• Title/Summary/Keyword: Cardiovascular flow

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Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

The Effect of Isoflavone Supplement on Plasma Lipids & Antioxidant Status in Hypercholesterolemic Postmenopausal Women (고지혈증인 폐경 후 여성에서 이소플라본 보충이 혈청 지질 농도 및 항산화능에 미치는 영향)

  • Lee, Jong-Ho;Kim, Eun-Mi;Chae, Ji-Sook;Jang, Yang-Soo;Lee, Jin-Hee;Lee, Geun
    • Journal of Nutrition and Health
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    • v.36 no.6
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    • pp.603-612
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    • 2003
  • Postmenopausal women are at an increased risk of developing coronary artery disease. This is due to primarily dyslipidemia accompanying the loss of estrogen secretion. Soy isoflavones are known to have weak estrogenic effects. The purpose of this study is to investigate whether isoflavone supplement improves the risk of cardiovascular disease in hypercholesterolemic postmenopausal women. Subjects consisted of 39 Korean postmenopausal women with hypercholesterolemia (total cholesterol $\geq$ 200 mg/㎗ or LDL cholesterol $\geq$ 130 mg/㎗). Subjects were divided into 2 groups; placebo group (PG), isoflavone supplement group (IG). During 12 weeks, subjects were given placebo and 80mg isoflavone daily. Anthropometric measurement, blood sample analysis and dietary intake measurement were taken at baseline and after 12 weeks. After 12 weeks, systolic blood pressure was decreased significantly (p < 0.01) and plasma HDL cholesterol level was increased significantly (p < 0.05) in IG. But there were no significant changes in plasma total cholesterol, LDL cholesterol and triglyceride levels after isoflavone supplementation. There was a negative correlation between initial plasma HDL cholesterol level and the extent of plasma HDL cholesterol reduction in IG (r=-0.572, p=0.012). Atherogenic index (AI), total-/LDL- cholesterol ratio and LDL/HDL cholesterol ratio were improved significantly after isoflavone supplementation. In subjects whose initial plasma LDL cholesterol level were above 160 mg/㎗, plasma malondialdehyde (MDA) level were decreased and total antioxidant status (TAS) were increased significantly after isoflavone supplement (p < 0.05). However there were no significant changes in flow-mediated dilator (FMD), the marker of endothelium-dependent vasodilation and nitroglycerine-mediated dilator (NMD), the marker of endothelium-independent vasodilation and the extent of DNA damage after isoflavone supplement. In conclusion, these results indicate that isoflavone supplement may decrease the risk of cardiovascular disease via improving blood pressure, HDL cholesterol level and AI in hypercholesterolemic postmenopausal women. Futhermore, in case of subjects with elevated LDL cholesterol level, isoflavone supplementation may have more antiatherogenic effects via improving antioxidant status.

Numerical Analysis of Conjugate Heat Transfer for Various Ice-Ball Shapes (다양한 아이스 볼 형상에 대한 복합열전달의 수치해석)

  • Park, Seo Won;Kim, Myoung Soo;Jeon, Byoung Jin;Choi, Hyoung Gwon
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.40 no.9
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    • pp.605-612
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    • 2016
  • In this study, numerical simulations were conducted for conjugate heat transfer around ice balls in an encapsulated ice thermal storage system. Four shapes of ice balls were modeled; the default one was a sphere, and the other three shapes were designed to enhance convective heat transfer through the ball surface. The flow around the ball was laminar, for which the Reynolds number was 300, and both forced and natural convections inside and outside the balls were considered. The simulations revealed that the magnitude of convective heat transfer for the different shapes decreased in the following order: bone, dimple, hole, and sphere. For the entire simulation, the maximum difference in the average temperatures of water inside the capsules was found to be $0.9^{\circ}C$. Therefore, it can be said that the effect of ice-ball shape on the performance of the ice thermal storage system is significant, considering that more than 0.3 million balls are used in this system.

