• 약학회지
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• 제37권6호
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• pp.605-614
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• 1993

To investigate the endothelial dependence of angiotensin II(A II)-induced responses in the systemic and pulmonary arterial system of acute renal hypertensive rats of 2-kidney, 1-ligation type (RHRs), A II-induced vasocontractile and pressor effects were evaluated in isolated arteries and in vivo, respectively. A II dose-dependently contracted intact thoracic aorta and pulmonary artery (E$_{max}$:40% at 10$^{-7}$M and 80% at 3$\times$10 $^{-8}$M, respectively) from normotensive rats(NRs), which was significantly increased by removal of endothelial cells or pretreatment with EDRF inhibitors. In NRs, A II increased mean systemic and pulmonary arterial pressure(33 and 5.6mmHg at 0.1 $\mu\textrm{g}$/kg, respectively), the effect being significantly increased (P<0.01) by L-NAME(30mg/kg, i.v.). However, A II-induced contraction of intact thoracic aorta and pulmonary artery(E$_{max}$: 33% at 10$^{-7}$M and 93% at 3$\times$10$^{-8}$M, respectively) from RHRs were not changed after endothelial function was disrupted as above; similarly, pressor effects of A II on the systemic and pulmonary arterial pressure in RHRs did not altered by L-NAME. A II tachyphylactic responses for intact thoracic aorta from NRs and RHRs(65 and 87% at 10$^{-8}$M, respectively) were greater than those for pulmonary artery(19 and 19% at 10$^{-8}$M, respectively). Distruption of endothelial function significantly (P<0.01) depressed A II tachyphylaxis for thoracic aorta, but not for pulmonary artery. These results suggest that vascular reactivity to A II is not altered in RHRs, and it is greater for pulmonary arterial system than for systemic arterial system. A II reactivity is EDRF-dependent in both arterial systems of NRs, but EDRF-independent for RHRs. Finally, EDRF is one of the major factors underlying A II tachyphylaxis for thoracic aorta, but not for pulmonary artery.

• Archives of Pharmacal Research
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• 제20권5호
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• pp.389-395
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• 1997

We investigated the interaction between nitric oxide and the renin angiotensin system in regulating isolated pulmonary arterial tension and pulmonary arterial pressure (PAP) in renal hypertensive rats (RHR) made by complete ligation of left renal artery. Losartan induced a depressor response that was smaller in RHR than in normotensive rats (NR) (3.3 and 7.0 mmHg, respectively, at 3.0 mg/kg, p<0.05), and the response was significantly reduced by $N^{G}$-nitro-Larginine methyl ester (L-NAME). Angiotensin II elevated the PAP (7.6 and 10.8 mmHg at $0.1 {\mu}g/kg$; 20.3 and 23.6 mmHg at $1.0{\mu}g/kg$, respectively) and contracted the isolated pulmonary artery ($pD_2$: 8.79 and 8.71, respectively) from both NR and RHR with similar magnitude, and these effects were significantly enhanced by L-NAME in NR, but not in RHR. Acetylcholine lowered the PAP slightly less effectively in RHR than in NR (3.8 and 6.0 mmHg at 10 .mu.g/kg, respectively) and relaxed the pulmonary artery precontracted with norepinephrine in both rats with similar magnitude ($E_max$: 60.8 and 63.6%, respectively), and the effect being completely abolished after pretreatment.with L-NAME or removal of endothelial cells. These results suggest that nitric oxide interacts with renin angiotensin system to control the pulmonary vascular tension and pulmonary arterial circulation of RHR.R.

• 대한약리학회지
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• 제29권2호
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• pp.213-223
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• 1993

