• Title/Summary/Keyword: cardiac safety

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Ultrastructure of Sarcocystis grueneri-like Sarcocysts from Cardiac Muscle of Red Deer (Cervus elaphus) in Korea (한국산 Red Deer (Cervus elaphus)의 심근에서 관찰된 Sarcocystis grueneri 양 포낭의 투과전자현미경 소견)

  • Son, Hwa-Young;Kim, Nam-Soo;Ryu, Si-Yun;Kim, Hyeon-Cheol;Rhee, Ju-Hee;Cho, Jeong-Gon;Park, Bae-Keun
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.595-599
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    • 2009
  • Sarcocystis grueneri-like sarcocysts were found from the cardiac muscles of a rearing red deer (Cervus elaphus) carcass in Korea. In the light microscopical examination of sarcocysts, they were oval to spherical cysts and 90-170$\times$110-380 ${\mu}m$ in size. However, there was no inflammation and myofiber degeneration. In the transmission electron microscope, these cysts were located within the sarcoplasm of the host cell and filled with merozoites. The sarcocysts were enclosed by a very thin wall (0.45-0.6 ${\mu}m$ thick) that consists of protrusions and ground substance. The primary cyst wall formed numerous strip-like protrusions which were 0.2-0.3 ${\mu}m$ wide and up to 4.2 ${\mu}m$ long. The protrusions were running in parallel with the surface of the cyst. A characteristic of the cyst wall was absent of fibrils inside the protrusions. Merozoites in the compartment measured about $15\times4\;{\mu}m$. The merozoite consisted of four regions: micronemes and rhoptries, amylopectin granule, nucleus, and amylopectin granules. The number of rhoptry was counted in 7-13.

An Experimental Hlodel of Isolated Lung Block for Evaluation of Pulmonary Preservation after Ischemial (허혈후 폐 보존효과를 측정하기 위한 폐장 분리관류 모형)

  • Sung, Sook-Whan;Lim, Cheong;Kim, Young-Tae;Park, Jong-Ho
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.573-579
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    • 1997
  • During the last 30 years, major organ transplantation has become popular, even in Korea, such as kidney, liver, etc. After the successful clinical cardiac transplantation in Korea, many cases of cardiac transplantation are being performed in some centers. But lung transplantation has a lot of obstacles, especially'donor shortage and decreased tolerability of the lung to ischemia-reperfusion injury. Usually it was considered that the maximum safety margin of ischemic time in lung transplantation was about 4 to 6 hours. So, many investigators have tried to develop better preservation methods and experimental model for evaluation of effectiveness in those various methods. But most of those methods had several drawbacks in clinical and experimental settings. So we developed an easily-controllable, reliable, and inexpensive experimental model of isolated rabbit lung block. Using these model, we evaluated its effectiveness and reliability for the experiment of ischemia-reperfusion injury in lung transplantation.

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Efficacy and Safety of Sirolimus-Eluting Stent With Biodegradable Polymer UltimasterTM in Unselected Korean Population: A Multicenter, Prospective, Observational Study From Korean Multicenter Ultimaster Registry

  • Soohyung Park;Seung-Woon Rha;Byoung Geol Choi;Jae-Bin Seo;Ik Jun Choi;Sung-Il Woo;Soo-Han Kim;Tae Hoon Ahn;Jae Sang Kim;Ae-Young Her;Ji-Hun Ahn;Han Cheol Lee;Jaewoong Choi;Jin Soo Byon;Markz RMP Sinurat;Se Yeon Choi;Jinah Cha;Su Jin Hyun;Cheol Ung Choi;Chang Gyu Park
    • Korean Circulation Journal
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    • v.54 no.6
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    • pp.339-350
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    • 2024
  • Background and Objectives: UltimasterTM, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of UltimasterTM stents in Korean patients with coronary artery disease. Methods: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. Results: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS). At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. Conclusions: The present registry shows that UltimasterTM stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Minimally invasive cardiac surgery with the partial mini-sternotomy in children (소아연령군에서의 부분흉골소절개를 통한 최소침투적심장수술)

  • 이정렬;임홍국;성숙환;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.466-471
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    • 1998
  • Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

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Comparison of Effects of Normothermic and Hypothermic Cardiopulmonary Bypass on Cerebral Metabolism During Cardiac Surgery (체외순환 시 뇌 대사에 대한 정상 체온 체외순환과 저 체온 체외순환의 임상적 영향에 관한 비교연구)

  • 조광현;박경택;김경현;최석철;최국렬;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.420-429
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    • 2002
  • Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature >34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation: Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result: VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p<0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p<0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p<0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p<0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p<0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p<0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p<0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p<0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p<0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.

Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

Valved Conduit with Glutaraldehyde-Fixed Bovine Pericardium Treated by Anticalcification Protocol

  • Lim, Hong-Gook;Kim, Gi Beom;Jeong, Saeromi;Kim, Yong Jin
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.333-343
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    • 2014
  • Background: A preclinical study was conducted for evaluating a valved conduit manufactured with a glutaraldehyde (GA)-fixed bovine pericardium treated using an anticalcification protocol. Methods: Bovine pericardia were decellularized, fixed with GA in an organic solvent, and detoxified. We prepared a valved conduit using these bovine pericardia and a specially designed mold. The valved conduit was placed under in vitro circulation by using a mock circulation model, and the durability under mechanical stress was evaluated for 2 months. The valved conduit was implanted into the right ventricular outflow tract of a goat, and the hemodynamic, radiologic, histopathologic, and biochemical results were obtained for 6 months after the implantation. Results: The in vitro mock circulation demonstrated that valve motion was good and that the valved conduit had good gross and microscopic findings. The evaluation of echocardiography and cardiac catheterization demonstrated the good hemodynamic status and function of the pulmonary xenograft valve 6 months after the implantation. According to specimen radiography and a histopathologic examination, the durability of the xenografts was well preserved without calcification at 6 months after the implantation. The calcium and inorganic phosphorus concentrations of the explanted xenografts were low at 6 months after the implantation. Conclusion: This study demonstrated that our synergistic employment of multiple anticalcification therapies has promising safety and efficacy in the future clinical study.

