• Title/Summary/Keyword: Cardiac structure

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The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

Right ventricular failure in congenital heart disease

  • Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.101-106
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    • 2013
  • Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

Homology Modeling of Chemokine Receptor CXCR3: A Novel Therapeutic Target against Inflammatory Diseases

  • M, Shalini;Madhavan, Thirumurthy
    • Journal of Integrative Natural Science
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    • v.8 no.3
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    • pp.164-175
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    • 2015
  • CXCR3 is a C-X-C chemokine receptor type 3 also known as GPR9 and CD183. CXCR3 is a G-Protein coupled chemokine receptor which interacts with three endogenous interferon inducible chemokine's (CXCL9, CXCL10 and CXCL11) and is proved to play a vital role in the Th1 inflammatory responses. CXCR3 has been implicated to be associated with various disease conditions like inflammatory diseases, autoimmune diseases, type I diabetes and acute cardiac allograft rejection. Therefore CXCR3 receptor is found to be an attractive therapeutic target for the treatment of inflammatory diseases. Inorder to decipher the biological function of a CXCR3, 3D structure is of much important but the crystal structure for CXCR3 has not yet been resolved. Hence, in the current study Homology modeling of CXCR3 was performed against various templates and validated using different parameters to suggest the best model for CXCR3. The reported best model can be used for further studies such as docking to identify the important binding site residues.

Development of a Multi-Modal Physiological Signals Measurement-based Wearable Device for Heart Sounds Analysis (멀티 모달 생체 신호 측정이 가능한 심음 분석 웨어러블 장치 개발에 관한 연구)

  • Lee, Soo Min;Lee, Mi Ran;Wei, Qun;Park, Hee Joon
    • Journal of Korea Multimedia Society
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    • v.25 no.9
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    • pp.1251-1256
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    • 2022
  • Auscultation of heart sounds using a stethoscope is the basic method to diagnose the cardiovascular disease and observation of abnormalities. However, the heart sound transmitted to the ear through the stethoscope is greatly affected by internal sounds such as organ movement or breathing. In addition, the user's experience significantly influences the accuracy of the auscultation result. Therefore, in this paper, we developed a wearable device that simultaneously measures heart sound and PPG signals for cardiac condition monitoring. The structure of the proposed device is designed to simultaneously measure heart sound and PPG signals when worn on a finger and placed on the chest. A prototype was implemented according to the design structure, and it was confirmed that the performance of measurements and collection for physiological signals was excellent through experiments.

Intervention with Balloon Valvuloplasty followed by Patent Ductus Arteriosus Stent in a Patient with Pulmonary Atresia with Intact Ventricular Septum (풍선판막성형술과 동맥관 스텐트를 이용하여 치료한 심실중격결손을 동반하지 않은 폐동맥 폐쇄 1례)

  • Lim, Han Hyuk;Kim, Young Deuk;Lee, Jae Hwan;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1256-1256
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    • 2005
  • Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

Estimation Method for Brain Activities are Influenced by Blood Pulsation Effect (Blood Pulsation의 효과가 뇌 활성화에 미치는 영향을 알아보는 방법)

  • Lee, W.H.;Ku, J.H.;Lee, H.R.;Han, K.W.;Park, J.S.;Kim, J.J.;Yoon, K.J.;Kim, I.Y.;Kim, S.I.
    • Journal of Biomedical Engineering Research
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    • v.28 no.3
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    • pp.338-343
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    • 2007
  • BOLD T2*-weighted MR images reflects cortical blood flow and oxygenation alterations. fMRI study relies on the detection of localized changes in BOLD signal intensity. Since fMRI measures the very small modulations in BOLD signal intensity that occur during changes in brain activity, it is also very sensitive to small signal intensity variations caused by physiologic noise during the scan. Due to the complexity of movement of various organs associated with heart beat, it is important to reduce cardiac related noise rather than other physiological noise which could be required with relatively simple method. Therefore, a number of methods have been developed for the estimation and reduction of cardiac noise in fMRI study. But, each method has limitation. In this study, we proposed a new estimation method for brain activities influenced by blood pulsation effect using regression analysis with blood pulsation signal and the correspond slice of fMRI. We could find out that the right anterior cingulate cortex and right olfactory cortex and left olfactory cortex were largely influenced by blood pulsation effect for new method. These observed areas are mostly on the structure of anterior cerebral artery in the brain. That is convinced with that our method would be valid and our new method is easier to apply in practice and reduce computational burden than the retrospective method.

