• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.375-384
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• 2011

Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with $90^{\circ}$ twisting, 4) experimental II (EA2) with $180^{\circ}$ twisting, and 5) experimental III (EA3) with $270^{\circ}$ twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0 $Ethilon^{(R)}$ (Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular $clamps^{(R)}$ (S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than $180^{\circ}$ twisting must be prevented in clinical practice.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.145-150
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• 2016

Background: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous $O_2$ saturation, and lactate were measured. Results: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

• Biomedical Science Letters
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• v.12 no.4
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• pp.375-383
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• 2006

The physiological responses following stress are different in individual or personality. We performed this study to clarify gender differences in influences of noise stress on physiological factors. 70 healthy subjects, which was divided man (n=30) and woman (n=40) groups, were exposed to 85 decibels of excavator noise for 15 minutes. Cardiac factors such as heart rate (HR), systolic and diastolic blood pressures (SBP and DBP, respectively), and heart rate-systolic pressure product (RPP) were determined. Transcranial Doppler ultrasound (TCD) was used to measure mean blood flow velocity (Vm), pulsatility index (PI), and resistance index (RI) in the middle, anterior and posterior cerebral arteries (MCA, ACA and PCA, respectively) before and during noise exposure. Cortisol level and hematological variables were also measured before (baseline) and immediately after the end of noise exposure. In the both groups HR, SBP, and RPP significantly decreased during noise exposure (P<0.05) but not significantly different between two groups (P>0.05). Vms of three cerebral arteries in man group decreased, whereas Vm of PCA in woman group fell during noise exposure (P<0.05). Vm, PI and RI in MCA and ACA during noise exposure were low in man group compared with woman group (P<0.05). Vm of PCA was low, whereas PI and RI of PCA were high in man group compared with woman group during noise exposure (P<0.05). Total leukocyte and red blood cell (RBC) counts slightly decreased during noise exposure but not significant (P>0.05). Levels in hematological variables decreased but not significant changed following noise exposure. Decreased rate of total leukocyte in man group was higher (P<0.05). Cortisol levels in the both groups decreased immediately after the end of noise exposure, while the decreased rate in man group was greater than that in woman group (p<0.05). These findings indicate that a transient exposure to experimental excavator noise may cause decreased changes in cardiac factors, cerebral hemodynamics and cortisol levels and the changes may be greater in men than in women.

• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.24-36
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• 2014

Objectives : This study was performed to evaluate the effects of moxibustion on cerebral blood flow, peripheral blood flow and blood pressure. Methods : We designed a randomized, cross-over study that included 20 healthy, male volunteers who were randomly assigned to one of two groups (the moxibustion group or the control group). The initial trial was followed by a washout period of one week before the groups were switched and the trial repeated. The cerebral blood flow and peripheral blood flow of the volunteers in both groups were measured by mean velocity (Vm), peak systolic velocity (Vs), pulsatility index (PI), perfusion units (PU) and mean blood pressure (BP) before the intervention (baseline), 30 minutes after the intervention, and again 60 minutes after the intervention. Results : 1. The Vm increased significantly in the moxibustion group. The Vs also constantly increased in moxibustion group, but there was no significant difference. 2. The PI decreased significantly in the control group at 0-30 minutes and in the moxibustion group at 30-60 minutes. 3. The PU constantly decreased in moxibustion group. In control group, the PU decreased at 30 minutes and increased slightly at 60 minutes. 4. The mean blood pressure did not show any significant difference between the two groups. Conclusions : This study shows that moxibustion at CV12 increased the cerebral blood flow. Based on this result, we can suggest that moxibustion at CV12 might be helpful in improving the functional recovery of stroke patients. However, further research needs to be conducted on a larger numbers of subjects in order to confirm these effects.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.418-426
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• 2004

Objectives : This study was designed to research whether transcranial doppler ultrasound(TCD) can yield a suitable diagnosis or prognosis for dizziness. Methods : To evaluate the blood flow, we measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of the middle cerebral artery(MCA), vertebral artery(VA) and basilar artery(BA) in 54 dizziness patients and 44 normal subjects. To investigate the difference between dizziness patients and normal subjects, we selected 54 dizziness patients diagnosed normal by Brain MRI, and 44 normal subjects who did not have any symptoms of hyperlipemia, hypertension, diabetes melitus, heart disease, or smoking, diagnosed normal by Brain MRI. 30-69 year olds were divided into 30-49 year olds, 50-59 year olds and 60-69 year olds. Results : In normal subjects, there was a significantly higher Vm, Vs in the MCA and BA, and Vs in the VA of female subjects, and there was a significant difference in PI in the MCA and BA increasing with age. In comparison with normal subjects, dizziness patients had a significantly lower Vm in the BA. Male dizziness patients had significantly lower PI in the MCA. 30-49 year olds had significantly lower Vm in the BA. Conclusions : The significant difference in blood flow velocities in the BA between dizziness patients and normal subjects suggests that dizziness is related to blocking of blood flow in the BA and that diagnosis and prognosis can be made through TCD. More detailed study of dizziness patients will be needed.

• Journal of Life Science
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• v.19 no.11
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• pp.1658-1665
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• 2009

This study was carried out on thirty men to define the association of inflammatory markers with physiological factors on one-time aerobic exercise (for 15 min. Post-exercise interleukin-6 (IL-6), mean corpuscular hemoglobin concentration (MCHC), heart rate (HR), systolic blood pressure (SBP), and pulsatility and resistance index of middle cerebral artery (PI and RI, respectively) levels were elevated compared to those measured pre-exercise. Total leukocyte and platelet counts, high-sensitivity C-reactive protein (hs-CRP), free radical (FR), and low density lipoprotein cholesterol (LDL) levels tended to decrease after exercise. Pre-exercise IL-6 levels were positively correlated with pre-exercise SBP levels, while post-exercise IL-6 level was positively correlated with post-exercise PI and RI levels. Post-exercise, hs-CRP levels were negatively related to SBP and HR. Pre-exercise, FR levels were positively associated to SBP, DBP, and HR. Post-exercise FR levels were negatively related to the post-exercise blood flow velocity in middle cerebral artery. Pre-exercise erythrocyte indices (RBC, MCV, MCH, and MCHC levels) were in inverse proportion to pre-exercise IL-6 levels. Post-exercise FR levels were inversely related to post-exercise total leukocyte, lymphocyte, monocyte, and MCH levels. Pre-exercise $Mg^{++}$ levels were in inverse proportion to pre-exercise IL-6, hs-CRP, or FR levels. These findings suggest that one-time aerobic exercise offers a significant relationship between inflammatory markers and some biochemical markers or electrolytes. Further studies need to be carried out for investigation of differences between genders or age groups following one-time or regular aerobic exercise.