• Title/Summary/Keyword: Cardiovascular protection

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The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery (하행대동맥 및 흉복부 대동맥 수술의 임상적 경험)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.584-589
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    • 2002
  • Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.

Changes in the Myocardial Antioxidant Enzyme System by Post-Ischemic Reperfusion During Corontory Artery Bypass Operations (관상동맥우회술시 심근허혈후 재관류에 의한 활성산소 방어효소계의 변화)

  • 김응중;김기봉
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.850-860
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    • 1996
  • Oxygen free radicals and their metabolites have been implicated as possible causes of reperrusion injury In animal models. Their role in the clinical setting is still controversial. The aim of this study was to evaluate the degree of tissue damage, oxidative stress. and changes in the antioxidant enzyme system in patients undergoing cor nary artery bypass graft operations(CABG) with myocardial protection by cold blood cardioplegia. In patients undergoing CABG(n:10). the levels of lactate dehydrogenate(LDH), creatine phosphokinase MB fraction(CK-MB), and malondialdehyde(M DA) were measured In the coronary sinus effluent before aortic cross clamping and 20 minutes after reperfusion. At the same time, the myocardial tissue activities of superoxide dismutase(SOD). catalase(CAT), glutathione peroxiddse(GSHPX), glutathione reductase (GSSGRd), and glucose 6-phosphate dehydrogenate(GfPDH ) were determined in the right atrial auricle excised before aortic cross clamping and in the left atrial auricle excised 20 minutes after reperfuslon. The levels of increased significantly after reperrusion(p< U.05). There were no significant changes in CAT and CfPDH levels. Western blot analysis was performed to study the induction of antioxidant enzyme and demonstrated increased amount of Cu,Zn-SOD.

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Expression of Bcl-2 Protein in Ischemia-Reperfused Myocardium of Rabbit (가토 허혈-재관류 심근에서의 Bcl-2 단백의 발현)

  • 류재욱;김삼현;서필원;박성식;최창휴;류경민;김영권;박이태;김성숙
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.924-927
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    • 1998
  • Background: Myocardial cell death after myocardial infarction or reperfusion is classified into necrosis and apoptosis. Bcl-2 protein is a cytoplasmic protein, which inhibits apoptosis and is expressed in acute stage of myocardial infarction but not in normal heart. This study was performed to investigate whether Bcl-2 protein was expressed respectively to the reperfusion time. Materials and methods: Thirty nine New Zealand white rabbits weighing 1.5-4.8 kg (mean, 2.9kg) were alloted into 7 groups (n=5 in each group) which underwent left anterior descending coronary artery(LAD) occlusion for 30 minutes, followed by reperfusion. The animals were sacrificed at 1, 4, 8, 12, 24 hours, and 3, 7 days after occlusion. Ventricle was excised immediately after intervention. Tissues were fixed in 10% buffured formalin and embedded in paraffin. Bcl-2 protein was detected by immunohistochemical stain with using monoclonal antibody against Bcl-2 protein. Results: The positive immunohistochemical reactivity for Bcl-2 protein was observed in 12, 24 hours, and 3 days reperfusion groups. Bcl-2 protein was detected in salvaged myocytes surrounding the infarcted area. Conclusions: Bcl-2 protein is expressed at the late acute stage of infarct. Therefore, the expression of Bcl-2 protein may not protect acute cell death, but may play a role in the prevention of late cell death after myocardial is chemia-reperfusion.

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Risk Factors of Morbidity and Mortality after Coronary Artery Bypass Grafting (관상동맥우회로 이식술 후 이환과 사망의 위험요인)

  • 박창률;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1159-1164
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    • 1998
  • Background: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. Material and Method: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery(CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. Result: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6%(9 of 137) with the mortality of 3.9%(5 of 128) for elective operation, and 44.4%(4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men(4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. Conclusion: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.

