• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.456-461
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• 2018

Carotid artery stenting (CAS) has emerged as an alternative treatment for carotid stenosis in patients poorly suited for endarterectomy. Intracerebral hemorrhage following carotid revascularization (endarterectomy, angioplasty, artery stenting) is rare and thought to be related to reperfusion injury in most cases. Early experience suggests an increased incidence of hemorrhage following CAS as compared to endarterectomy. In this study, data were obtained through a case report on an 80-year-old male patient with cerebral infarction. The 80-year-old hypertensive man developed sudden monoparesis in the left arm. He underwent CAS for 90% stenosis of the left proximal internal carotid artery. Brain CT after procedure showed acute hematoma with left posterior cerebral artery territorial hemorrhage, including the upper thalamus with extended intraventricular hemorrhage (IVH). Since this hemorrhage occurred in vascular territory unlikely to have been supplied by the treated artery, this case suggests that the mechanism of intracerebral hemorrhage following CAS may in some cases be different from hyperperfusion hemorrhage classically described following endarterectomy.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.59-69
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• 1988

This study was designed to investigate the effect of substitution of strontium for calcium on mechanical activity in isolated perfused spontaneously beating rat hearts. The mechanical activity of the hearts of Langendorff's preparation in conditions of low calcium and strontium-substitution for calcium was compared. The effect of norepinephrine and verapamil were also observed in those conditions. The results were as follows : 1. In low calcium, the mechanical activity of the heart preparation was significantly reduced, but when the equimolar strontium was substituted for the reduced calcium, the activity was kept at similar level to the normal condition. 2. When equimolar strontium was substituted for the total calcium in perfusate, the heart preparation stopped its beating, and it was not restored in spite of reperfusion with normal calcium perfusate. 3. Norepinephrine-induced positive inotropic effect was inhibited in low-calcium condition especially with low concentration of norepinephrine, but not in strontium-substitution for calcium. 4. Verapamil reduced the activity of the heart both in low-calcium and strontium-substitution as well as in normal calcium conditions. From above results, it was concluded that strontium served as a substitute of calcium in maintaining mechanical activity and in responsiveness to norepinephrine, and the influx of strontium through cell membrane is inhibited by verapamil as the influx of calcium.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.4
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• pp.207-211
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• 2004

The purpose of the present study was to evaluate the expression of cardiac marker protein in rabbit cardiac tissue that was exposed to ischemic preconditioning (IPC), or ischemiareperfusion injury (IR) using two-dimensional gel electrophoresis (2DE) and matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS). We compared 2DE gels of control (uninjured) cardiac tissue with those of IPC and IR cardiac tissue. Expression of one protein was detected in IR heart tissue, however the protein was not detected in the samples of control and IPC tissue. To further characterize the detected protein molecule, the protein in the 2D gel was isolated and subjected to trypsin digestion, followed by MALDI-MS. The protein was identified as myoglobin, which was confirmed also by Western blot analysis. These results are consistent with previous studies of cardiac markers in ischemic hearts, indicating myoglobin as a suitable marker of myocardial injury. In addition, the present use of multiple techniques indicates that proteomic analysis is an appropriate means to identify cardiac markers in studies of IPC and IR.

• The Korean Journal of Physiology and Pharmacology
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• v.15 no.4
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• pp.189-194
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• 2011

ATP-sensitive $K^+$ channels ($K_{ATP}$) are major component of preventing ischemia-reperfusion injury. However, there is little information regarding to the expressional difference of $K_{ATP}$ and its function between left and right ventricles. In this study, we measured the lactate dehydrogenase release of rabbit heart slices in vitro and determined the difference of the $K_{ATP}$ expression at the both ventricles by measuring the level of $K_{ATP}$-forming Kir6.2 (OcKir6.2) mRNA using in situ hybridization. The hearts were preconditioned with 15 min hypoxia and reoxygenated for 15 min before a hypoxic period of 60 min, followed by reoxygenation for 180 min. With hypoxic preconditioning (100% $N_2$) with 15 min, left ventricles (LV) showed higher release of LDH comparing with right ventricles (RV). Adding $K_{ATP}$ blocker glibenclamide ($10{\mu}M$) prior to a hypoxic period of 60 min, hypoxic preconditioning effect of RV was more abolished than LV. With in situ hybridization, the optical density of OcKir6.2 was higher in RV. Therefore, we suggest that different $K_{ATP}$ expression between LV and RV is responsible for the different response to hypoxia and hypoxic preconditioning of rabbit hearts.

