• 제목/요약/키워드: Heart atrium

검색결과 256건 처리시간 0.023초

단순 작업성 심관류 모델에서의 신생돈 심장의 보존 후 백혈구-제거 혈액을 이용한 재관류가 심근 VCAM-1 발현 및 심기능에 미치는 영향 (Effect of reperfusion with leukocyte-depleted blood on the expression of myocardial vascular cell adhesion molecule-1 (VCAM-1) and myocardial function in isolated working heart perfusion model)

  • 이정렬;석철준;서정욱;한재진
    • Journal of Chest Surgery
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    • 제33권3호
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    • pp.213-220
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    • 2000
  • Background: Adhesion of leukocytes to myocardium or vascular endothelium has been known as an importation initial step in the ischemia-reperfusion injury which may affect the cardiac function. Therefore, leukocyte-depleted reperfusion may inhibit ischemia-reperfusion induced functional and ultrastructural deterioration. In this study, we quantified the time-dependent expression of the vascular cell adhesion molecule-1(VCMA-1) on piglet myocardium and demonstrated its relation to functional recovery using isolated piglet heart perfusion model. Material and Method: Neonatal(1 to 3 day old) piglet heart was harvested with 4$^{\circ}C$ University of Wisconsin solution (UWS) and presrved in the same solution for 12 hours. Ex vivo model of an isolated working neonatal piglet heart perfusion consisting of membrane oxygenator and roller-pump was used (Fig. 1). Hearts were grouped into leukocyte-non-depleted (group A, n=8) and leukocyte-depleted group(group B, n=8). In group B, hearts were reperfused with leukocyte-depleted blood using a leukocyte filter (Sepacell R, Asahi Medical, Japan). Segments of right atrium were taken before and after 1, 2, 3, and 4 hours of reperfusion for the evaluation of expression of VCAM-1. The intensity of immunohistochyemical satining of the VCAM-1 on the myocardium were graded semiquantitatively (0 to 4). For the evaluation of myocardial stroke work indices were calculated as well at the same time-points. Result: Mean expressins of VCAM-1 on the myocardium at 0, 1, 2, 3, adn 4 hours of reperfusion were 0.63, 1.44, 1.64, 2.65, and 3.34 in group A, while 0.56, 1.40, 1.50, 1.88 and 2.14 in group B (Fig. 3). Mean stroke work indices at 0.5, 1, 2, 3, and 4 hours after reperfusion were 1.35$\times$104, 1.32$\times$104, 1.14$\times$104, 0.81$\times$104, 0.68$\times$104 erg/gm in group A, while 1.40$\times$104, 1.43$\times$104, 1.43$\times$104, 1.28$\times$104, and 1.12$\times$104 erg/em in group B(Fig. 4). Conclusion : In this study, we demonstrated that leukocyte-depletion attenuated the expression of VCAM-1 during reperfusion and the time-dependent functional deterioration of the myocardium was well correlated with the degree of VCAM-1 expression.

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양측 심방 연결을 형성하는 부분 폐정맥 환류 이상의 3D 프린팅 모델 (Three-Dimensional Printed Model of Partial Anomalous Pulmonary Venous Return with Biatrial Connection)

  • 김명경;김성목;김은경;장성아;전태국;최연현
    • 대한영상의학회지
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    • 제81권6호
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    • pp.1523-1528
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    • 2020
  • 부분 폐정맥 환류 이상은 드문 선천성 폐정맥 기형의 한 종류로 진단 시 종종 간과될 수 있다. 대부분의 경우 비 침습적인 영상검사인 심장 초음파, CT 또는 MRI로 진단을 하게 되는데, 2D 모니터를 이용한 영상진단은 삼차원적으로 복잡한 심장의 구조를 이해하는데 제한이 있다. 최근에는 CT와 MRI에서 얻은 의료 영상 데이터를 기반으로 3D 프린팅 기술을 이용하여 심장의 모형을 만드는 기술이 소개되어 점차 이용이 증가되고 있다. 본 증례 보고에서 저자들은 우측 상 폐정맥과 우측 중 폐정맥이 상대정맥으로의 각각 배출되며 우측 중 폐정맥을 통해 양측 심방 간의 연결이 이루어진 환자의 CT 영상 및 3D 프린팅 모델에 대해 보고하고자 한다.