Myocardial degeneration in Russian rat snake (Elaphe schrenckii)

  • Tiwari, Shraddha;Aufa, Sulhi;Park, Hyung-Hun;Cho, Ho-Seong;Park, Byung-Yong;Oh, Yeonsu
    • Korean Journal of Veterinary Service
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    • v.41 no.3
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    • pp.217-220
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    • 2018
  • A female Russian rat snake, Elaphe schrenckii, was presented for loss of movement. Physical examination showed the swelling in the area of heart. Radiographic examination revealed cardiomegaly, pericardial effusion, and a soft opacity in the area of swelling. Although pericardiocentesis to remove fluid out from the heart as well as vigorous treatments were given to the Russian rat snake, it died during treatments. Postmortem examination confirmed pericardial effusion of pale yellow, translucent fluid with mild dilation of the right atrium and ventricle. Formalin -fixed paraffin embedded tissue sections were stained with routine H&E and the classical von Kossa's method for histopathological demonstration. Histopathological examination revealed multifocal calcification in myocardium and consists of the displacement of muscular fiber by limy deposits. Congestive heart failure was suspicious for the snake when it was alive. In wild reptiles, muscle degeneration has been reported with nutrition disorders but the present case is the first report of myocardial degeneration in a Russian rat snake and contributes to the rare reports of cardiac disease in snakes.

Effect of Recombinant Porcine Somatotropin(rPST) Administration on Pig Health (유전공학 Porcine Somatotropin의 투여가 돼지의 건강에 미치는 영향)

  • Lee Chang-Woo;Bak Ung-Bok;Chang Byoung-Sun;Kim Nam-Joong;Lee Byung-Gueon
    • Journal of Veterinary Clinics
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    • v.9 no.1
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    • pp.333-366
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    • 1992
  • Safety of recombinant porcine somatotropin administration on pig was studied using 32 Landrace x Yorkshire crossbred pigs. The starting body weight ranged from 55.5kg to 65.3kg. Eight pigs were allotted to each low dose group of sustained releasing rPST(SL), high dose group of sustained releasing rPST(SH), daily injection group of rPST(DI), and control group(C). Pigs in SL group and SH group were injected subcutaneously twice in 3 week-interval with 1000$\mu\textrm{g}$ and 2000$\mu\textrm{g}$ of sustained releasing rPST per kg body weight, respectively. Pigs in DI group were injected intramuscularly with 100$\mu\textrm{g}$ of rPST everyday for 6 weeks. Blood was collected from anterior vena cava just before the first treatment, and at four weeks and six weeks of experiment. Hematological parameters and blood chemical parameters indicating liver function, kidney function, electrolyte metabolism, mineral metabolism and lipid metabolism were determined. Necropsy and urinalysis were performed after final blood collection. The results were summarized as follows, and it is concluded that rPST administration does not affect pig health negatively. 1. rPST administration did not affect kidney function as manisfested by BUN, creatinine and urinalysis. 2. rPST administration did not affect liver function as manisfested by total protein, albumin, serum AST activity serum ALT activity serum ALP activity, serum LDH activity, serum GGT activity and serum SDH activity. 3. rPST administration did not affect skeletal muscle, cardiac muscle and brain as manifasted by serum AST activity and serum LDH activity. 4. rPST administration increased blood glucose level within normal range. 5. rPST administration did not affect lipid metabolism as manisfested by triglyceride, cholesterol, and phospholipid concentrati on. 6. rPst administration dia not affect mineral metabolism as manisfested by calcium, phosphorus, magnesium and iron concentration. 7. rPST administration did not affect electrolyte metabolism as manisfested by Na, K, chloride concentration. 8. rPST administration did not affect erythrocyte count, leukocyte count, thrombocyte count, and plasma fibrinogen level.

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Analysis of 2002 year's Pesticides Poisoning Deaths' data of Korea National Statistical Office and Counterplan to Prevent Deaths Due to Herbicides Poisoning (2002년 농약중독 사망자 통계청 자료 분석 및 제초제 중독으로 인한 사망사고 예방 대책)

  • Kim Uk Jin;Kim Hyo Yun;Kim Seung Hwan;Kim Sun Wook;Cho Young Soon;Chung Sung Pil;Lee Hahn Shick
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.77-82
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    • 2004
  • Backgrounds: Deaths from pesticides poisoning has increased annually, but no studies have been reported. Especially paraquat is suspected to be a major material in pesticide poisoning deaths. In Korea, simple epidemiology of pesticides poisoning is not well known. So, there is no effective method to prevent pesticides poisoning. We tried to investigate the present status of pesticides poisoning with data from Korea National Statistical Office and suggest an effective counterplan. Methods: We analysed death cause data derived from Korean Statistical association, deaths causes being pesticides poisoning in the year 2002. Also, we investigated data from internet, mainly from Korea National Statistical Office home page. Results: Total 2,875 persons died after pesticides poisoning in 2002 year. Average age is 54.2 year, standard deviation being 17.7 year. Many victims (about $41\%$) died during the herbicides' non-necessary period (JanuaryMarch, October-December) Conclusion: Herbicides sale should be restricted only during herbicides' necessary period, and so called a pesticides safety supervisor system shall effectively prevent herbicides poisoning.

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