• Title/Summary/Keyword: Internal Organs

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Prevention of vibriosis in sea bass, Dicentrarchus labrax using ginger nanoparticles and Saccharomyces cerevisiae

  • Korni, Fatma M.M.;Sleim, Al Shimaa A.;Abdellatief, Jehan I.;Abd-elaziz, Rehab A.
    • Journal of fish pathology
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    • v.34 no.2
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    • pp.185-199
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    • 2021
  • Vibriosis is an important septicemic bacterial disease that affects a variety of commercial fish species, including cultured Dicentrarchus labrax. Nanotechnology has become an important modern tool for fish diseases prevention. Furthermore, nanomaterials have the ability to prevent and treat fish diseases. The current study was aimed to identify the causative agent of massive mortality of D. labrax commercial farm in Alexandria, Egypt. Experimental infection and the median lethal dose (LD50) of pathogenic isolate were assessed. Also, the effect of ginger nanoparticles (GNPs) and Sacchromyces cerevisiae as feed additives for prevention of vibriosis in D. labrax was carried out. Similarly, the tissue immunstimulant genes, IL-1β and TLR2 were measured in the spleen of feeding groups. The clinical signs of naturally diseased D. labrax showed corneal opacity and paleness of gills with excessive mucous secretion. The post-mortem abnormalities were severe hemorrhage and adhesion of internal organs. After bacteriological isolation and identification, the causative agent of mortality in the current study was Vibrio alginolyticus. The LD50 of V. alginolyticus was 1.5×105.4 CFU/ml. The experimentally infected D. labrax showed ulceration, exophthalmia and skin hemorrhages. The post-mortem findings of the experimentally infected D. labrax revealed internal hemorrhage, spleen darkness and paleness of liver. There is no mortality and 100% RPS in groups fed GNPs then injected with V. alginolyticus, in those fed a combination of GNPs and S. cerevisiae and a group fed normal diet then injected with physiological saline (control negative), respectively. Contrarily, there was 10% mortality and 87.5 RPS in the group fed S. cerevisae then injected with V. alginolyticus. On the other hand, the control positive group showed 79% mortality. The spleen IL-1β and TLR2 immunostimulant genes were significantly increased in groups of fish fed GNNP, S. cerevisiae and a combination of GNPs and S. cerevisiae, respectively compared to control group. The highest stimulation of those immunostimulant genes was found in the group fed a combination of GNPs and S. cerevisiae, while fish fed S. cerevisiae had the lowest level. Dietary combination of GNPs and S. cerevisiae was shown to be efficient in preventing of vibriosis, with greatest stimulation of spleen IL-1β and TLR2 immunostimulant genes.

Clinical Manifestations of the Lung Involvement in Behçet's Syndrome (Behçet 증후군에서 폐침범의 임상양상에 관한 고찰)

  • Park, Kwang Joo;Park, Seung Ho;Kim, Sang Jin;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.763-773
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    • 1996
  • Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

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A Study on the Blood-Letting Therapy in Elementary Questions (("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究))

  • Lee, Jun-Geun
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.1
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion (농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성)

  • Park, Jeong Woo;You, Seung Min;Seol, Won Jong;Paik, Eun Ki;Lee, Kyu Hoon;Seo, Joon Beom;Jeong, Seong Hwan;An, Chang Hyeok;Lim, Youg Hee;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.219-229
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    • 2003
  • Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.

The Mechanism of Interferon-$\gamma$ Induced Cytotoxicity on the Lung Cancer Cell Line, A549 (인터페론감마에 의한 A549 폐암세포주 세포독성의 기전)

