Background: Occlusive complications after arterial revascularization are difficult to treat and have high recurrence rate. This study was performed to establish an effective treatment modality and to evaluate the factors affecting the occlusive complications by analysis of clinical data. Material and Method: During the period of 5 years. 33 patients (55 reoperations) were studied at the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital following 173 arterial revascularization surgeries. The clinical characteristics, operating methods, the time intervals of reoperation, used graft, and the results of treatment were evaluated retrospectively. Result: All the patients were men except one and the mean age was 63.5 years old. The mean time internal from first operation to reoperation was 11.9 months. The cause of arterial occlusive diseases were 28 atherosclerosis and 5 Burger's diseases, Associated diseases were Hypertension $(57.6\%)$, Diabetes mellitus $(33.3\%)$, heart failure $(18.2\%)$, and so on. The mean rate of reoperation was 1.67 times and the most common type of first operation was femoro-popliteal bypass grafting $(57.6\%)$. The graft that used revascularization surgery were 25 cases of PTFE and 6 case were Dacron. There was no statistical difference between two groups. The kinds of reoperations were thrombectomy in 20 cases, angioplasty 18 cases, re-bypass surgery in 13 cases, and lumbar sympathectomy in 4 cases. The results of reoperation were 15 cases of functional recovery, 7 cases of limb salvage, 5 cases of above-knee amputation. 3 cases of below-knee amputation and 3 deaths. Conclusion: The main cause of occlusive complications are occlusion of inflow or outflow artery. Treatments were different according to the first operation methods and graft used. The most frequent time of reoperation was within one year after the first operation. We believe that graft surveillance especially during the first year is very important factor in observing the patient. We can look forward to improving limb salvage rate to perform additional treatment such as radiological interventions and lumbar sympathectomy.
Purpose: Endothelial progenitor cells (EPCs), which mediates neovascularization of uterine endometrium may be involved in the neovascularization in the utero-placental circulation. Low numbers of endothelial progenitor colony-forming unit (CFU) in culture are predictive biomarker of vascular disease. The aim of the present study was to evaluate whether the number of CFU in preeclampsia differed from that in normal pregnancy. Materials and Methods: Women with singleton normal (n=26) or preeclamptic (n=20) pregnancies were studied during the third trimester. The number of EPCs was quantified by CFU methodology. Plasma levels of angiogenic factors, vascular endothelial growth factor (VEGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) were determined by enzyme-linked immunoassay. Results: CFU numbers were significantly decreased in the preeclamptic patients compared with the controls (median, 3; range 1-12 vs. 31; 3-81 CFU/well, P<0.001). A majority of the cells comprising individual colonies were positive for endothelial characteristics (Ulex europaeus lectin staining and acetylated low-density lipoprotein uptake). Plasma levels of the sFlt-1 were highly elevated (P<0.001) in patient with preeclampsia compared to controls, whereas PlGF were highly reduced (P=0.004), but these factors did not associate with CFU numbers. Conclusion: Our results suggest that reduced numbers of CFU obtained from maternal peripheral blood may contribute to the development of preeclampsia.
Background: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. Material and Method: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. Result: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. Conclusion: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.
Journal of the Korea Society of Computer and Information
/
v.25
no.10
/
pp.115-123
/
2020
In this paper, we propose to evaluate the potential anti-inflammatory properties of root bark extract of Cudrania (C.) tricuspidata on lipopolysaccharide (LPS)-induced inflammation in macrophages of apolipoprotein E (ApoE) knockout (ApoE-/-) mice, murine model of atherosclerosis. Atherosclerosis is a chronic vascular inflammatory disease. C. tricuspidata is a small tree of the Moraceae family and its extract has anti-inflammatory activities. However, its role in the progress of atherosclerosis is not yet clear. To determine anti-inflammatory effects of C. tricuspidata in atherogenesis, we applied LPS in peritoneal macrophages of ApoE-/- mice and measured cell viability by CCK-8 and expression of pro-inflammatory cytokines by qRT-PCR following treatment with root bark extract of C. tricuspidata. Research data was expressed as differences between the cells treated with LPS and root bark extract and the cells treated with LPS alone (control) by a two-tailed non-parametric Mann-Whitney U-test using GraphPad Instat program. No cytotoxic effect was observed when the cells were treated with the extract at concentrations ≤ 100 ㎍/mL. The expression of inflammatory cytokines, including MCP-1, IL-1β, IFN-γ, TNF-α, and IL-6 were inhibited by the extract. These results indicated that the extract has an anti-inflammatory effect and therefore a possible role in the treatment of atherosclerosis.