Altered Electrophysiological Properties of Coronary Artery in Iso-prenaline-Induced Cardiac Hypertrophy

  • Kim, Na-Ri;Han, Jin;Kim, Eui-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.5 no.5
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    • pp.413-421
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    • 2001
  • An impaired smooth muscle cell (SMC) relaxation of coronary artery by alteration of $K^+$ channels would be the most potential explanation for reduced coronary reserve in left ventricular hypertrophy (LVH), however, this possibility has not been investigated. We performed morphometrical analysis of the coronary artery under electron microscopy and measured $Ca^{2+}-activated\;K\;(K_{Ca})$ currents and delayed rectifier K $(K_{dr})$ currents by whole-cell and inside-out patch-clamp technique in single coronary arterial SMCs from rabbits subjected to isoprenaline-induced cardiac hypertrophy. Coronary arterial SMCs underwent significant changes in ultrastructure. The unitary current amplitude and the open-state probability of $K_{Ca}$ channel were significantly reduced in hypertrophy without open-time and closed-time kinetic. The concentration-response curve of $K_{Ca}$ channel to $Ca^{2+}$ is shifted to the right in hypertrophy. The reduction in the mean single channel current and increase in the open channel noise of $K_{Ca}$ channel by TEA were more sensitive in hypertrophy. $K_{dr}$ current density is significantly reduced in hypertrophy without activation and inactivation kinetics. The sensitivity of $K_{dr}$ current on 4-AP is significantly increased in hypertrophy. This is the first study to report evidence for alterations of $K_{Ca}$ channels and $K_{dr}$ channels in coronary SMCs with LVH. The findings may provide some insight into mechanism of the reduced coronary reserve in LVH.

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A preliminary simulation for the development of an implantable pulsatile blood pump

  • Di Paolo, Jose;Insfran, Jordan F.;Fries, Exequiel R.;Campana, Diego M.;Berli, Marcelo E.;Ubal, Sebastian
    • Advances in biomechanics and applications
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    • v.1 no.2
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    • pp.127-141
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    • 2014
  • A preliminary study of a new pulsatile pump that will work to a frequency greater than 1 Hz, is presented. The fluid-structure interaction between a Newtonian blood flow and a piston drive that moves with periodic speed is simulated. The mechanism is of double effect and has four valves, two at the input flow and two at the output flow; the valves are simulated with specified velocity of closing and reopening. The simulation is made with finite elements software named COMSOL Multiphysics 3.3 to resolve the flow in a preliminary planar configuration. The geometry is 2D to determine areas of high speeds and high shear stresses that can cause hemolysis and platelet aggregation. The opening and closing valves are modelled by solid structure interacting with flow, the rhythmic opening and closing are synchronized with the piston harmonic movement. The boundary conditions at the input and output areas are only normal traction with reference pressure. On the other hand, the fluid structure interactions are manifested due to the non-slip boundary conditions over the piston moving surfaces, moving valve contours and fix pump walls. The non-physiologic frequency pulsatile pump, from the viewpoint of fluid flow analysis, is predicted feasible and with characteristic of low hemolysis and low thrombogenesis, because the stress tension and resident time are smaller than the limit and the vortices are destroyed for the periodic flow.

The Clinical Study of Ketamine HC1 on Oral Surgery (구강외과 영역에 있어서 Ketamine HC1의 임상적 고찰)

  • Cho, Byoung-Uk
    • The Journal of the Korean dental association
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    • v.11 no.1
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    • pp.45-52
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    • 1973
  • Ketamine HC1(Phencyclidine derivative) is a white, crystalline substance with melting point 259℃. It is soluble in water to a 20% clear, colorless solution. a 10% aqueous solution has a pH 3.5. The chemical structure is 2-(O-chlorophenyl)-2-(methylamino) cyclohexanone hydrochloride. It is a rapid acting, nonhypnotic, nonbarbiturate drug with a wide safety margin. The author used the anesthetic ketamine hydrochloride for oral surgery procedure in 16 patients(2 to 33 years). Anesthesia was achieved with a single intramuscular injection by introduction of manufacture. Result obtained as follows : 1. It was easily administered. 2. Onset time was rapid and duration was short. 3. The mild cardiac stimulation resulted in moderate increase in the blood pressure and pulse. 4. There was no significant respiratory depression. 5. The airway can be maintained without artificial support or endotracheal intubation. 6. All protective reflex maintained, which was important in oral surgery. 7. The best results were achieved in pediatric patients than adults.

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Shaftless Disk - type Self-bearing Motor for Artificial Heart (인공심장용 무축(無軸) 원판형 자기 부상 모터)

  • ;Toru Masuzawa;Yohji Okada
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2001.05a
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    • pp.559-564
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    • 2001
  • In order to apply into a compact and reliable centrifugal blood pump, this paper introduces a self-bearing motor in which a rotor is rotated without contact. The rotor is actively controlled in only radial directions, while the axial and tilting motions are passively stable owing to the disk-shape structure of the rotor. A prototype was made in outer-rotor type that is far better in the compactness than inner-rotor type. The prototype could be driven up to 8000 rpm with the rotor vibration under 0.12mm. The maximum cardiac output and pressure head were 9 L/min and over 200 mmHg, respectively. These experimental results show that the proposed self-bearing motor has sufficient performance for application to a real blood pump.

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