• 대한핵의학회지
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• 제31권1호
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• pp.36-42
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• 1997

관동맥우회로술을 실시하고 심근 SPECT를 수술전과 수술 후 3개월에 실시한 44명의 환자(남:여=25:19, 나이 $57.1세{\pm}8.2$)를 대상으로 악화된 심근 관류를 분절과 관상동맥영역의 수준에서 분석하였을 때 분절의 수준에서는 LCx영역에 있는 분절들이 유의하게 악화되었으나[odds ratio=2.54 (95% 신뢰구간. 1.53-4.22, p<0.01)] 영역의 수준에서는 LCx가 관류악화의 위험 인자는 아니었다. 혈관이식편의 종류와 관상동맥성형술 여부도 심근 관류 악화에 영향을 끼치지 못했다. 결과로 aortic cross clamp time이나 심폐우회시간, 원래 mid-LAD의 직경 등 알려진 수술전후 심근경색의 위험 인자들에 대한 데이터를 종합하여 심근 SPECT의 관류 악화를 평가하여야 하며 이 연구는 수술전후 심근경색을 연구하는 기본적인 데이터로 쓰일 수 있다고 생각하였다.

• Journal of Chest Surgery
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• 제22권4호
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• pp.609-619
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• 1989

During aortic valve surgery, cardioplegic solution is delivered through direct cannulation of both coronary ostia. Since this approach may cause an intimal injury leading to acute dissection or late ostial stenosis, this study was undertaken to evaluate myocardial protective effect of retrograde perfusion of cardioplegia [RCSP <% RRAP] in 18 clinical cases, which were compared with antegrade perfusion of cardioplegia in 27 clinical cases. This study were investigated 1] cease and return of electromechanical activity after cardioplegia infusion 2] the myocardial temperature during operation 3] the aortic cross clamping time and total bypass time 4] frequency of DC shock for defibrillation 5] need for inotropic drugs after operation 6] electrocardiographic evidence of myocardial infarction or ventricular arrhythmia after operation 7] the enzymes activity during preoperative and postoperative period as an evaluation of myocardial ischemic injury and 8] operative mortality rate The combination of retrograde cardioplegia and topical cooling with ice slush yielded promptly hypothermia of myocardium and shorter aortic cross-clamping time compared with antegrade cardioplegia [P < 0.05]. The temperature of the interventricular septum was maintained below 20oC by continuous perfusion or intermittent perfusion of cold blood cardioplegia and other results were no statistically significant difference between the two methods [P >0.05]. This technique provides clear operative field and avoids some serious complications which are caused by coronary ostial cannulation. These results suggested that the retrograde perfusion of cardioplegia is a simple, safe, and effective means of myocardial protection during open heart surgery.

• Journal of Chest Surgery
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• 제3권2호
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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.

• 대한핵의학회지
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• 제30권1호
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• pp.86-94
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• 1996

디피리다몰부하 및 휴식기 심근 SPECT를 통해 수술결과를 평가하였다. 수술전 관류감소를 보이는 분절들의 74%에서 심근관류가 호전되었으며 중증 지속적 관류결손을 보였던 분절도 일부(43%) 수술후 관류가 호전되었다. 관상동맥영역별로는 62%의 영역이 수술후 관류가 호전되었으며, 환자예를 기준으로 하면 수술환자 47%가 수술후 심근관류가 호전되었다. 수술전에 정상이었던 관류가 악화된 예와 수술전 관류보다 나빠진 관류소견을 보이는 예가 있었다. 수술대상 관상동맥을 결정하는데 수술전 부하/심근 SPECT를 참고하여야 할 것인지 조사하여야 한다고 생각하였다.

• 대한핵의학회지
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• 제32권4호
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• pp.314-324
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• 1998

목적: 이 연구의 목적은 어린이 모야모야병 환자에서 휴식기/아세타졸아미드 부하 Tc-99m-HMPAO SPECT가 Encephalo-duro-arterio-synangiosis (EDAS) 수술 후의 호전여부를 평가할 수 있는지를 알아보고자 함이었다. 대상 및 방법: 어린이 모야모야병 18명에서 21개의 대뇌반구에 EDAS 수술을 하였다. 수술 전과 수술 후 3개월에 휴식기/아세타졸아미드 부하 Tc-99in-HMPAO SPECT를 시행하여 휴식기관류와 관류예비능을 평가하여 비교하였다. 결과: 대뇌반구 모두에서 휴식기관류 또는 관류예비능 감소가 관찰되었다. 84개 뇌엽과 294개 영역 중52%의 뇌엽과 50%의 영역에 관류이상이 나타났다. 수술 후 휴식기 관류 또는 관류예비능이 감소한 영역의 60%가 호전되었고 반구는 71%가 호전되었다. 수술 전 휴식기 관류 감소가 심하지 않았을 때 수술후 호전가능성이 높았다. 수술 전 휴식 부하기 관류의 차이가 있는 경우 즉 관류예비능이 감소하였을 때 수술 후 관류 호전 가능성이 높았다. 결론: 어린이 모야모야병에서 수술 전 휴식기/아세타졸아미드 Tc-99m-HMPAO SPECT로 수술 후 호전여부를 예측할 수 있다.

