• Journal of Chest Surgery
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• v.3 no.2
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• pp.73-90
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• 1970

Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.37-45
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• 2006

The use of music as a means of inducing positive emotions and subsequent relaxation has been extensively studied by researchers. A great deal of this research has focussed on the use of music as a means of reducing feelings of anxiety and stress as well as aiding in the relief of numerous pathologies. The purpose of this study was to evaluate this effect of music using laser doppler flowmeter that monitors relative changes in the muscular blood cell perfusion, concentration of moving blood cells, mean velocity of the myofascial pain disorder patients. Total of 30 subjects were selected. They were monitored by LDF(Laser Doppler Flowmeter) during music listening for 3 minutes. LDF probe was placed over the temporalis muscle. The obtained results were as follows: 1. The average blood perfusion for 3 minutes of music listening at surface of temporalis muscles were elevated on both affected and unaffected parts compared to rest time. 2. The average of blood perfusion elevated during music listening at surface of temporalis muscles were higher in affected part than unaffected part. 3. Increase of blood perfusion during music listening is proportioin to that before music listening. In summary, these results may encouraging start to the elucidation of the hemodynamic events occuring during music listening and aimed to serve as a base for further studies.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.473-480
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• 2005

Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.280-286
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• 2009

Purpose: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. Materials and Methods: Eight patients (3 men and 5 women, 64.8$\pm$10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. Results: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1$\pm$2.2 ml/min/100 g and -2.1$\pm$2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3$\pm$2.9 ml/min/100 g, p =0.025 and 0.1$\pm$1.3%, p =0.036). Conclusion: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPEG would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.

• The Korean Journal of Pharmacology
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• v.31 no.1 s.57
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• pp.95-102
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• 1995

The pathogenesis of diabetic nephropathy is still not completely understood while renal disease is one of the most common disabling complications of diabetes. We, in the present study, investigated the possible involvement of oxidative stress in the development of diabetic nephropathy. To hasten the development of diabetic nephropathy, streptozotocin was injected to unilaterally nephrectomized rats (NEPH-STZ). Eight weeks later, NEPH-STZ rats developed severe hyperglycemia, proteinuria, and hypertension. The kidneys of these rats showed compensatory hypertrophy and mesangial expansion. In contrast, the rats with streptozotocin injection alone (STZ) did not increase urinary protein excretion. Nephrectomized non-diabetic rats (NEPH) developed increased urine protein excretion, but without prominent renal morphological changes. However, oxidation of renal cortical tissue protein significantly increased in all 3 groups of NEPH, STZ and NEPH-STZ in comparison to control rats (CONT). The result indicates the non-specificity of the oxidative tissue damage and suggests that the oxidative damage is hardly a sole mechanism leading to the development of the diabetic nephropathy. However, it would still be a contributing factor considering that the oxidative stress is a common final pathway mediating tissue damages in chronic diabetic complications and other serious illness.

• Journal of Acupuncture Research
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• v.21 no.2
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• pp.167-181
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• 2004

Objective : Carthami Flos has been used as a herb to promote blood circulation to remove blood stasis in oriental medicine for many centuries. To investigate treatment of cerebral vascular disease(CVA) by promoting blood circulation and removing blood stasis(活血化瘀法), we observed the experimental Effects of Aqua-Acupuncture of Carthami Flos on the Regional Cerebral Blood Flow and Mean Arterial Blood Pressure in Rats. Method : When aqua-acupuncture of Carthami Flos(ACF) was injected into LI4, Liv3, B23, B62, GV16, experimental effects of ACF on the regional cerebral blood flow(rCBF) and mean arterial blood pressure(MABP) is not known. Therefor, this study was designed to investigate the effects of ACF on the change of cerebral hemodynamics. The changes of rCBF and MABP were tested by Laser Doppler Flowmetry(LDF). Results : When ACF was injected into LI4, change of rCBF and MABP were decreased in a injected time-dependent manner. When ACF was injected into Liv3, change of rCBF and MABP were decreased in a injected time-dependent manner. When ACF was injected into B23, change of rCBF was significantly increased in a injected time-dependent manner, MABP did not change. When ACF was injected into B62, change of rCBF was increased in a injected time-dependent manner, change of MABP was significantly decreased after injection 60min. When ACF was injected into GV16, change of rCBF and MABP were similar to the change of normal. Conclusions : In conclusion, I suggested that ACF(LI4, Liv3) has an effect that depress the blood pressure & cerebral hemodynamic acceleration and ACF(B23, B62) has an anti-ischemic effect through the improvement of crebral hemodynamics.

