Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.
Modified Blalock-Taussig operation remains the standard technique of systemic-to-pulmonary artery shunt in patients of congenital heart disease with decreased pulmonary blood flow. We reviewed the 41 patients who had been performed modified Blalock-Taussig operation from March 1985 to Feb. 1988, and angiographically measured pulmonary artery size before and after shunt, and calculated pulmonary artery index [PAI] and ratio of left and right pulmonary artery to descending aorta[[LPA+RPA]/dAo]. The mean duration of palliation after shunt operation was 624 days and mean age of the patient at shunt operation was 3.59 years. Mean PAI increased significantly from 131.15*67.11 mm2/M2 preoperatively to 232.70*84.46 mm2/M2 postoperatively. Mean ratio of right and left pulmonary artery to descending aorta also increased significantly from 1.48*0.40 preoperatively to 1.92*0.50 postoperatively. All patients manifested clinical improvement; there was mean decrease in hematocrit of 8.95%, mean increase in arterial oxygen saturation of 11.08%. Pulmonary arterial growth was not influenced by age at operation, initial pulmonary artery size, or graft size, but significantly influenced by antegrade flow. The patients who have some antegrade flow were in more increase of PAI. There were no linear correlation between change of PAI, change of [[LPA+RPA]/dAo], SaO2, and duration. But, according to Scatterplot between change of PAI and duration, some complex correlation was suggested and mean PAI was decreased after 2-year palliation. We concluded that modified Blalock-Taussig operation is excellent palliative surgery for pulmonary artery growth especially on the patient who have some antegrade flow, and the proper duration of palliation was about 2 years.
Kim, Jeong-Kee;Kim, Byoung-Soo;Park, Chan-Woong;Seo, Dai-Bang;Yoo, Ho-Rhyong;Lee, Sang-Jun
Journal of Physiology & Pathology in Korean Medicine
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v.24
no.1
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pp.85-90
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2010
Several studies have demonstrated that ginseng-berry extract has several beneficial properties, including anti-inflammatory, antioxidant, and vasodilation properties. Ginseng-berry extract has also been shown to have the great potential against skin aging. Its beneficial mechanism against skin aging, however, has not been examined in detail. Also, the effects of ginseng-berry extract on microcirculation and skin cellular responses have not been investigated. Inhibition of skin microcirculation is the primary cause of many adverse biological effects, which is responsible for the skin aging and darkening. We investigated the beneficial effects of ginseng-berry extract on blood circulation, transcutaneous oxygen pressure in vivo model and also on skin microcirculation, cellular response and skin brightening effect in clinical trial. We found that oral administration of ginseng-berry extract markedly increased blood flow rate and transcutaneous $O_2$ pressure, but decreased transcutaneous $CO_2$ pressure. Also, it improved skin tone on cheeks, as is skin brighteness. These results suggest that ginseng-berry extract is a potent candidate for the treatment of skin aging and brightening by improving skin microcirculation.
Background : Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long tenn effect after thoracentesis. Method : We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. Result: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, POz are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation. 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and po, is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. Conclusion: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery.
Kim, Jae-Seung;Moon, Dae-Hyuk;Kim, Geun-Eun;Kim, Jong-S.;Kweon, Sun-Uck;Cho, Yong-Pil;Ryu, Jin-Sook;Lee, Hee-Kyung
The Korean Journal of Nuclear Medicine
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v.33
no.4
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pp.352-361
/
1999
Purpose: Carotid endarterectomy nay benefit patients with bilateral carotid stenosis by improving cerebro-vascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebro-vascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. Materials and Methods: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (>50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. Results: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of4 with stenotic Al/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. Conclusion: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.
