• Journal of Chest Surgery
• /
• 제28권6호
• /
• pp.601-605
• /
• 1995

Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

• 한국생물공학회:학술대회논문집
• /
• 한국생물공학회 2005년도 생물공학의 동향(XVII)
• /
• pp.205-205
• /
• 2005

• 한국임상수의학회지
• /
• 제18권4호
• /
• pp.358-362
• /
• 2001

Brain dead (BD) patients remain the largest source of solid organs for transplantation. BD has shown to decrease graft function and survival in rodent models. The aim of this study was to evaluate how brain death affects graft viability in the donor and kidney tolerance to cold preservation as assessed by survival in a canine transplantation. 13 Beagle dogs were used for the study. Brain death was induced by the sudden inflation of a subdural balloon catheter with continuous monitoring of arterial blood pressure and eletroencephalographic activity (n=3). Sixteen hours after conformation of brain death, kidney graft were retrieved (n=6). Non-BD donors served as controls (n=4). All kidneys were flushed with University of Wisconsin (UW) solution and preserved for 24 hours at 4$^{\circ}C$ before transplantation. Recipient survival rates, serum creatinine level were analyzed. Brain death induced the well-known Cushing reaction with a severe increase in blood pressure and tachycardia. Thereafter, cardiac function returned progressively to baseline within 8 hours and remained stable until the end of the experiment. All of dogs in both group transplanted were survived until 7 days (100%), and the kidneys showed functional early rejection at 8.3$\pm$0.5 days and 8.5$\pm$0.5 days after transplantation, in BD and allograft group, respectively. BD kidneys were functionally similar to control kidneys for 7 days after transplantated. Brain death has no deleterious effect on preservation injury and survival of dog kidney transplantation, although it induces changes in hemodynamic parameters. This study reveals that kidneys from BD donors do not exhibit more ischemia reperfusion injury, and support good early function and survival.

• Journal of Chest Surgery
• /
• 제22권6호
• /
• pp.927-935
• /
• 1989

Using an isolated Rat heart preparation of the Sprague Dawley strain, the YUMC cardioplegic solution k the St. Thomas Hospital Cardioplegic Solution were compared in the non waking K working heart perfusion systems by evaluating the hemodynamics, [bio] chemical, and light microscopic finding The heart rate k coronary flow of the two groups in the 20 minutes post ischemic recovery time were 288.6*6.5 vs 283.7*12 and 21.3*1.0 vs 19.0*1.7 respectively with no statistical significance existing. However the aortic systolic pressure, aortic overflow, cardiac output which were 81.7[4.2 vs 78.4*1.8, 18.3*1.1 vs 13.0*2.5 and 36.9*0.9 vs 32.0*3.2 respectively with P < 0.01 indicate that the comparison of these three parameters is statistically meaningful. The amount of CPK extracted in the 20 minutes post 120 minutes of ischemia was compared for the two cardioplegic solution, the results of which turned out to be similar, light microscopic findings were also found to be similar. It is thought that the YUMC cardioplegic solution provided better results than the St. Thomas hospital solution because of the differing composition of the two solution such as glucose, mannitol, albumin were put only in the former solution enhancing osmolarity of the cardioplegic solution providing better hemodynamic results.

• Journal of Chest Surgery
• /
• 제25권2호
• /
• pp.131-136
• /
• 1992

The effect of temperature of cardioplegic solution on myocardial preservation was studied using isolated rat heart perfusion technique. Twenty Sprague-Dawley rats, weighing 120~140gm, were pretreated with intraperitoneal injection of heparin sodium[300u/kg] and then the hearts were excised after cervical herniation 30 minutes later. The hearts were perfused in isolated working heart apparatus with oxygenated modified Tyrode solution at 37oC. After 10 minutes of non working heart perfusion, the hearts were subjected to arrest for 30 minutes by administration of 5cc cardioplegic solution at the temperature of 4oC [Group I ], 15oC [Group II], 25oC [Group III], 37oC[Group IV]. At the same time, the topical cooling of heart was performed using ice saline. After arrest, the hearts were reperfused by non working heart perfusion for 1 hour with modified Tyrode solution at 37oC. The CPK, GOT and LDH in reperfusate were measured at 5,20,40,60 minutes after start of reperfusion. With the values of those, we compared the effect of temperature of cardioplegic solution on myocardial preservation. The results were as follows; 1. The enzyme values in reperfusate were highest at 5 minute and after then declined. 2. At 5 minutes after reperfusion, the enzyme values in Group I were lower than those in other Groups. These results suggest that the cardioplegic solutions using for cardiac arrest and myocardial protection can be working better at 4oC than at any other temperature.

