• 제목/요약/키워드: Cardiac Injury

검색결과 305건 처리시간 0.023초

내독소에 의한 돼지의 급성 폐손상에서 산소기의 역할에 관한 연구 (The Role of Reactive Oxygen Free Radical in the Pathogenetic Mechanism of Endotoxin-Induced Acute Lung Injury in Domestic Pigs)

  • 김영환;유철규;정기호;최형석;이혁표;한성구;심영수;김건열;한용철
    • Tuberculosis and Respiratory Diseases
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    • 제38권4호
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    • pp.357-371
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    • 1991
  • To identify the pathogenetic role of reactive oxygen free radical-induced oxidation reaction in endotoxin-induced acute lung injury, we infused endotoxin into 8 domestic pigs; endotoxin only (n=3), pretreatment with dimethylthiourea (DMTU) (n=5). We observed the sequential changes in hemodynamic parameters, the concentration of plasma oxidized glutathione (GSSG) in pulmonary arterial and venous blood, and albumin content in bronchoalveolar lavage fluid (BALF). The results were as follows. 1) While cardiac output decreased, mean pulmonary arterial pressure, pulmonary vascular resistance, and alveolar-arterial oxygen difference increased over phase 1 (0-2 hr) and phase 2 (2-4.5 hr) by endotoxin, DMTU attenuated the above changes only during phase 2. 2) While the concentration of plasma GSSG increased significantly by endotoxin during phase 2, there were no significant differences between pulmonary arterial and venous GSSG contents during both phases. The increase in plasma GSSG content was attenuated by DMTU. 3) The content of BALF albumin was significantly lower in DMTU group than that of endotoxin group. These results suggest that reactive oxygen free radical-induced oxidation reaction may have an important pathogenetic role in endotoxin-induced acute lung injury in pigs, which seems to be greater during phase 2 rather than phase 1.

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흉부손상의 임상적 관찰 (Injuries of the Chest)

  • 박주철;노준량
    • Journal of Chest Surgery
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    • 제10권2호
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    • pp.327-336
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    • 1977
  • A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

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종격동 양성종양 21례에 대한 임상적 고찰 (Clinical Review of Benign Mediastinal Tumor)

  • 조성래;조광현;정황규
    • Journal of Chest Surgery
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    • 제10권2호
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    • pp.337-342
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    • 1977
  • A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

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Effects of pH, Buffer System and Lactate on the Simulated Ischemia-reperfusion Injury of H9c2 Cardiac Myocytes

  • Lee, Jun-Whee;Lee, Hye-Kyung;Kim, Hae-Won;Kim, Young-Hoon
    • The Korean Journal of Physiology and Pharmacology
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    • 제11권2호
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    • pp.45-55
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    • 2007
  • We elucidated the effects of various components of ischemic medium on the outcome of simulated ischemia-reperfusion injury. Hypoxia for up to 12 hours induced neither apoptotic bodies nor LDH release. However, reoxygenation after 6 or 12 hours of hypoxia resulted in a marked LDH release along with morphological changes compatible with oncotic cell death. H9c2 cells were then subjected to 6 hours of simulated ischemia by exposing them to modified hypoxic glucose-free Krebs-Henseleit buffer. Lowered pH (pH 6.4) of simulated-ischemic buffer resulted in the generation of apoptotic bodies during ischemia, with no concomitant LDH release. The degree of reperfusion-induced LDH release was not affected by the pH of ischemic buffer. Removal of sodium bicarbonate from the simulated ischemic buffer markedly increased cellular damages during both the simulated ischemia and reperfusion. Addition of lactate to the simulated ischemic buffer increased apoptotic cell death during the simulated ischemia. Most importantly, concomitant acidosis and high lactate concentration in ischemic buffer augmented the reperfusion-induced oncotic cell death. These results confirmed the influences of acidosis, bicarbonate deprivation and lactate on the progression and outcome of the simulated ischemia-reperfusion, and also demonstrated that concomitant acidosis and high lactate concentration in simulated ischemic buffer contribute to the development of reperfusion injury.

양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상 (Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis)

  • 정호진;최원석;강현재;정병천;이봉렬;이종주;이준영
    • Journal of Yeungnam Medical Science
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    • 제32권2호
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

Hydrogen sulfide restores cardioprotective effects of remote ischemic preconditioning in aged rats via HIF-1α/Nrf2 signaling pathway

