• The Korean Journal of Physiology and Pharmacology
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• v.20 no.5
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• pp.441-447
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• 2016

Despite the complex vascular effects of dexmedetomidine (DEX), its actions on human pulmonary resistance arteries remain unknown. The present study tested the hypothesis that DEX inhibits vascular tension in human pulmonary arteries through the endothelial nitric oxide synthase (eNOS) mediated production of nitric oxide (NO). Pulmonary artery segments were obtained from 62 patients who underwent lung resection. The direct effects of DEX on human pulmonary artery tension and changes in vascular tension were determined by isometric force measurements recorded on a myograph. Arterial contractions caused by increasing concentrations of serotonin with DEX in the presence or absence of L-NAME (endothelial nitric oxide synthase inhibitor), yohimbine (${\alpha}_2$-adrenoceptor antagonist) and indomethacin (cyclooxygenase inhibitor) as antagonists were also measured. DEX had no effect on endothelium-intact pulmonary arteries, whereas at concentrations of $10^{-8}{\sim}10^{-6}mol/L$, it elicited contractions in endothelium-denuded pulmonary arteries. DEX (0.3, 1, or $3{\times}10^{-9}mmol/L$) inhibited serotonin-induced contraction in arteries with intact endothelium in a dose-dependent manner. L-NAME and yohimbine abolished DEX-induced inhibition, whereas indomethacin had no effect. No inhibitory effect was observed in endothelium-denuded pulmonary arteries. DEX-induced inhibition of vasoconstriction in human pulmonary arteries is mediated by NO production induced by the activation of endothelial ${\alpha}_2$-adrenoceptor and nitric oxide synthase.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1191-1203
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• 1990

Pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries [abbreviated as PA+VSD+MAPCA in the following] has limited the success of attempts at accurate diagnosis and complete surgical repair. From April 1986 to September 1990, 23 patients with PA+VSD+MAPCA among 96 patients of PA+VSD in Seoul National University Children’s Hospital were encountered. The group comprised 14 male and 9 female patients with ages ranging from 17 days to 177 months [mean 49.6 months]. We operated one stage total repair on good pulmonary artery sized two patients by R.E.V. [Reparation a l’etage ventriculaire] and Rastelli operation respectively. And the 11 patients who had independent MAPCAs and hypoplastic central pulmonary artery were dealt with unifocalization and modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients later. We successfully had managed 7 patients whose MAPCAs could be ligated with modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients with R.E.V or Rastelli operation. Recently, three obstruction after 11 unifocalization procedures made us to try palliative right ventricle-pulmonary artery conduit operation by Gore-Tex vascular graft interposition under cardiopulmonary bypass. And so we managed another 3 patients with these procedures for the purpose of pulmonary artery growth whose central pulmonary artery were severely hypoplastic. We experienced one death after second stage repair whose central pulmonary artery was created by 12mm Gore-Tex vascular graft and was unifocalized.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.378-381
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• 2017

Patients with an atrial septal defect (ASD) and severe pulmonary arterial hypertension (PAH) are considered ineligible for defect closure surgery because of the risk of right ventricular decompensation and death after the operation. We report the case of a patient with large ASD and severe PAH who was able to undergo defect closure surgery successfully following long-term use of combined oral sildenafil and beraprost.

• Clinical and Experimental Pediatrics
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• v.57 no.10
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• pp.461-463
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• 2014

Decreased exercise capacity after Fontan surgery is relatively common and the failure of the Fontan state gradually increases with age. However, there is no further treatment for patients with Fontan circulation. Pulmonary vasodilation therapy is an effective method to solve this problem because pulmonary vascular resistance is a major factor of the Fontan problem. Inhaled iloprost is a chemically stable prostacyclin analogue and a potent pulmonary vasodilator. We experienced two cases of Fontan patients treated with inhaled iloprost for 12 weeks. The first patient was an 18-year-old female with pulmonary atresia with an intact ventricular septum, and the second patient was a 22-year-old male with a double outlet right ventricle. Fifteen years have passed since both patients received Fontan surgery. While the pulmonary pressure was not decreased significantly, improved exercise capacity and cardiac output were observed without any major side effects in both patients. The iloprost inhalation therapy was well tolerated and effective for the symptomatic treatment of Fontan patients.

• Korean Journal of Veterinary Research
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• v.6 no.1
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• pp.76-81
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• 1966

This study was conducted to observe the condition of the ramification of the bronchus and pulmonary blood vascular system by injection of vinylite into the bronchial tree and pulmonary blood vessels in normal adult swines. The results obtained were summarized as follows. 1. Lungs of swine were composed of the same pulmonary territories as in lungs of human and dog. 2. Bronchial tree of swine also were axial divergency in the patterns. 3. Ramification of the left and right apical lobes are especially complex patterns but cardiac and diaphragmatic lobes are a little monotonous. 4. Intermediate lobe corresponding to mediobasalis branch of human lungs formed only one lobe in swine lung. 5. Pulmonary artery of right apical lobe was mono branch form in all case by authors observation. 6. $B._2$ streched into the seg. dorsalis of the right apical lobe was especially developed compare to $B._1$, $B._3$ of the seg, apicalis and seg, ventralis.

