• Journal of Chest Surgery
• /
• v.30 no.1
• /
• pp.11-16
• /
• 1997

The Increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter(group A, n: 10) or 15mMo1 per liter(group B, n: 10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas'Hospital solution) was infused for 2 minutes, and prepared within 4$^{\circ}C$ Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfuslon was reestablished after I hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, $\pm$ dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and flutamic oxaloacetic transaminase) were performed each other at whic rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, + dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P < 0.05). But, there were no signicant differences in the recovery rate of dp/dt max, and reperfunion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid (P > 0.05).

• Journal of Chest Surgery
• /
• v.10 no.2
• /
• pp.299-314
• /
• 1977

Clinical experience on 16 cases of open heart surgery under the extracorporeal circulation with mild or moderate hypothermia and partial hemodilution technique at the National Medical Center during the period from June 1976 to October 1977. Nine of sixteen were congenital heart disease and seven were acquired heart disease. The age of the patient ranged between 6 and 48 years. The body weight varied from 18.5kg to 60kg and body surface area 0. 79-1.70m2. The average priming volume of pump oxygenator was 2080 ml, which was consisted fresh ACD blood, buffered Hartmann`s solution, Mannitol, 50% dextrose in water and Vit. C. The average hemodilution rate was 27%. The average flow 2.3 L/min/m2 or 80 ml/min and the duration of perfusion varied from 31 min to 270 min with average of 107 min. The perfusion was carried out under the mild or moderate hypothermia using core cooling alone in 10 cases, core cooling and local myocardial cooling with $0-4^{\circ}C$ physiologic saline in 2 cases. From a hemodynamic point of view, the blood pressure dropped down around 80 mmHg after the initiation of perfusion follwed by increase to safety level and stable during the perfusion. The central venous pressure remained within normal limits. In most cases, hemoglobin and hematocrit decreased during and after the perfusion. Hemogiobin level was decreased, average of 20.6 %, hematocrit 18.6%, pletelets 55% postoperatively. Plasma hemoglobin increased moderately, from preperfusion average valve of 7.79 mg % to post-perfusion value of 54.7 mg %. Electrolytes changes during cardiopulmonary bypass showed definite hypokalemia but changes of Na, Ca were not definite. Arterial blood gas analysis during cardiopulmonary bypass suggested that the metabolic acidosis which was accompanied by respiratory alkalosis which was corrected postoperatively. As the opera tive complication, transient hemoglobinuria in 4 cases and neurological signs in 2 cases were all cured. There were 2 death cases and operative mortality rate was 12.5%.

• The Journal of Pediatrics of Korean Medicine
• /
• v.14 no.2
• /
• pp.1-32
• /
• 2000

It has long been known that SOAT is effective for sudden palpitation occurring unexpectedly in Oriental Medicine. However, effect of SOAT on the isolated heart has not been studied yet. The purpose of this study is to investigate the effect of SOAT on hemodynamics and ECG of isolated rat hearts induced by electrical stimulation using Langendorff perfusion apparatus for nonworking heart. SOAT extract was manufactured by water-alcohol precipitated method. Sprague-Dawley rats weighting $120{\sim}150g$ were used for the experiments, Subject animals were divided into four groups, which are consisted of 1) control(Group orally administered by normal saline 1ml for 14days), 2) sample A(Group orally administered by SOAT extract 1ml for 14days), 3) sample C(Group injected by SOAT extract 0.5ml after stimulation, 4) sample C(Group injected by SOAT extract 1ml after stimulation. To evluate the effects of SOAT on hemodynamics and ECG of isolated rat heart induced by stimulation, heart rate, left ventricular pressure, systolic power, diastolic power, coronary artery perfusion volume and ECG were measured using Langendorff apparatus in both stimulation mode(5 volts, 450 beats/min) and arrythmic mode(5 volts, 420 beats/min including 60 beats/min) The results obtained are as follows : 1. After receiving stressful electrical stimuli, isolated heart showed the heart rate, left ventricular pressure, systolic power, diastolic power, coronary artery perfusion volume were all decreased temporarily, but perfusion continued longer recovery to the control state appeared. However, the coronary artery perfusion volume diminished continuously. 2. The heart rates did not change significantly with both stimulation mode and arrhythmic mode, among experimental groups. 3. The left ventricular pressure showed with both stimulation mode and arrhythmic mode, the significant changes(p<0.05) especially in the injection sample group. In case of stimulation mode, low concentration injection group(0.5ml) was more significantly increased rather than high concentration group(1ml) and in case of arrhythmic mode, high density group(1ml) was so increased than the other(0.5ml). 4. For the systolic power and diastolic power, no significant changes were noticed in the stimulation mode, but in the arrhythmic mode of injection sample groups, significant change(p<0.05) was noticed in both systolic power and diastolic power. Specially the high concentration group(1ml) showed more significant increase than the low concentration group. 5. For the coronary artery perfusion volume, no significant change difference among sample groups was observed in both the stimulation mode and the arrhythmic mode. 6. For the ECG recordings, arrhythmia was induced by electrical stimulus of arrythmia mode and after the stimulus was removed, irregular wave appeared temporarily, but as perpusion continued, recovery to the control state was abtained like the stimulation mode. According to the above results, SOAT significantly changed the hemodynamic data from the electrically stressed, isolated hearts of connected Langendorff perfusion apparatus and we propose SOAT has the direct effects on the muscular function of heart.