A Study on GPU Computing of Bi-conjugate Gradient Method for Finite Element Analysis of the Incompressible Navier-Stokes Equations (유한요소 비압축성 유동장 해석을 위한 이중공액구배법의 GPU 기반 연산에 대한 연구)

  • Yoon, Jong Seon;Jeon, Byoung Jin;Jung, Hye Dong;Choi, Hyoung Gwon
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.40 no.9
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    • pp.597-604
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    • 2016
  • A parallel algorithm of bi-conjugate gradient method was developed based on CUDA for parallel computation of the incompressible Navier-Stokes equations. The governing equations were discretized using splitting P2P1 finite element method. Asymmetric stenotic flow problem was solved to validate the proposed algorithm, and then the parallel performance of the GPU was examined by measuring the elapsed times. Further, the GPU performance for sparse matrix-vector multiplication was also investigated with a matrix of fluid-structure interaction problem. A kernel was generated to simultaneously compute the inner product of each row of sparse matrix and a vector. In addition, the kernel was optimized to improve the performance by using both parallel reduction and memory coalescing. In the kernel construction, the effect of warp on the parallel performance of the present CUDA was also examined. The present GPU computation was more than 7 times faster than the single CPU by double precision.

Pulsatility Estimation of a Pulsatile Decellularizing Device for the Fabrication of Organ Scaffold (생체장기용 지지체 제작을 위한 박동형 탈세포화 장치의 박동성 평가)

  • Kim, Dong Sun;Yang, Se-Ran;Park, Sung Min;Choi, Seong Wook
    • Journal of Biomedical Engineering Research
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    • v.38 no.2
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    • pp.62-73
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    • 2017
  • To identify a solution for the restricted availability of healthy lungs and the high risk of immune rejections following organ transplantation, tissue engineering techniques for culturing lungs have been studied by many research groups. The most promising method for culturing lungs is the utilization of a bio-scaffold that was prepared using harvested organs from human donors or other animals by removing their original cells. In this study, a pulsatile perfusion pump was used to alleviate the cell removal effect with the high fluid-dynamic power of the perfusion stream during the decellularization process, while other conventional studies focused on chemical methods to identify efficient detergents. The purpose of this study was to analyze the developed device by using energy equivalent pressure (EEP), which is an indicator of pulsatility, to understand the characteristics of pulsatile energy transmitted according to the load size by using the artificial model and compare it with the measured EEP. The pulsatility of the device can be estimated with the concept of fluid-dynamic energy during a particular constant time period or fluid-dynamic power represented as EEP and EEP increment. Because the measured EEP of perfusion flow during decellularization can be changed by the amount of fluid leakage and the degree of clogging in the capillary vessels, EEP should be measured to determine whether the decellularization is progressing without problems. The decrement of EEP caused by the high perfusion resistance was observed from some experimental results that were obtained with artificial models. EEP can be used to monitor the decellularization process after analyzing the varying EEP according to the amount of load. It was confirmed that the EEP was maintained at a high level in the experiment using the harvested lungs from 12-13-week-old rats. In addition, it was confirmed that the cell removal time was faster than when continuous perfusion was performed. In this study, pulsatile power delivered to the lungs was measured to monitor the process of cell removal, and it serve as the evidence for efficient decellularization.

Alteration in Leukocyte Subsets and Expressions of FcγR and Complement Receptors among Female Ragpickers in Eastern India

  • Mondal, Nandan K.;Siddique, Shabana;Banerjee, Madhuchanda;Roychoudhury, Sanghita;Mukherjee, Sayali;Slaughter, Mark S.;Lahiri, Twisha;Ray, Manas R.
    • Safety and Health at Work
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    • v.8 no.2
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    • pp.198-205
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    • 2017
  • Background: There are a million ragpickers in India who gather and trade recyclable municipal solid wastes materials for a living. The objective of this study was to examine whether their occupation adversely affects their immunity. Methods: Seventy-four women ragpickers (median age, 30 years) and 65 age-matched control housemaids were enrolled. Flow cytometry was used to measure leukocyte subsets, and leukocyte expressions of $Fc{\gamma}$ receptor I (CD64), $Fc{\gamma}RIII$ (CD16), complement receptor 1 (CD35) and CR3 (CD11b/CD18), and CD14. Serum total immunoglobulin-E was estimated with enzyme-linked immunosorbent assay. Results: Compared with the controls, ragpickers had significantly (p < 0.0001) higher levels of CD8-T-cytotoxic, CD16+CD56+natural killer, and CD4+CD45RO+memory T-cells, but depleted levels of CD19+B-cells. The percentage of CD4+T-helper-cells was lower than the control group (p < 0.0001), but their absolute number was relatively unchanged (p = 0.42) due to 11% higher lymphocyte counts in ragpickers. In ragpickers, the percentages of CD14+CD16+intermediate and CD14dim CD16+nonclassical monocyte subsets were elevated with a decline in CD14+CD16-classical monocytes. The expressions of CD64, CD16, CD35, and CD11b/CD18 on both monocytes and neutrophils, and CD14 on monocytes were significantly higher in ragpickers. In addition, ragpickers had 2.7-times more serum immunoglobulin-E than the controls (p < 0.0001). After controlling potential confounders, the profession of ragpicking was positively associated with the changes. Conclusion: Ragpicking is associated with alterations in both innate (neutrophils, monocytes, and natural killer cell numbers and expression of complement and $Fc{\gamma}$ receptors) and adaptive immunity (numbers of circulating B cells, helper, cytotoxic, and memory T cells).