  • Oh, Yeon-Mok;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.63-68
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    • 1996
  • Background: Interferon-$\gamma$ has various biologic effects, including antiviral effect, antitumor proliferative effect, activation of macrophage and B lymphocyte, and increased expression of major histocompatibility complex. Especially, antitumor proliferative effect of interferon-$\gamma$ has already been proved to be important in vivo as well as in vitro. And, clinical studies of interferon-$\gamma$ have been tried in lung cancer patients. However, the mechanism of antitumor effect of interferon-$\gamma$ has not yet been established despite of many hypotheses. "Necrosis" is a type of cell death which is well known to occur in the circumstances of severe stresses. In contrast, "apoptosis" is another type of cell death which occurs in such biological circumstances as embryonic development, regression of organs, and self-tolerance of lymphocytes. And, apoptosis is an active process of cell death in which cells are dying with fragmentations of their cytoplasms and nuclei. And, in the process of apoptosis the DNAs of cells are cleaved between nucleosomes by unidentified endonuclease and therefore DNAs of apoptotic cells result in a typical electrophoresis pattern known as DNA ladder pattern. Recently it has been suggested that cytotoxic effect of interferon-$\gamma$ occurs via apoptosis. To elucidate the mechanism of antitumor cytotoxic effect of interferon-$\gamma$, we microscopically observed a lung cancer cell line, A549 which was treated with interferon-$\gamma$. We observed A545 treated with interferon-$\gamma$ was dying fragmented. And so, we performed this study to find out that the mechanism of antitumor cytotoxic effect of interferon-$\gamma$ be apoptosis. Method: We treated A549, human lung cancer cell line with various concentration of interferon-$\gamma$ and quantified its cytotoxic effect of various periods, 24 hours, 72 hours and, 120 hours by MTT(dimethylthiazolyl diphenyltetrazolium bromide) bioassay. Also, after we treated A549 with 100 units/mi of interferon-$\gamma$ for 120 hours, we observed the pattern of cell death with inverted microscope and we extracted DNAs from the dead A549 cells and observed the pattern of 1.5% agarose gel electrophoresis with ethidium bromide staining. Result: 1) Cytotoxic effect of interferon-$\gamma$ on A549: For the first 24 hours, threre was little cytotoxic effect and for between 24 hours and 72 hours, there was the beginning of cytotoxic effect and for 120 hours there was increased cytotoxic effect. 2) Pattern of A549 cell death by interferon-$\gamma$: We observed with inverted microscope that A549 cells were dying fragmented. 3) DNA ladder pattern of gel electrophoresis: We observed DNA ladder pattern of gel electrophoresis of extracted DNAs from dead A549 cells. Conclusion: We concluded that the mechanism of interferon-$\gamma$induced cytotoxicity on lung cancer cell line, A549 be via apoptosis.

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Development of the Whole Body 3-Dimensional Topographic Radiotherapy System (3차원 전신 정위 방사선 치료 장치의 개발)

  • Jung, Won-Kyun;Lee, Byung-Yong;Choi, Eun-Kyung;Kim, Jong-Hoon;An, Seung-Do;Lee, Seok;Min, Chul-Ki;Park, Cham-Bok;Jang, Hye-Sook
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.63-71
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    • 1999
  • For the purpose of utilization in 3-D conformal radiotherapy and whole body radiosurgery, the Whole Body 3-Dimensional Topographic Radiation Therapy System has been developed. Whole body frame was constructed in order to be installed on the couch. Radiopaque catheters were engraved on it for the dedicated coordinate system and a MeV-Green immobilizer was used for the patient setup by the help of side panels and plastic rods. By designing and constructing the whole body frame in this way, geometrical limitation to the gantry rotation in 3-D conformal radiotherapy could be minimized and problem which radiation transmission may be altered in particular incident angles was solved. By analyzing CT images containing information of patient setup with respect to the whole body frame, localization and coordination of the target is performed so that patient setup error may be eliminated between simulation and treatment. For the verification of setup, the change of patient positioning is detected and adjusted in order to minimize the setup error by means of comparison of the body outlines using 3 CCTV cameras. To enhance efficiency of treatment procedure, this work can be done in real time by watching the change of patient setup through the monitor. The method of image subtraction in IDL (Interactive Data Language) was used to visualize the change of patient setup. Rotating X-ray system was constructed for detecting target movement due to internal organ motion. Landmark screws were implanted either on the bones around target or inside target, and variation of target location with respect to markers may be visualized in order to minimize internal setup error through the anterior and the lateral image information taken from rotating X-ray system. For CT simulation, simulation software was developed using IDL on GUI(Graphic User Interface) basis for PC and includes functions of graphic handling, editing and data acquisition of images of internal organs as well as target for the preparation of treatment planning.

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Use of Respiratory Motion Reduction Device (RRD) in Treatment of Hepatoma (간암의 방사선치료 시 호흡운동 감소장치(respiratory motion reduction device, RRD)의 유용성에 관한 연구)

  • Lee Suk;Seong Jinsil;Kim Yong Bae;Cho Kwang Hwan;Kim Joo Ho;Jang Sae Kyung;Kwon Soo Il;Chu Sung Sil;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.319-326
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    • 2001
  • Purpose : Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). Materials and methods : For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to $50\%$ of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. Results : When patients breathed freely, average movement of diaphragm was $12{\pm}1.9\;mm$ in prone position in contrast to $16{\pm}1.9\;mm$ in supine position. In prone position, difference in diaphragm movement with and without RRD was $3{\pm}0.9\;mm$ and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to $22.7\%$ in DVH analysis. Conclusion : Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.