• Journal of Biomedical Engineering Research
• /
• v.28 no.4
• /
• pp.449-454
• /
• 2007

An electrohydraulic (EH) pump-driven closed-loop blood pressure regulatory system was developed based on flow-mediated vascular occlusion using the vascular occlusive cuff technique. It is very useful for investigating blood pressure-dependant physiological variability, in particular, that could identify the principal mediators of renal autoregulation, such as tubuloglomerular feedback (TGF) and myogenic (MYO), during blood pressure regulation. To address this issue, renal perfusion pressure (RPP) should be well regulated under various experimental conditions. In this paper, we designed a new EH pump-driven RPP regulatory system capable of implementing precise and rapid RPP regulation. A closed-loop servo-controlwas developed with an optimal proportional plus integral (PI) compensation using the dynamic feedback RPP signal from animals. An in vivo performance was evaluated in terms of flow-mediated RPP occlusion, maintenance, and release responses. Step change to 80 mmHg reference from normal RPP revealed steady state error of ${\pm}3%$ during the RPP regulatory period after PI action. We obtained rapid RPP release time of approximately 300 ms. It is concluded that the proposed EH RPP regulatory system could be utilized in in vivo performance to study various pressure-flow relationships in diverse fields of physiology, and in particular, in renal autoregulation mechanisms.

• Archives of Plastic Surgery
• /
• v.41 no.6
• /
• pp.668-672
• /
• 2014

Background Negative-pressure wound therapy (NPWT) is believed to accelerate wound healing by altering wound microvascular blood flow. Although many studies using laser Doppler have found that NPWT increases perfusion, recent work using other modalities has demonstrated that perfusion is reduced. The purpose of this study was to investigate the influence of NPWT on tissue oxygenation of the foot, which is the most sensitive region of the body to ischemia. Methods Transcutaneous partial pressure of oxygen ($TcpO_2$) was used to determine perfusion beneath NPWT dressings of 10 healthy feet. The sensor was placed on the tarso-metatarsal area of the foot and the NPWT dressing was placed above the sensor. $TcpO_2$ was measured until it reached a steady plateau state. The readings obtained at the suction-on period were compared with the initial baseline (pre-suction) readings. Results $TcpO_2$ decreased significantly immediately after applying NPWT, but gradually increased over time until reaching a steady plateau state. The decrease in $TcpO_2$ from baseline to the steady state was 2.9 to 13.9 mm Hg (mean, $9.3{\pm}3.6$ mm Hg; $13.5{\pm}5.8%$; P<0.01). All feet reached a plateau within 20 to 65 minutes after suction was applied. Conclusions NPWT significantly decrease tissue oxygenation of the foot by 2.9 to 13.9 mm Hg. NPWT should be used with caution on feet that do not have adequate tissue oxygenation for wound healing.

• Journal of Biomedical Engineering Research
• /
• v.36 no.4
• /
• pp.135-142
• /
• 2015

Outflow cannulation site of left ventricular assist device(LVAD) chosen by considering anatomical structure of thoracic cavity and vascular system. Though outflow cannulation site influences blood perfusion at each branch, there is no standard rule or quantitative data. In this study, we computed the amount of blood perfusion at each arterial branch numerically according to outflow cannulation sites(ascending aorta, aortic arch, descending aorta). We generated computational meshes to the three-dimensionally reconstructed arterial system. Clinically measured arterial pressure were used for inlet boundary condition, porous media were applied to mimic blood flow resistance. Blood perfusion through left common carotid artery was 2.5 times higher than other cases, and that through right common carotid artery was 1.1 times higher than other branches. Although this is simulation study, will be useful reference data for the clinical study of LVAD which considers blood perfusion efficiency.