급성 신성 고혈압쥐 (2-kidney, 1-ligation type)의 전신성 동맥계와 폐 동맥계에 대한 내피 의존적 혈관반응성을 규명하기 위하여, 적출 혈관 및 마취상태의 흰쥐에 대한 acetylcholine (ACh)의 혈관이완작용 및 혈압강하 작용을 측정하였다. 혈장 renin 활성(PRA)은 신동맥 결찰전 $7.31{\pm}0.63\;ng/ml/hr$ A I에 비해 결찰 $6{\sim}8$일후에는 $19{\sim}22\;ng/ml/hr$ A I으로 유의성있게 증가하였으며, 이는 수축기혈압의 상승과 $(154{\pm}1.83{\rightarrow}190{\sim}215\;mmHg)$ 일정한 상관성을 유지하였다. 신성 고혈압쥐 및 정상 혈압쥐의 흉곽 대동맥은 내피세포 존재시 ACh에 의해 용량의존적으로 이완되었으며, 이때 신성고혈압쥐에서의 반응은 정상 혈압쥐에 비해 유의성있게 감소하였다(각각 34% 및 86%, p<0.01). 또한 ACh은 신성 고혈압쥐 및 정상 혈압쥐의 폐동맥에 대해서도 내피세포 존재시에 이완반응을 초래하였다. 그러나, 흉곽 대동맥에서와는 달리 두 군간에 유의성있는 차이가 없었다. 이들 반응은 내피세포 제거후 또는 EDRF 억제제 (L-NAME, MB, $10^{-5}$ M) 투여후 유의성있게 억제되었다. $ACh(0.1{\sim}10\;{\mu}g/kg,\;i.v.)$은 신성 고혈압쥐 및 정상 혈압쥐에서 전신성 동맥압의 강하를 초래하였는데, 신성 고혈압쥐에서 다소 감소하였으나 유의성있는 차이는 없었으며 ($SAPm;\;10\;{\mu}g/kg$에서 각각 39%, 46 %), 이들 작용은 L-NAME(30 mg/kg, i.v.) 전처치후 유의성있게 억제되었다. ACh에 의한 폐동맥압 강하는 신성 고혈압쥐 및 정상 혈압쥐 사이에 서로 비슷하게 나타났다. 그러나, 신성 고혈압 쥐 및 정상 혈압쥐에서 ACh에 의한 폐동맥압의 강하율은 전신성 동맥압의 강하율보다 유의성있게(p<0.01) 작았으며, 또한 L-NAME $(0.1{\sim}100\;mg/kg,\;i.v.)$에 의한 폐동맥압의 상승은 전신성 동맥압의 상승보다 유의성있게(p<0.01) 작았다. 이상의 실험 결과들은 급성 신성 고혈압쥐의 전신성 동맥계에서는 내피세포 손상이 초래되지만, 폐동맥계에서는 초래되지 않는다는것을 제시해준다. 또 신성고혈압쥐 및 정상 혈압쥐에서 EDRF 의 basal release 및 ACh 유발성 EDRF function은 전신성 동맥계에 비해 폐동맥계에서 적다는 것을 제시해준다.

• 한국전산유체공학회:학술대회논문집
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• 한국전산유체공학회 2008년도 춘계학술대회논문집
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• pp.542-546
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• 2008

In this study, we developed a whole cardiovascular system model combined with a Laplace heart based on the numerical cardiac cell model and a detailed arterial network structure. The present model incorporates the Laplace heart model and pulmonary model using the lumped parameter model with the distributed arterial system model. The Laplace heart plays a role of the pump consisted of the atrium and ventricle. We applied a cellular contraction model modulated by calcium concentration and action potential in the single cell. The numerical arterial model is based upon a numerical solution of the one-dimensional momentum equations and continuity equation of flow and vessel wall motion in a geometrically accurate branching network of the arterial system including energy losses at bifurcations. For validation of the present method, the computed pressure waves are compared with the existing experimental observations. Using the cell-system-arterial network combined model, the pathophysiological events from cells to arterial network are delineated.

• Journal of Chest Surgery
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• 제16권3호
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• pp.362-367
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• 1983

Pulmonary arteriovenous fistula is a congenital malformation resulting from errant capillary development, with incomplete formation or disintegration of the vascular septa that normally divide the primitive connections between the venous and arterial plexuses. It generally occurs as part of the disorder known as hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease]. The hereditary lesion is transmitted as a simple non-sex-linked dominant trait. It may be single or multiple, too small to see on plain chest films or large and easily recognized. One third of the lesions are multiple on plain chest film. The pathogenesis of its symptoms is that unoxygenated, desaturated arterial blood enters into the pulmonary venous system, directly. Recently we have experienced a case of the pulmonary arteriovenous fistula in 26 years old male soldier, which was confirmed by pulmonary angiography preoperatively. 2 thumb-tip sized, well circumscribed cystic masses filled with bright red colored blood were seen in subpleural and anterolateral portion of the right upper lobe. Right upper Iobectomy was performed due to close approximation of the fistula with pulmonary vein. Microscopically, it shows angiomatous dilatation of the abnormal vessels embedding in the parenchyma. Postoperative physiologic studies show nearly normal arterial oxygen saturation, hemoglobin and RBC count. There was good, uneventful postoperative course.

• Journal of Chest Surgery
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• 제18권4호
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• pp.806-811
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• 1985

Pulmonary arteriovenous fistula is a rare congenital vascular malformation in the lung, resulting from erroneous capillary development, with incomplete formation or disintegration of the vascular septa that would normally divide the primitive connection between the venous and arterial plexus. The pathogenesis of its symptom is that unoxygenated and desaturated arterial blood enter into the pulmonary venous system directly. Recently we have experienced a case of multiple pulmonary arteriovenous fistula in a 15 year old male patient, who presented the symptom of cyanosis and dyspnea on exertion. The operation revealed well circumscribed and multilobulated aneurysmal lesion in left lower lobe with its subpleural and posterolateral basal location, and another aneurysmal lesion in inferior lingular segment of left lung. There was no abnormal connection between the fistula and systemic circulation. The left lower lobectomy was performed along with local extirpation of the inferior lingular segment of left lung. Both lesions showed angiomatous dilatation of the various sized vessels embedded in the parenchyma microscopically. Postoperative clinical course disclosed much improvement in symptoms and in the value of blood gas analysis. The patient was discharged without any complication.