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Physicochemical and sensory characteristics of sponge cakes supplemented with black tea powder (홍차 분말을 첨가한 스펀지케이크의 품질 및 항산화 활성)

  • Lee, Jun Ho;Choi, Ji Eun
    • Food Science and Preservation
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    • v.23 no.2
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    • pp.188-193
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    • 2016
  • Black tea is rich in phenolic antioxidants that has shown diverse health benefits such as protection against cardiovascular diseases and cancers. Thus, it is rational to incorporate black tea into suitable food products such as sponge cakes to enhance their nutritional and functional qualities. The aim of this study was to investigate the effect of the addition of black tea powder (BTP) on the quality of sponge cake. The pH of cakes ranged from 7.00~7.17, with no remarkable differences. Height decreased while baking loss rate and hardness significantly increased with increases in the content of BTP in the formulation (p<0.05). For crumb color values, $L^*-value$ decreased while $a^*$ and $b^*-values$ increased as a result of BTP substitution. 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) radical scavenging activities were significantly increased (p<0.05) with increases in the content of BTP which were well correlated. Hedonic sensory results indicated that sponge cakes supplemented with 2~4% BTP obtained the most favorable acceptance scores. On the basis of the overall observations, sponge cakes supplemented with 2~4% BTP were found to be benefit from the functional properties of BTP, without compromising on consumer acceptance.

Analysis of Studies on Samul-tang for Fundamental Establishment of Evidence Based Medicine (EBM 기반구축을 위한 사물탕 연구 문헌 분석)

  • Kim, Jung-Hoon;Lee, Jun-Kyoung;Ha, Hye-Kyoung;Seo, Chang-Seob;Lee, Ho-Young;Jung, Da-Young;Lee, Nam-Hun;Lee, Jin-Ah;Huang, Dae-Sun;Shin, Hyun-Kyoo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.779-788
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    • 2009
  • To establish the fundament for EBM of Traditional Korean Medicine, the papers on Samul-tang which was frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. The papers were classified by the registration of domestic or international journals, by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Of total 67 papers on Samul-tang, 58 volumes were registered in domestic journals and 9 volumes were in international journals of which 8 volumes were in SCI journals. Since 1978, publishments of papers have continuously increased. The papers on instrumental analyses were 6, biological studies were 58 volumes, clinical studies were 3. Instrumental analyses were preceeded with standard compounds(gallic acid, albiflorin, paeoniflorin, benzoic acid, ferulic acid, 5-HMF). And biological studies showed improvement of cardiovascular function and circulation, antianemia, brain protection, immunoregulation, antistress, radioprotection, antifatigue, antiinflammation and antiallergy, antioxidative effect. Through clinical studies, antifatigue, improvement of insomnia and osteoporosis were reported. Samul-tang could be used to tonify and activate blood. And further study on clinical field need to be conducted in accordance with biological study.

A Study in Bridging Sciatic Nerve Defects with Combined Skeletal Muscle and Vein Conduit in Rats (백서의 좌골신경에서 정맥 및 골격근을 이용한 결손신경 봉합술에 대한 연구)

  • Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.29-38
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    • 1997
  • A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

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The Local Myocardial Perfusion Rates of Right Atrial Cardioplegia in Hearts with Coronary Arterial Obstruction (관상동맥 협착을 동반한 심장에서 심근보호액 우심방 관류법의 심근 국소관류량)

