• Title/Summary/Keyword: Cardiovascular Research

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Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results (경피적 동맥관 폐쇄술에 사용된 Duct-Occlud Coil의 종류에 따른 중-단기 결과의 비교)

  • Kim, Myung Kwan;Han, Dong Ki;Choi, Jae Young;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Sul, Jun Hee;Lee, Sung Kue
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.158-164
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    • 2005
  • Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

Location of Ruptured Bullae in Secondary Spontaneous Pneumothorax

  • Choi, Jinseok;Ahn, Hyo Yeong;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su;Lee, Jonggeun
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.424-429
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    • 2017
  • Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

Preventive Effects of Peony Root Extracts on Oxidative Stress, Thrombosis and Atherosclerosis (백작약 추출물이 항산화활성, LDL 산화 억제 및 혈전용해에 미치는 영향)

  • Park, Soon-Gi;Lee, Min-Ja;Jung, Hyun-Jung;Lee, Hye-Sook;Kim, Hyuck;Na, Sun-Taek;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.88-103
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    • 2009
  • Objectives: There is currently increased interest in the identification of natural antioxidant compounds derived from various plants. Peony Root (PR) is used worldwide for the treatment of many types of cardiovascular disease including atherosclerosis and hypertension. It has been used in Korean traditional medicine for the treatment of glycosuria, hypertension and cancer. However, to date, no studies concerning the antioxidant properties of PR have been conducted. Therefore, this study was conducted to evaluate the in vitro scavenging activity, inhibitory effect of LDL oxidation of pro-oxidant reactive species and anti-thrombosis effect in response to treatment with PR using various screening methods including biological and non-biological oxidants. Methods: In this study, the antioxidant activity of extract from PR was studied with in vitro methods by measuring the antioxidant activity by TEAC, measuring the scavenging effects on reactive oxygen species (ROS) [superoxide anion, hydroxyl radical] and on reactive nitrogen species (RNS) [nitric oxide and peroxynitrite] as well as measuring the inhibitory effect on $Cu^{2+}$-induced human LDL oxidation and the inhibitory effect on collagen-induced platelet aggregation. Results: The PR extracts were found to have a potent scavenging activity of oxidative stress [DPPH, superoxide anion, hydroxyl radical, nitric oxide and peroxynitrite, etc.] as well as an inhibitory effect on LDL oxidation and on platelet aggregation. Conclusions: The PR extracts have anti-oxidative and anti-atherosclerotic effects in vitro system, which can be used for developing pharmaceutical drugs against oxidative stress and atherosclerosis.

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Inhibition of Tumor Necrosis $Factor-{\alpha}$ mRMA Expression by a Limited Series of Tetrahydroisoquinolines in Mouse Peritoneal Macrophages

  • Jung, Tae-Ho;Lee, Young-Soo;Kang, Young-Jin;Lee, Bog-Kyu;Ko, Young-Shin;Seo, Han-Geuk;Chung, Soo-Youn;Lee, Duck-Hyung;Yun-Choi, Hye-Sook;Chang, Ki-Churl
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.4
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    • pp.325-331
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    • 2000
  • Tumor necrosis $factor-{\alpha}\;(TNF-{\alpha})$ plays important roles in inflammatory responses. Some of tetrahydroisoquinoline (THI) compounds exhibited to inhibit iNOS expression in animal studies and RAW 264.7 cells, but the action of THI on inflammatory reaction was not fully investigated. In the present study, we examined a limited series of THIs (higenamine, YS-51 and THI-52) on the $TNF-{\alpha}$ mRNA expression in mouse peritoneal macrophages by Northern analysis. When thioglycollate-stimulated peritoneal macrophages were incubated with LPS (100 ng/ml), expression of $TNF-{\alpha}$ mRNA was evident and reached its maximum at 2.5 h, which was reduced concentration-dependently by treatment with THIs. When the $TNF-{\alpha}$ activity of macrophage-conditioned media was measured using a TNF-sensitive L929 fibroblast cell line, CCL 1, all THIs increased the cell viability in a concentration dependent manner. The concentrations of THIs used are not cytotoxic by itself when analysed by MTT. Furthermore, nitrite/nitrate level was significantly reduced by the presence of THIs in cells treated with $LPS+interferon-{\gamma}\;(IFN-{\gamma}).$ It is concluded, thus, that these results strongly indicated that THIs can suppress the $TNF-{\alpha}$ expression and reduce NO, which may be useful for the inflammatory disorders.