삼첨판 폐쇄증 Fontan 수술 3례 보고 (Fontan Operation for 3 Cases of Tricuspid Atresia)

  • 이상호;홍장수;이영균
    • Journal of Chest Surgery
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    • 제14권1호
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    • pp.26-32
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    • 1981
  • Three cases of tricuspid atresia were treated by Fontan varieties of operation in this department in 1980. The first case was 19 year old girl who underwent Glenn operation at the age of 6 years. Her second operation was done with ASD closure and 16mm Ionescu-Shiley valved conduit insertion between right atrium and main pulmonary artery. The second case was a 5 year old boy who underwent Kreutzer operation successfully utilizing 14mm Ionescu-Shiley va]ved conduit. The above mentioned 2 cases were Type Ib after Keith`s classification, whose immediate postoperative courses were complicated by pleura] effusion [in 2nd case chylothorax] hepatomegaly, and ascites. Those complications were relieved completely by medical treatment and closed thoractomy; Postoperative follow-up up to 11 months and 1 year periods were satisfactory with disappearance of cyanosis and dyspnea. The third case was a 8 year old boy who had complete TGA with TA [Keith`s Type IIb] who underwent Kreutze`s operation utilizing 14mm Ionescu-Shiley valved conduit, he died of low cardiac output Immediately after open heart surgery.

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보간환(補肝丸) 전탕액(煎湯液)이 가토(家兎)의 심혈관계(心血管系)에 미치는 영향(影響) (Effects of Boganhwan Water Extract on the Cardiovascular System in Rabbits)

  • 구원회;문병순
    • 대한한방내과학회지
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    • 제17권1호
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    • pp.8-33
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    • 1996
  • The present experiment was designed to understand the effect of Boganhwan on the cardiovascular system in experimental animals. And thus the Blood pressure, isometric movement of atrium,Mg++-Ca++-ATPasc activity of sarcoplasmin reticulum. liver function, prothrombin time, and changes of blood composition were measured in the presence of Boganhwan. The results obtained here were as following: 1. The blood pressure decreased in the presence of SAMOOLTANG, and the decreasing effect was more stimulated by adding Bangpoong and Ganghwa(Boganhwan) 2. The oral administration of the drug for 7days also demonstrated the decreasing of blood pressure and the effect was stimulated by adding Bangpoong and Kanghwal. 3. The autonomic nerve blocking agents such as atropine and regitine did not demonstrate the effect on the drug action. 4. Boganhwan inhibited the cardiac isometric movement and rate by stimulating the Mg++-Ca++-ATPase activity of the heart sarcoplasmins reticulum. 5. Boganhwan increased the number of red blood cell, hematocrit percentage, hemoglobin concentration, and prothrombin time. 6. The drug stimulated the liver metabolism by stimulating the total ATPase activity. According to the results. Boganhwan demonstrated the decreased blood pressure and it also increased the hemoglobin concentration and the hematocrit percent. These effects stanches the hypertension. anemia, and cerebrovascular accident.

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Arrhythmogenic Right Ventricular Cardiomyopathy in a Cat with Hepatic Lipidosis

  • Nam, Aryung;Park, Hyung-Jin;Kim, Jun-Seok;Song, Kun-Ho;Youn, Hwa-Young;Seo, Kyoung-Won
    • 한국임상수의학회지
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    • 제33권3호
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    • pp.160-164
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    • 2016
  • A Turkish angora cat with a one-week history of anorexia and vomiting was diagnosed with hepatic lipidosis. During hospitalization and treatment, the cat suddenly showed respiratory-related clinical signs, including coughing and dyspnea, 13 days after initial diagnosis. Due to the poor response to treatment, the patient was euthanized at the owner's request. A postmortem histopathologic examination of the cat's heart showed dilation and wall thinning of the right atrium and ventricle, with fibrofatty infiltration corresponding to an arrhythmogenic right ventricular cardiomyopathy (ARVC). This is a case report of ARVC concurrent with hepatic lipidosis in a cat; both diseases are related to disturbances in lipid metabolism.

기니픽 심장에서 magnesium의 생리학적 영향 (Physiological effects of magnesium in the guinea pig hearts)

  • 장성은;김상진;강형섭;김진상
    • 대한수의학회지
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    • 제41권3호
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    • pp.311-317
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    • 2001
  • In this work we have investigated the physiological effects of $MgCl_2$ in isolated atrium, papillary muscle, perfused heart and anesthesized guinea pig, The addition or infusion of $MgCl_2$ (0~20 mM or mg/kg) to perfused hearts and to anesthesized guinea pigs induced a marked and dose-dependent negative chronotropic effect. The sinoatrial node automaticity could also be reduced by $MgCl_2$. The addition of $MgCl_2$to isolated atria and to papillary muscles induced a marked and dose-dependent negative inotropic effect. The threshold voltage could be increased by $MgCl_2$in papillary muscle. Increasing $MgCl_2$ shortened the action potential duration (APD) in dose-dependent manner at 30% ($APD_{30}$) and 90% repolarization ($APD_{90}$) measured with conventional microelectrode technique in papillary muscle. In anesthesized guinea pig, the magnesium infusion resulted in a dose-dependent drop in blood pressure. These results suggested that magnesium is closely associated with cardiac physiological condition and exerts antiarrhythmic activities.