  • Lee, Jae-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.1-16
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    • 1992
  • The quantitatively measured local myocardial perfusion rates with microspheres are used as an objective indicator of even distribution of cardioplegic solution, and the efficacy of the retrograde right atrial route of cardioplegia is evaluated in hearts with various levels of coronary arterial obstruction. After initial antegrade cardioplegia under the median sternotomy and aortic cannulation, 60 hearts from anesthetized New Zealand white rabbits are divided in random order as normal group [ligated left main coronary artery ; MA, MR] and diagonal group [ligated proximal diagonal artery ; LA, LR]. Half of each group [N=10] are perfused with antegrade cardioplegia[A] under the pressure of 100 cmH2O and the other half with retrograde right atrial route[R] under the pressure of 60 cmH2O[St. Thomas cardioplegic solution mixed with measured amount of microspheres]. The myocardium is subdivided into segments as A[atria], RV[right ventricle]. S[septum], LV[normally perfused left ventricular free wall], ROI[ischemic myocardium of left ventricular free wall]. LV and RQI are further divided into N[subendocardium] and P[subepicardium]. The resulting local myocardial perfusion rates and N /P of each group are compared with Wilcoxon rank sum test. The weight of the hearts is 5.94$\pm$0.66g, and there are no statistically significant dif-ferences[p>0.05, ANOVA] between six compared group. The mean flow rate[F: ml /g / min] of MR group is comparable with MA group[p>0.05], but in N and L group, there are significantly depressed F with right atrial route of cardioplegia, which means elevated perfusion resistance with this route. In spite of no significant differences in delivered doses of microsphere[DEL] between compared groups[p>0.05, ANOVA], there are significantly depressed REC and NF in hearts with right atrial cardioplegia which suggests increased requirement of cardioplegic solution with this route. The interventricular septum shows poor perfusion with right atrial route of cardioplegia without obstruction of supplying coronary arteries. But, with obstruction of coronary artery supplying septum as in M group, the flow rate is superior with right atrial route of infusion. The left ventricular free wall perfusion rates of every RQI with R route are superior to that of A route[p<0.05]. But, in LV segments, there are unfavorable effects of right atrial cardioplegia in L group, although the subendocardial perfusion is well maintained in N group. The LV free wall of left main group shows depressed perfusion rates with antegrade route as compared with RQI segments of diagonal group. But, by contraries, there are increased perfusion rates and superior N /P ratio with retrograde right atrial route. It implies more effective perfusion with right atrial route of cardioplegia in more proximal coronary arterial obstruction[i.e., M group as compared with L group]. As a conclusion, all region of ischemia have superior perfusion rates with right atrial car-dioplegia as compared with antegrade route, and especially excellent results can be obtained in hearts with more proximal obstruction of coronary arteries which would otherwise result in more severe ischemic damage. But, the depressed perfusion rates of the segments with normal coronary artery in hearts with coronary arterial obstruction may be a problem of concern with right atrial cardioplegia and needs solution.

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Cardioprotective Efficacy of Ischemic Preconditioning on Long-Term Myocardial Preservation in Isolated Rat Heart (적출 쥐 심장에서 장시간의 심장보존시 허혈성 전조건화가 심근보호에 미치는 영향)

  • 허동명;장봉현
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.605-612
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    • 2000
  • Background: Ischemic preconditioning enhances the tolerance of myocardium against ischemia/reperfusion injury, with the enhancement of the recovery of post-ischemic myocardial function. This study was disigned to assess whether the protective effect of ischemic preconditioning could provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rate heart. Material and method: Fourty four Spargue-Dawley rats, weighing 300~450gm, were divided into four groups. Group 1(n=7) and group 3(n=12) were subjected to 30 minutes of aerobic Langendorff perfusion without ischemic preconditioning and then preserved in saline solution at 2~4$^{\circ}C$ for 4 hours and 5 respectively. Group 2(n=7) and group 4(n=18) were perfused in the same way for 20 minutes, followed by 3 minutes of global mormothermic ischemia and 10 minutes of perfusion and then preserved in the same cold saline solution for 4 hours and 5 hours respectively. Heart rate, left ventricular developed pressure(LVDP), and coronary flow were measured at 15 minutes during perfusion as baseline. Spontaneous defibrillation time was measured after reperfusion. Heart rate, LVDP, and coronary flow were also recorded at 15 minutes, 30 minutes, and 45 minutes during reperfusion. Samples of the apical left ventricular wall were studied using a transmission electron microscope. Result: Time of spontaneous defibrillation(TSD) was significantly longer in group 4 than in group 1(p<0.001), and TSD in group 1 was significantly longer in comparision to that of group 2(p<0.05). Heart rate at 45 minutes was significantly higher in group 1 than in group 4(p<0.05). Heart rate at 15 min was significantly higher in group 2 than in group 1(p<0.001) and in group 4 than in group 3(p<0.05). Left ventricular developed pressure(LVDP) at 30 minutes and 45 minutes was higher in group 1 than in group 4(p<0.01), LVDP at 45 minutes was higher in group 4 than in group 3(p<0.05). Rate-pressure product(RPP) at 30 minutes and 45 minutes was higher in group 1 than in group 4(p<0.05). RPP at 15 minutes was higher in group 2 than in group 1(p<0.01). RPP at 30 minutes and 45 minutes was higher in group 4 than in group 3(p<0.05). Group 2 showed relatively less sarcoplasmic edema and less nuclear chromatin clearance than group 1. Group 4 showed less myocardial cell damage than group 3, group 4 showed less myocardial cell damage than group 3, group 4 showed more myocardial cell edema than group 1. Conclusion: Ischemic preconditioning enhanced the recovery of postischemic myocardial function after 4 hours and 5 hours preservation. However, it was not demonstrated that ischemic preconditioning could definitely provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rat heart.