  • Wang, Haixia;Shi, Xin;Cheng, Longlong;Han, Jie;Mu, Jianjun
    • The Korean Journal of Physiology and Pharmacology
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    • 제25권3호
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    • pp.239-249
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    • 2021
  • The present study explored the therapeutic potential of hydrogen sulfide (H2S) in restoring aging-induced loss of cardioprotective effect of remote ischemic preconditioning (RIPC) along with the involvement of signaling pathways. The left hind limb was subjected to four short cycles of ischemia and reperfusion (IR) in young and aged male rats to induce RIPC. The hearts were subjected to IR injury on the Langendorff apparatus after 24 h of RIPC. The measurement of lactate dehydrogenase, creatine kinase and cardiac troponin served to assess the myocardial injury. The levels of H2S, cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), nuclear factor erythroid 2-related factor 2 (Nrf2), and hypoxia-inducible factor (HIF-1α) were also measured. There was a decrease in cardioprotection in RIPC-subjected old rats in comparison to young rats along with a reduction in the myocardial levels of H2S, CBS, CSE, HIF-1α, and nuclear: cytoplasmic Nrf2 ratio. Supplementation with sodium hydrogen sulfide (NaHS, an H2S donor) and l-cysteine (H2S precursor) restored the cardioprotective actions of RIPC in old hearts. It increased the levels of H2S, HIF-1α, and Nrf2 ratio without affecting CBS and CSE. YC-1 (HIF-1α antagonist) abolished the effects of NaHS and l-cysteine in RIPC-subjected old rats by decreasing the Nrf2 ratio and HIF-1α levels, without altering H2S. The late phase of cardioprotection of RIPC involves an increase in the activity of H2S biosynthetic enzymes, which increases the levels of H2S to upregulate HIF-1α and Nrf2. H2S has the potential to restore aging-induced loss of cardioprotective effects of RIPC by upregulating HIF-1α/Nrf2 signaling.

LncRNA PART1 Attenuates Myocardial Ischemia-Reperfusion Injury by Regulating TFAP2C/DUSP5 Axis via miR-302a-3p

  • Min Zeng;Xin Wei;Jinchao Zhou;Siqi Luo
    • Korean Circulation Journal
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    • 제54권5호
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    • pp.233-252
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    • 2024
  • Background and Objectives: Myocardial ischemia-reperfusion injury (MIRI) refers to the damage of cardiac function caused by restoration of blood flow perfusion in ischemic myocardium. However, long non-coding RNA prostate androgen regulated transcript 1 (PART1)'s role in MIRI remain unclear. Methods: Immunofluorescence detected LC3 expression. Intermolecular relationships were verified by dual luciferase reporter assay. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, flow cytometry and transferase-mediated dUTP nick-end labeling (TUNEL) assays analyzed cell viability and apoptosis. The release of lactate dehydrogenase was tested via enzyme-linked immunosorbent assay (ELISA). Left anterior descending coronary artery surgery induced a MIRI mouse model. Infarct area was detected by 2,3,5-triphenyltetrazolium chloride staining. Hematoxylin and eosin staining examined myocardial injury. ELISA evaluated myocardial marker (creatine kinase MB) level. Results: PART1 was decreased in hypoxia/reoxygenation (H/R) induced AC16 cells and MIRI mice. PART1 upregulation attenuated the increased levels of Bax, beclin-1 and the ratio of LC3II/I, and enhanced the decrease of Bcl-2 and p62 expression in H/R-treated cells. PART1 upregulation alleviated H/R-triggered autophagy and apoptosis via miR-302a-3p. Mechanically, PART1 targeted miR-302a-3p to upregulate transcription factor activating enhancer-binding protein 2C (TFAP2C). TFAP2C silencing reversed the protected effects of miR-302a-3p inhibitor on H/R treated AC16 cells. We further established TFAP2C combined to dual-specificity phosphatase 5 (DUSP5) promoter and activated DUSP5. TFAP2C upregulation suppressed H/R-stimulated autophagy and apoptosis through upregulating DUSP5. Overexpressed PART1 reduced myocardial infarction area and attenuated MIRI in mice. Conclusion: PART1 improved the autophagy and apoptosis in H/R-exposed AC16 cells through miR-302a-3p/TFAP2C/DUSP5 axis, which might provide novel targets for MIRI treatment.

알코올성 지방간과 비알코올성 지방간 성인에 있어 혈청 철 표지자, 심장 표지자, 생화학적 표지자의 차이 (Difference in Serum Iron, Cardiac, and Biochemical Indices between Alcoholic and Non-alcoholic Fatty Liver)

