• Title/Summary/Keyword: Cardiovascular flow

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Shear Stress and Atherosclerosis

  • Heo, Kyung-Sun;Fujiwara, Keigi;Abe, Jun-Ichi
    • Molecules and Cells
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    • v.37 no.6
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    • pp.435-440
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    • 2014
  • Hemodynamic shear stress, the frictional force acting on vascular endothelial cells, is crucial for endothelial homeostasis under normal physiological conditions. When discussing blood flow effects on various forms of endothelial (dys)function, one considers two flow patterns: steady laminar flow and disturbed flow because endothelial cells respond differently to these flow types both in vivo and in vitro. Laminar flow which exerts steady laminar shear stress is atheroprotective while disturbed flow creates an atheroprone environment. Emerging evidence has provided new insights into the cellular mechanisms of flowdependent regulation of vascular function that leads to cardiovascular events such as atherosclerosis, atherothrombosis, and myocardial infarction. In order to study effects of shear stress and different types of flow, various models have been used. In this review, we will summarize our current views on how disturbed flow-mediated signaling pathways are involved in the development of atherosclerosis.

Successful Bridge to Heart Transplantation through Ventricular Assist Device Implantation and Concomitant Fontan Completion in a Patient with Glenn Physiology: A Case Report

  • Ji Hong Kim;Ji Hoon Kim;Ah Young Kim;Yu Rim Shin
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.312-314
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    • 2024
  • A 3-year-old boy with Glenn physiology exhibited refractory heart failure with reduced ejection fraction. To improve the patient's oxygen saturation, he underwent ventricular assist device (VAD) implantation with concomitant Fontan completion. The extracardiac conduit Fontan operation was performed with a 4-mm fenestration. For VAD implantation, Berlin Heart cannulas were positioned at the left ventricular apex and the neo-aorta. Following weaning from cardiopulmonary bypass, a temporary continuous-flow VAD, equipped with an oxygenator, was utilized for support. After a stabilization period of 1 week, the continuous-flow VAD was replaced with a durable pulsatile-flow device. Following 3 months of support, the patient underwent transplantation without complications. The completion of the Fontan procedure at the time of VAD implantation, along with the use of a temporary continuous-flow device with an oxygenator, may aid in stabilizing postoperative hemodynamics. This approach could contribute to a safe transition to a durable pulsatile VAD in patients with Glenn physiology.

Dynamic Performance Evaluation of Blood Flow Simulator Based on Windkessel Models (공기압력모델에 기반한 혈류 시뮬레이터의 동적 특성 평가)

  • Chun, Sejong;Jin, Jonghan
    • Journal of the Korean Society for Precision Engineering
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    • v.33 no.6
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    • pp.509-516
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    • 2016
  • A blood flow simulator is one of the experimental devices used to better understand the cardiovascular system. Time-Domain analysis is not sufficient to understand the cardiovascular system because of the effects related to pulsating flows. Even when the mean pressure and mean flow rate of the blood flow simulators are satisfied, the dynamic properties can differ from the desired performance. In this paper, the Windkessel model, a well-known mathematical model of the cardiovascular system, was employed to obtain optimized pressure using initial values. The Windkessel parameters, including flow resistance, R, are expected to lead to a better understanding of the dynamic behavior of cardiovascular systems.

Color Doppler Flow Mapping of a Moving Orifice: Proximal Flow Convergence (운동입구에서의 컬러도플러유동매핑: 근위유동수렴)

  • Kim, Young-H.;Yoganathan, Ajit P.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.11
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    • pp.39-42
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    • 1992
  • Color Doppler flow mapping (CDFM) was performed on an $\underline{in\;vitro}$ experimental setup with a regurgitant moving orifice using the proximal isovelocity surface area (PISA) technique. PISA flow rates underestimated actual flow rates by as much as 65%, which is very important in diagnosing patients with valvular regurgitations or stenosis. The correction factor considering the velocity of the orifice improved the PISA flow rates.

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An Eperimental Study of Chungpyesagan-tang on Cerebral Blood Flow and Nitric Oxide in Cerebral Ischemia of Rat (뇌허혈시 청폐사간탕이 뇌혈류 및 산화질소에 미치는 영향에 대한 실험적 연구)

  • Kim, Young Suk;Jung, Woo Sang;Park, Seong Uk;Moon, Sang Kwan;Go, Chang Nam;Cho, Ki Ho;Bae, Hyung Sup;Lee, Kyung Sup;Lee, Doo Ick
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.1-7
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    • 2005
  • Objectives: Chungpyesagan-tang is a famous oriental Objectives: medicine treatment frequently used to stroke in Korea. The objective of this study is to evaluate the mechanism of the therapeutic effect of Chungpyesagan-tang on stroke in rat. Methods: We compared the difference in regional cer Methods: ebral blood flow, nitric oxide (NO) synthesis between the control and the Chungpyesagan-tang-treated group after ligating middle cerebral artery. Results: In our study, cerebral blood flow increased more in the stroke rats which had been fed by Chungpyesagan-tang than in the control. Chungpyesagan-tang induced vascular NO synthesis, but had no effect on neuronal NO synthesis. Conclusion: The mechanism of Chngpyesagan-tang's therapeutic effect on ischemic stroke could be explained by increasing cerebral blood flow and vascular NO synthesis.