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Inferential Structure and Reality Problem in Diagnosis of Oriental Medicine (한의 진단의 추론형식과 실재성)

  • Park, Geong-Mo;Choi, Seong-Hoon;Ahn, Gyu-Seok
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.55-84
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    • 1997
  • Inferential structure and reality problem is a serious issue to O.M.(oriental medicine). The study will analyze this issue through a philosophical and historical comparative study of W.M.M(Western modern medicine) and O.M. First, I presuppose some basic ideas. The first is the division of the 'the philosophy of medicine' and 'the medicine itself'. Second, there is a 'visibility' that discriminate between 'the abstractive concept' and 'the concrete object' in diagnostic terminology. The third is the separation of disease, the entity and disease, the phenomenon. Finally, the distinction between the cause of disease and the nature of disease. Through these basic concepts, this study will analyze O.M's diagnostic methodology, 'Pattern identification of the S.A.S(sign and symptom)'. The results are follows: 1. O.M's views disease as a phenomenon. So, the S.A.S, which is visible, is the disease itself. Tough the analysis and inference of the S.A.S, 證(zheng) the essence is derived. 2. 證(zheng) can be considered as 'the abstractive concept' reflecting the essence of a disease. 3. 證(zheng) is not arrived through causal sequence reasoning but rather by analogical reasoning. 4. 證(zheng) is 'the non-random correlative combination of S.A.S', pattern. These patterns secure the abstractive deduction in reality. that is, The causality, the positivism, the view of disease as entity, and anatomical knowledge are the traits peculiar to W.M.M. But, these properties can not be applied universally to every medical systems. Also, these properties do not indicate the superiority or inferiority of any medical system. 5. 證(zheng) summarizes the patients condition simultaneously with the S.A.S. However, 證(zheng) doesn't necessarily indicate the knowledge about the actual internal organ. That is, Early in O.M.'s history, the diagnostic terminologies including 證(zheng) were analogical reflections of a naive knowledge of internal organs and external environmental factors. Later, the naive knowledge in 證(zheng) changed int new nature, an abstractive concept. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. It is recommended that O.M. diagnostics should pay close attention to the ambiguity of the diagnostic methodology in order to further development. At present time, the concept and the system peculiar to O.M. can not be explained by common language. but O.M.'s practitioner can not persist in this manner an: longer. Along with the internal development of O.M., the adjustment of O.M.'s diagnostic terminology needs to be adopted.

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Application of the Pulsatile Cardiopulmonary Bypass in Animal Model (이중 박동성 인공심폐기의 동물 실험)

  • Shin, Hwa-Kyun;Won, Yong-Soon;Lee, Jea-Yook;Her, Keun;Yeum, Yook;Kim, Seung-Chul;Min, Byoung-Goo
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.1-10
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    • 2004
  • Background: Currently, the cardiopulmonary machine with non-pulsatile pumps, which are low in internal circuit pressure and cause little damage to blood cells, is widely used. However, a great number of experimental studies shows that pulsatile perfusions are more useful than non-pulsatile counterparts in many areas, such as homodynamic, metabolism, organ functions, and micro-circulation. Yet, many concerns relating to pulsatile cardiopulmonary machines, such as high internal circuit pressure and blood cell damage, have long hindered the development of pulsatile cardiopulmonary machines. Against this backdrop, this study focuses on the safety and effectiveness of the pulsatile cardiopulmonary machines developed by a domestic research lab. Material and Method: The dual-pulsatile cardiopulmonary bypass experiment with total extracorporeal circulation was conducted on six calves, Extracorporeal circulation was provided between superior/inferior vena cava and aorta. The membrane oxygenator, which was placed between the left and right pumps, was used for blood oxygenation. Circulation took four hours. Arterial blood gas analysis and blood tests were also conducted. Plasma hemoglobin levels were calculated, while pulse pressure and internal circuit pressure were carefully observed. Measurement was taken five times; once before the operation of the cardiopulmonary bypass, and after its operation it was taken every hour for four hours. Result: Through the arterial blood gas analysis, PCO2 and pH remained within normal levels. PO2 in arterial blood showed enough oxygenation of over 100 mmHg. The level of plasma hemoglobin, which had total cardiopulmonary circulation, steadily increased to 15.87 $\pm$ 5.63 after four hours passed, but remained below 20 mg/㎗. There was no obvious abnormal findings in blood test. Systolic blood pressure which was at 97.5$\pm$5.7 mmHg during the pre-circulation contraction period, was maintained over 100 mmHg as time passed. Moreover, diastolic blood pressure was 72.2 $\pm$ 7.7 mmHg during the expansion period and well kept at the appropriate level with time passing by. Average blood pressure which was 83$\pm$9.2 mmHg before circulation, increased as time passed, while pump flow was maintained over 3.3 L/min. Blood pressure fluctuation during total extracorporeal circulation showed a similar level of arterial blood pressure of pre-circulation heart. Conclusion: In the experiment mentioned above, pulsatile cardiopulmonary machines using the doual-pulsatile structure provided effective pulsatile blood flow with little damage in blood cells, showing excellence in the aspects of hematology and hemodynamic. Therefore, it is expected that the pulsatile cardiopulmonary machine, if it becomes a standard cardiopulmonary machine in all heart operations, will provide stable blood flow to end-organs.

A Literature Review of The Senile Hypotension (노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kwak, Ik-Hoon;Kim, Jong-Dae;Jeong, Ji-Cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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