• Title/Summary/Keyword: Cardiovascular system

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Anesthetic and Cardiovascular Effects Induced by a Combination of Midazolam and Thiopental in Dogs (개에 있어서 Midazolam과 Thiopental 병용 투여시 마취 및 심순환기계에 미치는 영향)

  • 김희정;임희란;김휘율
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.352-362
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    • 1999
  • Thiopental sodium is known as ultrashort-acting barbiturates and can be employed advantageously for numerous conditions. But thiopental has the side effects of cardiovascular and respiratory systems which has barbiturates and are depend on the dose of thiopental. The side effects are reduced when the thiopental is preceded by a tranquilizer and sedative. In these drugs, benzodiazepines have the minimal effects of cardiovascular and respiratory systems. In this study, the effects of midazolam preanesthetic administration, followed by thiopental anesthetic induction, on cardiovascular system and thiopental induction requirement were studied in 14 mixed breed dogs. Cardiovascular data were recorded baseline, after premedication of saline 0.45 ml/kg or midazolam 0.1, 0.2, 0.4, 0.8 mg/kg, intubation, and 5, 10, 15, 20, 30 minutes after intubation. Extubation, head-up, sternal recombency, standing, and walking recovery times were recorded. The results were summarized as follows; (1) The 0.1, 0.2, 0.4, and 0.8 mg/kg dosages of midazolam insignificantly decreased thiopental dose requirement necessary to accomplish intubation by 6, 20, 21 and 28%. (2) The 0.1, 0.2, 0.4, and 0.8 mg/kg dosages of midazolam insignificantly reduced the times of extubation, head-up, sternal recumbency, standing, and walking recovery. (3) Midazolam was effective in reducing the frequency and duration of arrhythmia after intubation. (4) Heart rates of preanestheic midazolam administraion groups increased after thiopental injection which insignificantly changed smaller than those of control group. (5) Arterial blood pressures did not vary significantly among groups.

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Total Arch Replacement with Stented Elephant Trunk in DeBakey Type I Acute Aortic Dissection

  • Choi, Hyung-Yoon;Song, Suk-Won;Hong, Sun-Chang;Lim, Sun-Hee
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.68-71
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    • 2013
  • A 67-year-old female patient was treated with conventional total arch replacement and insertion of a stented elephant trunk (SET) graft into the descending thoracic aorta for acute DeBakey type I aortic dissection at one time. She had been treated with right coronary artery stent insertion for acute myocardial infarct 4 days earlier, and at that time, she was diagnosed with acute DeBakey type I aortic dissection from the ascending aorta to the suprarenal artery based on trans-esophageal echocardiography and aorta computed tomography. Through a median sternotomy, we inserted the SET graft through the opened aorta to the descending aorta. We also performed anastomosis between the proximal stented graft and the distal aortic arch, and then performed total arch replacement. For acute DeBakey type I aortic dissection, we report total arch replacement with insertion of a SET graft as a combination of conventional surgery and the interventional technique.

Treatment of Refractory Chylous Ascites with an Innovative Peritoneovenous Shunt: Temporary Usage of a Continuous Renal Replacement System: A Case Report

  • Park, Jiyoun;Lee, Jae Jun;Lee, Jung Hee;Shim, Young Mog
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.81-84
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    • 2022
  • Esophagectomy and esophageal reconstruction are commonly chosen as surgical options for esophageal cancer. However, prolonged untreated chyle leakage is associated with a poor prognosis. We report the case of a patient with refractory chylous ascites. To limit the ongoing fluid loss, we utilized the chylous ascites as an additional fluid source in a renal replacement therapy system. A continuous renal replacement therapy (CRRT) drainage system was modified to drain both the chylous ascites and venous blood. The ascites drainage rate was determined empirically and regulated by a dial-flow extension set. The CRRT mode was set to continuous venovenous hemodiafiltration and maintained for 7 days. After the patient was weaned from CRRT, ascites did not reaccumulate, and the patient's general condition improved dramatically. No infections related to the system occurred. This procedure temporarily alleviates symptoms and provides more time for alternative treatment strategies.

