• Journal of Chest Surgery
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• v.37 no.7
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• pp.553-558
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• 2004

Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CAB G) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. Material and Method: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. Result: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. Conclusion: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.658-668
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• 2022

Purpose To evaluate the effectiveness of the transradial artery approach (TRA) for treating malfunctioning arteriovenous fistulas (AVFs) in patients on hemodialysis. Materials and Methods A retrospective analysis was conducted in this single-center study of TRA endovascular procedures in 73 patients (43 male and 30 female; mean age of 67.4 years (range, 42-92 years) with malfunctioning AVFs, between January 2008 and April 2019. Patients' baseline and lesion characteristics, technical and clinical success, and complications were evaluated, and functional patency was analyzed using the Kaplan-Meier method. Results Radial artery approaches were successful in all patients. Angioplasty performed using the TRA achieved technical and clinical success rates of 98.6%(72/73) and 91.7%(67/73), respectively. The median primary patency time was 18.8 ± 15.9 months. The primary functional patency rates at 3, 6, and 12 months were 82.1%, 68.6%, and 63.9%, respectively. There were no major complications or adverse events, such as hand ischemia, related to the radial artery approach. Conclusion In selected cases, the TRA can be used complementary to the transvenous approach to treat malfunctioning AVFs.

• Journal of Gastric Cancer
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• v.20 no.3
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• pp.256-266
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• 2020

Purpose: This study aimed to examine the early postprandial changes in gastrointestinal (GI) hormones and hemodynamics in terms of early dumping syndrome after gastrectomy for gastric cancer. Materials and Methods: Forty patients who underwent gastrectomy for gastric cancer and 18 controls without previous abdominal surgery were enrolled. Before and 20 minutes after liquid meal ingestion, blood glucose, glucagon-like peptide-1 (GLP-1), and GLP-2 concentrations and superior mesenteric artery (SMA) and renal blood flow were measured. The patients' heart rates were recorded at 5-minute intervals. All subjects were examined for dumping syndrome using a questionnaire based on Sigstad's clinical diagnostic index. Results: The postprandial increases in blood glucose, GLP-1, and GLP-2 levels as well as SMA blood flow and heart rate were greater in patients who underwent gastrectomy than in controls (all P<0.010). Patients who underwent gastrectomy showed a significantly decreased renal blood flow (P<0.001). Among patients who underwent gastrectomy, distal gastrectomy was a significant clinical factor associated with a lower risk of early dumping syndrome than total gastrectomy (hazard ratio, 0.092; 95% confidence interval, 0.013-0.649; P=0.017). Patients who underwent total gastrectomy showed a greater postprandial increase in blood glucose (P<0.001), GLP-1 (P=0.030), and GLP-2 (P=0.002) levels as well as and heart rate (P=0.013) compared to those who underwent distal gastrectomy. Conclusions: Early postprandial changes in GI hormones and hemodynamics were greater in patients who underwent gastrectomy than in controls, especially after total gastrectomy, suggesting that these changes play a crucial role in the pathophysiology of early dumping syndrome.

• Korean Journal of Acupuncture
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• v.25 no.2
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• pp.199-210
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• 2008

Objectives : This study was performed to investigate the effect of invasive laser acupuncture therapy with green light (LAT-G) at HT7(Sinmun), SP3(Taebaek) on the blood pressure in hypertensive rat induced by two kidney one clip. Methods : The experiments were performed on Sprague Dawley rats. 2K1C hypertension model was prepared by constricting the left renal artery with a sliver clip. Animals were divided into four groups, which were simple acupuncture treatment group with straight needle insertion on the square(AT-SS), acupuncture treatment group with reducing manipulation in the opposite channel direction(AT-RD), laser acupuncture treatment group with green light 532 nm, 10mW power in the opposite channel direction(LAT-G10) and laser acupuncture treatment group with green light 532 nm, 20mW power in the opposite channel direction(LAT-G20). The treatments were performed once per two days for 10 days. Results : Body weight was increased significantly in LAT-G20 group compared with AT-RD group. The blood pressure was significantly decreased in LAT-G20 and LAT-G10 groups compared with AT-SS group. Conclusions : These results suggest that green laser acupuncture therapy at SP3 ${\cdot}$ HT7 is more effective than straight needle insertion on the square for controlling hypertension. It is possible that invasive green laser acupuncture therapy (532 nm) can be used as a reducing method of the traditional acupuncture techniques.

• The Korean Journal of Physiology
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• v.28 no.2
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• pp.225-231
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• 1994

The present study was undertaken to investigate the role of endogenous nitric oxide in renin release under different physiological conditions. In the first series of experiments, renin release was either inhibited by acute volume-expansion (VE) or stimulated by clipping one renal artery in the rat. VE was induced by intravenous infusion of saline (0.9% NaCl) up to 5% of the body weight over 45 min under thiopental (50 mg/kg, IP) anesthesia. VE caused a decrease of plasma renin concentration (PRC). With $N^G-nitro-L-arginine$ methyl ester $(L-NAME,\;5\;{\mu}g/kg\;per\;min)$ superadded to VE, PRC decreased further. The magnitude of increase in plasma atrial natriuretic peptide levels following VE was not affected by the L-NAME. In two-kidney, one clip rats, L-NAME-supplementation resulted in a decrease, and L-arginine-supplementation an increase of PRC. Plasma atrial natriuretic peptide levels were significantly lower in the L-arginine group than in the control. Blood pressure did not differ among the L-NAME, L-arginine, and control groups. In another series of experiments, the renin response to a blockade of NO synthesis was examined using in vitro preparations from isolated renal cortex. L-NAME significantly increased basal renin release, although it was without effect on the isoproterenol-stimulated release. These findings suggest that endogenous nitric oxide significantly contributes to the renin release. Since many factors may affect the renin release in vivo, an interaction between NO and renin under various pathophysiological states is to be further defined.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• The Korean Journal of Physiology
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• v.25 no.1
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• pp.37-48
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• 1991