Coronary Artery Disease Affected by Moyamoya Disease - A case report - (관상 동맥 질환을 동반한 모야모야 병 1례의 증례 보고)

  • 김학제;조원민;류세민;황재준;손영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.231-234
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    • 2002
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However, moyamoya diseases are recently being reported as a systemic process. We experienced one case of coronary artery occlusive disease affected by moyamoya disease. The patient was a 35-year-old female, experiencing intermittent NYHA class ll dyspnea and exertional chest pain for 6 months and right paresthesia for 1 month before admission. Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left frontal lobe. In coronary artery angiogram, left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB. Both internal mammary arteries were used for LAD and LCx. Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi, and nondiseased coronary arteries were good and patent. We concluded that this patient's coronary artery disease was affected by moyamoya disease, and moyamoya disease should be evaluated in the extracerebral cardiovascular system.

Pharmacokinetics and Pharmacodynamics Following Oral Administration of Pimobendan-Pentoxifylline Powder Formulation Mixture in Dogs (개에서 피모벤단-펜톡시필린 분말 제형 합제의 경구투여시 약물약동학 및 약물약력학에 대한 연구)

  • Ro, Woong-bin;Song, Doo-won;Kang, Yeo-lim;Park, You-jin;Yoo, Cho-rong;Lee, Jong-ho;Kim, Ki-hun;Jeong, Sang-hee;Kang, Min-hee
    • Journal of Veterinary Clinics
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    • v.36 no.1
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    • pp.46-52
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    • 2019
  • Pimobendan has inotropic and vasodilating effects on cardiovascular system, and pentoxifylline is known to decrease blood viscosity and improve blood flow to the heart. This study investigated the pharmacokinetics and pharmacodynamics following oral administration of pimobendan-pentoxifylline powder mixture in dogs. Eight healthy dogs were included and were divided into control (n = 4) and experimental (n = 4) groups. Vehicle powder and pimobendan-pentoxifylline powder mixture (pimobendane 0.25 mg/kg, pentoxifylline 15 mg/kg) were administrated orally to control and experimental groups, respectively. Plasma samples and measurement of echocardiographic indices were obtained for 24 hours following administration. Pimobendan and pentoxifylline concentrations were investigated using liquid chromatography-mass spectrometer (LC-MS) assay. The elimination half-life ($T_{1/2}$) were $2.65{\pm}1.42hours$ for pimobendan and $0.29{\pm}0.23hours$ for pentoxifylline. The time to reach maximum concentration ($T_{max}$) were $1.08{\pm}0.72hours$ for pimobendan and $0.29{\pm}0.14hours$ for pentoxifylline. The maximum blood concentration ($C_{max}$) were $2.83{\pm}1.50ng/mL$ for pimobendan and $1184.33{\pm}932.37ng/mL$ for pentoxifylline. Among echocardiographic indices, fractional shortening (FS), left ventricular internal diameter at end systole (LVIDs), and pre-ejection period (PEP) showed significant changes at 1-4 hours after the administration of pimobendan-pentoxifylline powder mixture. No adverse effects were observed during the investigation. This study demonstrates that pimobendan-pentoxifylline powder mixture can be used to control cardiovascular diseases in dogs.

