• Title/Summary/Keyword: cardiovascular system

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Clinial Analysis of Surgical Management for Descending Necrotizing Mediastinitis (하행 괴사성 종격동염의 수술적 치료에 대한 임상적 고찰)

  • Yu, Jeong-Hwan;Lim, Seung-Pyung;Lee, Seok-Ki;Kim, Yong-Ho;Kim, Si-Wook;Kang, Shin-Kwang;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.463-468
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    • 2008
  • Background: Descending necrotizing mediastinitis (DNM) is a life-threatening cervico-mediastinal infection extending from the oropharynx or periodontal space. We reviewed clinical outcomes of DNM patients that underwent surgical management. Material and Method: We analyzed the demographic and surgical data from 8 patients (6 males and 2 females) that underwent surgical management for DNM between August 2003 and August 2007. Result: The mean age was $56.6{\pm}12.3$ ($34{\sim}72$) years, Types of DNM were I (n=2), IIA (n=1), and IIB (n=5), based on the classification system of Endo et al. Four patients were septic at the time of operation. The infectious organism was identified in three cases and turned out to be Streptococcus. ICU stay was $24.3{\pm}17.9$ ($3{\sim}58$) days, and hospital stay was $49.1{\pm}33.8$ ($20{\sim}125$) days, There were two deaths (25%), both of which were due to multi-organ failure. Conclusion: Despite aggressive surgical drainage and appropriate medical management, DNM still had a high mortality rate, Early diagnosis and prompt surgical intervention are key to DNM management. In addition, transcervical drainage should be used in limited disease only.

Short-term Mechanical Circulatory Support with a Centrifugal Pump - Results of Peripheral Extracorporeal Membrane Oxygenator According to Clinical Situation

  • Lee, Woo-Surng;Chee, Hyun-Keun;Song, Meong-Gun;Kim, Yo-Han;Shin, Je-Kyoun;Kim, Jun-Seok;Lee, Song-Am;Hwang, Jae-Joon
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.9-17
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    • 2011
  • Background: A peripheral extracorporeal membrane oxygenator (p-ECMO) has been developed to support patients who are dying due to a serious cardiopulmonary condition. This analysis was planned to define the clinical situation in which the patient benefits most from a p-ECMO. Material and Methods: Between June 2007 and Aug 2009, a total of 41 adult patients used the p-ECMO. There were 23 males and 18 females (mean age $54.4{\pm}15.1$ years). All patients had very unstable vital signs with hypoxia and complex cardiac problems. We divided the patients into 4 groups. In the first group, a p-ECMO was used as a bridge to cardiac operation. In the second group, patients did not have the opportunity to undergo any cardiac procedures; nevertheless, they were treated with a p-ECMO. In the third group, patients mostly had difficulty in weaning from CPB (cardiopulmonary bypass) after cardiac operation. The fourth group suffered from many complications, such as pneumonia, bleeding, infections, and LV dysfunction with underlying cardiac problems. All cannulations were performed by the Seldinger technique or cutting down the femoral vessel. A long venous cannula of $DLP^{(R)}$ (Medtronic Inc, Minneapolis, MN) or $RMI^{(R)}$ (Edwards Lifesciences LLC, Irvine, CA) was used together with a 17~21 Fr arterial cannula and a 21 Fr venous cannula. As a bypass pump, a Capiox emergency bypass system ($EBS^{(R)}$; Terumo, Tokyo, Japan) was used. We attempted to maintain a flow rate of $2.4{\sim}3.0\;L/min/m^2$ and an activated clotting time (ACT) of around 180 seconds. Results: Nine patients survived by the use of the p-ECMO. Ten patients were weaned from a p-ECMO but they did not survive, and the remainder had no chance to be weaned from the p-ECMO. The best clinical situation to apply the p-ECMO was to use it as a bridge to cardiac operation and for weaning from CPB after cardiac operation. Conclusion: Various clinical results were derived by p-ECMO according to the clinical situation. For the best results, early adoption of the p-ECMO for anatomical correction appears important.