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상실성빈맥의 수술치험 -1예 보고- (Surgical Treatment of Supraventricular Tachyarrhythmia -One case report-)

  • 김치경;정진용;곽문섭;김세화;이홍균;홍순조
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1137-1144
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    • 1988
  • Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60$^\circ{C}$ for 90 seconds. The accessory pathway was successfully ablated without specific problems.

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원발성 좌심실 점액육종 -1례 보고- (Primary Left Atrial Myxosarcoma -One case Report-)

  • 박철;김종석;이연재;김한용;유병하;김종국;권오춘;김병헌
    • Journal of Chest Surgery
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    • 제34권11호
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    • pp.861-864
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    • 2001
  • 원발성 심장 점액육종은 대단히 희귀하며 원발성 심장 종양 중에서도 드물다. 저자들은 희귀한 원발성 심장 점액육종을 보고하는 바이다. 환자는 40세 여자 환자로 운동시 호흡 곤란과 심계 항진을 주소로 내원하였다. 심초음파 검사로 좌심방내 종양이 발견되어 응급 수술을 시행하였다. 좌심방내의 고식적 종양 절제후 병리 소견상 심장 점액 육종으로 진단되었으며 수술 후 별다른 합병증 없이 퇴원하였다.

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복잡 심기형에서의 동맥 전환술에 대한 연구 (Arterial Switch Operation in Complex Congenital Heart Diseaes (Application, procedure analysis,risk assessment,and results))

  • 김용진
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.237-246
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    • 1995
  • Between March 1989 and December 1994, one-stage repair was performed for correction of the intracardiac malformations associated with aortic coarctation in 34 patients or interrupted aortic arch in 8 patients via median sternotomy. There were 26 male and 16 female patients, and their body weight ranged from 1.8 to 8 kg [mean weight, 4.0 1.4 kg . The age at the operation ranged from 7 days to 18 months [mean age, 3.1 $\pm$ 3.8 months . The repair of aortic coarctation or interrupted aortic arch was performed using extended end-to-end anastomosis in most of the patients [86%, 36/42 , and six patients underwent ductal tissue excision and patch aortoplasty. Intracardiac defects were corrected concomitantly through the right atrium unless the anatomy dictated otherwise. Obstructive outlet septum was resected whenever necessary. There were seven early deaths [16.8 % , and three late deaths with a mean follow-up period of 25 months [range from 1 to 65 months . Three patients were reoperated upon residual subaortic stenosis, stenosis at the RPA origin, and subacute bacterial endocarditis respectively. None showed any significant residual or anastomotic stenosis postoperatively. One stage repair of the aortic coarctation and interrupted aortic arch associated with intracardiac defect leaves no native coarctation shelf tissue or residual hypoplasia in the repaired segment, has low incidence of recurrent or residual stenosis, minimizes reoperation and incisions, and manages arch hypoplasia easily. We concluded that surgical results of one-stage repair for the intracardiac malformation associated with aortic coarctation or interrupted aortic arch are reasonable.

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관통성 흉부 자상에 의한 심실중격 결손증: 증례보고 (Ventricular Septal Defect by Penetrating Chest Trauma - Report of One Case -)

  • 김문환;이철주
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.429-434
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    • 1992
  • We experienced a rare case of traumatic ventricular septal defect by penetrating stab injury The patient was 26-year-old women who got stab wound at the left anterior third intercostal space and left sternal border with a knife. seven hours after admission, the patient was undertaken an emergency thoracotomy due to hypovolemic shock caused by massive bleeding from transected left internal mammary artery, vein, and right ventricular outflow tract. On postoperative second day, the patient was suffered from moderate dyspnea, and arterial blood gas analysis and chest X-ray revealed hypoxemia and pulmonary edema. Right heart cardiac catheterization with Swan-Ganz Cathater showed oxygen step-up between right atrium and main pulmonary artery and a 1.6:1 ratio of pulmonary to systemic blood flow. At operation, harsh systolic thrill was palpable along right ventricular outflow tract. Through small vertical right ventriculotomy, the linear ventricular septal laceration on infundibular septum was noticed, and its size was 1.5cm with sharp margin This defeat was repaired by three interrupted matress sutures using Prolene 4-O with pledget. Her postoperative course was uneventful, and she discharged with good physical condition.

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