• The Korean Journal of Physiology and Pharmacology
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• v.11 no.2
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• pp.57-64
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• 2007

Ischemic preconditioning (IPC) is known to protect the heart against ischemia/reperfusion (IR)-induced injuries, and regional differences in the mitochondrial antioxidant state during IR or IPC may promote the death or survival of viable and infarcted cardiac tissues under oxidative stress. To date, however, the interplay between the mitochondrial antioxidant enzyme system and the level of reactive oxygen species (ROS) in the body has not yet been resolved. In the present study, we examined the effects of IR- and IPC-induced oxidative stresses on mitochondrial function in viable and infarcted cardiac tissues. Our results showed that the mitochondria from viable areas in the IR-induced group were swollen and fused, whereas those in the infarcted area were heavily damaged. IPC protected the mitochondria, thus reducing cardiac injury. We also found that the activity of the mitochondrial antioxidant enzyme system, which includes manganese superoxide dismutase (Mn-SOD), was enhanced in the viable areas compared to the infarcted areas in proportion with decreasing levels of ROS and mitochondrial DNA (mtDNA) damage. These changes were also present between the IPC and IR groups. Regional differences in Mn-SOD expression were shown to be related to a reduction in mtDNA damage as well as to the release of mitochondrial cytochrome c (Cyt c). To the best of our knowledge, this might be the first study to explore the regional mitochondrial changes during IPC. The present findings are expected to help elucidate the molecular mechanism involved in IPC and helpful in the development of new clinical strategies against ischemic heart disease.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.12-24
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• 2014

Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport. Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods. Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement. Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.

• Proceedings of the SCSK Conference
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• 2003.09a
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• pp.13-34
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• 2003

Fructose-1, 6-diphosphate (FOP), a glycolytic metabolite is reported to ameliorate inflammation and inhibit the nitric oxide production in murine macrophages stimulated with endotoxin. It is also reported that FOP has cytoprotective effects against hypoxia or ischemia/reperfusion injury in brain and heart. In this study, we examined whether FDP has protective effects on UV-induced oxidative damage in skin cell culture system and human skin in vivo. FDP had a protective role in UVB-induced LDH release and ROS accumulation in HaCaT although it did not show direct radical scavenging effect in the experiment using 1, 1-diphenyl-2-picrylhydrazyl (DPPH). FDP also preserved cellular GSH content after UV irradiation in HaCaT and normal human fibroblast culture system. Cellular oxidative stress induces multiple downstream signaling pathways that regulate expression of multiple gene including MMP-1 and collagen, we examined the effects of FDP on UV-induced alteration of these protein expression in fibroblast culture and human skin in vivo. The increased MMP-1 expression in fibroblast and human skin by UV irradiation was significantly decreased by FDP. FDP also prevented the UV-induced decrease of collagen expression in fibroblast and human skin. Moreover, the decreasing the intracellular levels of reducing equivalents in human fibroblast by glutathione (GSH) depletion lowered the UVA dose threshold for reduction of procollagen expression, indicating that the differences of glutathione contents define the susceptibility of fibroblasts towards UV-induced reduction of procollagen expression. FDP also preserved cellular GSH content after UV irradiation, indicating that FDP has protective effects on UV-induced reduction of procollagen expression, which are possibly through maintaining intracellular reducing equivalent. Based on these premises, we examined the effect of daily use of a moisturizer containing FDP on facial wrinkle in comparison with vehicle moisturizer lacking FDP. In the clinical study, FDP significantly decreased facial wrinkle compared with vehicle alone after 6 months of use. Our results suggest that FDP has anti-aging effects in skin by increasing cellular antioxidant system and preventing oxidative signal and inflammatory reaction. Therefore FDP may be useful anti-aging agent for cosmetic purpose.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.230-240
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• 1987

Cardioplegia and myocardial protection were performed under cardiopulmonary bypass during open-heart surgery with the use of cold St. Thomas Hospital cardioplegic solution [4=C] for the coronary artery perfusion and normal saline solution [4- C] for the topical cardiac cooling. To maintain the state of myocardial protection, coronary artery reperfusion was carried out using St. Thomas Hospital cardioplegic solution at the interval of 30 minutes. A total number of patients studied were 57 cases, including 37 cases of correction for congenital cardiac anomalies and 20 cases for acquired heart valvular diseases. Cardiopulmonary bypass time during the surgery was observed to be average of 87.89*47.55 hours, aortic cross-clamping time to be average of 76.68~44.27 hours raging from 30 to 191 minutes. In order to evaluate the effects of myocardial protection in the surgery, serum enzyme levels were determined. To observe the relationship between aortic cross-clamping time and myocardial protection effects, patients studied were divided into the following 3 groups. I group: aortic cross-clamping time, 60 minutes, II group: aortic cross-clamping time, 90 minutes, III group: aortic cross-clamping time, over 91 minutes. 1. Changes in serum enzyme levels in postoperative period. [1] SCOT; The postoperative value [increased over 200 units] for ischemic myocardial injury during operation was observed in 11 cases [19.3% of the total] of the total patients studied, of which 4 cases [13.3%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [2] LDH; The positive value [increased over 900 units] for ischemic myocardial injury during operation was observed in 9 cases [15.7% of the total] of the total patients studied, of which 2 cases [6.6%] in I group, 1 case [10.0%] in II group, and 6 cases [35.3%] in III group. [3] CPK; The positive value [increased over 800 units] for ischemic myocardial injury during operation was observed in 10 cases [17. 5% of the total] of the total patients studied, including 4 cases [13. 3%] in I group, 1 case [10.0%] in II group, and 5 cases [29.4%] in III group. 2. The myocardial protection method used in the present study was demonstrated to be effective for the myocardial protection in the surgery with aortic cross-clamping time of up to 90 minutes. A few ischemic myocardial injury were observed in the surgery with aortic cross-clamping time over 91 minutes, but no significant cardiac dysfunction was noted. The surgery with aortic cross-clamping time of up to 191 minutes did not appear to give rise any significant interference with postoperative recovery.

