• Journal of Chest Surgery
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• v.37 no.7
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• pp.570-577
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• 2004

CT angiography is now available to evaluate the early graft patency after coronary bypass surgery. We investigated whether patency or occlusion of the bypass grafts can be visualized by CT angiography and what factors effect the visuality. Material and Method: Fifty patients underwent scanning with a 4-slice computed tomographic scanner (Somatom Volume ZoomTM; Siemens, Germany) before being discharged after coronary artery bypass grafting. To evaluate graft patency and relationship between the quality of graft image and the characteristics of the diseased coronary vessels, 50 internal thoracic artery grafts, 18 radial artery grafts, and 56 vein grafts were included in this study. Result: All vein grafts (24 grafts; 32 anastomoses) to left coronary artery system were well visualized, but 3 grafts (4.7%) of 30 vein grafts (35 anastomoses) to right coronary artery system were not visualized. The latter was also occluded in invasive coronary angiographic study. Thirty-nine (78%) internal thoracic artery grafts were well visualized, 8 (16%) faintly visualized, and 3 (6%) not visualized, but all the internal artery grafts were well patent in invasive coronary angiographic study. Conclusion: Unvisualized vein grafts in CT angiography means occlusion of the grafts, but unvisualized arterial grafts in CT angiography may not mean occlusion of the graft but result from competitive flow between the graft and coronary artery. To confirm patency of the unvisualized arterial grafts, invasive coronary angiography is needed.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.571-578
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• 1995

Rastelli operation in which right ventricle[RV and pulmonary artery[PA is connected with an artificial graft is effective in increasing the pulmonary blood flow in certain types of congenital heart disease but, in many, it requires a reoperation because of the relative stenosis of graft that develops as the patients become old. The purpose of this study is to evaluate the various factors which many influence the long term outcome of such patients following a Rastelli operation. A total of 47 patients underwent a Rastelli operation during a 15 year period between November, 1978 and October 1993. The mean follow-up period is 76.1 51.3 months.1 Among the 47 patients, a valved conduit was used in 30[63.8% , and non-valved conduit in 17[36.2% patients. In the 8 patients[17.0% who died postoperatively, a valved conduit was used in 5 [16.6% and a non-valved conduit in 3[17.6% . There was no statistical difference in mortality between the 2 groups. There was a good linear correlation between the body surface area[X and the conduit size[Y [Y=3.86X + 14.6, R=0.55, P=0.01 .2 Ten patients underwent replacement of the conduit during the follow-up period. The type of conduit used and the frequency of subsequent replacement were as follows: Ionescu-Shiley, valved-33.3%, Carpentier-Edwards, valved-30.8%, Hancock, valved-80% and non-valved conduit-9.1%. The median period free of reoperation was 110 months for the valved and 79 months for the non-valved group, there being no statistical difference between the 2 groups. 3 The patients who did not require reoperation are all doing well [New York Heart Association Functional Classification: Class I . Pressure gradient between the RV and the PA was 20 mmHg in 10 randomly selected patients who did not require reoperation and 92 9 mmHg in 10 patients who did require reoperation.4 In the 10 patients who underwent a conduit replacement procedure.5 Among patients undergoing reoperation, 2 died from endocarditis.The remaining 8 patients are doing well without limitation in physical activity at a mean follow-up period of 32.7 33.9 months [range 2 to 89 months . 6 At 5, 7, and 10 years, the reoperation-free rates among all patients were 96%, 91% and 29% and the survival rates were 82%, 82% and 71%. In conclusion, Rastelli operation is an effective procedure in ameliorating symptoms in a select group of patients with congenital heart disease. Because of the inherent nature of relative graft stenosis and degeneration, a long-term follow-up is required under the proper selection of the graft material.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.1
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• pp.73-78
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• 2012

Excessive intake of trans fats is known to be a risk factor for cardiovascular diseases. Previously, we have shown that green tea extract (GTE) lowers the intestinal absorption of lipids and lipid-soluble compounds in rats. This study was conducted to investigate a possible role of GTE on the lymphatic absorption of elaidic acid, a major trans fat in the diet. Adult male Sprague-Dawley rats with lymph duct cannula were infused via an intraduodenal catheter at 3.0 mL/hr for 8 hr with a lipid emulsion containing $180.0{\mu}mol$ elaidic acid, $400.0{\mu}mol$ triolein, $20.7{\mu}mol$ cholesterol, $3.1{\mu}mol$ ${\alpha}$-tocopherol, and $396.0{\mu}mol$ sodium-taurocholate with or without (control) GTE in a 24 mL PBS buffer (pH, 6.4). Simultaneously, lymph was collected hourly for 8 hr via the lymph duct cannula. There was a significant difference in lymph flow by GTE. Also, the lymphatic absorption of elaidic acid for 8 hr was significantly lower in rats infused with GTE than in those not infused with GTE. Similarly, GTE infusion decreased the lymphatic outputs of cholesterol, oleic acid, and phospholipids, compared with the controls. These findings provide clear evidence that GTE has an inhibitory effect on the intestinal absorption of elaidic acid and other lipids. Our work here provides the foundation for further studies to examine and evaluate dietary strategies to ameliorate dietary trans fats from the diet.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.617-621
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• 1990