The characteristics of probenecid effect on renal urate excretion in the cat were studied by clearance method and compared with those in the rabbit. In the cat GFR was $3.03{\pm}0.09\;ml/min{\cdot}kg$, and endogenous plasma urate concentration was $1.12{\pm}0.57\;{\mu}g/ml$, which is less than that in the rabbit $(3.33{\pm}0.46\;{\mu}g/ml)$. In the rabbit, $FE_{ur}$ was $1.76{\pm}0.08$ and net urate secretion was observed, while, in the cat $FE_{ur}$ was $0.70{\pm}0.02$ and net reabsorption was observed. In the cat $FE_{ur}$ was dependent on urine flow and independent of plasma urate concentration. In the rabbit $FE_{ur}$ was suppressed by infusion of probenecid $(30\;mg/kg\;-0.6\;mg/kg{\cdot}min)$ into femoral vein. In the cat the same dose of probenecid increased $FE_{ur}$ and concomitantly increased urine flow. Thus, an increase in $FE_{ur}$ by probenecid could be considered to be resulted from a change in urine flow. In the cat infusion of probenecid $(2.5\;mg/kg{\cdot}min)$ into renal artery markedly suppressed $FE_{P\;A\;H}$, but the effects on $FE_{ur}$ and urine flow were similar to those when probenecid was infused into femoral vein. These results indicate that in the cat kidney urate filtered through glomerulus is reabsorbed by a probenecid-insensitive mechanism with no evidence for net secretion.

• Biomolecules & Therapeutics
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• v.4 no.4
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• pp.349-353
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• 1996

The present study examined pharmacokinetic profiles of KBP31705-Cl27 and KBP30603-901, new platinum coordination complexes synthesized as anticancer candidates, in comparison with two well-known platinum-containing anticancer agents, cisplatin and carboplatin in rats. Under sodium pentobarbital anesthesia of male Sprague-Dawley rats, urinary bladder, and femoral artery and vein were catheterized for urine collection, blood sampling and drug injection, respectively Following i.v. administration of cisplatin (2 mg/kg), KBP31705-C127 (2 mg/kg), carboplatin (20 mg/kg) or KBP30603-901 (20 mg/kg), blood samples were collected at 2, 4, 6, 8, 10, 15, 20, 30, 45, 60 and 120 minutes. Urine samples were collected at 1-hr interval for 4 hr. Platinum concentrations in plasma and urine were measured using an inductively coupled plasmamass spectrometer. The plasma concentration-time curves were biphasic for all drugs during the time period studied. Compared with cisplatin, KBP31705-C127 showed similar decay patters in the alpha- and betaphases with slightly lower plasma concentrations. Urinary platinum excretion for cisplatin and KBP31705-C 127 was 56 and 52% of the administered dose in 4 hr, respectively. With regard to carboplatin and KBP 30603-901, a similar decay pattern was also observed in the alpha-phase. The half life of KBP30603-901 in the beta-phase, however, was much longer than that of carboplatin, which was consistent with the urinary excretion results that 46 and 59% of the administered dose were excreted in the urine in 4hr, respectively. The results suggest that platinum coordination complexes are primarily excreted via the renal route and KBP30603-901 can elicit longer duration of action due to slower renal excretion compared to carboplatin.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.137-152
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• 1998

Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.

• The Korean Journal of Physiology
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• v.16 no.1
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• pp.1-11
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• 1982

Force development of smooth muscle cells is directly regulated by the concentration of free calcium ions in the sarcoplasm, and the sarcoplasmic concentration of calcium ion can be modulated by electrogenic Na-K pump. The role of Na-K pump on vascular tone was studied in isolated rabbit renal artery. Helical strips of arterial muscle were prepared from left renal arteries. All experiments were performed in $HCO_3^--buffered$ Tyrode solution which was aerated with $3%CO_2-97%\;O_2$ mixed gas and kept at $35^{\circ}C$. In some experiments, rabbit was injected intraperitoneally $18{\sim}24$ hours prior to the experiments, with a large dose(5 mg/kg body wt) of reserpine, in order to eliminate the catecholamines present in intrinsic adrenergic nerve terminate. Treatment used in this experiment that inhibits Na-K pump was the exposure of strips to K-free Tyrode solution. Contractile response to K free Tyrode solution developed slowly and the time required for maximum contracture was $20{\sim}30$ minutes. This K-free contracture was rapidly relaxed by the addition of potassium to the bathing solution. No K-free contracture occurred in a Ca-free Tyrode solution. But contraction developed rapidly when calcium ion was added to the bathing solution after 30 minute exposure of the strip to Ca-free Tyrode solution. This contracture was completely inhibited by Ca-antagonist, verapamil. The K-free contracture was abolished by ${\alpha}-adrenergic$ blocker, phentolamine, as well as by the catecholamine depletion from adrenergic nerve terminals. Even in reserpinized strip, the exogenous norepinephrine-induced contraction in K-free Tyrode solution was rapidly suppressed by the addition of potassium ion. The results of this experiment suggest that K free contracture develops by norepinephrine release from adrenergic nerve terminals, while the relaxation of K-free contracture is induced by the activation of electrogenic Na-K pump.