• KSBB Journal
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• 제13권3호
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• pp.259-267
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• 1998

Optimal feeding strategies in bioreactor operation of Scutellaria baicalensis G. plant cell culture were investigated to maximize the production of flavone glycosides by using a structured kinetic model which can predict culture growth and flavone glycosides synthesis in a rigorous, quantitative manner. For the production of baicalin and wogonin-7-0-GA, the strategies for glucose feeding into Scutellaria baicalensis G. plant cell culture were proposed based on the model, which are a periodic fed-batch operation with maintenance of cell viability and of specific production rate respectively, and a perfusion operation with maintenance of specific production rate for baicalin and wogonin-7-0-GA. Simulation results showed that the highest volumetric concentration of flavone glycosides was obtained in a periodic fed-batch operation with maintenance of cell viability among all the suggested strategies. In the periodic fed-batch operations, the higher volumetric production of flavone glycosides was achieved compared with that in the perfusion operation. It can be concluded that a periodic fed-batch operation with maintenance of cell viability would be the optimal and practical operating strategy of Scutellaris baicalensis G. plant cell culture for the production of flavone glycosides.

• 한국미생물·생명공학회지
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• 제18권1호
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• pp.61-65
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• 1990

Murine hybridoma 세포배양시 lectin 계통의 생산 증진제가 무혈청 배지의 단계적 유입에 의해 약 40mg/l의 단일항체를 생산함으로서 단일항체의 생산성을 증가시킬 수 있음이 확인됐으며, 또한 이 배양공법으로 무혈청 배지에서 연속배양이 불가능한 세포의 배양이 가능했다. 이같은 무혈청 배지의 단계적 유입공법으로 약 28 x $10^{-10}$mg/cells/h의 속도로 단일항체가 생산된 것에 비해, 10 혈청이 포함된 배지로는 연속 배양시 11.1 x $10^{-10}$mg/cells/h 의 속도로 생산됐으며 회분배양의 경우는 4.0 x $10^{-11}$mg/cells/h의 속도로 생산됐다.

• Journal of Chest Surgery
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• 제7권2호
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• pp.189-200
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• 1974

The mitral valve replacement with Beall prosthetic valve was performed on three patients, and double valve replacement. aortic and mitral valve, was performed in this department.1) The preoperative studies about the first case were compatible with mitral steno-insufficency.The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary hypass using hypothermic hemodilution technique. The total perfusion time was eighty minutes. Immediate postoperative course was smooth, but this patient was died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation. Autopsy on this patient revealed that no thrombus and no ball variance could be found, and endothelization on the valve cuff was satisfactory. 2) The preoperative studies on the second case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary bypass using hypothermic hemodilution technigue. The total perfusion time was 123 minutes. This patient was discharged in good condition and follow-up study after 16 months revealed the patient had enjoyed healthy life. 3) The preoperative studies about the third case were compatible with aortic insufficiency and mitral stenoinsufficiency. The diseased valves were replaced with type 2 sutureless Magovern aortic valve and the medium sized Beall mitral prosthesis under cardiopulmonary bypass using hypothermic hemodilution technIque and coronary artery perfusion. The total perfusion time was 155 minutes. This patient was discharged in good condition, but thromboembolism was developed 2 months after discharge. 4) The preoperative studies about the fourth case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve. The total perfusion time was 132 minutes. The atrioventricular block developed just after operation but converted to normal sinus rhythmn on the third postperative day. The preoperative NYHA functional classification IV was converted to Class 1 or 11 at the time of discharge and this patient enjoyed healthy life. Attendum; The fifth case, nineteen years old male with mital insufficiency underwent Beall valve replacement and his course was uneventful 2 weeks after operation.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1679-1682
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• 2008

Pulsatile Extracorporeal Membrane Oxygenation(ECMO) can mitigate the heart load and raise the patient's blood perfusion. But If the ECMO pulsate the blood flow during the systolic period, It can burden to the patient's heart. To avoid the heart injury, we have to consider the relation between output of ECMO, hemodynamic states and heart movement. To raise the efficacy of the pulsatile ECMO, we investigated the coronary perfusion, cardiac muscle tension and hemodynamic states during the ECMO perfusion by using the mathematical model of human blood circulatory system and ECMO. The outflow data of the pulsatile ECMO(T-PLS, Bioheartkorea, Korea) was obtained in vitro experiments. According to the phase and pumping rate of the ECMO, the heart's load and coronary perfusion could be adjusted to the proper levels. The results of the human- ECMO lumped parameter model showed that the synchronizing operation of the pulsatile ECLS can be helpful at stabilizing the patient's hemodynamic states.

• 대한핵의학회지
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• 제34권5호
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• pp.426-432
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• 2000

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.