• Molecules and Cells
• /
• 제21권1호
• /
• pp.1-6
• /
• 2006

Bcl-2/adenovirus E1B 19 kDa-interacting protein 3 (BNIP3) is a mitochondrial pro-apoptotic protein that has a single Bcl-2 homology 3 (BH3) domain and a COOH-terminal transmembrane (TM) domain. Although it belongs to the Bcl-2 family and can heterodimerize with Bcl-2, its pro-apoptotic activity is distinct from those of other members of the Bcl-2 family. For example, cell death mediated by BNIP3 is independent of caspases and shows several characteristics of necrosis. Furthermore, the TM domain, but not the BH3 domain, is required for dimerization, mitochondrial targeting and pro-apoptotic activity. BNIP3 plays an important role in hypoxia-induced death of normal and malignant cells. Its expression is markedly increased in the hypoxic regions of some solid tumors and appears to be regulated by hypoxia-inducible factor (HIF), which binds to a site on the BNIP3 promoter. Silencing, followed by methylation, of the BNIP3 gene occurs in a significant proportion of cancer cases, especially in pancreatic cancers. BNIP3 also has a role in the death of cardiac myocytes in ischemia. Further studies of BNIP3 should provide insight into hypoxic cell death and may contribute to improved treatment of cancers and cardiovascular diseases.

• Journal of Chest Surgery
• /
• 제36권8호
• /
• pp.576-582
• /
• 2003

심폐바이패스 없이 시행하는 관상동맥 우회수술 중에 심장을 조작하는 동안 심근의 수축력이 저하되고 혈역학적 불안정성이 초래될 수 있다. 본 연구에서는 수술 중의 여러 가지 혈역학적 지표들의 변화양상을 관찰하고 이러한 혈역학적 지표의 변화가 수술 후 결과에 미치는 영향을 평가해 보고자 하였다 대상 및 방법: 2001년 3월부터 2002년 8월까지 시행한 71명의 관상동맥 우회수술 환자 중에서 심페바이패스 없이 시행하는 관상동맥 우회수술을 시행받은 50명을 대상으로 하였다. 체동맥압, 폐동맥압, 혼합정맥산소포화도, 심박출계수 등을 심장을 들어올리기 전과 목표관상동맥을 노출하여 관상동맥을 고정한 후, 그리고 혈관이식편의 원위부 문합 후에 각각 측정하였다. 수술 후에는 CK-MB, Troponin I 등 심장효소의 농도를 측정하고, 수술 후 강심제의 요구량, 수술 후 출혈량 및 수혈량, 수술 후 인공호흡기 보조시간 및 수술 후 중환자실 체류시간 등을 조사하여 분석하였다 결과: 환자당 평균 원위문합수는 2.8$\pm$0.9개이었다. 심장을 들어올려 고정기로 고정할 때 심장의 모든 위치에서 혈압의 하강과 폐동맥압의 상승이 유의하게 나타났지만, 문합을 시행하는 동안에는 유의한 변화를 볼 수 없었다. 심장효소 농도는 수술 후 1일째 치고치를 보여, CK-MB 29.2$\pm$46.7, troponin 10.69$\pm$0.86이었다 수술 중에 혈역학적 변수들 중에서 심전도의 허혈성 변화와 혈관수축제의 정맥내 일시주사 등이 수술 후 심장효소 농도에 영향을 주었다. 그러나 심장 효소 이외의 다른 결과는 차이가 없었다. 결론: 수술 중에 유의한 혈역학적 변화는 심장을 들어올려 고정할 때 발생하였으며, 문합하는 동안에는 의미있는 변화를 보이지 않았다. 수술 중에 심전도의 허혈성 변화가 나타났거나, 혈역학적 안정성을 유지하기 위하여 혈관수축제의 정맥내 일시주사 등이 필요하였던 군에서 수술 후 심장효소 농도의 증가를 보였으나 수술 후 결과에는 영향을 미치지는 않았다. 결론적으로, 수술 중의 심전도의 허혈성 변화나 혈관수축제의 일시주사의 필요여부가 수술 중의 허혈성 손상을 나태내는 지표가 될 수 있다고 생각한다.