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Multiple Embolic Aortic Valve Endocarditis with Small Patent Ductus Arteriosus in Adult

  • Kim, Seon Hee;Song, Seunghwan;Kim, Min Su;Kim, Sang-Pil;Choi, Jung Hyun
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.137-140
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    • 2014
  • A 50-year-old female was admitted to Pusan National University Hospital with complaints of fatigue and sweating. Echocardiography showed a small patent ductus arteriosus (PDA) and highly mobile vegetations on the aortic valve. Emergency operation was performed due to the high risk of embolization and severe aortic regurgitation. When the pulmonary artery opened, we found unexpected fresh vegetation. The tissue of the PDA was fragile and infected. We successfully removed the infected tissue, closed the PDA with a patch, and replaced the aortic valve with a mechanical prosthesis.

Inhibitory Effect of Panax notoginseng on Nitric Oxide Synthase, Cyclo-oxygenase-2 and Neutrophil Functions

  • Park, Soon-Gi;Joo, Shin-Tak;Ban, Chang-Gyu;Moon, Jin-Young;Park, Sun-Dong;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.5
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    • pp.1295-1302
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    • 2006
  • Our preliminary aim is to elucidate the pharmacokinetic features of the PNS(Panax notoginseng Buck F.H. Chen. (Arialiaceae) root). First, we assessed the prevention of neurtrophil functions. A Panax notoginseng inhibited neutrophil functions, including degranulation, superoxide generation, and leukotriene B4 production, without any effect on 5-lipoxygenase activity. This Panax notoginseng reduced nitric oxide (NO) and prostaglandin E2 production in mouse peritoneal macrophages stimulated with lipopolysaccharide, whereas no influence on the activity of inducible NO synthase, cyclo-oxygenase-2 or cyclo-oxygenase-1 was observed. Panax notoginseng significantly reduced mouse paw oedema induced by carrageenan. The results indicate that Panax notoginseng exerts anti-inflammatory effects related to the inhibition of neutrophil functions and of NO and prostaglandin E2 production, which could be due to a decreased expression of inducible NO synthase and cyclo-oxygenase-2.

Cellular Viability of Cryopreserved Porcine Valve According to Warm Ischemic Time (Warm Ischemic Time 에 따른 냉동보존돼지판막의 세포생존율)

