• Journal of Chest Surgery
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• v.32 no.12
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• pp.1065-1077
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• 1999

Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.34 no.10
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• pp.893-899
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• 2010

A previous study showed that hemodynamics is correlated with stenosis in the coronary artery. The flow characteristics and the distributions of the hemodynamic wall parameters in the coronary artery are investigated under physiological flow condition. The present study also aims to establish the mechanism of the generation of atherosclerosis by analyzing the hemodynamic variables in the coronary artery where atherosclerosis frequently occurs. The stenosis phenomena due to atherosclerosis are related to not only the biochemical reaction between blood and blood vessels but also the hemodynamic factors sush as flow separation and oscillatory wall shear stress. As the bifurcated angle increases, the size of the recirculation area that appears in the cross section increases and disturbed flow is observed in this area. We speculate that this area is the starting point of atherosclerosis in the coronary artery.

• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.433-441
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• 2010

Purpose: This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia. Methods: Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method. Results: HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum. Conclusion: The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.

• Journal of Biomedical Engineering Research
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• v.24 no.4
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• pp.329-337
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• 2003

Blood in congenital or acquired AY fistula(arteriovenous fistula) flows from arteries directly to veins. detouring peripheral micro-circulation. This makes a great effect on the hemodynamics of human cardiovascular system. In this study, a computational method using lumped parameter mode) was proposed to simulate the cardiovascular hemodynamics of patients with acute AV fistula The cardiovascular system model with a fistula compartment in left lower limb was built using 17 standard lumped compartments. Using fourth order Runge-Kutta method. we solved numerically the unsteady linear set of the ordinary differential equations resulting from application of Kirchhoff's law to the lumped parameter hemodynamic model. The baroreceptor reflex system was implemented to explain the auto-regulation effect of the cardiovascular system with acute AV fistula.

• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.94-102
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• 2003

Purpose : Cerebral blood flow (CBF) reactivity to acetazolamide (ACZ) is useful to select patients with hemodynamic failure. However, it is still a matter of speculation that varying degrees of regional CBF increases after ACZ administration represent the severity or stage of regional hemodynamic failure as assessed by positron emission tomography (PET). We studied to elucidate whether ACZ challenge $^{123}I-IMP$ brain single photon emission tomography (SPECT) can accurately grade the seventy of regional hemodynamic failure. Materials and Methods: Eighteen patients (M: 16, F: 2, average age: 61 years) with unilateral occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA). Patients undewent $^{123}I-IMP$ brain SPECT study with acetazolamide challenge and PET study was carried out within 2 weeks before and after SPECT study. Five healthy volunteers with a mean age of 48 years (range: 28-73 yr, M: 3, F: 2) underwent PET studies to determine normal values. In SPECT study, an asymmetry index (Al)-the percentage of radioactivity of region of interest (ROI) in the occlusive cerebrovascular lesion to the contralateral homologous ROI-was used for numerical evaluation of relative $^{123}I-IMP$ distribution. In PET study, regional CBF, oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen ($CMRO_2$) and cerebral blood volume (CBV) values were measured with $^{15}O-labeled$ gas inhalation method and the values were used for comparison with Al (Al during acetazolamide challenge-Al of basal study) on the SPECT study. ROls were classified by severity into three groups (normal, stage I and stage II). Results: Mean values of Al in areas with normal, stage I and stage II hemodynamic failure were $6.25{\pm}7.77%\;(n=107),\;-10.38{\pm}10.41%\:(n=117)\;and\;13.30{\pm}10.51%\;(n=140)$, respectively. Al significantly differed with each groups (p<0.05). Correlation between Al and CBF, OEF and CBV/CBF in hemisphere with occlusive cerebrovascular lesion was 0.20 (p<0.01), -0.28 (p<0.01) and -0.28 (p<0.01), respectively. Conclusion: We concluded that $^{123}I-IMP$ brain SPECT with acetazolamide challenge could determine the severity ad stage of regional hemodynamic failure as assessed by PET.