• The Korea Journal of Herbology
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• v.21 no.2
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• pp.151-158
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• 2006

Objectives : The purpose of the present study is to observe the neuroprotective effect of the $NeuBo153^{\circledR}$ on transient focal cerebral ischemia in rats. Methods : $NeuBo153^{\circledR}$ was made by mixing the herbs, mainly the root of Panax ginseng, the root of Rehmannia glutinosa and Poria cocos, the stem bark of Acanthopanax senticosus, the root of Scutellaria baicalensis and Mel, and heating for 96 hours. Transient Focal cerebral ischemia (2 h of ischemia, 22 h of reperfusion) was induced by intraluminal suture method with SD rats. Sensory motor function was tested by rotarod test, prehensile traction test, beam balance test and foot fault test at 24 h after ischemia. The brain slices were stained by 2% 2, 3, 5-triphenyltetrazolium chloride and the infarct volume was measured by graphic analyzer at 24 h after ischemia. Results : $NeuBo153^{\circledR}$ treated group did not show significant differences compared with vehicle treated group in body temperature. Oral administration of $NeuBo153^{\circledR}$ reduced brain infarct volume by 29.7% compared with vehicle treated group. $NeuBo153^{\circledR}$ also showed protective effects on sensory motor functional deficits. Conclusion : $NeuBo153^{\circledR}$ treatment reduced brain damage and improved functional deficits induced by MCAo. It showed neuroprotective effects even when treatment was relayed 2 h after injury. Further research is required to evaluating long term functional recovery am accurate therapeutic range and mechanisms.

• Archives of Pharmacal Research
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• v.28 no.1
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• pp.61-67
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• 2005

We evaluated the antiplatelet effects of two classes of ATP-sensitive potassium channel openers $(K_{ATP}\;openers)$ on washed human platelets, and the study's emphasis was on the role of mitochondrial $K_{ATP}$ in platelet aggregation. Collagen-induced platelet aggregation was inhibited in a dose dependent manner by lemakalim and SKP-450, which are potent cardio-nonselective $K_{ATP}$ openers, and also by cardioselective BMS-180448 and BMS-191095 $(IC_{50}\;:\;1,130,\;>\;1,500,\;305.3\;and\;63.9\;{\mu}M,\;respectively)$, but a significantly greater potency was noted for the cardioselective $K_{ATP}$ openers. The latter two $K_{ATP}$ openers also inhibited platelet aggregation induced by thrombin, another important blood-borne platelet activator, with similar rank order of potency $(IC_{50}\;:\;498.0\;and\;104.8{\mu}M\; for\;BMS-180448\;and\;BMS-191095,\;respectively)$. The inhibitory effects of BMS-191095 on collagen-induced platelet aggregation were significantly blocked by a 30-min pretreatment of platelets with glyburide $(1{\mu}M)$ or sodium 5-hydroxyde­canoate$(5-HD,\;100{\mu}M)$, a nonselective and selective mitochondrial $K_{ATP}$ antagonist, respectively, at similar magnitudes; this indicates the role of mitochondrial $K_{ATP}$ in the antiplatelet activity of BMS-191095. However, glyburide and 5-HD had no effect when they were added to the platelet cuvette immediately prior to the addition of BMS-191095. These findings indicate that cardioselective mitochondrial $K_{ATP}$ openers like BMS-191095 are able to exert cardioprotective effects in cardiac ischemia/reperfusion injury via dual mechanisms directed at the inhibition of platelet aggregation and the protection of cardiomyocytes, and both these mechanisms are mediated by mitochondrial$K_{ATP}$.