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Effects of herbal acupuncture(Atratylodes japonica, Coix lachrymajobi, Ephedra sinica, Atratylodes japonica mixed with Coix lachrymajobi and Ephedra sinica mixed with Green tea) at Pungnyung(ST40) and Umnungchon(SP9) in obese Rats induced by high fat diet (고지방식이(高脂肪食餌)로 유발(誘發)된 비만백서(肥滿白鼠)모델에서 창출(蒼朮), 의이인(薏苡仁), 마황(麻黃), 창출합의이인(蒼朮合薏苡仁) 마황합록차(麻黃合綠茶) 약침(藥鍼)이 혈청지질(血淸脂質) 및 간기능(肝機能)에 미치는 영향(影響))

  • Youn, Dae-Hwan;Kang, Ja-Don;Joo, Joon-Sung;Chae, Woo-Seok;Na, Chang-Su
    • Journal of Pharmacopuncture
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    • v.7 no.1 s.12
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    • pp.87-100
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    • 2004
  • Objective : This research was performed to investigate the effect of herbal acupuncture(Atratylodes japonica, Coix lachrymajobi, Ephedra sinica, Atratylodes japonica mixed with Coix lachrymajobi and Ephedra sinica mixed with Green tea) at Pungnyung(ST40) and Umnungchon(SP9) on weight gain, food intake, food efficiency, serum of lipid concentrations, liver function and HDL to total cholesterol ratio of rats fed high fat diet for 5weeks. Method : Experimental groups were divided into normal group(Normal), high fat diet group(Control), high fat diet and Atractylodes japonica-herbal acupuncture group(AJ), high fat diet and Coix lachrymajobi-herbal acupuncture group(CL), high fat diet and Ephedra sinica-herbaI acupuncture group(ES), high fat diet and Atractylodes japonica+Coix lachrymajobi-herbal acupuncture group(AJ+CL), Ephedra sinica+Green tea-herbal acupuncture group(ES+GT). Herbal acupuncture was bilaterally treated at the level of 132.5mg/kg body weight per 2day. Results : Body weight and food efficiency were decreased in AJ, ES, AJ+CL, ES+GT. The level of serum total cholesterol, triglyceride and free fatty acid were increased in AJ, ES, ES+GT. That of serum HDL-cholesterol was increased in AJ. The change of food intake, the level of serum phospholipid and ALP were not significant. The HDL to Total cholesterol ratio was increased in AJ and ES. Conclusion : Atractylodes japonica-herbal acupuncture in ST40 SP9 is effective on Body weight, food efficiency ratio, the level of serum lipid, protection of liver function and prevention cardiovascular risk by obesity induced by high fat diet. Herbal acupuncture mixed Ephedra sinica with Green tea can control the body weight, food efficiency ratio and the level of serum lipid.