• Journal of Chest Surgery
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• v.30 no.5
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• pp.528-532
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• 1997

After early surgical repair of ventricular septal rupture complicated by myocardial infarction, newly developed ventricular septal defects were discovered on the 7th and the 40th postoperative day in 2 cases. We reoperated these patients for closure of newly developed ventricular septal defects with Dacron patch successfully on the 77th and the loth day after discovery of those defects. From these results we conclude that early surgical rep ir for ruptured ventricular septum following myocardial infarction is an appropriate approach with low risk and that remnant or recurred ventricular septal defect can be corrected rather safely with proper myocardial preservation and unrestricted application of intraaortic balloon pump or other ventricular assist device.

• Journal of forensic and investigative science
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• v.3 no.1
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• pp.50-59
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• 2008

The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.759-770
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• 1985

This study was experimentally undertaken to evaluate the effect of hypothermic oxygenated cardioplegic solution on myocardial protection during prolonged aortic cross clamping under cardiopulmonary bypass. Dogs were divided into two groups control group [received hypothermic unoxygenated cardioplegic solution] and experimental group [received hypothermic oxygenated cardioplegic solution]. Coronary sinus effluent was obtained at once and 30, 60, 90 minutes after cross-clamping for the determination of pH, PCO2,PO2 and lactate level during the infusion of cardioplegic solution and myocardial biopsies were obtained after cessation of 90 minutes of aortic cross-clamping. The results obtained were as follows: 1. There was no significant differences in the pH and PCO2 between the oxygenated and unoxygenated cardioplegic solution but the PO2 of the oxygenated solution was 4 times greater than unoxygenated solution, and also the oxygenated solution had a significantly greater oxygen content [2.020.05 ml 02/min] and had much more oxygen delivery than unoxygenated solution. 2. The myocardial oxygen consumption and the myocardial oxygen extraction in oxygenated group were 1.63 ml 02/100 ml and 67.32% respectively, which was greater than those in unoxygenated group. 3. Regarding to pH and PCO2 of coronary sinus effluent, there was no significant differences between two groups in early period of infusion of cardioplegic solution, but the pH shifted to acidosis from 60 minutes, PCO2 increased from 90 minutes of aortic cross-clamping, and PO2 markedly decreased from 90 minutes of aortic cross-clamping in unoxygenated group. 4. The lactate concentration of coronary sinus effluent revealed relatively normal in both groups, but showed slight increase up to 27.54.56 mg/100 ml at 90 minutes of aortic cross-clamping in unoxygenated group. 5. On electron microscopic study, the ultrastructural integrity of myocardial cells in oxygenated group was well preserved within 90 minutes. Slight swelling and deformity of mitochondria, interfibrillar widening, and disarrangement of myofibrils were observed at 90 minutes after aortic cross-clamping in unoxygenated group. From these results, the use of hypothermic oxygenated cardioplegic solution seemed to be effective and better method for the preservation of ischemic myocardium during the prolonged aortic cross-clamping.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.442-449
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• 1979

Although anoxic cardiac arrest produces a dry, quiet field, the ability of the myocardium to withstand the anoxic insult is uncertain. The current growth of interest in the use of various cardioplegic solutions ` has resulted in the development of a number of different solutions. In this study, 51 consecutive cases of elective open heart surgery with the aid of extracorporeal circulation were reviewed retrospectively to compare two methods of myocardial preservation. All of these open heart operations had been performed, using hemodilution principle under the moderate hypothermia at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyungpook National University from December, 1975 to July, 1979. In the 31 consecutive cases that form the anoxic arrest group, the operations were done with intermittent aortic cross-clamping and topical cardiac hypothermia. The heart was cooled topically by cold normal saline, which was converted to ice slush before application to the pericardial sac. Twenty of 51 consecutive cases were assigned to the cold cardioplegic method [the cardioplegic group], in which two kinds of cold cardioplegic solutions [Young solution and G IK solution] were infused into the aortic root proximal to the aortic cross clamp for myocardial preservation. Mean total aortic cross clamp times were 43 minutes in the anoxic arrest group and 67 minutes in the cardioplegic group. In the post-operative period, spontaneous regular heart beatings were recovered in 80 percent of the cardioplegic group as opposed to 25.7 percent of the anoxic arrest group. Ventricular fibrillation requiring DC shock was seen in 32.3 percent of the anoxic arrest group and 10 percent of the cardioplegic group. In the cardioplegic group, mean CPK-MB was one positive value on the first post-operative day, and mean LDH 1 was elevated to 51 0 units/ml on the 2nd post-operative day. These results indicate that protecting the myocardium with cold cardioplegia is superior to use of the anoxic cardiac arrest.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.246-253
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• 1988

