• Korean Circulation Journal
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• v.53 no.7
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• pp.425-451
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• 2023

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA₂DS₂-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

• International Journal of Vascular Biomedical Engineering
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• v.1 no.2
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• pp.36-41
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• 2003

Both flow visualizations and computational fluid dynamics were performed to determine hemodynamics in a total cavopulmonary connection (TCPC) model for surgically correcting congenital heart defects. From magnetic resonance images, an anatomically correct glass model was fabricated to visualize steady flow. The total flow rates were 4, 6 and 8L/min and flow rates from SVC and IVC were 40:60. The flow split ratio between LPA and RPA was varied by 70:30, 60:40 and 50:50. A pressure-based finite-volume software was used to solve steady flow dynamics in TCPC models. Results showed that superior vena cava(SVC) and inferior vena cava(IVC) flow merged directly to the intra-atrial conduit, creating two large vortices. Significant swirl motions were observed in the intra-atrial conduit and pulmonary arteries. Flow collision or swirling flow resulted in energy loss in TCPC models. In addition, a large intra-atrial channel or a sharp bend in TCPC geometries could influence on energy losses. Energy conservation was efficient when flow rates in pulmonary branches were balanced. In order to increase energy efficiency in Fontan operations, it is necessary to remove a flow collision in the intra-atrial channel and a sharp bend in the pulmonary bifurcation.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.6-12
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• 2012

Objective: Coenzyme (CoQ10) is an enzymatic co factor used in normal cellular metabolism. Recent evidence shows that in people with heart disease it can reverse endothelial cell damage in the blood vessels. It is also a potent antioxidant. Design: One group pretest-posttest design. Methods: In the present study, endothelial function was evaluated using the response to occlusion and heat before and 2 weeks after administration of CoQ10, 300 mg/day. Thirty Eight subjects, who are physical therapy students, participated in a series of experiments to see if taking 300 mg of CoQ10 daily for 2 weeks would impact resting blood flow in the forearm skin and the blood flow response to 4 minutes of vascular occlusion and the response to local heat ($42^{\circ}C$) for 6 minutes. Results: The results showed that, for this population, there was no difference in the response to heat. However, the response to occlusion was improved after administration of CoQ10. Conclusions: It would appear that in a young population CoQ10 has no effect on the nitric oxide vasodilator pathway in skin but does influence other vasodilator pathways.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.461-470
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• 2001

A unhealthy 58-year-old male patient required extraction of left upper second molar due to advanced periodontitis. Lidocaine contained 1 : 100000 epinephrine for left posterior superior alveolar nerve block was administered in the mucobuccal fold above the second molar to be treated at the local private dental clinic. After four hours of posterior superior alveolar block anesthesia, patient feeled double vision and discomfort of eyeball movement. At next day, he complained difficulty of left eyeball movement, vertigo and diplopia. He was referred to our department via local clinic and department of ophthalomology of our hospital. He was treated by medication and eyeball exercise, and then follow up check. The double vision and medial rectus muscle palsy disappeared patially after 2 months of block anesthesia. We described herein an ocular complication of diplopia and inferior rectus muscle palsy after posterior superior alveolar nerve block for extraction of left upper second molar, and review the cause or origin of this case. The autonomic nervous system is presented as the logical basis for the untoward systems of ophthalmologic sign likely to diplopia and inferior rectus muscle palsy, rather then simple circulation of anesthetic solution in the vascular network.

• Journal of Sensor Science and Technology
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• v.19 no.1
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• pp.17-24
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• 2010

This paper describes a real time reliable monitoring method and analysis system using wrist type oximeter for ubiquitous healthcare service based on IEEE 802.15.4 standard. Photoplethysmograph(PPG) is simple and cost effective technique to measure blood volume change. In order to obtain and monitor physiological body signals continuously, a small size and low power consumption wrist type oximeter is designed for the measurement of oxygen saturation of a patient unobtrusively. The measured data is transferred to a central PC or server computer by using wireless sensor nodes in wireless sensor network for storage and analysis purposes. LabVIEW server program is designed to monitor stress indicator from heart rate variability(HRV) and process the measured PPG to accelerated plethysmograph(APG) by appling second order derivatives in server PC. These experimental results demonstrate that APG can precisely describe the features of an individual's PPG and be used as estimation of vascular elasticity for blood circulation.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.2
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• pp.10-16
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• 2005