• 대한한방내과학회지
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• 제11권2호
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• pp.1-15
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• 1990

Certain oriental medication have been shown to be effective in decreasing pulmonary vascular resistance and increasing cardiac output in primary pulmonary artery pressure secondary to pulmonary edema. So oleic acid was administered in 14 dogs in order to induce acute lung injury. And we studied the hemodynamics and blood gas changes of Pyengpaetang(50mg, 100mg) with continuous postive pressure was ventilation in pulmonary edema. The pulmonary edema group, arterial oxygenation was improved after 5 and $10cmH_2O$ PEEP(positive end expiratory pressure), but cardiovascular system was depressed. Blood pressure and cardiac output were decreased, and CVP, MP AP, PCWP were increased. In Pyengpaetang(50mg) group, mean aortic pressure was decreased and PCWP(pulmonary capillary wedge pressure) was decreased remarkably, while there was a significant increase in cardiac output. And there was improvement in $PaO_2$ and $PaCO_2$ without hemodynamic changes after applying 5cm $H_2O$ PEEP, but arterial blood gases$(PaO_2,\;PaCO_2)$ were improved, while cardiovascular effects were depressed after cm $H_2O$ PEEP. In Pyengpaetang(100mg) treated group, there was no significant hemodynamic change. But mean pulmonary arterial pressure was significantly increased, and cardiac output was decreased significantly after applying the more degree of PEEP. And blood gases were not changed significantly after applying the more degree of PEEP. The above results suggest that the effects of Pyengpaetang(50mg) group is superior to those of Pyengpaetang(100mg) group on the effects of hemodynamics and gas exchanges in acute lung injury in dogs. So we can conclude that lower degree PEEP 5cm $H_2O$ is more beneficial in Pyengpaetang(50mg) treated group.

• Journal of Chest Surgery
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• 제33권1호
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• pp.7-19
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• 2000

Background :To assess the accuracy of Electron-Beam Tomography(EBT) in following evaluation of the pulmonary vascular system after a shunt operation in the cyanotic con-genital heart disease with pulmonary stenosis or pulmonary atresia. Material and Method : Sixteen patients(M:F=11:5) who received Blalock-Taussig(n=8) bidirectional cavo-pulmonary shunt(n=10) and unifocalization (n=2) were ncluded in the study. We evaluated the patency of the shunt the morphology of intrapericardial and hilar pulmonary arteries(PA) peripheral pulmonary vascularity by background lung attenuation and the abundance of arterial & venous collateral. Angiography(n=12) and echocardiography(n=20) were used as the gold standard for the comparison of EBT results. Result: EBT was consistent with angiogram/ echo in 100% of the evaluation for the patency of the shunt and in 12(by angiogram 100%) and 19(by echo 95%) for the detection the hypoplasia stenosis or interruption of central PA In measuring of PA EBT and angiogram corrlated(r=0.91) better than EBT-echo(r=0.88) or echo-angiogram(r=0.72) Abundant systemic arterial collateral were noted in 4 and venous collateral in 3 cases. In evaluating the peripheral pulmonary vascularity the homogenous and normal-ranged lung attenuation(m=6) decreased but homo-genous attenuation(n=1) segment-by-sgment heterogeneous attenuation(n=3) homogenous but asymmetrical attenuation(n=3) segment-by-segment heterogeneous attenuation(n=3) homogenous but asymmetrical attenuation(n=3) and venous congestion(n=2) were observed nd 12 of them were compatible with the blood flow pattern revealed by cardiac catheterization. Conclusion: EBT was accurate in the integrated evaluation of the pulmonary vascular system after the shunt including the patency of the shunt operaion the morphology and dimension of the central and hilar PAs and the loco-regional pulmonary flow in the lung parenchyma. It suggests the useful information about the need of secondary shunt operation the proper timing time for total repair and the need of interventional procedure prior to total repair.

• Korean Circulation Journal
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• 제53권6호
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• pp.406-417
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• 2023

Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO₂] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO₂ was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

• Journal of Chest Surgery
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• 제15권2호
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• pp.183-187
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• 1982

Pulmonary arteriovenous fistula is a congenital vascular malformation In the lung, various synonyms including Pulmonary cavernous vascular malformation, Pulmonary arteriovenous aneurysm, Cavernous hemangioma of the lung0 Pulmonary telangiectasia, Pulmonary hamartoma, etc. The pathogenesis of its symptoms is that unoxygenated, desaturated arterial blood enters into the pulmonary venous system directly. Recently we have experienced one case of the pulmonary arteriovenous fistula which was diagnosed as the pulmonary cystic lesion of the lung preoperatively in 20 years old, 61 kg, male patient. Operation was revealed well circumscribed cystic lesion filled with blood, subpleural and anterior mediobasal location, and bright red colored aspirates on two times needle aspirations. Microscopic finding shows ill circumscribed vascular lesion composed of varying sized blood vessels with irregular thickening of wall and final pathological diagnosis is Pulmonary Arteriovenous Fistula. Basal segmentectomy was done and the patient shows good postoperative course.