• 순환기질환의공학회:학술대회논문집
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• 2006.10a
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• pp.55-56
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• 2006

• Journal of Biomedical Engineering Research
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• v.22 no.5
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• pp.393-402
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• 2001

A computational model representative of cardiovascular circulation was built using 12 standard lumped compartments. Especially, both the baroreceptor reflex and the cardiopulmonary reflex control model were implemented to explain the auto-regulation of cardiovascular system. Another important aspect of this model is to utilize the impulse-response curve of the nerve system in transferring the impulse error signals to autonomous nerve system. For the verification of this model, we have computed the normal hemodynamic conditions and compared those with the clinical data. Then. hemodynamic shock of 20% hemorrhage to cardiovascular system was simulated to test the effects of the control system model. The results of these two simulations were well matched with the experimental ones. The steady state LBNP simulation was also performed. The transient changes of hemodynamic variables due to ramp increase of bias pressure of LBNP showed good agreement with the physiological experiments. Numerical solution using only the baroreflex model showed relatively a larger deviation from the experimental data. compared with the one using the control model haying both the baroreflex and the cardiopulmonary reflex systems, which shows an important role of the cardiopulmonary reflex system for the simulation of the hemodynamic behavior of the cardiovascular system .

• Journal of Chest Surgery
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• v.9 no.1
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• pp.20-26
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• 1976

Author has performed experimental study on hemodynamic changes of lung following radical hilar stripping and contralateral pulmonary artery ligation. In view of hemodynamic changes in group 1 (right pulmonary artery ligation only) and group 2(left hilar stripping+right pulmonary artery ligation). group 2 showed remarkable decrease rate in oxygen uptake (P<0.001) and total pulmonary blood flow(P<0.001), and the more increase rate in mean pulmonary artery pressure(P<0.02) and total pulmonary vascular resistance (P<0.001). Meanwhile, the decrease percent of left lung vascular resistance was lower than group 1(P<0.001). The hemodynamic changes in group 1 returned to control range two weeks later. In the group 2, two dogs were expired as a result of atelectasis and pulmonary hypertension. Among allying 8 dogs, five months after operation, follow up studies performed in two dogs, which showed normal pulmonary hemodynamics similar to preoperative data. The altered blood gas values and decreased oxygen uptake are more remarkable in denervated lung, which may due to pulmonary hypertension and partly retained more secretion in bronchial trees than usual. Important factors of raising pulmonary vascular resistance and pulmonary artery pressure are considered as the increased blood flow to remaining left lung and dysfunction of pulmonary vascular bed to accept the increased blood flow after denervation. Loss of nerve innervation had a influence, to some extent, to the decrease of oxygen uptake and the increase of pulmonary vascular resistance and pulmonary artery pressure. There can be little question that denervation does impair the pulmonary hemodynamics, however, intact pulmonary nerve innervation is not absolutely essential for survival of the animal.

• Proceedings of the KSME Conference
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• 2001.11b
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• pp.529-532
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• 2001

The purposes of the present study are to investigate hemodynamic characteristics and to define shear-sensitive remodeling in the stenosed coronary models. Two models for the compensatory remodelling used for this research are a pre-stenotic dilation and a post-stenotic dilation models for the computer simulation. The peak wall shear stress on the post-stenotic model is higher than that of the pre-stenotic model. Two recirculation zones are generated in the pre-stenotic model, and the zones in the pre-stenotic model are smaller than those in the post-stenotic model. Variation of the wall shear stress in the pre-stenotic model is lower than that in the post-stenotic model. In computer simulation with the post-stenotic model, higher temporal and spatial shear fluctuation and stress suggested shear-sensitive remodeling. Shear-sensitive remodeling may be associated with the increased risk of plaque rupture, the underlying cause of acute coronary syndromes, and sudden cardiac death.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1660-1664
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• 2008

Extra-corporeal Life Support System (ECLS) is the device used in emergency cases to substitute a extracorporeal circulation in open heart surgery, cardiac arrest or in acute cardiopulmonary failure. To obtain the effect of counter-pulsation on hemodynamic response in the ECLS quantitatively, we developed cardiovascular model which consists of 12 compartment model of heldt et al. and 3 compartment model of Schreiner et al. based on windkessel approximation. We compared coronary perfusion, arterial pulse pressure, cardiac output, and left ventricular pressure-volume diagram according to flow configuration such as counter-pulsation, copulsation, and continous flow. When counter-pulsation was applied, 5% higher coronary perfusion, 26% lower pulse pressure, and 2% higher cardiac output than copulsation condition were calculated. We conclude that counter-pulsation configuration in the ECLS is hemodynamically more stable than copulsation and influences the positive effect to recover ventricles.