Clinical outcome of transcatheter closure of patent ductus arteriosus in small children weighing 10 kg or less

  • Park, Young-A;Kim, Nam-Kyun;Park, Su-Jin;Yun, Bong-Sic;Choi, Jae-Young;Sul, Jun-Hee
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.1012-1017
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    • 2010
  • Purpose: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. Methods: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable $Coil^{(R)}$, PFM Nit-$Occlud^{(R)}$, or Amplatzer duct $occluder^{(R)}$. A retrospective review of the treatment results and complications was performed. Results: The mean age of patients was $9.1{\pm}5.9$ months (median, 8 months), and mean weight was $7.6{\pm}1.8kg$ (median, 7.8 kg). The mean diameter of PDA was $3.2{\pm}1.4mm$ (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was $3.0{\pm}3.3$ days, and mean follow-up duration was $21.0{\pm}19.6$ months. There were no major complications in any of the patients. Conclusion: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

STRATOS Titanium Rib Bridge for Chest Wall Reconstruction after Infantile Fibrosarcoma Resection: A Case Report

  • Llalle, Wildor Samir Cubas;Valenzuela, Maisa;Pachas-Canales, Carlos;Vasquez-Arias, Jaime
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.539-542
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    • 2021
  • Resection and reconstruction of the chest wall for the radical surgical treatment of malignant soft tissue tumors are currently considered a substantial challenge for thoracic surgeons. We present an unusual case of infantile fibrosarcoma with tropomyosin 3-neurotrophic receptor tyrosine kinase 1 fusion in a 13-year-old patient. The surgical treatment consisted of radical resection of the right posterior chest wall and reconstruction with the use of the STRATOS (Strasbourg Thoracic Osteosynthesis System) titanium rib bridge system. The patient had a favorable postoperative course and received respiratory-ventilatory rehabilitation, adjuvant therapy with chemotherapeutic agents, immunotherapy, and radiotherapy.

Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access

  • Keum, Dong-Yoon;Kim, Jae-Bum;Chae, Min-Cheol
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.202-207
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    • 2013
  • Background: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method. Materials and Methods: Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results: There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%). Conclusion: Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

Development of an integrative cardiovascular system model including cell-system and arterial network (세포-시스템 차원의 혈류역학적 심혈관 시스템 모델의 개발)

  • Shim, Eun-Bo;Jun, Hyung-Min
    • 한국전산유체공학회:학술대회논문집
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    • 2008.03b
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    • pp.542-546
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    • 2008
  • In this study, we developed a whole cardiovascular system model combined with a Laplace heart based on the numerical cardiac cell model and a detailed arterial network structure. The present model incorporates the Laplace heart model and pulmonary model using the lumped parameter model with the distributed arterial system model. The Laplace heart plays a role of the pump consisted of the atrium and ventricle. We applied a cellular contraction model modulated by calcium concentration and action potential in the single cell. The numerical arterial model is based upon a numerical solution of the one-dimensional momentum equations and continuity equation of flow and vessel wall motion in a geometrically accurate branching network of the arterial system including energy losses at bifurcations. For validation of the present method, the computed pressure waves are compared with the existing experimental observations. Using the cell-system-arterial network combined model, the pathophysiological events from cells to arterial network are delineated.

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Pharmacological Actions of $\imath$--Muscone on Cardiovascular System ($\imath$--Muscone의 실험관계에 관한 약리연구)

  • 조태순;김낙두;허인회;권광일;박석기;심상호;신대희;박대규
    • Biomolecules & Therapeutics
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    • v.5 no.3
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    • pp.299-305
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    • 1997
  • In order to investigate the pharmacological properties of ι-muscone, effects of ι-muscone and musk were studied on the cardiovascular system with various experimental models. In isolated rat aorta, ι-muscone and musk made the relaxation of blood vessels in maximum contractile response to phenylephrine (10$^{-6}$ M) in endothelium-containing rings of the rat aorta, but not in endothelium-denuded rings. However, ι-muscone and musk in the presence of the inhibitor of NO synthase and guanylate cyclase did not make the relaxation of blood vessels. In spontaneously hypertensive rats (SHRs), ι-muscone and musk slightly reduced blood pressure but significantly decreased heart rate. In the isolated perfused rat hearts, ι-muscone and musk did not affect significantly on LVDP, contractile force, coronary flow and (-dp/dt)/(+dp/dt). These results suggest that ι-muscone and musk have weak cardiovascular effects with relaxation of blood vessel and decrease of heart rate, but without significant cardiac functions.

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Dynamic Performance Evaluation of Blood Flow Simulator Based on Windkessel Models (공기압력모델에 기반한 혈류 시뮬레이터의 동적 특성 평가)

  • Chun, Sejong;Jin, Jonghan
    • Journal of the Korean Society for Precision Engineering
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    • v.33 no.6
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    • pp.509-516
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    • 2016
  • A blood flow simulator is one of the experimental devices used to better understand the cardiovascular system. Time-Domain analysis is not sufficient to understand the cardiovascular system because of the effects related to pulsating flows. Even when the mean pressure and mean flow rate of the blood flow simulators are satisfied, the dynamic properties can differ from the desired performance. In this paper, the Windkessel model, a well-known mathematical model of the cardiovascular system, was employed to obtain optimized pressure using initial values. The Windkessel parameters, including flow resistance, R, are expected to lead to a better understanding of the dynamic behavior of cardiovascular systems.