A heart supplies blood of about 15, 000 liters to each human organ in a day. A normal function of heart valves is necessary to accomplish these enormous work of heart. The disease of heart valve develops to a narrowness of a closure, resulting in an abnormal circulation of blood. In an attempt to eliminate the affliction of heart valves, the operative method to replace with artificial heart valves has developed and saved numerous patients over past 30 years. This replacement operation has been performed since early 1960`s in Korea, but all the artificial heart valves used are imported from abroad with very high costs until recent years. New artificial heart valves have been developed in Korea Advanced Institute of Science and Technology since early 1980`s. The first developed valve was designed with a free-floating pyrolytic carbon disk that is suspended in a titanium cage. The design of the valve was tested in vitro, and in animals in 1987. The results from this study was that the eccentrically placed struts creates a major and minor orifice when the disc opens and stagnation of flow in the area of the minor orifice has led to valve thrombosis. In this work, the design of the valve was changed from a single - leaflet valve to double - leaflet one in order to resolve the problems observed in the first - year tests. Morphological and hemodynamic studies were made for the newly designed valves through the in vitro and in vivo tests. The design and partial materials of the artificial heart valve was improved comparing with first - year`s model. The disc in the valve was modified from single - leaflet to bi - leaflet, and the material of the cage was changed from titanium metal to silicon - alloyed pyrolytic carbon. A test was made for the valve in order to examine its mechanical performance and stability. Morphological and hemodynamic studies were made for the valve that had been implanted in tricuspid position of mongrel dogs. All the test animals were observed just before the deaths. A new artificial heart valve was designed and fabricated in order to resolve the problems observed in the old model. The new valve was verified to have good stability and high resistance to wear through the performance tests. The hemodynamic properties of the valve after implantation were also estimated to be good in animal tests. Therefore, the results suggest that the newly designed valve in this work has a good quality in view of the biocompatibility. However, valve thrombosis on valve leaflets and annulus were found. This morphological findings were in accordance with results of surface polishing status studies, indicating that a technique of fine polishing of the surface is necessary to develop a valve with higher quality and performance.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.191-199
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• 2017

Background: This study was conducted to provide a comparison between the clinical outcomes of primary percutaneous coronary intervention (PCI) and that of fibrinolysis followed by routine invasive treatment in ST elevation myocardial infarction (STEMI). Methods: A total of 184 consecutive STEMI patients who underwent primary PCI or fibrinolysis followed by a routine invasive therapy were enrolled from 2004 to 2011, and their major adverse cardiovascular events (MACEs) were compared. Results: Among the 184 patients, 146 patients received primary PCI and 38 patients received fibrinolysis. The baseline clinical characteristics were similar between both groups, except for triglyceride level ($68.1{\pm}66.62$ vs. $141.6{\pm}154.3mg/dL$, p=0.007) and high density lipoprotein level ($44.6{\pm}10.3$ vs. $39.5{\pm}8.1mg/dL$, p=0.005). The initial creatine kinase-MB level was higher in the primary PCI group ($71.5{\pm}114.2$ vs. $35.9{\pm}59.9ng/mL$, p=0.010). The proportion of pre-thrombolysis in MI 0 to 2 flow lesions (92.9% vs. 73.0%, p<0.001) was higher and glycoprotein IIb/IIIa inhibitors were administered more frequently in the primary PCI group. There was no difference in the 12-month clinical outcomes, including all-cause mortality (9.9% vs. 8.8%, p=0.896), cardiac death (7.8% vs. 5.9%, p=0.845), non-fatal MI (1.4% vs. 2.9%, p=0.539), target lesion revascularization (5.7% vs. 2.9%, p=0.517), and stroke (0% vs. 0%). The MACEs free survival rate was similar for both groups (odds ratio, 0.792; 95% confidence interval, 0.317-1.980; p=0.618). The clinical outcome of thrombolysis was not inferior, even when compared with primary PCI performed within 90 minutes. Conclusion: Early fibrinolysis with optimal antiplatelet and antithrombotic therapy followed by appropriate invasive procedure would be a comparable alternative to treatment of MI, especially in cases of shorter-symptom-to-door time.

