• Journal of Chest Surgery
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• v.45 no.2
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• pp.73-79
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• 2012

Background: Aortic cross clamping is associated with spinal cord ischemia. This study used a rat spinal cord ischemia model to investigate the effect of distal aortic pressure on spinal cord perfusion. Materials and Methods: Male Sprague-Dawley rats (n=12) were divided into three groups. In group A (n=4), the aorta was not occluded. In groups B (n=4) and C (n=4), the aorta was occluded. In group B the distal aortic pressures dropped to around 20 mmHg. In group C, the distal aortic pressure was decreased to near zero. The carotid artery and tail artery were cannulated to monitor the proximal aortic pressure and the distal aortic pressure. Fluorescent microspheres were used to measure the regional blood flow in the spinal cord. Results: After aortic occlusion, blood flow to the cervical spinal cord showed no significant difference among the three groups. In groups B and C, the thoracic and lumbar spinal cord and renal blood flow decreased. No microspheres were detected in the thoracic and lumbar spinal cord of group C. Conclusion: The spinal cord blood flow is dependent on the distal aortic pressure after thoracic aortic occlusion.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Molecules and Cells
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• v.40 no.8
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• pp.542-549
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• 2017

Cardiomyocyte apoptosis is initiated by various cellular insults and accumulated cardiomyocyte apoptosis leads to the pathogenesis of heart failure. Excessive reactive oxygen species (ROS) provoke apoptotic cascades. Manganese superoxide dismutase (MnSOD) is an important antioxidant enzyme that converts cellular ROS into harmless products. In this study, we demonstrate that MnSOD is down-regulated upon hydrogen peroxide treatment or ischemia/reperfusion (I/R) injury. Enhanced expression of MnSOD attenuates cardiomyocyte apoptosis and myocardial infarction induced by I/R injury. Further, we show that miR-23a directly regulates the expression of MnSOD. miR-23a regulates cardiomyocyte apoptosis by suppressing the expression of MnSOD. Our study reveals a novel model regulating cardiomyocyte apoptosis which is composed of miR-23a and MnSOD. Our study provides a new method to tackling apoptosis related cardiac diseases.

• The Korean Journal of Physiology and Pharmacology
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• v.15 no.4
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• pp.217-239
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• 2011

We carried out a series of experiment demonstrating the role of mitochondria in the cytosolic and mitochondrial $Ca^{2+}$ transients and compared the results with those from computer simulation. In rat ventricular myocytes, increasing the rate of stimulation (1~3 Hz) made both the diastolic and systolic [$Ca^{2+}]$ bigger in mitochondria as well as in cytosol. As L-type $Ca^{2+}$ channel has key influence on the amplitude of $Ca^{2+}$ -induced $Ca^{2+}$ release, the relation between stimulus frequency and the amplitude of $Ca^{2+}$ transients was examined under the low density (1/10 of control) of L-type $Ca^{2+}$ channel in model simulation, where the relation was reversed. In experiment, block of $Ca^{2+}$ uniporter on mitochondrial inner membrane significantly reduced the amplitude of mitochondrial $Ca^{2+}$ transients, while it failed to affect the cytosolic $Ca^{2+}$ transients. In computer simulation, the amplitude of cytosolic $Ca^{2+}$ transients was not affected by removal of $Ca^{2+}$ uniporter. The application of carbonyl cyanide 4-(trifluoromethoxy) phenylhydrazone (FCCP) known as a protonophore on mitochondrial membrane to rat ventricular myocytes gradually increased the diastolic [$Ca^{2+}$] in cytosol and eventually abolished the $Ca^{2+}$ transients, which was similarly reproduced in computer simulation. The model study suggests that the relative contribution of L-type $Ca^{2+}$ channel to total transsarcolemmal $Ca^{2+}$ flux could determine whether the cytosolic $Ca^{2+}$ transients become bigger or smaller with higher stimulus frequency. The present study also suggests that cytosolic $Ca^{2+}$ affects mitochondrial $Ca^{2+}$ in a beat-to-beat manner, however, removal of $Ca^{2+}$ influx mechanism into mitochondria does not affect the amplitude of cytosolic $Ca^{2+}$ transients.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.74-79
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• 1996

