• Journal of Chest Surgery
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• v.19 no.1
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• pp.153-159
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• 1986

A 11 month old child with transposition of the great arteries and a large ventricular septal defect [VSD] underwent repair by VSD closure and arterial switching with translocation of the coronary ostia. Cardiopulmonary bypass was established along with core cooling to between 18 degree C and low flow was employed. By LeCompte maneuver, we avoided the use of a tubular prosthesis in the repair of pulmonary outflow tract. The post-operative course was uneventful.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.601-608
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• 2005

Background: To maximize the histological advantage and minimize the physiological disadvantage, we have been using the skeletonized gastroepiploic artey (GEA) as a free graft for total arterial revascularization. The aims of the current study was to assess the efficacy of the skeletonized GEA as a composite or extended graft for total arterial revascularization. Material and Method: Between January 2000 and Feburary 2005, 133 patients (43 female, mean age=61.8 yrs) undergoing coronary artery bypass grafting (CABG) with a skeletonized GEA as free graft (22 extended, 107 composite and 4 others) were enrolled in this study. Coronary angiograms were performed in the immediate (median 44 days, n=86), early (median 366 days, n=56) and midterm (median 984 days, n=29) postoperative periods. Result: There were 3 ($2.2\%$) early and 4 ($3.3\%$) late cardiac-related deaths. The mean number of distal anastomoses per patient was 3.34 for total graft and 1.92 for GEA graft. The immediate, early, and midterm GEA patency were 157/159 ($98.7\%$), 106/142 ($94.6\%$), and 53/56 ($94.6\%$), respectively. During follow-up, four patients required percutaneous intracoronary intervention because of GEA and target coronary artery stenosis or competitive flow. Conclusion: These data demonstrate satisfactory clinical and angiographic results in the skeletonized GEA as free graft for total arterial revascularizatioh. Although we need a careful longer follow-up, the skeletonized GEA as a free graft will be a valuable option 'to be' for CABG.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.373-377
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• 2014

Background: This paper aimed to verify the effects of renal replacement therapy on changing the levels of serum creatinine for different veno-arterial and veno-venous configurations in prolonged extracorporeal membrane oxygenation (ECMO) patients. Methods: The subjects were chosen 71 patients who had undergone more than 1,440 minutes (24 hours) of the therapy from among 117 patients who had undergone ECMO insertion between January 2008 and December 2012. The patients were separated into the veno-arterial configuration group I (51 patients) and the veno-venous configuration group II (20 patients). The difference in the level of serum creatinine (${\Delta}Cr$) between before or just after ECMO insertion ($Cr_I$) and the level when the pump time was between 2,880 and 4,320 minutes ($Cr_F$) was checked (${\Delta}Cr=Cr_F-Cr_I$), and the average ${\Delta}Cr$ for each group was compared using a Student t-test at the confidence interval (CI) of 95%. Results: The change in the level of serum creatinine was an increase of 0.341 mg/dL (${\sigma}$=0.9202) for group I and a decrease of 0.120 mg/dL (${\sigma}$=1.5292) for group II. The change was significantly high for group I (p=0.011, CI=95%). Meanwhile, within group I, when renal replacement therapy was not done, there was a significant increase in the level of serum creatinine (p=0.009, CI=95%). Conclusion: For ECMO insertion patients whose pump time was more than 1,440 minutes, there was a significant change in the level of serum creatinine when renal replacement therapy was not done, for the veno-arterial configuration of group I.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.366-379
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• 2017

In this study, we performed a systematic review and meta-analysis to identify the effects of exercise on endothelial progenitor cells (EPCs) in patients with cardiovascular disease (CVD). We conducted database searches (Cochrane Library, PubMed, EMBASE, ScienceDirect, CINAHL, Scopus, KoreaMed, KISS, RISS, KMBASE) for the effect of exercise on cardiovascular disease, using heart disease, coronary artery disease, heart failure, cardiovascular disease, exercise, motor activity, rehabilitation, and endothelial progenitor cells as the keywords. Of the 539 studies identified, 9 met the inclusion and exclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze the effect size and the publication bias was checked with a funnel plot. Exercise was found to improve the VEGF (vascular endothelial growth factor), CD34+KDR+, and endothelial function, assessed via FMD (flow-mediated dilation), in the exercise vs. control groups, viz. 2.008 (95% CI 0.204-3.812), 1.399 (95% CI 0.310-2.489), and 1.881 (95% CI 0.848-2.914), respectively. Exercise improved the VEGF, number of EPCs, and endothelial function in the CVD patients. Considering the increasing prevalence and mortality rates for cardiovascular disease in Korea, the findings of this study that analyzed the effects of exercise on EPCs might provide guidelines for planning exercise interventions for patients with CVD.