An in vitro model providing with a recirculating perfusion apparatus using an isolated canine heart and its autogenous blood, which was prepared for study of myocardial protection method. This apparatus was easily used by quick connect system and maintained well heart function for about 2 hours. The Langendorff perfusion was initiated for a 10 minute period by introducing perfusate at 37` into the aorta from aortic reservoir located 100 cm above the heart. The isolated perfused working canine heart model was a left heart preparation in which oxygenated perfusion medium [at 37K] entered the cannulated left atrium at a constant flow rate [900ml/ min] under 20 mmHg overflow system and was spontaneously ejected[no electrical pacing] via an cannula against a hydrostatic pressure of 80 cm H2O. During this working period, various indices of cardiac function were measured. The cardiac functions were stable for over 2 hours with perfusion of Krebs-Henseleit solution and autologous blood[1:1] mixture in volume and maintained heart rate ]]3-122/bpm peak systolic pressure 109-113 mmHg, cardiac output 900 ml / min and left atrial mean pressure 8-9 mmHg. In this model, the efficiency of myocardia] protection could be easily measured by means of functional, enzymatic, biochemical and ultrastructural assessment. And also, we believe this model to be a useful assessment screening model of recovery state after long duration of myocardial preservation of donor heart without difficult transplantation procedures.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.587-592
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• 1984

Potassium cardioplegia for myocardial preservation is being used extensively in open heart surgery. This study was designed to investigate the change in serum and urine potassium before, during, after the administration of cold blood potassium cardioplegic solution containing 28-30 mEq/L [28.6\ulcorner.56 mEq/L] of potassium chloride in 6 dogs. Total potassium dose used in the study was 14.9\ulcorner.89 mEq/L [1.2 mEq/Kg]. Mean potassium level in serum was within normal limits. Urinary excretion of potassium decreased during bypass but increased after bypass and eventually exceeded the amount of potassium infused as cold blood potassium cardioplegic solution. While cold blood potassium cardioplegia is a safe and efficient method of myocardial protection, postoperative potassium level must be observed carefully in order to detect obligatory potassium excretion following open heart surgery.

• Journal of Ginseng Research
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• v.40 no.4
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• pp.462-465
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• 2016

In the present study, we investigated whether treatment with GBCK25 facilitated the recovery of hemodynamic parameters, left ventricle systolic pressure, left ventricular developed pressure, and electrocardiographic changes. GBCK25 significantly prevented the decrease in hemodynamic parameters and ameliorated the electrocardiographic abnormality. These results indicate that GBCK25 has distinct cardioprotective effects in rat heart.

• Journal of Ginseng Research
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• v.37 no.3
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• pp.273-282
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• 2013

The present study was designed to investigate the cardioprotective effects of Korean Red Ginseng extract (KRG) on isoproterenol (ISO)-induced cardiac injury in rats, particularly in regards to electrocardiographic changes, hemodynamics, cardiac function, serum cardiac enzymes, components of the myocardial antioxidant defense system, as well as inflammatory markers and histopathological changes in heart tissue. ISO (150 mg/kg, subcutaneous, two doses administered at 24-hour intervals) treatment induced significant decreases in P waves and QRS complexes (p<0.01), as well as a significant increase in ST segments. Moreover, ISO-treated rats exhibited decreases in left-ventricular systolic pressure, maximal rate of developed left ventricular pressure ($+dP/dt_{max}$) and minimal rate of developed left ventricular pressure ($-dP/dt_{max}$), in addition to significant increases in lactate dehydrogenase, aspartate transaminase, alanine transaminase and creatine kinase activity. Heart rate, however, was not significantly altered. And the activities of superoxide dismutase, catalase and glutathione peroxidase were decreased, whereas the activity of malondialdehyde was increased in the ISO-treated group. ISO-treated group also showed increased caspase-3 level, release of inflammatory markers and neutrophil infiltration in heart tissue. KRG pretreatment (250 and 500 mg/kg, respectively) significantly ameliorated almost all of the parameters of heart failure and myocardial injury induced by ISO. The protective effect of KRG on ISO-induced cardiac injury was further confirmed by histopathological study. In this regard, ISO treatment induced fewer morphological changes in rats pretreated with 250 or 500 mg/kg of KRG. Compared with the control group, all indexes in rats administered KRG (500 mg/kg) alone were unaltered (p>0.05). Our results suggest that KRG significantly protects against cardiac injury and ISO-induced cardiac infarction by bolstering antioxidant action in myocardial tissue.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.887-893
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• 1989

Donor availability is a major limiting factor in heart transplantation. Prolonging donor heart preservation would facilitate distant heart procurement. The setup used was the isolated retrograde perfused nonworking rabbit heart model and 4 hours of preservation at 2oC. And the electron microscopic findings of the myocardium were evaluated after reperfusion for 5 minutes. The following three groups [each group, n=4] were prepared: Group I: the heart was arrested with the St. Thomas Hospital solution [STH] and stored in Ringers lactate solution [RLS]; Group II: the heart was arrested with STH and stored in Modified Collins-Sachs solution [MCS]; Group g: the heart was arrested with and stored in MCS. The result was the most severe myocardial injury in the Group III on electron microscopic study.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.632-643
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• 2004

Background: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high. concentration of histidine biological buffer which confer a buffering capacity superior to that of blood.. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is. exceeding 120 minutes at two different temperature (10 to 12$^{\circ}C$, 22 to 24$^{\circ}C$) using the Langendorff apparatus, Material and Method: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm $H_2O$. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10∼12$^{\circ}C$) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22∼24$^{\circ}C$) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. Result: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02$\pm$0.29, 1.52$\pm$0.26, 1.56$\pm$0.45, 2.22$\pm$0.44 respectively. Conclusion: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22∼ 24$^{\circ}C$). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.