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Development of the Cardiovascular Simulator for Pulse Diagnosis Study (맥진연구를 위한 심혈관계 시뮬레이터의 개발)

  • Lee, Ju-Yeon;Shin, Sang-Hoon
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.16 no.1
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    • pp.19-26
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    • 2012
  • Objectives The aim of this study is to develop a cardiovascular simulator that can reproduce blood pressure pulse and blood flow similar to those of the human body. Methods In order to design a system similar to the human cardiovascular system, the required performances were determined by investigating the hemodynamic characteristics of the heart and the arterial system. Main organ to be imitated is heart in simulator. The rest of the system was minimally designed. Also, a blood pressure and blood flow measurement system was developed for measuring the results. Results The developed system showed blood pressure pulse at similar range of the human aorta. The result waveform include primary wave caused by ventricular systole except reflected wave. Conclusions The blood pressure and blow flow patterns were replicated by the simulator. These patterns were similar to those of the human body. The system will play an important role in studying pulse diagnostics.

Clinical Value of Intraoperative Flow Measurements of Brachiocephalic Arteriovenous Fistulas for Hemodialysis

  • Lee, Jonggeun;Lee, Seogjae;Chang, Jee Won;Kim, Su Wan;Song, Jung-Kook
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.121-126
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    • 2020
  • Background: The aim of this study was to analyze the clinical outcomes of autogenous brachiocephalic arteriovenous fistulas and to investigate the factors associated with 1-year patency after initiation of hemodialysis. Methods: We retrospectively reviewed the medical records of 41 patients who underwent surgery to create an autogenous brachiocephalic arteriovenous fistula between January 2015 and December 2017, received hemodialysis at the same hospital for longer than 1 year, and were monitored for their vascular access status. Intraoperative flow was measured using transit-time ultrasonography. Results: The 1-year primary and secondary patency rates were 61% (n=25) and 87.8% (n=36), respectively. The functional group (subjects who required no intervention to maintain patency within the first year after hemodialysis initiation) displayed a significantly higher median intraoperative flow rate (450 mL/min) than the non-functional group (subjects who required intervention at least once regardless of 1-year patency) (275 mL/min) (p=0.038). Based on a receiver operating characteristic curve analysis, all patients were additionally subdivided into a high-flow group (>240 mL/min) and a low-flow group (≤240 mL/min). The high-flow group included a significantly greater number of functional brachiocephalic arteriovenous fistulas than the low-flow group (74.2% vs. 20%, respectively; p=0.007). Conclusion: Transit-time flow, as measured with intraoperative transit-time ultrasonography, was associated with patency without the need for intervention at 1 year after initiation of hemodialysis.

Review of Simulators for Cardiovascular System (심혈관계 시뮬레이터의 연구동향)

  • Shin, Sang-Hoon;Lee, Ju-Yeon
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.15 no.1
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    • pp.55-66
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    • 2011
  • Objectives: The purpose of this study is to review the simulator for cardiovascular system. Methods & Results: Simulators were classified according to the structure and function of cardiovascular system. Heart and blood vessel were selected as the represent of structure. Blood pressure and blood flow were chose as the functional index. With the view points of four keywords, four kinds of simulators were selected: artificial heart, pressure simulator, flow simulator, and pulse simulator. Conclusions: This paper discussed the state of the art of research and development of the selected four kinds of simulators.

Using Continuous Flow Data to Predict the Course of Air Leaks After Lung Lobectomy

  • Jaeshin Yoon;Kwanyong Hyun;Sook Whan Sung
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.179-185
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    • 2023
  • Background: Assessments of air leaks are usually performed subjectively, precluding the use of air leaks as an evaluation factor. We aimed to identify objective parameters as predictive factors for prolonged air leak (PAL) and air leak cessation (ALC) from air flow data produced by a digital drainage system. Methods: Flow data records of 352 patients who underwent lung lobectomy were reviewed, and flow data at designated intervals (1, 2, and 3 hours postoperatively [POH] and 3 times a day thereafter [06:00, 13:00, 19:00]) were extracted. ALC was defined by flow less than 20 mL/min over 12 hours, and PAL was defined as ALC after 5 days. Cumulative incidence curves were obtained using Kaplan-Meier estimates of time to ALC. Cox regression analysis was performed to determine the effects of variables on the rate of ALC. Results: The incidence of PAL was 18.2% (64/352). Receiver operating characteristic curve analysis showed cut-off values of 180 mL/min for the flow at 3 POH and 73.3 mL/min for the flow on postoperative day 1; the sensitivity and specificity of these values were 88.9% and 82.5%, respectively. The rates of ALC by Kaplan-Meier analysis were 56.8% at 48 POH and 65.6% at 72 POH. Multivariate Cox regression analysis revealed that the flow at 3 POH (≤80 mL/min), operation time (≤220 minutes), and right middle lobectomy independently predicted ALC. Conclusion: Air flow measured by a digital drainage system is a useful predictor of PAL and ALC and may help optimize the hospital course.