• Nutrition Research and Practice
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• v.8 no.4
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• pp.368-376
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• 2014

BACKGROUND/OBJECTIVES: The objectives of this study were to investigate the effects of lycopene on the migration, adhesion, tube formation capacity, and p38 mitogen-activated protein kinase (p38 MAPK) activity of endothelial progenitor cells (EPCs) cultivated with high glucose (HG) and as well as explore the mechanism behind the protective effects of lycopene on peripheral blood EPCs. MATERIALS/METHODS: Mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation. EPCs were identified after induction of cellular differentiation. Third generation EPCs were incubated with HG (33 mmol/L) or 10, 30, and $50{\mu}g/mL$ of lycopene plus HG. MTT assay and flow cytometry were performed to assess proliferation and apoptosis of EPCs. EPC migration was assessed by MTT assay with a modified boyden chamber. Adhesion assay was performed by replating EPCs on fibronectin-coated dishes, after which adherent cells were counted. In vitro vasculogenesis activity was assayed by Madrigal network formation assay. Western blotting was performed to analyze protein expression of both phosphorylated and non-phosphorylated p38 MAPK. RESULTS: The proliferation, migration, adhesion, and in vitro vasculogenesis capacity of EPCs treated with 10, 30, and $50{\mu}g/mL$ of lycopene plus HG were all significantly higher comapred to the HG group (P < 0.05). Rates of apoptosis were also significantly lower than that of the HG group. Moreover, lycopene blocked phosphorylation of p38 MAPK in EPCs (P < 0.05). To confirm the causal relationship between MAPK inhibition and the protective effects of lycopene against HG-induced cellular injury, we treated cells with SB203580, a phosphorylation inhibitor. The inhibitor significantly inhibited HG-induced EPC injury. CONCLUSIONS: Lycopene promotes proliferation, migration, adhesion, and in vitro vasculogenesis capacity as well as reduces apoptosis of EPCs. Further, the underlying molecular mechanism of the protective effects of lycopene against HG-induced EPC injury may involve the p38 MAPK signal transduction pathway. Specifically, lycopene was shown to inhibit HG-induced EPC injury by inhibiting p38 MAPKs.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1391-1398
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• 1992

The hypothesis tested is that shifts in pH, induced when a cardioplegic solution is oxygenated, can be detrimental. The object of this study is to evaluate the effect of the pH of the oxygenating cardioplegic solution on postischemic recovery in the isolated rat heart. Either 100% oxygen or 95% oxygen: 5% carbon dioxide was added to the cardioplegic solution[St. Thomas` Hospital No. 2] and determined postischemic recovery of isolated rat hearts after 2 hours and 3 hours of 20oC cardioplegic protected ischemia. Heart were arrested and reinfused every 30 minutes throughout the ischemic period with cardioplegic solution. When 100% oxygen was added, the pH of the cardioplegic solution increased from 7.8[no oxygen] to 8.5[100% oxygen] without any change in postischemic functional recovery. But when 95% oxygen ; 5% carbon dioxide was added, the pH of the cardioplegic solution reversely decreased to 6.84 in the 2-hour ischemic group and 6.73 in the 3-hour ischemic group, associated with improved postischemic functional recovery. After 2-hour ischemia, systolic pressure improved from 88.2$\pm$3.7%[no oxygen] and 88.7$\pm$3.8%[100% oxygen] to 96.6$\pm$1.8%[95% oxygen : 5% carbon dioxide], p<0.05, aortic flow from 43.3$\pm$3.1% and 38.4$\pm$10.6% to 74.5$\pm$5.0%, p<0.001, cardiac output from 55.5$\pm$4.6% and 47.4%$\pm$10.6% to 73.1$\pm$4.6%, p<0.05, stroke volume from 62.7$\pm$4.6% and 52.0$\pm$10.1% to 77.2$\pm$4.6%, p<0.05, and dP/dT from 59.3$\pm$7.2% and 56.7$\pm$7.6% to 78.9$\pm$4.6%, p<0.05. The infused amount of the cardioplegic solution during 2-hour ischemic period was similar in three groups. After 3-hour ischemia, cardiac output improved from 17.0$\pm$3.8%[no oxygen] to 45.9$\pm$7.5%[95% oxygen: 5% carbon dioxide], p<0.05, and stroke volume from 21.0$\pm$3.9%[no oxygen] to 50.1$\pm$6.6%[95% oxygen: 5% carbon dioxide], p<0.01. In conclusion, the St. Thomas` Hospital No. 2 cardioplegic solution should be oxygenated but with 95% oxygen: 5% carbon dioxide and not 100% oxygen because of the additive effect of a relatively "Acidotic" pH.t; pH.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.911-917
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• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Korean Journal of Veterinary Research
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• v.39 no.2
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• pp.247-256
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• 1999