• Neonatal Medicine
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• v.25 no.2
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• pp.78-84
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• 2018

Purpose: To investigate the hemodynamic risk factors for necrotizing enterocolitis (NEC), we analyzed the characteristics of descending aorta (DA) blood flow in preterm neonates, who later developed NEC. Methods: This was an observational case-control study on 53 preterm neonates at a tertiary referral center. Clinical and echocardiographic data were collected from 23 preterm neonates with NEC (NEC group), and compared with those of 30 preterm neonates without NEC (control group). Echocardiography was done at a median (interquartile range) of 5 (3-9) days after birth and 2 (1-2.5) days before the diagnosis of NEC. Results: Basic clinical characteristics including gestational age, birth weight, Apgar score, breast feeding status, use of umbilical catheters, and mode of invasive ventilator care were similar between the groups. Compared with the control group, the lowest diastolic velocity of DA was significantly decreased, whereas the diastolic reverse flow and the ratio of diastolic reverse to systolic forward flows were significantly increased in the NEC group. In addition, the resistive index (RI) of DA was significantly increased in the NEC group and showed a positive association with the development of NEC. Multivariate logistic regression analysis showed that increasing RI of DA was an independent risk factor for the development of NEC (P=0.008). Conclusion: Significant changes in DA flow characteristics including decreased diastolic velocity and increased diastolic reverse flow along with increased peripheral vascular resistance were observed before the development of NEC in preterm neonates. These findings may help clinicians stratify in advance neonates at a risk of developing NEC and may help improve outcomes in these neonates.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.547-554
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• 2010

Purpose: The purpose of this study is to delineate the optimal time of venous revascularization for preventing the flap necrosis due to venous occlusion, and to clarify the usefulness of tissue oxygen pressure ($TcpO_2$) in the determination of the point of time for venous revascularization. Methods: Thirty-six, $3{\times}3\;cm$ sized epigastric island flap was elevated in left abdomen of male Sprague-Dawley rat weighing 250 gram. Flaps were randomly assigned to six groups of six flaps according to the duration of venous occlusion with microvascular clamp; 10 minutes in the group I as the control, 60 minutes in the group II, 2 hours in the group III, 3 hours in the group IV, 4 hours in the group V, and 6 hours in the group VI, respectively. Just before removal of clamp after flap was reposed in situ, the ratio of $TcpO_2$ (tissue oxygen pressure) of the island flap to that of right abdomen was calculated in each group, and tissue specimen was harvested from the distal area of the flap for histological evaluation of vascular change. Five days later, survival area of the flap was estimated, and evaluated the correlation between the tissue oxygen pressure and the rate of flap survival. Results: The $TcpO_2$ and the survival rate of flap were decreased proportionally with the duration of venous occlusion. The ratio of the $TcpO_2$ of the flap is decreased abruptly to below sixty percentile compared to the $TcpO_2$ of normal tissue, and the survived area of the flap is decreased to nine-tenth of the designed size after three hours of total venous occlusion. Histologically, the number of congested vessels was increased according to venous occluded time, and proportionally increased after 3-hours of occlusion significantly. Conclusion: There is a close correlation between the $TcpO_2$ and the survival rate of flaps according to the duration of venous occlusion. Therefore, the $TcpO_2$ represents the hemodynamic changes within the flap, and thought to be an alternative effective tool in the flap monitoring for venous revascularization.