  • Park, Young-Hwan;Yoon, Chee-Soon;Lee, Chong-Eun;Chang, Byung-Chul;Park, Chong-Chul;Hwal, Su;Cho, Bum-Koo
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.305-310
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    • 2001
  • 배경: 판막대치술에 냉동보존판막의 이용은 감염에 대한 저항성과 탁월한 혈류역학으로 증가하고 있다. 판막육아세포의 생존율은 이식된 냉동보존 판막의 내구성에 영향을 미친다고 알려져 있고, 세포의 생존율은 warm ischemic time에 영향을 받는 것으로 알려져 있다. 냉동 보존하여 이식할수 있는 공여 판막의 warm ischemic time 의 적정치를 구하기 위하여, warm ischemic time에 다른 세포의 생존율을 관찰하였다. 대상 및 방법: 1.조직의 획득: 실제 판막을 냉동 보존하는 상황과 유사하게 하기 위하여 도살된 돼지의 심장과 폐를 밀봉한 상태로 4~8$^{\circ}C$로 냉장 보관하여 (warm ischemic time) 일정시간이 경과한 후, 심장과 폐에서 심장을 적출하여 4$^{\circ}C$하트만 용액에 24시간 보관하였다.(cold ischemic time). Warm ischemic time에 따라 2시간, 12시간, 24시간 36시간으로 4군으로 나누었으며, 각 군마다8개의 돼지 심자을 이용하였다. 2. 조직의 멸균: RRMI 1640에 항생제를 섞은 용액에 멸균하고, 3 냉동과 냉동보존; American tissue bank에서 제시한 냉동곡선에 따라 냉동하여, 액체질소 탱그에서 7일간 보존 후 해동하였다. 4. 생존율의 측정; 판막의 생존율 검사는 Triphan blue test로 하였고, 각각 warm ischemic period후 , cold ischemic period 후, 해동 후에 시행하였다. 5. 분석방법; 분석은 SAS program의 pearson correlation으로 하였다. 결과: 1. 멸균, 냉동과 냉동 보존하는 과정의 적합성을 규명하기 위하여 이 과정의 전과 후인 Cold ischemic period 후와 해동 후의 대동맥판막의 생존율의 차이를 비교한 결과, 차이가 없었다.(p =0.619). 2, warm ischemic time 과 warm ischemic period 후 , Cole ischemic period 후와 해동후의 대동맥판막의 생존율과의 correlation 은 각각 R= -0.857, -.0.673과 -0.549로 강하거나 , 혹은 뚜렷한 음성적 관계가 있었다. 삼천판막의 생존율과 대동맥판막의 생존율과 뚜렷한 상관관계가 있었다. 결론; 1. Warm ischemic time 이 길어지면 판막유아세포의 생존율이 감소하고, 12시간 이상되면 해동후의 판막육 아페포의 생존율이 50% 이하로 떨어졌다. 2. 본 연구에서 시행한 판막의 냉동보존방법은 세포의 생존율을 유지하는데 양호한 것으로 나타났으며 삼천판막으로 대동맥판막의 생존율을 예측해 볼 수 있다. 3. 그러나, 이식후 장기간 적절한 내구성을 갖기 위한 이식될 판막의 생존율은, 육아세포에 관한 여구가 좀 더 되어야 규명될 것이다.

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Conversion of Total Atrio-pulmonary Connection to Total Cavo-pulmonary Connection - Review of Indications and Hemodynamic Characteristics - (심방-폐동맥 문합술 후 총 체정맥-폐동맥 문합술로의 전환 - 수술 적응증 및 혈역학적 특징의 검토 -)

  • Seo, Jung Ho;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.199-207
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    • 2002
  • Purpose : Since the successful application of total atrio-pulmonary connection(TAPC) to patients with various types of physiologic single ventricles in 1971, post-operative survival rates have reached more than 90%. However some patients have been shown to present with late complications such as right atrial thrombosis, atrial fibrillation and protein losing enteropathy eventually leading to re-operation to control the long-term complications. The aim of this study is to review the results of total cavo-pulmonary connection(TCPC) in cases with late complications after TAPC. Methods : Between Jan. 1995 and Dec. 2000, 6 patients(5 males and 1 female) underwent cardiac catheterization $11{\pm}3$ months after conversion of previous TAPC to TCPC. We compared the hemodynamic and morphologic parameters before and after TCPC and also assessed the clinical outcomes. The indications for TAPC were tricuspid atresia in 4 cases and complex double-outlet right ventricle with single ventricle physiology in 2 cases. Results : There was no peri-operative mortality and all patients were clinically and hemodynamically improved at a mean follow-up of 11 months(range : 4 to 13). However, protein losing enteropathy recurred in 2 patients; this was were successfully treated with subcutaneous administration of heparin. Right atrial pressure before TCPC was $18.0{\pm}3.6mmHg$, but baffle pressure, corresponding to right atrial pressure decreased to $14.8{\pm}3.6mmHg$ after TCPC. The size of the pulmonary arteries did not regress after TCPC. Conclusion : The conversion of TAPC to TCPC improves clinical and hemodynamic status by decreasing the right atrial pressure and by providing a laminar cavo-pulmonary flow which enhances the effective pulmonary circulation in the so-called Fontan circulation.