Because patients with coronary artery disease (CAD) have depressed vagal modulation and the mortality risk from acute myocardial infarction is lower in patients with higher vagal modulation, methods that can increase vagal modulation are desirable in patients with CAD. We intended to inspect the effect of recumbent posture on vagal modulation. By using angiography, 33 patients with abnormal (CAD group) and 33 patients with normal coronary arteries (control group) were studied. The nonlinear as well as the linear characteristics of heart rate variability (HRV) were analyzed on these patients in three recumbent postures: namely, the supine, right lateral decubitus, and left lateral decubitus postures. The lower the normalized high-frequency power (nHF) in the supine or left lateral decubitus posture, the higher the increase in the nHF when the posture was changed from supine or left lateral decubitus to right lateral decubitus in both groups of patients. Right lateral decubitus posture can lead to the highest vagal modulation and the lowest sympathetic modulation among the three recumbent postures in both normal and patients with CAD. Therefore, the right lateral decubitus posture can be used as an effective physiologic vagal enhancer in patients with CAD.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.2
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• pp.17-24
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• 2005

The main purpose of our study is to propose a new methodology to develop the multi-parametric measure including linear and nonlinear measures of heart rate variability diagnosing cardiovascular disease. We recorded electrocardiogram for three recumbent postures; the supine, left lateral, and right lateral postures. Twenty control subjects (age: $56.70{\pm}9.23$ years), 51 patients with angina pectoris (age: $59.98{\pm}8.41$ years) and 13 patients with acute coronary syndrome (age: $59.08{\pm}9.86$ years) participated in this study. To develop the multi-parametric measure of HRV, we used the multiple discriminant analysis method among statistical techniques. As a result, the multiple discriminant analysis gave 75.0% of goodness of fit. When the linear and nonlinear measures of HRV are individually used as a clinical tool to diagnose cardiac autonomic function, there is quite a possibility that the wrong results will be obtained due to each measure has different characteristics. Although our study is a preliminary one, we suggest that the multi-parametric measure, which takes into consideration the whole possible linear and nonlinear measures of HRV, may be helpful to diagnose the cardiovascular disease as a diagnostic supplementary tool.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.568-571
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• 2009

Accessory middle cerebral artery (MCA) is an infrequent vascular anomaly of the brain. Cerebral aneurysms associated with this anomalous artery are also very rare. To our knowledge, there have only been ten previous reports of an aneurysm associated with accessory MCA. The authors present two patients with accessory MCA-related aneurysms. A 38-year-old male and a 59-year-old female both presented with sudden-onset severe headache. In both patients, computed tomography (CT) scan revealed subarachnoid hemorrhage. A subsequent angiogram demonstrated an accessory MCA arising from the anterior cerebral artery (ACA) and a saccular aneurysm at the anterior communicating artery (ACoA) complex associated with an accessory MCA. Surgical clipping allowed for complete exclusion of the aneurysm from the arterial circulation. Based on our review of the ten cases of aneurysms associated with accessory MCA documented in the literature, we suggest that accessory MCA-related aneurysms can be classified according to whether the accessory MCA originates from the proximal A1 segment or from the ACoA complex. We also emphasize the importance of precise interpretation of preoperative angiograms and intraoperative precaution in determining the presence of this anomalous artery prior to temporary clip placement.

• Herbal Formula Science
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• v.6 no.1
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• pp.215-226
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• 1998

Geagibokrounghwan (桂技茯笭湯) has long been used to cure human diseases such as vascular and blood disorders. However, it is still unkown on its action mechanism, physiolosical and biochemical meaning. Thus, many attempts were tried to show the scientific background covering the above mentioned mechanism. The effect of Geagibokrounghwan, which was known to date, as follow; effective circulation of body blood system, proliferation of leucocytes and antioxidative action. In this study, we have applied the Geagibokrounghwan administration and feed to mouse, to see effects on the expression of superoxide dismutase(SOD) mRNA as antioxidative agent and oxygen radical scavenger. Total RNAs includingmRNA have been isolated from liver and white blood cells after mice were fed with cholesterol in high dose. Also, in a separate group, the cholesterol-administrated mice were fed with Geagibokrounghwan to see the effects on SOD transcription. and then reverse transcriptase-polymerase chain reaction (RT-PCR) usion each primer set (SOD-F;GATGAAAGCGGTGT-3'; SOD-R; 5'-CCTGTGGAGTGATT-3') were performed to trace theamounts of mRNA. SOD mRNA was specifically expressed in Geagibokrounghwan-fed mice at 2 weeks after treatment, however, gradually reduced after 4 weeks. These results indicate that Geagibokrounghwan is highly applicable in treatment of the above mentioned human diseases.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.1
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• pp.1-5
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• 2005

Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.