This paper describes a methodology for the development of models of discrete event system(DES). The methodology is based on transformation of continuous state space into discrete one to homomorphically represent dynamics of continuous processes in discrete events. This paper proposes a formal structure which can couple DES models within a framework. The structure employs the DEVS formalism for the DES models. The proposed formal structure has been applied to develop a DEVS model for the human cardiovascular system. For this, the cardiac cycle is partitioned into a set of phases based on events identified through VisSim simulation in the CS of the electrical analog model. VisSim is the simulation tool of visual environment for developing continuous, discrete, and hybrid system models and performing dynamic simulation. For each phase, a CS of the electrical analog model for the cardiovascular system has been simulated by VisSim 2.0. To validate this model, first develop the DEVS model, then simulate the model in the DEVSIM++ environment. It has same simulation results for the data obtained from the CS simulation using VisSim. The comparison shows that the DEVS model represents dynamics of the human heart system at each phase of cardiac cycle.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.96-104
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• 2006

Insamsansa-eum (Renshenshanzha-yin, ISE) is a new medicine developed to prevent and treat atherosclerotic diseases. To explore antiatherosclerotic effects of ISE, we evaluated the effects of ISE on serum lipids of hypercholesterolemic rats in vivo, as well as its antioxidant activities in vitro. In vitro, ISE showed 1,1-diphenyl-2-picrylhydrazyl (DPPH) and superoxide radical scavenging activities, and inhibited hemolysis induced by 2,2' -azobis-2-amidinopropane dihydrochloride (AAPH) in a dose-dependent manner. In vivo, ISE significantly inhibited increase of total cholesterol (TC), low-density lipoprotein cholesterol (LDL) and triglyceride (TG) values in both high cholesterol diet and Triton WR-1339 models. It also significantly inhibited decrease of high-density lipoprotein cholesterol (HDL) value in the high cholesterol diet model. Collectively, our data suggest that ISE has the potential to control the risk of atherosclerosis development.

• Environmental Analysis Health and Toxicology
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• v.29
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• pp.5.1-5.7
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• 2014

Objectives Numerous studies have revealed the adverse health effects of acute and chronic exposure to particulate matter less than $10{\mu}m$ in aerodynamic diameter ($PM_{10}$). The aim of the present study was to examine the spatial distribution of $PM_{10}$ concentrations and cardiovascular mortality and to investigate the spatial correlation between $PM_{10}$ and cardiovascular mortality using spatial scan statistic (SaTScan) and a regression model. Methods From 2008 to 2010, the spatial distribution of $PM_{10}$ in the Seoul metropolitan area was examined via kriging. In addition, a group of cardiovascular mortality cases was analyzed using SaTScan-based cluster exploration. Geographically weighted regression (GWR) was applied to investigate the correlation between $PM_{10}$ concentrations and cardiovascular mortality. Results An examination of the regional distribution of the cardiovascular mortality was higher in provincial districts (gu) belonging to Incheon and the northern part of Gyeonggi-do than in other regions. In a comparison of $PM_{10}$ concentrations and mortality cluster (MC) regions, all those belonging to MC 1 and MC 2 were found to belong to particulate matter (PM) 1 and PM 2 with high concentrations of air pollutants. In addition, the GWR showed that $PM_{10}$ has a statistically significant relation to cardiovascular mortality. Conclusions To investigate the relation between air pollution and health impact, spatial analyses can be utilized based on kriging, cluster exploration, and GWR for a more systematic and quantitative analysis. It has been proven that cardiovascular mortality is spatially related to the concentration of $PM_{10}$.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.8-15
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• 2020