• Journal of Chest Surgery
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• v.45 no.5
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• pp.323-325
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• 2012

Pulmonary tumor embolism can be a cause of respiratory failure in patients with cancer even though it occurs rarely. We describe a 56-year-old man who underwent a pulmonary tumor embolectomy using cardiopulmonary bypass on beating heart combined with inferior vena cava embolectomy and right radical nephrectomy. Aggressive surgical treatment in this severe case is necessary not only to reduce the fatal outcome of pulmonary embolism in the short run, but also to improve the oncological prognosis in the long term.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.664-667
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• 2002

Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

• Korean Journal of Radiology
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• v.2 no.3
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• pp.121-131
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• 2001

Echocardiography and catheterization angiography suffer certain limitations in the evaluation of congenital heart diseases in adults, though these are overcome by MRI, in which a wide field-of view, unlimited multiplanar imaging capability and three-dimensional contrast-enhanced MR angiography techniques are used. In adults, recently introduced fast imaging techniques provide cardiac MR images of sufficient quality and with less artifacts. Ventricular volume, ejection fraction, and vascular flow measurements, including pressure gradients and pulmonary-to-systemic flow ratio, can be calculated or obtained using fast cine MRI, phase-contrast MR flow-velocity mapping, and semiautomatic analysis software. MRI is superior to echocardiography in diagnosing partial anomalous pulmonary venous connection, unroofed coronary sinus, anomalies of the pulmonary arteries, aorta and systemic veins, complex heart diseases, and postsurgical sequelae. Biventricular function is reliably evaluated with cine MRI after repair of tetralogy of Fallot, and Senning's and Mustard's operations. MRI has an important and growing role in the morphologic and functional assessment of congenital heart diseases in adolescents and adults.

• Biomedical Science Letters
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• v.12 no.3
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• pp.255-259
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• 2006

Reactive oxygen species (ROS) is one of the main pathological factors in endothelial disorder. For example, an atherosclerosis is induced by the dysfunction of vascular endothelial cells. The dysfunction of vascular endothelial cells cascades to secrete intercellular adhesion molecule (ICAM)-l substance by ROS. Therefore, The ROS is regraded as an important factor of the injury of vascular endothelial cells and inducement of atherosclerosis. Oxygen radical scavengers playa key role to prevention of many diseases mediated by oxidative stress of ROS. In this study, the toxic effect of ROS on vascular endothelial cells and the effect of antioxidant, vitamin E on bovine pulmonary vascular endothelial cell line (BPVEC) treated with hydrogen peroxide were examined by the colorimetric assay. ROS decreased remarkably cell viability according to the dose- and time-dependent manners. In protective effect of vitamin E on BPVEC treated with hydrogen peroxide, vitamin E increased remarkably cell viability compared with control after BPVEC were treated with $15{\mu}M$ hydrogen peroxide for 6 hours. From these results, it is suggested that ROS has cytotoxicity on cultured BPVEC and oxygen radical scavenger such as vitamin E is very effective in prevention of oxidative stress-induced cytotoxicity.

• Korean Journal of Veterinary Research
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• v.6 no.1
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• pp.57-75
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• 1966

This study was conducted to observe the condition of the ramifications of the bronchus and pulmonary blood vascular system by injecting the vinylite into the bronchial tree and pulmonary blood vessels in 100 normal adult dogs. The results obtained were summarized as follows: 1. Lungs of dog were composed of the same pulmonary territories as in lungs of human. 2. Cardiac lobe corresponding to R.medio-bassalis of human lungs was well developed and situated as a independent cardiac lobe, in ventral side of right lung. 3. Bronchial tree were in the patterns of axial divergency and blood vascular systems were (in general) branched along the bronchial tree, arteries lying near the bronchial tree but veins apart from it. 4. Among the branching patterns of bronchus pulmonary artery and pulmonary vein in each lobe, the type presented most frequently were noted, which were designated basic type by the author. 5. Pulmonary blood vessels were not always branched in accordance with bronchial tree, diverged inmore complex patterns, especially in venous vascular system. 6. Ramus anterior (lobe apicalis) was always observed in all casting specimen. 7. There was a case of peculiar variation patterns of the ramification in the bronchi directing into the left apical and cardiac lobe, arose respectivelly, at independent origin of bifurcation in the left bronchial stem, and a case of peculiar variation pattern of the artery entering left apical lobe and cardiac lobe, had a same origin of the bifurcation at rami pulmonary artery, and then divided respectivelly into the rami medi artery and rami left apical lobe artery. 8. In the classification based on the patterns of bronchial and blood vasculor divergencys, there were a lot of significant combination cases in their patterns.