Pharmacological Actions of New Wonbang Woohwangchungsimwon Pill on Cardiovascular System (신원방우황청심원의 심혈관계에 관한 약효)

  • 조태순;이선미;김낙두;허인회;안형수;권광일;박석기;김상호;신대희
    • YAKHAK HOEJI
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    • v.43 no.2
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    • pp.237-250
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    • 1999
  • In order to investigate the pharmacologic properties of New Wonbang Woohwangchungsimwon Pill(NSCH), effects of Wonbang Woohwangchungsimwon Pill (SCH) and NSCH were compared using various experimental models. In rat aorta, NSCH and SCH made the relaxation of blood vessels in maximum contractile response to phenylephrine (10-6 M) regardless to endothelium containing or denuded rings of the rat aorta. Furthermore, the presence of the inhibitors of NO synthase and guanylate cyclase did not affect significantly the relaxing effects of NSCH and SCH. NSCH and SCH inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats (SHRs), NSCH and SCH decreased significantly heart rate. These, at high doses, had a negative inotropic effects that was a decrease of left ventricular developed pressure and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In guinea-pig papillary muscle, these had no effects on parameters of action potential such as action potential amplitude (APA), $V_{max}$ and resting membrane potential (RMP) at low doses, whereas inhibitory the cardiac contractility at high doses. Furthermore, these had a significant inhibitory effects on palpitation of the heart in normotensive rats and SHRs. These had a significant inhibitory effects on palpitation of the heart in normotensive rats and SHRs. These results suggest that NSCH and SCH have weak cardiovascular effects, and that there is no significant differences between cardiovascular effects of two preparations.

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Effects of Sasim-tang Water Extract on Blood Pressure and Regional Cerebral Blood Flow Volume in Rats (사심탕(瀉心湯)이 백서(白鼠)의 혈압(血壓) 및 국소(局所) 뇌혈류량(腦血流量)에 미치는 영향(影響))

  • Lee, Kwang-Gyu;Moon, Byung-Sun;Lee, In;Kim, Jin-Su;Lee, Key-Sang
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.417-424
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    • 2000
  • Objective : The purpose of this study was to investigate the effects of Sasim-tang water extract on the cardiovascular systems including changes of blood pressure and regional cerebral blood flow volume (rCBF) in male Sprague-Dawely rats. Methods : The changes of blood pressure were recorded by data acquisition system composed of MacLab and Macintosh computer. The changes of rCBF were observed by Laser-Doppler flowmetry through a opened cranial window. Results : 1. The changes of blood pressure was not affected by Sasim-tang extract intravenous injection in rats. 2. After pretreatment with propranolol(3mg/kg), L-NNA(10mg/kg) and 000(10mg/kg), the changes of blood pressure was not affected by Sasim tang extract intravenous injection in rats. 3. The changes of rCBF was increased in dose-dependent manner by Sasim-tang extract intravenous injection in rats. 4, After pretreatment with propranolol(3mg/kg), ODQ(10mg/kg) and L-NNA(10mg/kg), rCBF was significantly decreased in dose- dependent manner by Sasim-tang extract intravenous injection in rats. Conclusions : These results suggest that Sasim-tang was related to the regulation of the sympathetic nerve system, nitric oxide synthesis and synthesis of cyclic GMP.

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A Study of the Cardiovascular Aging Effect on the Pulse Shape (심혈관 노화가 맥상(脈象)에 미치는 영향)

  • Shin, Sang-Hoon;Rhim, Hye-Whon;Park, Young-Jae;Park, Young-Bae
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.9 no.1
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    • pp.59-68
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    • 2005
  • Background and purpose: Cardiovascular disease will undoubtedly rise along with the aging of the 'baby-boom' generation. The purpose of this study is to find the new index of the cardiovascular aging. Methods: The effects of aging on the heart and the arterial system are surveyed in the point of structure and function. Results: Arterial stiffening is due to the fatiguing effects of periodic stress on the arterial wall and is the main reason for increasing pulse wave velocity. The systolic hypertension is caused by the early return of wave reflection. The increased after-load by the arterial change leads to the development of left ventricular hypertrophy. The reduction in left ventricular compliance cause the impairments of the diastolic function. In contrast to the lower limb, aging effect in the upper limb are almost due to the ascending aortic pressure wave and the reflected wave from the lower limb. Conclusion: We have the following points. (1) The change of physiological pulse pattern by age can be explained by the early returning of reflected wave. (2) The atrial pulse in old age are generated by the left ventricular hypertrophy.