• Journal of Chest Surgery
• /
• v.32 no.12
• /
• pp.1065-1077
• /
• 1999

Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

• Journal of Ginseng Research
• /
• v.31 no.1
• /
• pp.23-33
• /
• 2007

Ginsenosides are one of the most well-known traditional herbal medicines frequently used for the treatment of cardiovascular symptoms in korea. The anti-ischemic effects of the mixture of ginsenoside $Rg_3$, and CK on ischemia-induced isolated rat heart were investigated through analyses of changes in hemodynamics ; blood pressure, aortic flow, coronary flow, and cardiac output. The subjects in this study were divided into four groups: normal control, the mixture of ginsenoside $Rg_3$ and CK, an ischemia-induced group without any treatment, and an ischemia-induced group treated with the mixture of ginsenoside $Rg_3$ and CK. There were no significant differences in perfusion pressure, aortic flow, coronary flow and cardiac output between them before ischemia was induced. The supply of oxygen and buffer was stopped for five minutes to induce ischemia in isolated rat hearts, and the mixture of ginsenoside $Rg_3$ and CK was administered during ischemia induction. Treatments of the mixture of ginsenoside $Rg_3$ and CK significantly prevented decreases in perfusion pressure, aortic flow, coronary flow, and cardiac output under ischemic conditions. In addition, hemodynamics (except heart rate) of the group treated with the mixture of ginsenoside $Rg_3$ and CK significantly recovered 60 minutes after reperfusion compared to the control group (mixture+ischemia vs ischemia - average perfusion pressure: 74.4${\pm}$2.97% vs. 85.1${\pm}$3.01%, average aortic flow volume: 49.11${\pm}$2.72% vs. 59.97${\pm}$2.93%, average coronary flow volume: 58.50${\pm}$2.81% vs. 72.72${\pm}$2.99%, and average cardiac output: 52.47${\pm}$2.78% vs. 63.11${\pm}$2.76%, p<0.01, respectively). These results suggest that treatment of the mixture of ginsenoside $Rg_3$ and CK has distinct anti-ischemic effects in ex vivo model of ischemia-induced rat heart.

• Proceedings of the KSME Conference
• /
• 2008.11a
• /
• pp.1660-1664
• /
• 2008

Extra-corporeal Life Support System (ECLS) is the device used in emergency cases to substitute a extracorporeal circulation in open heart surgery, cardiac arrest or in acute cardiopulmonary failure. To obtain the effect of counter-pulsation on hemodynamic response in the ECLS quantitatively, we developed cardiovascular model which consists of 12 compartment model of heldt et al. and 3 compartment model of Schreiner et al. based on windkessel approximation. We compared coronary perfusion, arterial pulse pressure, cardiac output, and left ventricular pressure-volume diagram according to flow configuration such as counter-pulsation, copulsation, and continous flow. When counter-pulsation was applied, 5% higher coronary perfusion, 26% lower pulse pressure, and 2% higher cardiac output than copulsation condition were calculated. We conclude that counter-pulsation configuration in the ECLS is hemodynamically more stable than copulsation and influences the positive effect to recover ventricles.

• Journal of Chest Surgery
• /
• v.21 no.2
• /
• pp.231-239
• /
• 1988

Currently numerous methods are in use for myocardial hypothermia as a myocardial preservation modality for cardiac operation. During cardiac ischemia after crystalloid cardioplegia[4C GIK solution], topical cold saline[Group I, a=9], topical ice slush[Group II, n=9] and topical ice chip[Group III, a=10] have been compared for myocardial surface cooling in the isolated rat heart model of cardiopulmonary bypass. During postischemic period, hemodynamic functions[aortic flow, coronary flow, peak aortic pressure and heart rate], biochemical enzymatic activities and cellular injuries with electron microscope were evaluated in this isolated rat heart perfusion model. Postischemic aortic flow, cardiac output and peak aortic pressure in Group I and Group II recovered better than Group III.[p< 0.05] Postischemic creatine kinase and lactate dehydrogenase leakages in Group II and Group III increased more than Group l and postischemic mitochondrial swelling in Group III was more severe than Group I, and Group II.[p< 0.05] These results suggest that topical cold saline was the better method than topical ice slush or topical ice chip as a myocardial preservation modality in the isolated rat heart model of cardiopulmonary bypass.