A disease of young Holstein calves characterized by recurrent pneumonia, ulcerative and granulomatous stomatitis, enteritis with bacterial overgrowth, periodontitis, delayed wound healing, persistent neutrophilia and death at an early age had been originally described in 1983 and again in 1987. Most of these calves had stunted growth and a persistent, progressive neutrophilia (often exceeding 100,000/ml). By investigation of pedigrees, all of the affected calves have now been traced to a common sire and confirmed by polymerase chain reaction (PCR) diagnostic DNA testing to be homozygous carriers of a defective allele for bovine CD18. Neutrophils from these calves have several functional deficits and, most importantly, fail to adhere in a ${\beta}_2$-integrin dependent manner. The ${\beta}_2$-integrins represent a family of glycoproteins which participate in various leukocyte adhesion reactions during host defense. The presence or absence of ${\beta}_2$-integrin molecules can be demonstrated on the surface of neutrophils, monocytes and lymphocytes from normal or affected calves using specific monoclonal antibodies and flow cytometry, or by colloidal gold immunolabeling and scanning electron microscopy in backscatter mode. Deficiency of the ${\beta}_2$-integrins on all leukocyte types in Holstein calves is analogous to leukocyte adhesion deficiency (LAD) seen in humans. Neutrophils in bovine (BLAD) and human LAD patients are unable to adhere to the endothelial lining of the cardiovascular system thus interrupting egression of neutrophils into infected tissues. Other leukocytes, while still deficient in expression of the ${\beta}_2$-integrins, are still able to efficiently egress from the blood stream due to interactions of other adhesion molecules that are not as highly expressed on neutrophils. Both BLAD cattle and LAD children (who do not receive bone marrow transplants) often die at an early age as a result of the failure of neutrophils to extravasate into infected tissues. In 1991, Shuster, et $al^{27}$, identified two point mutations within the alleles encoding bovine CD18 in a Holstein calf afflicted with leukocyte adhesion deficiency. One mutation causes an aspartic acid to glycine substitution at amino acid 128 (D128G) in an extracellular region of this adhesion glycoprotein that is highly conserved (> 95% identity) between humans, cattle and mice. The other mutation is silent. Numerous calves with clinical symptoms of leukocyte adhesion deficiency have since been tested and all have been found homozygous for the D128G allele. In addition, calves homozygous far the D128G allele have been identified during widespread DNA testing in the United States. All cattle with the mutant allele are related to one bull, who through artificial insemination (A.I.), sired many calves in the 1950's and 1960's. The carrier frequency of the D128G CD18 allele among U.S. Holstein cattle had reached approximately 15% among active A.I. bulls and 8% among cows. By 1993, the organization of the dairy industry and the diagnostic test developed to genotype cattle, enabled virtually complete eradication of bovine leukocyte adhesion deficiency among current and future A.I. bulls.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.213-220
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• 1983

Pulmonary function is the determinant of blood gas tension. However, Acid-Base disturbances can also alter partial pressures of oxygen and carbon dioxide in arterial blood. During respiratory acidosis $PO_2$ will be lowered and reverse changes will be produced during respiratory alkalosis. On the other hand, in metabolic acidosis $PO_2$ will be elevated and $PCO_2$ will be lowered by the respiratory compensation, and reverse response will be induced in metabolic alkalosis. Urinary gas tension has many influencing factors than arterial blood and difficult to estimate the tendency of its alterations. Urinary $PO_2$ and $PCO_2$ are not always identical level as venous blood. It is to be altered by blood gas tension, flow rate of urine, metabolic rate of kidney, and Acid-Base status of blood. Particularly countercurrent exchange of oxygen and carbon dioxide in the renal medulla will make larger alteration of gas tension than venous blood. After induction of Acid-Base disturbances [disturbances] arterial and urinary $PCO_2$, $PO_2$, urinary volume, and osmolarity were determined in dogs, and the relationships between arterial and urinary $PCO_2$ , $PO_2$ Acid-Base disturbances, urinary volume, and osmolarity were investigated. 1. During the acute Metabolic and Respiratory disturbances urinary pH did not respond on respiratory origin. However, there were immediate urinary response in pH on metabolic origin. 2. Urinary $PO_2$, $PCO_2$, did not always follow arterial or venous gas tension and Acid-Base disturbance. Urinary $PCO_2$, correlate well with the urinary volume. The larger the urinary volume, $PCO_2$ lowered to the venous level. The smaller the urinary volume, urinary $PCO_2$ tends to be higher. However urinary $PO_2$ did not have any particular correlation with urinary volume. 3. Correlation between urinary $PCO_2$ and $PO_2$ were inversely proportional to arterial blood. Differences of $PCO_2$ between arterial blood and urine also did not have any particular correlation with urinary volume. This may suggest that changes on blood gas tensions can influence on urinary $PCO_2$. 4. There were eminent clear inverse correlation between urinary $PCO_2$ and osmolar concentrations of urine. Above results strongly suggest that partial pressure of gas in urine primarily depend upon counter-current exchanges in renal medullary tissues.