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The Bioinformatics and Molecular Biology Approaches for Vascular Cell Signaling by Advanced Glycation Endproducts Receptor and Small Ubiquitin-Related Modifier

  • Kim, June Hyun
    • Interdisciplinary Bio Central
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    • v.4 no.4
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    • pp.12.1-12.6
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    • 2012
  • The advanced glycation endproducts receptor (AGE-R) is a signal transduction receptor for multiligand such as S100b and AGEs. S100b has been demonstrated to activate various cells with important links to atherosclerosis initiation and progression including endothelial cells, and smooth muscle cells via AGE-R, triggering activation of multiple signaling cascades through its cytoplasmic domain. Many studies have suggested AGE-R might even participate in the cardiovascular complications involved in the pathogenesis of type I diabetes. Recently, Small Ubiquitin-Related Modifier 1 (SURM-1 also known as SUMO-1) has been recognized as a protein that plays an important role in cellular post-translational modifications in a variety of cellular processes, such as transport, transcriptional, apoptosis and stability. Computer Database search with SUMOplot Analysis program identified the five potential SURMylation sites in human AGE-R: K43, K44, K123, and K273 reside within the extracellular domain of AGE-R, and lastly K374 resides with the cytosolic domain of AGE-R. The presence of the consensus yKXE motif in the AGE-R strongly suggests that AGE-R may be regulated by SURMylation process. To test this, we decided to determine if AGE-R is SURMylated in living vascular cell system. S100b-stimulated murine aortic vascular smooth muscle cells were used for western blot analysis with relevant antibodies. Taken together, bioinformatics database search and molecular biological approaches suggested AGE-R is SURMylated in living cardiovascular cell system. Whilst SURMylation and AGE-R undoubtedly plays an important role in the cardiovascular biology, it remains unclear as to the exact nature of this contribution under both physiological and pathological conditions.

Effect of Prostaglandin $F_{2{\alpha}}$ on the Central Regulation of Cardiovascular Effect in Conscious Rat (심혈관계의 중추조절에 대한 Prostaglandin $F_{2{\alpha}}$의 영향)

  • Lee, S.B.;Kim, I.S.;Kim, O.N.;Cho, K.C.
    • The Korean Journal of Pharmacology
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    • v.18 no.1
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    • pp.11-16
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    • 1982
  • This study was carried out in order to clarify whether the cardiovascular effect of prostaglandin(PG) $F_{2{\alpha}}$ might be centrally mediated. In unrestrained conscious rat, $PGF_{2{\alpha}}$ was administered into the lateral ventricle. The mechanism of action was also studied by observing the interaction with several adrenergic antagonists injected subcutaneously, Indomethacin was administered into lateral ventricle to investigate the role of endogenous $PGF_{2{\alpha}}$ on the central regulation of cardiovascular system. The results were as follows: 1) The intraventricular injection of $PGF_{2{\alpha}}$ produced an increase in blood pressure and heart rate. 2) The pretreatment with phenoxybenzamine (2 mg/g, s.c.) inhited pressor, but not heart rate responses to the intraventricular injection of $PGF_{2{\alpha}}$ $(2{\mu}g/kg)$. 3) The pretreatment with propranolol (1 mg/kg, s.c.) inhibited tachycardia, but not pressor responses to the intraventricular injection of $PGF_{2{\alpha}}(2{\mu}g/kg)$. 4) The intraventricular injection of indomethacin $(40{\mu}g/kg)$ could not induce significant changes in blood preesure and heart rate. 5) The result indicates that intraventricular injection of $PGF_{2{\alpha}}$ produces pressor and tachycardia responses in the unanesthetized rat, and it is mediated primarily by centrally increased sympathetic outflow. But the endogenous $PGF_{2{\alpha}}$ synthetized in the brain seems to play minor role in the direct regulation of cardiovascular system.

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Do Opioid Receptors Play a Role in Blood Pressure Regulation?