In 1959, Satomura used spectral Doppler ultrasound to express the velocity of red blood cells according to time change, and Kato defined a zero-base line that could tell the direction of blood flow, making it possible to know the direction of blood flow. This became the basis for the widely used classifications of Triphasic, Biphasic, and Monophasic. However, the above classification has limitations that confuse users with the meaning and timing of use in a clinical environment. As a result, the American Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU) A consensus document on Doppler waveform analysis was declared by the joint committee. This study tried to review this consensus and to suggest nomenclature and modifiers that can be used in the domestic vascular ultrasound clinical field. The joint committee formed by SVM and SVU recommended that the use of the triphasic waveform and the biphasic waveform be used as a multiphasic waveform rather than being used due to the ambiguity of interpretation. In addition, it was agreed to name the hybrid-type waveform, which is a monophasic and high-resistance waveform, which has always been a problem of interpretation in a clinical environment, as an intermediate resistive waveform. In addition, in order to increase the communication efficiency between the interpreter and the sonographer, waveform analysis was classified into a main descriptor and a modifier, and it was recommended to use a single nomenclature by unifying various synonyms. It is expected that this literature review will provide accurate arterial spectral Doppler waveform interpretation and an agreed-upon nomenclature to radiologists performing vascular ultrasound examination in clinical practice, and will be utilized as basic data that can contribute to the improvement of public health.
Journal of the Korean Society of Food Science and Nutrition
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v.44
no.7
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pp.961-969
/
2015
To investigate the effect of n-3 fatty acid from Bokbunja (Rubus coreanus Miq.) seed oil (BSO), we examined improvement of plasma triglycerides and cholesterol in vivo. Five-week-old ICR mice were divided into five groups of six mice each; Control, high fat diet (HFD) control (negative control), salmon oil control (positive control, HFD+commercial n-3 fatty acid), and BSO experimental groups (HFD+1 g/60 kg BW/d, HFD+2 g/60 kg BW/d). After 4 weeks of BSO treatment, we measured serum triglyceride and cholesterol levels. The levels of low-density lipoprotein/very-low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and total cholesterol were significantly (P<0.05) reduced in the group fed BSO at 2 g/60 kg BW/d compared to the negative control. Levels of triglycerides, which are similar to cholesterol, were also significantly (P<0.05) reduced in the same group. To investigate further, we tested blood coagulation parameters. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were not significantly different among the five groups according to BSO. However, the 2 g/60 kg BW/d BSO group treated with PT and aPTT showed a tendency to live longer than the negative control. Taken together, BSO might improve blood homeostasis mediated via hypo-lipidemic and anti-coagulation activities.
Objective : Carthami Flos has been used as a herb to promote blood circulation to remove blood stasis in oriental medicine for many centuries, and Amun(GV15) has been used as a meridian point to treat apoplexy etc. To investigate treatment of cerevral vascular disease(CVA) by promoting blood circulation and removing blood stasis(活血化瘀法), we observed the experimental effects and mechanism of auqa-acupunture of Carthami Flos(ACF) injected into GV15 on cerevral hemodynamics and cardiovascular system of rats. Method : Aqua-acupuncture of Carthami Flos(ACF) was injected into GV15, and then we investigated experimental effects and mechanism of ACF on the cerebral hemodynamics[regional cerebral blood flow(rCBF), pial arterial diameter(PAD), meal arterial blood pressure(MABP)] and cardiovascular system[cardiac muscle contractile force(CMF), heart rate(HR)I by pretreatment with methylene blue(MTB) and indomethacin(IDN). The changes in rCBF, MABP, CMF and HR were tested by Laser Doppler Flowmetry(LDF), and the changes in PAD was determinated by video microscopy methods and video analyzer. Results :The results were as follows in normal rats ; The changes of rCBF and PAD were significantly increased by ACF($120{\mu}{\ell}/kg$) in a injected time-dependent manner, but MABP was not changed by ACF. The changes of cardiovascular system were increased by ACF in a injected time-dependent manner. And pretreatment with MTB was significantly inhibited ACE induced increase of rCBF and PAD, and was decreased ACF induced increase of HR. And pretreatment with IDN was increased ACF induced MABP and CMF. And the results were as follows in cerebral ischemic rats ; The changes of rCBF was increased stabilizly by treatment with ACF($120{\mu}{\ell}/kg$) in during the period of cerebral reperfusion, but pretreatment with MTB was increased ACF induced increase of rCBF during the period of cerebral reperfusion. The results were as follows in normal rats ; The changes of rCBF and PAD were significantly increased by ACF($120{\mu}{\ell}/kg$) in a injected time-dependent manner, but MABP was not changed by ACF. The changes of cardiovascular system were increased by ACF in a injected time-dependent manner. And pretreatment with MTB was significantly inhibited ACF induced increase of rCBF and PAD, and was decreased ACF induced increase of HR. And pretreatment with IDN was increased ACF induced MABP and CMF. And the results were as follows in cerebral ischemic rats ; The changes of rCBF was increased stabilizly by treatment with ACF($120{\mu}{\ell}/kg$) in during the period of cerebral reperfusion, but pretreatment with MTB was increased ACF induced increase of rCBF during the period of cerebral reperfusion Conclusions : In conclusion, ACF causes a diverse response of rCBF, PAD an HR, and action of ACF is mediated by cyclic GMP. I suggested that ACF has an anti-ischemic effect through the improvement of crebral hemodynamics in a transient cerebral ischemia.