• Journal of Biomedical Engineering Research
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• v.43 no.3
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• pp.136-146
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• 2022

In this study, it is intended to provide basic data that can help develop a cardiovascular simulator for performance evaluation of pulse wave detectors by identifying the development status of domestic and overseas cardiovascular simulators. A total of 119 papers were selected by excluding duplicate literature, gray literature, and literature not related to a cardiovascular simulator. Based on the selected literature, the research trend of cardiovascular simulators was analyzed. As a result of analyzing the purpose of the study, most of the simulators were developed to evaluate the hemodynamic properties of artificial hearts and valves. In addition, it was used for simulation evaluation or hemodynamic studies such as pulse wave studies. As a result of analyzing configurations of the simulators, a heart most often consisted of only one left ventricle. For blood vessels, the Windkessel model was most often constructed using chambers and valves. In most studies, blood was reproduced by mixing glycerin and water to reproduce both density and viscosity. In addition, as a result of analysis from the perspective of medical device performance evaluation, simulators for evaluating artificial heart and artificial valves have been studied a lot, whereas simulators for blood pressure, pulse wave, and blood flow devices have been relatively insignificant. Based on the review results, we suggested considerations when developing a simulator for performance evaluations of a pulse wave detector.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.671-677
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• 1995

Skeletonization of the internal mammary artery [IMA during myocardial revascularization procedures may provide some advantages, compared with the pedicle graft of the artery. In 17 patients undergoing IMA grafting by skeletonization technique, flow through the artery was measured on mean arterial pressure of 50-55 mmHg immediately after cardiopulmonary bypass started [first flow and just before its anastomosis to left anterior descending artery [second flow . In 16 patients except 1 patient whose graft was injured during mobilization, the first flow of IMA graft was 32.3 $\pm$ 7.4 ml/min and the second flow increased to 59.6$\pm$25.9 ml/min without any treatment and the site for anastomosis of the IMA graft was more than 1.0 cm above the bifurcation. On the basis of previous clinical studies, the flow of the skeletonized IMA was greater than that of the pedicle graft [59.6 $\pm$ 25.9 ml/min versus 37.7$\pm$ 14.1 ml/min, p < 0.05 . In comparison between the skeletonized IMA and the IMA graft intraluminally dilated with papaverine solution, there was no significant difference between two flows[59.6 $\pm$25.7 ml/min versus 74.7 $\pm$31.4 ml/min, not significant , but the former showed longer graft and anastomosis of more proximal portion of the graft to left anterior descending artery. In conclusion, the technique of internal mammary artery skeletonization has consistently produced a satifactory conduit for myocardial revascularization procedures. We have adopted IMA skeletonization not only because of the flow, diameter, and vessel length obtained but also because of limited perivascular tissue disruption that occurs during the dissection.

• The Korean Journal of Physiology
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• v.19 no.2
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• pp.139-153
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• 1985

The passive tilt has been performed to study the orthostasis on the cardiovascular system. The orthostasis due to upright tilt was demonstrated as follows: the venous return, cardiac output and systemic arteiral blood pressure were decreased, whereas there was concomitant increase of heart rate, through the negative feedback mediated by such as the baroreceptor . Previous investigators have suggested that the tolerance to the orthostasis could he increased by blocking the cholinergic fiber with atropine which prevented vasodilation and bradycardia through the vasovagal reflex during the orthostasis. However, this hypothesis has not been clearly understood. This study was attempted to clarify the effect of atropine on the tolerance of the cardiovascular system to the upright and head-down tilt, and to investigate the change of the blood flow through head and lower leg with Electromagnetic flowmeter in both tilts before and after atropine state. Fourteen anesthetized dogs of $10{\sim}14kg$ were examined by tilting from supine position to $+77^{\circ}$ upright position (orthostasis), and then to $-90^{\circ}$ head-down position (antiorthostasis) for 10 minutes on each test. And the same course was taken 20 minutes after intravenous administration of 0.5mg atropine. The measurements were made of the blood flow(ml/min.) on the carotid artery, external jugular vein, femoral artery and femoral vein. At the same time pH, $PCO_2$, $PO_2$ and hematocrit (Hct) of the arterial and venous blood, and heart rate(HR) and respiratory rate (RR) were measured. The measurements obtained from upright and head-down tilt were compared with those from supine position. The results obtained are as follows: In upright tilt, the blood flow both on the artery and the vein through head and lower leg were decreased, however the decrement of blood flow through the head was greater than the lower leg And the atropine attenuated the decrement of the blood flow on the carotid artery, but not on the vessels of the lower leg. HR was moderately increased in upright tilt, but slightly in head-down tilt. The percent change of HR after the atropine administration was smaller than that before the atropine state in both upright and head-down tilts. Before the atropine state, RR was decreased in upright tilt, whereas increased in head-down tilt. However after the atropine state, the percent change of RR was smaller than that of before the atropine state in both upright and head-down tilts. In upright tilt, venous $PCO_2$ was increased, but arterial $PO_2$ and venous $PO_2$ were slightly decreased. Hct was increased in both upright and head-down tilts. The findings of blood $PCO_2$, $PO_2$ and Hct were not interferred by the atropine. In conclusion, 1;he administration of atropine is somewhat effective on improving the cardiovascular tolerance to postural changes. Thus, atropine attenuates the severe diminution of the blood flow to the head during orthostasis, and also reduces the changes of HR and RR in both orthostasis and antiorthostasis.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1055-1065
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• 1996