• Journal of Veterinary Clinics
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• v.27 no.2
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• pp.136-141
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• 2010

The aim of this study is to investigate whether medetomidine (MED) and tiletamine/zolazepam (ZT) combination in dogs provide the sufficient analgesia during the period of the stage of surgical anesthesia determined by the response to the noxious stimuli, which were evaluated by the change of electroencephalogram (EEG) and hemodynamic values. Seven clinically healthy, adult beagle dogs were used. They were used repeatedly at interval of a week, according to a randomized design. This study had 2 experimental groups. In Group 1, dogs received $30\;{\mu}g/kg$ of medetomidine and 10 mg/kg of tiletamine/zolazepam. Both drugs were administered intramuscularly. In Group 2, dogs were medicated with the same method as in Group 1, except the pedal withdrawal reflex test was done. In Group 2, interdigital regions were grasped with a mosquito forceps for 30 seconds, every 5 min from 10 min to 45 min after ZT injection. During all recording stages, the power for each band, mean arterial pressure and heart rates were calculated. On EEG, no significant changes were observed between groups. Although mean arterial pressure and heart rate were increased 10 min after ZT injection, no significant differences were observed between groups. In conclusion, the MED and ZT anesthesia in dogs are seemed to provide a satisfactory analgesic effect during the period of surgical anesthesia based on EEG with pedal withdrawal reflex test.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.425-446
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• 1988

After 24 hours of preservation under 15 mmHg perfusion pressure the recovery rates of isolated canine hearts were determined. Preservation was performed in a cold room maintained at 4*C with 4 different types of perfusates bubbled with a mixture of 95% 0y and 5% CO~ using a modified perfusion unit designed in our institute. The perfusates used were as follows; Group 1: Krebs-Henseleit solution, Group 2: Krebs solution added by albumin and PGE1. Group 3: Modified Wicomb*s solution, Group 4: Modified Collin*s solution. The extent of myocardial recovery was evaluated using a modified isolated carmine perfusion model by measuring heart rate, systolic arterial pressure, left atrial pressure[LAP] and cardiac output. In addition to the above hemodynamic parameters, biochemical and enzymatic assays from perfusates and electron microscopic changes of the myocardium were also studied. The results were as follows; 1] The heart recovery rates were 41.6%, 53.4% and 108.9% in groups 1, 2 and 3, respectively, and group 3 elicited the best result[p< 0.001]. The heart beat was never recovered in group 4. 2] Recovered systolic arterial pressures[mmHg] were 63.3% in group 1, 94.9% in group 2 and 94.3% in group 3. 3] LAPs[mmHg] were 20 in group 1, 13.5 in group 2 and 11.2 in group 3, which suggested that the best myocardial preservation was elicited in group 3[p< 0.05]. 4] Cardiac output, the sum of aortic stroke volume and coronary leakage, were 69.1% in group 2, and 90.7% in group 3, but these were not statistically significant[p=0.24]. No aortic stroke output was measured in group 1 and 4. 5] The degree of myocardial edema increase was 17.5` in group 1, 24.6% in group 2, 20.9% in group 3 and 55.3% in group 4. But there were no statistical differences in each group[p= 0.08]. 6] CPK-MB[U/L] levels were increased 750% and 332%[p< 0.05], glucose levels[mg/dl] 60.5% and 78.2% and SGOT[U/L] levels 523% and 333%, in groups 2 and 3, respectively. Biochemical and enzymatic assays could not be performed in group 1 and group 4, because of poor recovery of heart beat. 7] Electron microscopic findings in the myocardium of most groups revealed slight to moderate muscle cell and mitochondrial edema. But all these findings were within the limits of reversible change. From these above results, it is suggested that modified Wicomb*s solution seems to be the most useful physiologic salt solution for preservation of the heart. We propose that after further study and improvement, our portable continuous hypothermic perfusion system will contribute to the development of a better preservation method for donor hearts for human heart transplantation.