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.6
/
pp.1714-1721
/
2004
This experimental study was designed to investigate the mechanism of Palmul-Tang(PMT) on the changes of cerebral hemodynamics in rats. The changes of cerebral hemodynamics in normal rats were as follows ; The PMT-induced increase in regional cerebral blood flow was significantly inhibited by pretreatment with indomethacin(1㎎/㎏, i.p.), an inhibitor of cyclooxygenase, and was inhibited by methylene blue(10㎍/㎏, i.p.), an inhibitor of guanylate cyclase. The PMT-induced dilation in pial arterial diameter was significantly inhibited by pretreatment with indomethacin and methylene blue. The PMT-induced increase in mean arterial blood pressure was significantly inhibited by pretreatment with indomethacin but was increased by methylene blue. This results were suggested that the mechanism of PMT was mediated by cyclooxygenase. The changes of cytokine production in cerebral ischemic rats were as follows ; In cytokine production of serum by drawing from femoral arterial blood after middle cerebral arterial occlusion 1hr, sample group was decreased IL-1β and TNF-α production compared with control group, IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 1hr, sample group was significantly decreased IL-1β production compared with control group and decreased TNF-α production compared with control group. IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 4 hrs, sample group was significantly decreased IL-1β production compared with control group, but IL-10 production of sample group was similar to that of control group. sample group was increased TNF-α and TGF-β production compared with control group. These results suggested that PMT had inhibitive effect on the brain damage by inhibiting IL-1β and TNF-α production, but by accelerating TGF-β production. The present author thought that PMT had an anti-ischemic effect through the improvement of cerebral hemodynamics and inhibitive effect on the brain damage.
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.2
/
pp.419-426
/
2004
This experimental study was designed to investigate the effects of Yukgunja-tang(YGJT) on the inhibition of cerebral ischemia in rats. And We measured regional cerebral blood f1ow(rCBF) and pial arterial diameter(PAD) in cerebral ischemic rats, and cytokines production in serum Of cerebral ischemic rats. The results were as follows; Both rCBF and PAD were significantly and stably increased by YGJT(10 mg/kg, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in control group. In cytokine production of serum by drawing from femoral arterial blood after middle cerebral arterial occlusion(MCAO) 1 hr, IL-1β and TGF-β production of sample group were similar to that of control group, but sample group was decreased TNF-α production compared with control group, and was significantly increased IL-10 production in compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 1 hr, sample group was significantly decreased IL-1β and TNF-α production compared with control group, but TGF-β production of sample group was similar to that of control group, and sample group was significantly increased IL-10 production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 4 hrs, sample group was significantly decreased IL-1β production compared with control group, and sample group was decreased TNF-α production in compared with control group, but TGF-β production of sample group was similar to that of control group, and sample group was increased IL-10 production compared with control group. This results were suggested that YGJT has inhibitive effect on the brain damage by inhibited IL-1β production and TNF-α production, but accelerated IL-10 production. We thought that YGJT should have an anti-ischemic effect through the improvement of cerebral hemodynamics and inhibitive effect on the brain damage.
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