• Title/Summary/Keyword: cardiovascular system

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Influence of the Central Benzodiazepinergic System on Peripheral Cardiovascular Regulation

  • Koh, Jeong-Tae;Ju, Jeong-Min;Shin, Dong-Ho;Cho, Han-Ho;Choi, Bong-Kyu;Kim, Jae-Ha
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.3
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    • pp.287-295
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    • 1998
  • Diazepam is known to have cardiovascular depressive effects through a combined action on benzodiazepinergic receptor and the GABA receptor-chloride ion channel complex. Moreover, it is known that barbiturates also have some cardiovascular regulatory effects mediated by the central GABAergic system. Therefore, this study was undertaken to delineate the regulatory actions and interactions of these systems by measuring the responses of the cardiovascular system and renal nerve activity to muscimol, diazepam and pentobarbital, administered intracerebroventricularly in rabbits. When muscimol $(0.03{\sim}0.3\;{\mu}\;g/kg)$, diazepam $(10{\sim}100\;{\mu}\;g/kg)$ and pentobarbital $(1{\sim}10\;{\mu}\;g/kg)$ were injected into the lateral ventricle of the rabbit brain, there were similar dose-dependent decreases in blood pressure (BP) and renal nerve activity (RNA). The relative potency of the three drugs in decreasing BP and RNA was muscimol > pentobarbital > diazepam. Muscimol and pentobarbital also decreased the heart rate in a dose-dependent manner; however, diazepam produced a trivial, dose-independent decrease in heart rate. Diazepam $(30\;{\mu}g/kg)$ augmented the effect of muscimol $(0.1\;{\mu}g/kg)$ in decreasing blood pressure and renal nerve activity, but pentobarbital $(3\;{\mu}g/kg)$ did not. Bicuculline $(0.5\;{\mu}g/kg)$, a GABAergic receptor blocker, significantly attenuated the effect of muscimol in decreasing BP and RNA, either alone or with diazepam, and that of pentobarbital in decreasing BP and RNA, either alone or with muscimol. We inferred that the central benzodiazepinergic and barbiturate systems help regulate peripheral cardiovascular function by modulating the GABAergic system, which adjusts the output of the vasomotor center and hence controls peripheral sympathetic tone. Benzodiazepines more readily modulate the GABAergic system than barbiturates.

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Intracardiac Foreign Body (Bone Cement) after Percutaneous Vertebroplasty

  • Yang, Jun Ho;Kim, Jong Woo;Park, Hyun Oh;Choi, Jun Young;Jang, In Seok;Lee, Chung Eun
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.72-75
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    • 2013
  • Percutaneous vertebroplasty is a relatively easy and minimally invasive procedure used in treating vertebral fractures. However, the procedure has many complications, one of which is bone cement leakage, which happens frequently. Leakage to the paravertebral venous system, in particular, may lead to especially devastating consequences. Here we report a case of a 65-year-old male patient with an intracardiac foreign body (bone cement) that generated a perforation on the right ventricle, and result in hemopericardium after percutaneous vertebroplasty. We performed open heart surgery to remove the foreign body.

Anomalous origin of left coronary artery arising from the right coronary cusp presenting with chest discomfort and syncope on physical exercise (12세 여아에서 운동 중 발생한 흉통 및 실신 - 왼쪽 주 관상동맥의 이상 기시의 진단 및 수술적 치료 1례)

  • Baik, Ran;Kim, Nam Kyun;Park, Han Ki;Park, Young Hwan;Yoo, Byung Won;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.248-252
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    • 2010
  • Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.

Repair of the Subarterial Type of VSD via a Left Minithoracotomy with using AESOP - A case report - (AESOP을 이용한 좌측 최소개흉술하 동맥하형 심실중격 결손증 교정술 - 1예 보고 -)

  • Moon, Duk-Hwan;Lee, Jae-Won;Cho, Hyun-Jin;Je, Hyoung-Gon;Jung, Sung-Ho;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.630-632
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    • 2008
  • Minimally invasive cardiac surgery using AESOP (Automated Endoscope System for Optimal Positioning) offers certain advantages such as better a cosmetic outcome, a shortened post operative recovery time and a shorten hospital stay, and these advantages are not achieved by conventional cardiac surgery. We report here on our first robot-assisted (AESOP) left minithoracotomy surgery in a 26 year-old female with a subarteral ventricular septal defect, and this might have been treated by median sternotomy before the development of AESOP.

Endocarditis with Intracardiac Migration of Transvenous Permanent Pacing Lead - 1 Case Report - (영구 경정맥 심박조율도관의 심장내 이동과 동반된 심내막염 - 1례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.831-834
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    • 2002
  • When any part of the pacemaker system is infected, all pacemaker hardware should be removed, because reinfection rates of 51% to 77% have been noted in patients whose infected pacemaker system has been only partially explanted. The removal of infected leads during cardiopulmonary bypass prevents mechanical injury as well as the spread of infection and vegetation. We report one case of endocarditis by staphylococcus aureus with infected transvenous pacing lead which was migrated into the heart from the left subclavian vein. We removed the migrated pacing lead and vegetation under cardiopulmonary bypass.