This experiment was undertaken to assess the effect of nitric oxide, isosorbide dinitrate, and sodium nitroprusside, which are known to increase coronary flow by vasodilation and to improve the cardiac function of an ischemic heart The experiment was carried out to investigate the effect of nitric oxide on the coronary artery of an ischemic rat myocardium using isolated constant pressure Langendorfr system. The experimental parameters were lactate and CK-MB for the frozen myocardium and coronary flow. the quantity of coyonary flow, left ventricular developed pressure (LVDP), and dp/dt. The experimental groups were decided as control group (Group I), nitric oxide group (Group II), Iso orbide dinitrate group (Group III) and sodium nitroprusside group (Group IV). Statistical analysis was performed using repeated measured analysis of variance and 2tudent t-test The results were as follows: 1 . The lactic acid contents of group II and IV were less than other groups for the frozen myocardium at preischemic state (p< 0.0025), whereas the determined coronary flows were higher. 2. In the ratio of produced lactic acid between the preischemia and reperfusion for the coronary flow, group II and IV exhibitrod less value than others (p< 0.005). 3. Group II and III were less than others in the coronary flow for the quantity of CK-MB, but or the frozen myocardium, group II and IV were less. 4. Group II and IV showed higher coronary flow compared to others throughout entire experimental period (p< 0.005). 5. Group II was highest at the preischemic state for the left ventricular developed pressure. 6. The +maximal dp/dt of group II was highest compared to others. 7. Group I exhibi ed the highest recovery rate of coronary flow between prelschemla and reperfusion. 8. The(-dp/dt)1(+dp/dt) ratio was 116%, 100%, 100%, and 55% for the 4 groups, respectively And the recovery rate of total dp/dt was 34%, 67%, 51%, and 76% for the four groups, respectively.

• Journal of Mechanical Science and Technology
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• v.16 no.11
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• pp.1470-1476
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• 2002

The goal of this work is to design and build an implantable artificial lung that can be inserted as a whole into a large vein in the body with the least effect on cardiovascular hemodynamics. The experimental results demonstrate that the pressure drop is not entirely related to viscosity effects. The friction factor decreases with an increase in the number of tied-hollow fibers at a constant Reynolds number A uniform flow pattern without stagnation is observed at all numbers of tied hollow fibers tested. The tied hollow fiber module, built in this study with 3 cm of outer diameter of module. 380 m of outer diameter of tied hollow fiber, and 700 number of tied hollow fiber with length of 60 cm, which shows a pressure drop of 13-16 mmHg, satisfies the required pressure drop qualifying 15 mmHg as an intravascular artificial lung.

• Proceedings of the KSME Conference
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• 2007.05b
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• pp.2791-2796
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• 2007

In their long journey through the cardiovascular circuit, erythrocytes are coerced to shape transform and assume different shapes on account of varying flow conditions in different blood vessels. The present work was aimed to visualize these erythrocyte shape transformations by an invitro microcirculatory model, and assess multi-shape erythrocyte deformability. The model uses an in-house fabricated, inexpensive disposable micro flow channel to mimic certain invivo conditions and a fast frame video microscopic system for imaging the shape changes in erythrocytes. Results show the multi-shape transformation of erythrocyte christened as discoidal shape, the asymmetrically deformed 'hat' and 'bullet-like' shapes, and the axially deformed 'slipper' and 'spindle-like' shapes. Specific erythrocyte showed the shape transition and transformation while passing through the observed window. The obtained erythrocyte shapes very analyzed for deformability index using image processing techniques that varied significantly (p <0.001) for different shapes as compared with the resting shape.