  • Rhee, H.M.;Holaday, J.W.;Long, J.B.;Gaumann, M.D.;Yaksh, T.L.;Tyce, G.M.;Dixon, W.R.;Chang, A.P.;Mastrianni, J.A.;Mosqueda-Garcia, R.;Kunos, G.
    • The Korean Journal of Pharmacology
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    • v.24 no.2
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    • pp.153-164
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    • 1988
  • The potential role of endogenous opioid peptides (EOPS) in cardiovascular regulation has only recently been entertained. EOPS have been localized in brain, spinal cord, autonomic ganglia, particularly the adrenal gland, and many other peripheral tissues. There are at least five major types of opioid receptors; namely ${\mu},\;{\delta},\;k,\;{\sigma},\;and\;{\varepsilon}$ and Experimental evidence indicates that cardiovascular actions of the peptide are mediated primarily by ${\mu},\;{\delta}$ and k receptors, and that these receptor types may be allosterically coupled. In anesthetized rabbits met-enkephalin decreased blood pressure and heart rate, which closely paralleled a reduction in sympathetic discharge. Naloxone, but not naloxone methobromide, antagonized these effects, which suggests a central site of action of met-enkephalin. A number of autonomic agents, particularly adrenergic ${\alpha}$-and, ${\beta}-agonists$ and antagonists modify the cardiovascular actions of met-enkephalin. Experiments in reserpine-treated and adrenalectomized rats provide no evidence of sympathetic nervous system involvement in the pressor responses to intravenous injection of opioid peptides, but rather suggest a direct peripheral action. Finally, activation of a beta-endorphinergic pathway projecting from the arcuate nucleus to the nucleus tractos solitarii in rats can cause naloxone reversible hypotension and bradycardia. There is evidence to implicate this pathway in antihypertensive drug action and in the modulation of baroreflex activity.

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Design and Implementation of Electrocardiogram Data Interpretation system using AdaBoost Algorithm (AdaBoost 알고리즘을 이용한 심전도 정보 판독 시스템의 설계 및 구현)

  • Lim, Myung-Jae;Hong, Jin-Kyoung;Kim, Kyu-Ho;Choi, Mi-Lim
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.10 no.2
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    • pp.129-134
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    • 2010
  • Diseases such as cardiovascular illnesses, according to the National Statistical Office opened reveals that 600-800 people were killed, blood pressure, arteriosclerosis, heart disease, stroke, etc. will be a flow of blood disorders that occur in cardiovascular illnesses today are fulfilling the Master / Slave samangryulin disease appears high. Died of cardiovascular disease also told them the correct first aid survival when patients are accounted for approximately 40% of emergency rapid response is required. Therefore, this paper, the weak classifier in the AdaBoost algorithm to generate a strong classifier by combining effects throughout the analysis to measure the ECG, and cardiovascular disease that occurred to you as soon as the emergency management system that can deliver on the proposed Desk was. The electrocardiogram data measured by the ZigBee-based sensors, communication devices and emergency transport for emergency alarms in the determination and monitoring of the management desk by providing health services to enable the delivery was fast.

Korean Red Ginseng Water Extract Restores Impaired Endothelial Function by Inhibiting Arginase Activity in Aged Mice

  • Choi, Kwanhoon;Yoon, Jeongyeon;Lim, Hyun Kyo;Ryoo, Sungwoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.2
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    • pp.95-101
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    • 2014
  • Cardiovascular disease is the prime cause of morbidity and mortality and the population ages that may contribute to increase in the occurrence of cardiovascular disease. Arginase upregulation is associated with impaired endothelial function in aged vascular system and thus may contribute to cardiovascular disease. According to recent research, Korean Red Ginseng water extract (KRGE) may reduce cardiovascular disease risk by improving vascular system health. The purpose of this study was to examine mechanisms contributing to age-related vascular endothelial dysfunction and to determine whether KRGE improves these functions in aged mice. Young ($10{\pm}3$ weeks) and aged ($55{\pm}5$ weeks) male mice (C57BL/6J) were orally administered 0, 10, or 20 mg/mouse/day of KRGE for 4 weeks. Animals were sacrificed and the aortas were removed. Endothelial arginase activity, nitric oxide (NO) generation and reactive oxygen species (ROS) production, endothelial nitric oxide synthase (eNOS) coupling, vascular tension, and plasma peroxynitrite production were measured. KRGE attenuated arginase activity, restored nitric oxide (NO) generation, reduced ROS production, and enhanced eNOS coupling in aged mice. KRGE also improved vascular tension in aged vessels, as indicated by increased acetylcholine-induced vasorelaxation and improved phenylephrine-stimulated vasoconstriction. Furthermore, KRGE prevented plasma peroxynitrite formation in aged mice, indicating reduced lipid peroxidation. These results suggest KRGE exerts vasoprotective effects by inhibiting arginase activity and augmenting NO signaling and may be a useful treatment for age-dependent vascular diseases.