Completely Port-Accessed Atrial Septal Defect Patch Closure Using the da Vinci System (다빈치 로봇을 이용한 포트 접근에 의한 심방중격 결손 폐쇄 수술)

  • Kim, Gwan-Sic;Lee, Jae-Won;Jung, Sung-Ho;Kim, Joon-Bum;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.409-412
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    • 2010
  • We have experienced five cases of atrial septal defect closure under complete port access using the da Vinci system. We used only six 8∼12 mm ports without thoracotomy or sternotomy for operation.

The effectiveness of oriental medical therapy compared to oriental-western medical therapy on acute bell's palsy (급성기 말초성 안면신경마비에 대한 한방치료와 한양방 병용치료의 효과비교)

  • Cho, Ki-Ho;Jung, Woo-Sang;Hong, Jin-Woo;Hwang, Jae-Woong;Na, Byung-Jo;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.29 no.1
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    • pp.146-155
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    • 2008
  • Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

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Characteristics of Cardiovascular Adverse Drug Reactions Reported to KFDA (식품의약품안전청에 보고된 심혈관계 약물유해반응의 특성 분석)

  • Rhew, Ki-Yon;Cho, Hea-Kyoung;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.41-46
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    • 2012
  • Adverse drug reaction (ADR) is a global problem of major concern in health care. ADRs can be accrued in any organs or systems. However, cardiovascular ADRs could be a more serious problem if they are irreversible or severe. For this reason, this study was conducted to analyze pattern and severity of cardiovascular ADRs, and suspicious medication. Total 646 reports including cardiovascular ADRs reported to the KFDA between January and June 2010 were analyzed. Amlodipine besylate (36 reports, 3.3%), iopromide (29 reports, 2.7%), tramadol HCl (28 reports, 2.6%) were most suspicious drugs that occurred cardiovascular ADRs. The most common cardiovascular ADRs were hypotension( 236 reports, 33.1%), palpitation (134 reports, 18.8%), and hypertension (89 reports, 12.5%). The most frequent ADRs were occurred in the age group of more than 60. This result could be of help to prescribers and other healthcare providers to predict and prevent cardiovascular ADRs. Also this study suggested that patients with cardiovascular ADR risk factors should be intensively monitored during the medications.

A Risk Prediction Model for Operative Mortality after Heart Valve Surgery in a Korean Cohort

  • Kim, Ho Jin;Kim, Joon Bum;Kim, Seon-Ok;Yun, Sung-Cheol;Lee, Sak;Lim, Cheong;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Lee, Seung Hyun;Yoo, Jae Suk;Sung, Kiick;Je, Hyung Gon;Hong, Soon Chang;Kim, Yun Jung;Kim, Sung-Hyun;Chang, Byung-Chul
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.88-98
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    • 2021
  • Background: This study aimed to develop a new risk prediction model for operative mortality in a Korean cohort undergoing heart valve surgery using the Korea Heart Valve Surgery Registry (KHVSR) database. Methods: We analyzed data from 4,742 patients registered in the KHVSR who underwent heart valve surgery at 9 institutions between 2017 and 2018. A risk prediction model was developed for operative mortality, defined as death within 30 days after surgery or during the same hospitalization. A statistical model was generated with a scoring system by multiple logistic regression analyses. The performance of the model was evaluated by its discrimination and calibration abilities. Results: Operative mortality occurred in 142 patients. The final regression models identified 13 risk variables. The risk prediction model showed good discrimination, with a c-statistic of 0.805 and calibration with Hosmer-Lemeshow goodness-of-fit p-value of 0.630. The risk scores ranged from -1 to 15, and were associated with an increase in predicted mortality. The predicted mortality across the risk scores ranged from 0.3% to 80.6%. Conclusion: This risk prediction model using a scoring system specific to heart valve surgery was developed from the KHVSR database. The risk prediction model showed that operative mortality could be predicted well in a Korean cohort.

Score System for Operative Risk Evaluation in Coronary Artery Bypass Surgery (관상동맥 우회로술의 수술 위험인자에 대한 스코어 시스템)

  • Kang Joon-Kyu;Kim Chong-Wook;Sheen Seung-Soo;Chung Cheol-Hyun;Lee Jae-Won;Song Meong-Gun;Lee Jung-Sook;Song Hyun
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.749-753
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    • 2006
  • Background: The purpose of this study is to assess a score system for operative risk evaluation of CABG. Material and Method: From January 2001 to September 2005, retrospective study for various perioperative factors of 2993 cases was done. Result: The early operative mortality was 2.4% and the beta coefficients of 7 core variables related to it (preoperative LV dysfuction, preoperative renal failure, MI within 1 week, reoperation, combined surgery, preoperative atrial fibrillation, preoperative IABP) were adjusted to score system. ROC curve and Hosmer and Lemeshow goodness of fit test was done. Conclusion: This score system was effective in assessing operative risk of CABG. But It is necessary to gather larger volume of case and perform multicenter study.