Kim, Sung Eun;Yin, Ming Zhe;Kim, Hae Jin;Vorn, Rany;Yoo, Hae Young;Kim, Sung Joon
The Korean Journal of Physiology and Pharmacology
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v.24
no.1
/
pp.111-119
/
2020
In vascular smooth muscle, K+ channels, such as voltage-gated K+ channels (Kv), inward-rectifier K+ channels (Kir), and big-conductance Ca2+-activated K+ channels (BKCa), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (IKv and IKir) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) IKv was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) IKv inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) IKir was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) IBKCa did not differ between branches. Moreover, in PAH rats, IKir and IKv decreased in SCSMCs, but not in RCSMCs or LCSMCs, and IBKCa did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in IKv and IKir occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller IKir in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K+ concentration under increased activity of the myocardium.
Kim, Sung-wook;Jeong, Hyun-woo;Wei, Tung-shuen;Cho, Myeng-rae;Yun, Yeo-choong
Journal of Acupuncture Research
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v.21
no.2
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pp.167-181
/
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.
Nicotine is one of the major components of cigarette smoking which causes various systemic and local diseases to human body. Mitogenic effects of nicotine to systemic disease are interesting factors in the results of cellular Proliferation especially to vascular and pulmonary tissue or cells. The study of local effects concerns with destruction of tissue and delayed healing rate after various surgical treatment. Platelet-Derived Growth factor(PDGF) and Insulin-like growth factor(IGF) are blown as major mitogens to human PDL cells. The purpose of this study was to investgate the mitogenic effects of nicotine to human PDL cells. We studied the expression of PDGF-$\alpha$ receptor, PDGF-$\beta$receptor, and IGF-l receptor mRNA from the nicotine treated human PDL cells by northern analysis. The experimental groups were divided into different serum($1\%,\;10\%$) and nicotine (100ng/m1,1000ng/m1) concentrations and each group was studied by time course. The results of this study showed upregulation of PDGF-${\alpha},\;{\beta}$ receptor and IGF-l receptor mRNA at 100ng/ml nicotine concentration and $10\%$ serum group to the time course. These results suggest that physiologically attainable nicotine concentrations may stimulate the mitogenic gene synthesis to human PDL cells in vitro.
Lee, Dong Soo;Lee, Tae Won;Kim, Gye Yean;Kim, Hwi Jung;Song, So Hyang;Kim, Seok Chan;Kim, Young Kyoon;Song, Jung Sup;Park, Sung Hak
Tuberculosis and Respiratory Diseases
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v.43
no.4
/
pp.623-629
/
1996
Bronchial carcinoid tumors are uncommon, constituting approximately 5% of all primary lung cancers. Carcinoid tumors belong to the calss of neuroendocrine tumors that consist of cells that can store and secrete neuramines and neuropeptides. Neuroendocrine tumors of the lung include three pathologic types : a low-grade malignancy, the so-called 'typical carcinoid', a more aggressive tumor, the "atypical carcinoid", and the most aggressive malignant neoplasm, the small-cell carcinoma. Atypical carcinoid tumor have a higher malignant potential, is more commonly peripheral than is the typical carcinoid tumor. Histologic features would characterize a carcinoid as hitologically atypical : increased mitotic activity, pleomorphism and irregularity of neuclei with promonent nucleoli, hyperchromatin, and abnormal nuclear-cytoplasmic ratio, areas of increased cellularity with disorganization of architecture, and areas of tumor necrosis. Metastatic involvement of regional lymph nodes and distant organ is common. The prognosis is related to size of the tumor, typical of atypical appearance, endoluminal of extraluminal growth, vascular invasion, node metastasis, Pulmonary resection is the treatement of choice for bronchial carcinoid. We experienced one case of bronchopulmonary atypical carcinoid tumor. In the case, radiologic study showed solitary lung mass with liver metastasis and the level of 5-HIAA was elevated. There was no history of cutaneous flushing, diarrhea, valvular heart disease. The authors reported a case of bronchopulmonary atypical carcinoid tumor with review of literatures.
The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto es during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1. Plasma volume was increased in the patients during the oliguric-and hypertensive diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2. Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3. Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4. Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5. Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance in these cases. Relatively increased circulating blood volume due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6. Cardiac hemodynamic alteration returned to normal during late stage of the diuretic phase, while renal hemodynamic changes were normalized at six months after the onset.
Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.
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