n=15), who received hyperoxemic CPB (about Pa $O_{2}$ 400 mmHg). Myeloperoxidase (MPO), malondialdehyde (MDA), adenosine monophosphate (AMP), and troponin-T (TnT) concentrations in coronary sinus blood were determined at pre- and post-CPB. Total leukocyte and neutrophil counts in arterial blood were measured at the before, during, and after CPB. Lactate concentration in mixed venous blood was analyzed during CPB, and cardiac index (Cl) and pulmonary vascular

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Noncardiac Applications of Cardiopulmonary Bypass (비심장질환에서의 심폐바이패스 적용)

  • Kim, Won-Gon;Oh, Sam-Sae;Kim, Ki-Bong;Ahn, Hyuk;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.877-883
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    • 1998
  • Background: Cardiopulmonary bypass(CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. Material and Method: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava(MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm(GA), 1 for renal cell carcinoma(RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients(MOVC 4, GA 1, RC 1). Result: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26$^{\circ}C$ on average in MOVC, and 19$^{\circ}C$ in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients(malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. Conclusion: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.

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Synthesis of Block Copdymers Consistin(3 of Poly($\tau$-benzy1 L-glutamate) and Polyoxpropylene and Their Drug Release Behsviours (Poly($\tau$-benzy1 L-glutamate)와 polyoxpropylene으로 된 블록 공중합체의 합성 및 약물방출특성)

  • 강인규;김우식
    • Journal of Biomedical Engineering Research
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    • v.13 no.1
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    • pp.55-64
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    • 1992
  • AB -type block copolymers of poly($\tau$-benzyl L-glutamate) (PBLG, a segment) and polyoxypropylene (POP, Bsegment) were synthesized and they were reacted with polyoxypropylene his(6-aminohexyl) (POE) to enhance the hydrophilicity of the poly- mers. The degree of swelling of the POE -crosslinked block copolymers (CPB -2) was higher than that of the block dopolymers (PB). The amount of 5-fluorouracil re- leased from CPB-2 block copolymers was greater than that from the PB block copol- ymers when they were incubated in the same period. These results indicate that the amount of 5-fluorouracil released from the matrices is proportional to the hydrophilicity of the polymers. Observing polymer surfaces by scanning electron mi- croscope, pores (diameter ; $0.5-1.5{\mu}$m) were appeared on the surface of CPB-2

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Construction of Yield Criterion for AZ31 Sheet Alloy by Considering Tension-Compression Asymmetry (인장-압축 비대칭성을 고려한 AZ31 판재의 항복함수 구성)

  • Yoon, J.H.;Cazacu, Oana;Lee, J.H.
    • Transactions of Materials Processing
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    • v.20 no.8
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    • pp.527-533
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    • 2011
  • In order to take into account the strong anisotropy and the tension-compression asymmetry of AZ31 sheet alloy, the Cazacu-Plunkett-Barlat yield criterion(Cazacu, 2006), CPB06, was adopted in the present material modeling. The variation of anisotropic coefficients which describe the yield surface evolution of AZ31 is optimized using an interpolation function based on specific calibration results. It generates continuous yield surfaces, which makes it possible to describe the different hardening rates in tension and compression as well as tension-compression asymmetry of magnesium alloys. The ability of the CPB06 yield criterion to predict experimental results was demonstrated and compared with that of the Hill(1948) yield criterion.

The Value of Mixed Venous Oxygen Saturation during and after Cardiopulmonary Bypass (체외순환중의 중심 정맥 산소포화도의 의의)

  • 이재원
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.7-10
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    • 1995
  • Mixed Venous oxygenation saturation[SvO2 is a variable determined in part by the externally controlled factors and in part by the patient during CPB. I monitored the SvO2 and tested it as a parameter for the regulation of pump output and as a criteria for the need of inotropics after CPB. With the help of SvO2, I increased the pump flow especially during rewarming for more optimal oxygenation of cells. After CPB, the calculated cardiac index was used as an indicator for the need of inotropic support with greater accuracy and without any clinical problems. I conclude that the SvO2 is an easily checkable variable and a good indicator for optimal oxygenation at cell level, and can be used as an objective criteria for the need of postoperative inotropic support.

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Development of Substrate for Carboxypeptidase-B by Employing Thiaarginine Peptides

  • 홍남주;박영애;손기남
    • Bulletin of the Korean Chemical Society
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    • v.19 no.2
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    • pp.189-193
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    • 1998
  • Carboxypeptidase-B (CPB) is involved in the biosynthesis of numerous peptide hormones and neurotransmitters. CPB catalyzes hydrolysis of the basic amino acids from the C-terminal position in polypeptides during posttranslational prohormonal processing. Various peptides containing thiaarginine residue at C-terminal position were synthesized and tested for their hydrolysis by CPB. A colorimetric assay, employing Ellman's reagent to detect the thioguanidine released upon hydrolysis of the dipeptide substrates, showed that thiaarginine is a suitable mimetic for arginine. Kinetic studies on the four substrates, Z-L-Ala-DL-thia-Lys, Z-L-Ala-DL-thia-Arg, Z-L-Lys-DL-thia-Arg, and Z-L-Lys(Boc)-DL-thia-Arg, gave Km (mM) of 0.66, 5.08, 0.024, and 0.006 and kcat (min-1) of 340, 5200, 151 and 335, respectively.