  • 김철유;문성민;현경예;김대식;최석철
    • 생명과학회지
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    • 제19권2호
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    • pp.185-191
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    • 2009
  • 비록 음주가 간손상을 일으키는 지방간의 원인이 되긴 하나 다른 인자들 역시 지방간의 원인이 된다. 우리는 알코올성 지방간(알코올군) 및 비알코올성 지방간 남성(비알코올군)에 있어 철 표지자, 심장표지자, 그리고 생화학적 표지자의 변화와 차이를 연구하였다. 알코올군이 비알코올군 보다 신체지수, 수축기 및 확장기 혈압, 좌우 안압이 유의하게 더 높았다. 또한 혈색소 농도, 적혈구 용적률, 평균 적혈구 혈색소량, 평균 적혈구혈색소 농도, 단구 수 역시 알코올군이 비알코올군 보다 유의하게 더 높았다. 생화학적 지수인 alanine aminotransferase, ${\gamma}$-glutamyltranspeptidase, 총콜레스테롤, 중성지방, 저밀도콜레스테롤, 혈당, 크레아티닌, 요산 등도 알코올군이 비알코올군 보다 유의하게 높았고, 철 지수인 철, 총철결합능, 페리틴 농도 역시 알코올군이 의미있게 더 높았다. 이러한 결과들은 장기적인 알코올 기인성 지방간이 비음주 지방간에 비해 혈청 철농도, 심혈관 표지자, 그리고 생화학적 표지자들을 더 상승시키며, 이는 심혈관 질환 및 대사성 증후군과 같은 성인병에 노출될 가능성이 보다 높을 수 있음을 시사하고 있다.

심장혈관 조영술과 심장혈관 인터벤션의 환자 선량 평가 (Patient Radiation Dose Values During Interventional Cardiology Examinations in University Hospital, Korea)

  • 김정수;이종혁;정혜경;김정민;조병렬
    • 대한방사선기술학회지:방사선기술과학
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    • 제39권1호
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    • pp.27-33
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    • 2016
  • 심장혈관 조영술과 인터벤션은 현대 성인병의 증가로 급격히 증가하고 있다. 심장혈관 인터벤션은 장시간 동일 부위에 방사선을 조사하는 검사로 방사선으로 인한 피부상해를 일으킬 수 있다. 본 연구에서는 의료기관의 심장혈관 인터벤션의 진단참조준위를 조사하여 환자의 피폭선량을 감소시키는 도구로 사용하고자 한다. 본 연구는 147명의 환자에서 심장혈관 조영술과 인터벤션을 대상으로 누적 투시시간, 누적 투시면적선량, 영상촬영을 위한 면적선량, 누적 면적선량, 공기커마, 동영상 수, 총 영상 수에 대한 정보를 획득하여 진단참조준위를 설정하였다. 심장혈관 조영술의 진단참조준위와 인터벤션의 진단참조준위에 해당하는 면적선량 값은 각각 $44.4 Gy{\cdot}cm2$$298.6Gy{\cdot}cm2$로 나타났고 투시시간에 대한 진단참조준위는 각각 191.5 sec와 1935.3 sec로 나타났다. 진단참조준위는 반드시 넘으면 안 되는 값은 아니다. 하지만 진단참조준위를 제정하여 의료 기관에서 사용하고 있는 선량의 참조 값을 설정하고 이를 검토하는 과정은 환자의 불필요한 피폭선량을 감소시키는데 기여할 것이다.

Factors influencing success and safety of AED retrieval in out of hospital cardiac arrests in Singapore

  • NG, Jonathan Shen You;HO, Reuben Jia Shun;YU, Jae Yong;NG, Yih Yng
    • 한국응급구조학회지
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    • 제26권2호
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    • pp.97-111
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    • 2022
  • 연구 목적: 병원 밖 심정지(OHCA)에서 자동제세동기(AED)의 사용은 환자의 생존율을 향상시킨다. 싱가포르는 절도를 막고자 공공 AED를 '브레이크 글래스' 기전의 잠금 박스로 보호하고 있는데 지역사회 대응자들은 AED를 회수하기 위해 유리를 깨면서 부상을 당하곤 했다. 최초로 시도한 본 연구는 성공적인 AED 회수에 영향을 미치는 요인들을 밝히고 만연한 부상을 문서화하고자 하였다. 연구 방법: 설문지를 작성, 배포하였다. 참가자는 지난 12개월 동안 OHCA에 대처한 자들이다. 비교 검정은 피셔-프리만-할턴 정확 검정 또는 피어슨 카이제곱 검정을 사용하여 5% 유의 수준에서 시행되었고, 로짓링크함수를 사용하여 다중로지스틱회귀분석을 시행하였다. 연구 결과: 88명의 참가자가 적격했다. 성공적인 AED의 회수는 직업, 연령, 성별 및 시간 영향을 받지 않았다. myResponder 앱의 활성화로 OHCA에 대응했던 참가자들은 성공적으로 AED를 회수할 가능성이 높았다. (AOR 11.111, 95% CI: 2.141-58.824) 결 론: 모바일 myResponder 앱을 활용할 경우 AED회수 성공률이 훨씬 높았다. AED의 성공적 회수는 시간 뿐만 아니라 이용자의 성별, 연령, 직업과 무관했다. 싱가포르에서 지역사회 대응자들은 부상 위험에도 불구하고 심정지에 대응할 적극적 자세가 되어 있다.