Background: We aimed to investigate the associations of critical care provided in a cardiac surgical intensive care unit (CSICU) staffed by an attending intensivist with improvements in intensive care unit (ICU) quality and reductions in postoperative complications. Methods: Patients who underwent elective isolated coronary artery bypass grafting (CABG) between January 2007 and December 2012 (the control group) were propensity-matched (1:1) to CABG patients between January 2013 and June 2018 (the intensivist group). Results: Using propensity score matching, 302 patients were extracted from each group. The proportion of patients with at least 1 postoperative complication was significantly lower in the intensivist group than in the control group (17.2% vs. 28.5%, p=0.001). In the intensivist group, the duration of mechanical ventilation (6.4±13.7 hours vs. 13.7±49.3 hours, p=0.013) and length of ICU stay (28.7±33.9 hours vs. 41.7±90.4 hours, p=0.018) were significantly shorter than in the control group. The proportions of patients with prolonged mechanical ventilation (2.3% vs. 7.6%, p=0.006), delirium (1.3% vs. 6.3%, p=0.003) and acute kidney injury (1.3% vs. 5.3%, p=0.012) were significantly lower in the intensivist group than in the control group. Conclusion: A transition from an open ICU model with trainee coverage to a closed ICU model with attending intensivist coverage can be expected to yield improvements in CSICU quality and reductions in postoperative complications.

• Korean Journal of Pharmacognosy
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• v.47 no.1
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• pp.49-54
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• 2016

In our search for natural products affecting blood circulation, the n-butanol fraction from whole plant of Glehnia littoralis Fr. Schm. (GLB) improved blood lipid parameters, and ameliorated obesity in high-fat-diet (HFD)-fed C57BL/6 mouse model. Hyperlipidemia was induced by high-fat-diet for 4 weeks, and then GLB was orally administrated with 400 mg/kg/day for 4 weeks. GLB-treated group showed that the gain in body weight was significantly attenuated, the levels of total cholesterol and triglyceride significantly lowered on blood chemical analysis, and significantly prolonged the mice bleeding time when compared with those of HFD control group. Concomitantly, phytochemical composition of GLB was investigated by HPLC-hyphenated spectroscopy, and two major phenolic compounds, rutin and chlorogenic acid were identified in the GLB. Taken together, these results indicate that GLB has cardiovascular protective effects and could be a natural medicine candidate for the prevention of cardiovascular disease.

• Korean Journal of Acupuncture
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• v.33 no.2
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• pp.58-66
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• 2016

Objectives : In order to find a possible non-invasive manipulation tool for maintenance of the cardiovascular functions in hemorrhagic shock, this study was aimed at evaluating effects of acupoints acupressure on the changes in blood pressure and heart rate from an animal model of hemorrhagic shock. Methods : In adult Sprague-Dawley rats, hemorrhagic shock was induced by a withdrawal of arterial blood from the femoral artery with volume of 0.8 ml per 100 g of body weight using peristaltic syringe pump. We applied the acupressure with a pressure oscillator to tail as a control and 2 different acupoints of sobu(HT8), youngchun(KI1) under 3 different conditions : 1) normal arterial blood pressure without bleeding, 2) at the beginning of bleeding, and finally 3) hemorrhagic shock. Results : Under normal arterial blood pressure without hemorrhage, there was a significant increase in systolic and diastolic blood pressures by the acupressure to the tail, HT8 and especially KI1 for 30 sec compared with before acupressure. Under hemorrhagic shock condition, the tail acupressure had minimal changes in cardiovascular parameters. Either the HT8 or KI1 acupressure resulted in a significant increase in arterial pressure but did not heart rate. At the beginning of bleeding, tail acupressure failed to change the reduction of arterial pressure and heart rate. However, there was a significant increase in blood pressure and heart rate following either the HT8 or especially KI1 acupressure. Conclusions : HT8 and KI1 acupressure affected cardiovascular signs but tail acupressure did not in rat model of hemorrhagic shock. These experimental data suggest that a acupressure with a pressure oscillator to HT8 or KI1 can be one of alternative emergency manipulations to ameliorate compromised cardiovascular functions under hemorrhagic shock condition.