• 대한약리학회지
• /
• 제30권3호
• /
• pp.321-330
• /
• 1994

허혈전처치(ischemic preconditioning)의 재관류심근손상 보호작용과 그 기전을 규명하기 위한 연구의 일환으로 허혈전처치가 심근세포의 산소라디칼 생성능력에 미치는 영향을 검토하였다. 흰쥐 적출심장의 Langendorff 관류표본에서 실험적인 허혈(30분)-재관류(20분)손상을 유도하였고, 허혈전처치는 재관류손상 유도전에 5분 허혈-5분 재관류를 3회 반복하여 시행하였다. 허혈심근 재관류손상의 지표로 심수축기능, 세포질효소 유출, 칼슘 유입 및 미세형태학적 변화를, 그리고 심근세포의 산소라디칼 생성기전으로 xanthine oxidase system의 변동을 허혈전처치와 비전처치 재관류 심장들에서 비교검토하였다. 연구 성적은 다음과 같다. 1. 허혈전처치는 허혈-재관류 심장의 관상혈류량, 심박수, 좌심실압 등 심기능의 저하를 현저히 회복시켰다(회복률; 91%) 2. 허혈-재관류 심장에서 lactate dehydrogenase 유출증가는 허혈전처치에 의해 현저히 저하되었다. 3. 허혈-재관류 심근세포의 전자현미경상 미세구조는 허혈전처치시 비교적 잘 보존되었으며, 특히 myofibril 구조의 보존이 매우 뚜렷하였다. 4. 허혈-재관류시 산화성 조직손상 척도의 하나인 malondialdehyde 생성이 허혈전처치에 의하여 현저히 감소되었다. 5. 허혈전처치 심장에서 xanthine oxidase(D,O 및 D/O형)활성은 변화되지 않았으나 그 기질인 hypoxanthine의 조직함량은 현저히 감소되었다. 이상의 결과들로 부터 허혈전처치는 세포수준에서 허혈심근의 재관류손상을 방지하며, 허혈전처치에 따른 산소라디칼 생성 감소가 재관류손상 방지에 일부 기여할 수 있으리라 사료된다.an을 2주간 처치한 경우에도 영향을 받지 않았다. 이상의 결과로 미루어 아마도 losartan의 내피세포에 대한 작용은 constitutive NO 생성을 증가시키나 inducible NO 생성에는 영향을 미치지 않을 것으로 여겨진다.cium ion이 상당히 중요한 역할을 하는데, 특히 소뇌에서의 NO생성의 감소는 이들 약물들의 치명적 부작용인 tardive dyskinesia와 매우 깊은 관련을 추측할 수 있다. 그러나, 더 많은 약물들의 검색으로 일관적인 기본 결과가 필요 되고 또 각개 약물의 특정적 기전이 연구되기 위하여 현재 실험중이다.(신칭(新稱), Cystostereum subabruptum), 털융단버섯(신칭(新稱), Tomentella pilosa), 노란소나무무늬버섯(신칭(新稱), Asterostroma laxum), 붉은소나무비늘버섯(신칭(新稱), Hymenochaete cruenta), 가루소나무비늘버섯(신칭(新稱), Hymenochaete fuliginosa), 소나무비늘버섯(신칭(新稱), Hymenochaete tabacina), 갈색시루삔버섯(신칭(新稱), Inonotus radiatus), 벚나무진흙버섯(신칭(新稱), Phellinus pomaceus), 회주름구멍버섯(신칭(新稱), Antrodia crassa), 층주름구멍버섯(신칭(新稱), Antrodia serialis), 흰그물구멍버섯(신칭(新稱), Ceriporia reticulata), 겹친손등버섯(신칭(新稱), Oligoporus balsameus), 점박이손등버섯(신칭(新稱), Oligoporus guttulatus), 무른흰살버섯(신칭(新稱), Oxyporus cuneatus), 각목버섯(신칭(新稱),

• The Korean Journal of Physiology and Pharmacology
• /
• 제11권2호
• /
• pp.57-64
• /
• 2007

Ischemic preconditioning (IPC) is known to protect the heart against ischemia/reperfusion (IR)-induced injuries, and regional differences in the mitochondrial antioxidant state during IR or IPC may promote the death or survival of viable and infarcted cardiac tissues under oxidative stress. To date, however, the interplay between the mitochondrial antioxidant enzyme system and the level of reactive oxygen species (ROS) in the body has not yet been resolved. In the present study, we examined the effects of IR- and IPC-induced oxidative stresses on mitochondrial function in viable and infarcted cardiac tissues. Our results showed that the mitochondria from viable areas in the IR-induced group were swollen and fused, whereas those in the infarcted area were heavily damaged. IPC protected the mitochondria, thus reducing cardiac injury. We also found that the activity of the mitochondrial antioxidant enzyme system, which includes manganese superoxide dismutase (Mn-SOD), was enhanced in the viable areas compared to the infarcted areas in proportion with decreasing levels of ROS and mitochondrial DNA (mtDNA) damage. These changes were also present between the IPC and IR groups. Regional differences in Mn-SOD expression were shown to be related to a reduction in mtDNA damage as well as to the release of mitochondrial cytochrome c (Cyt c). To the best of our knowledge, this might be the first study to explore the regional mitochondrial changes during IPC. The present findings are expected to help elucidate the molecular mechanism involved in IPC and helpful in the development of new clinical strategies against ischemic heart disease.

• Journal of Chest Surgery
• /
• 제47권3호
• /
• pp.233-239
• /
• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.