Ultrastructrual Change of Myocardium in Open Cardiac Surgery with Cold Blood Cardioplegia (개심술 시 냉혈성 심정지액 사용에 따른 허혈 전후 심근 미세구조의 변화)

  • 김병호;김대현;공준혁;조준용;손윤경;이종태
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.638-645
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    • 2003
  • The purposes of this study were to evaluate the effect of myocardial protection with our cold blood cardioplegic solution and to observe the relationship between ultrastructural study and other evaluation methods and its effectiveness. Material and Method: We evaluated the changes of myocardial ultrastructure using semi-quantitative scoring system, CK-MB fraction, SGOT and LDH1/LDH2, and EKG in 18 patients undergoing valvular heart surgery and coronary artery bypass grafting (CABG). Right atrial auricular biopsies were taken before the cardiopulmonary bypass (CPB) and shortly after the end of CPB. Myocardium-related serum enzymes & EKG were checked for 3 days of postoperative period and their postoperative peak enzyme value and observed new Q wave & ST segment elevation in EKG were choosen. Result: There were 8 males and 10 females, and their mean age was 55.6$\pm$13. Eight patients underwent valvular heart surgery and ten coronary artery bypass grafting, The mean CPB time was 119$\pm$29 minutes and the mean aortic cross-clamp (ACC) time was 75.4$\pm$24 minutes. Before the start of CPB, the mean mitochondrial score was 4.28$\pm$0.53 and after the end of CPB, it significantly increased to 2.35$\pm$0.79. There was no evidence of perioperative myocardial infarction in terms of myocardiumrelated serum enzyme value and Q wave and ST change in EKG. There was no significant relationship between pre-CPB and post-CPB mitochondrial score and the mean time of CPB and ACC, and the mean value of postoperative peak CK-MB, SGOT and LDH1/LDH2, but there was relatively positive correlation of CPB time with peak LDH1/LDH2. Conclusion: Despite the apparent satisfactory results in myocardium-related serum enzymes & EKG, with this study using the cold blood cardioplegic solution, there were many changes in myocardial ultrastructures, and more studies are needed to obtain further information.

Thiopental Prevents A Beta-Endorphin Response to Cardiopulmonary Bypass (체외순환전 투여된 Thiopental이 Beta-endorphin치 변화에 미치는 영향)

  • Song, Sun-Ok;Carr, Daniel B.;Park, Dae-Pal;Jee, Dae-Lim;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.350-358
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    • 1997
  • We studied the effects of adding a single bolus(500 mg) of sodium thiopental to a continuous infusion of low-dose fentanyl on plasma beta-endorphin immunoreactivity(iBE) responses to cardiopulmonary bypass(CPB) in 28 patients undergoing elective coronary artery bypass grafting or valve procedures. Thiopental was injected just prior to the initiation of CPB. The iBE levels and the hemodynamic indices such, as mean arterial pressure, cardiac output and systemic vascular resistance were measured before CPB, at 30 min and again at 60 min after the initiation of the bypass. The results were as follows. After the initiation of CPB, iBE levels increased at 30 min and 60 min(P=0.006, P=0.004 respectively) in the control group, but not in the thiopental group. There were significant differences in the changes of iBE levels between the groups(F=8.7, G-G=0.002, P=0.001). The hemodynamic indices were similar in both groups. In conclusion, pretreatment with thiopental just before the initiation of CPB prevents the stress-induced beta-endorphin response to CPB.

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Influence of perceived friendship on customer participation behavior and customer citizenship behavior as well as customer cooperation (지각된 프렌드십이 고객참여 및 시민행동과 협력에 미치는 영향)

  • Ahn, Jin-Woo;Chun, Myung-Hwan
    • Management & Information Systems Review
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    • v.35 no.1
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    • pp.155-172
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    • 2016
  • Customer participation behavior(CPB) and customer citizenship behavior(CCB) which are customers' active functions and roles implemented in service encounter contribute to the service quality. Thanks to these ideas, many researches focus on the influences of these two customers' behaviors on relational outcomes, additionally. However, when examining the characteristics of CPB and CCB, it is notable that CPB and CCB are positively influenced by relationships between customers and firms, adversely. In other words, it is necessary to find that commercial friendship representing a deep relationship can address these two customers' behaviors, as well as may influence relational outcomes. As results, intimate friendship between a customer and an encounter provider has a positive influence on CPB and CCB, expectedly. These findings show that customers having prior contacts can play active roles in a service encounter. Additionally, it is identified that CPB and CCB have positive influences on the relational outcomes such as customer cooperations. Consequently, CPB and CCB are likely to be on the loop of a relational circulation.

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