Ref-1 protects against FeCl3-induced thrombosis and tissue factor expression via the GSK3β-NF-κB pathway

  • Lee, Ikjun;Nagar, Harsha;Kim, Seonhee;Choi, Su-jeong;Piao, Shuyu;Ahn, Moonsang;Jeon, Byeong Hwa;Oh, Sang-Ha;Kang, Shin Kwang;Kim, Cuk-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.1
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    • pp.59-68
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    • 2021
  • Arterial thrombosis and its associated diseases are considered to constitute a major healthcare problem. Arterial thrombosis, defined as blood clot formation in an artery that interrupts blood circulation, is associated with many cardiovascular diseases. Oxidative stress is one of many important factors that aggravates the pathophysiological process of arterial thrombosis. Apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ref-1) has a multifunctional role in cells that includes the regulation of oxidative stress and anti-inflammatory function. The aim of this study was to investigate the therapeutic effect of adenovirus-mediated Ref-1 overexpression on arterial thrombosis induced by 60% FeCl3 solution in rats. Blood flow was measured to detect the time to occlusion, thrombus formation was detected by hematoxylin and eosin staining, reactive oxygen species (ROS) levels were detected by high-performance liquid chromatography, and the expression of tissue factor and other proteins was detected by Western blot. FeCl3 aggravated thrombus formation in carotid arteries and reduced the time to artery occlusion. Ref-1 significantly delayed arterial obstruction via the inhibition of thrombus formation, especially by downregulating tissue factor expression through the Akt-GSK3β-NF-κB signaling pathway. Ref1 also reduced the expression of vascular inflammation markers ICAM-1 and VCAM-1, and reduced the level of ROS that contributed to thrombus formation. The results showed that adenovirus-mediated Ref-1 overexpression reduced thrombus formation in the rat carotid artery. In summary, Ref-1 overexpression had anti-thrombotic effects in a carotid artery thrombosis model and could be a target for the treatment of arterial thrombosis.

Impacts of Pre-transplant Panel-Reactive Antibody on Post-transplantation Outcomes: A Study of Nationwide Heart Transplant Registry Data

  • Darae Kim;Jin-Oh Choi;Yang Hyun Cho;Kiick Sung;Jaewon Oh;Hyun Jai Cho;Sung-Ho Jung;Hae-Young Lee;Jin Joo Park;Dong-Ju Choi;Seok-Min Kang;Myoung Soo Kim;Jae-Joong Kim
    • Korean Circulation Journal
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    • v.54 no.6
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    • pp.325-335
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    • 2024
  • Background and Objectives: The number of sensitized heart failure patients on waiting lists for heart transplantation (HTx) is increasing. Using the Korean Organ Transplantation Registry (KOTRY), a nationwide multicenter database, we investigated the prevalence and clinical impact of calculated panel-reactive antibody (cPRA) in patients undergoing HTx. Methods: We retrospectively reviewed 813 patients who underwent HTx between 2014 and 2021. Patients were grouped according to peak PRA level as group A: patients with cPRA ≤10% (n= 492); group B: patients with cPRA >10%, <50% (n=160); group C patients with cPRA ≥50% (n=161). Post-HTx outcomes were freedom from antibody-mediated rejection (AMR), acute cellular rejection, coronary allograft vasculopathy, and all-cause mortality. Results: The median follow-up duration was 44 (19-72) months. Female sex, re-transplantation, and pre-HTx renal replacement therapy were independently associated with an increased risk of sensitization (cPRA ≥50%). Group C patients were more likely to have longer hospital stays and to use anti-thymocyte globulin as an induction agent compared to groups A and B. Significantly more patients in group C had positive flow cytometric crossmatch and had a higher incidence of preformed donor-specific antibody (DSA) compared to groups A and B. During follow-up, group C had a significantly higher rate of AMR, but the overall survival rate was comparable to that of groups A and B. In a subgroup analysis of group C, post-transplant survival was comparable despite higher preformed DSA in a desensitized group compared to the non-desensitized group. Conclusions: Patients with cPRA ≥50% had significantly higher incidence of preformed DSA and lower freedom from AMR, but post-HTx survival rates were similar to those with cPRA <50%. Our findings suggest that sensitized patients can attain comparable post-transplant survival to non-sensitized patients when treated with optimal desensitization treatment and therapeutic intervention.