• 제목/요약/키워드: Langendorff

검색결과 78건 처리시간 0.029초

심마비용액의 삼투압을 유지하기위한 첨가 물질들의 차이가 심근보호에 미치는 영향 (The Effect of Additives in the Cardioplegic Solution on the Recovery of Myocardium, Compariosn Among Albumin, Mannitol, and Glucose)

  • 김은기;이종국;이상헌
    • Journal of Chest Surgery
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    • 제24권11호
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    • pp.1058-1067
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    • 1991
  • High potassium cardioplegia is a widely accepted procedure to enhance myocardial protection from ischemic injuries associated with open heart surgery. Maintaining optimum osmolarity of the cardioplegic solution is one of the required conditions for an ideal cardioplegic solution Albumin is an frequently added component for maintaining optimum osmolarity of clinically used cardioplegic solutions. But the source of albumin is human blood so that the supply is limited and the cost of manufacturing is relatively high. Recently there are moves to minimized the use of blood product for fear of blood-associated infections or immunological disorders. In this experiment, we substituted mannitol or glucose for albumin added to the cardioplegic solution which has been used at the Wonju Medical College, To determine whether addition of mannitol or glucose instead of albumin in the cardioplegic solution can produce satisfactory myocardial protection during ischemia, three different groups of isolated rat heart perfused by modified Langendorff technique were studied. Wonju Cardioplegic Solution was selected as a standard high potassium[18mEq/L of K+] cardioplegic solution. Three kinds of cardioplegic solution were made by modifying the composition maintaining the same osmolarity[339$\pm$1mOsm/Kg] Isolated rat heart were perfused initially with retrograde nonworking mode and then changed to working mode. After measuring the heart rate, systolic aortic pressure, aortic flow, coronary flow, ischemic arrest by aorta cross clamp and cardioplegia was made maintaining the temperature of water jacket at 10oC. The heart was rewarmed and reperfused after 60min of ischemic arrest with intermittent cardioplegia at the 30min interval. The time to return of heart beat and the time required to get. Regular heart beat were observed after reperfusion. The recovery rate of the functional variables-heart rate, systolic aortic pressure, aortic flow, coronary flow and cardiac output were calculated and compared among the three groups of different cardioplegia-albumin, mannitol, and glucose. The wet weight and dry weight was measured and the water content of the heart as figured out for comparison. The time to return of heart beat was fastest in the albumin group, The functional recovery rates were best in the albumin group also. In the above conditions, albumin was the best additive to the cardioplegic solution compared to the mannitol or glucose.

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Calcium Current and Background Current Activation in L-triiodothyronine Loaded Ventricular Myocytes of the Rabbit

  • Han, Jin;Kim, Eui-Yong;Han, Jae-Hee;Park, Choon-Ok;Hong, Seong-Geun;Leem, Chae-Hun;So, In-Suk;Ho, Won-Kyung;Earm, Yung-E;Sung, Ho-Kyung
    • The Korean Journal of Physiology
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    • 제26권2호
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    • pp.99-111
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    • 1992
  • Permissive action of thyroid hormone at the level of Ca channel and responsible mechanisms underlying thyroid hormone-induced change in myocardial contractile state and $T_3-induced$ arrhythmias were investigated in rabbit ventricular or atrial myocytes using whole cell patch clamp technique. Single cells were isolated by Langendorff perfusion with collagenase. Cardiac myocytes were incubated in $low-Cl^-,$, $high-K^+$ medium containing $1_{\mu}M\;L-triiodothyronine\;(T_3)$ at $4^{\circ}C$ for 2.10 hours. The calcium currrent $(I_{Ca})$ was increased in $T_3$ loaded cells, however, the shape of current voltage curve and reverse potential did not altered. Cyclic AMP, cyclic GMP, isoprenaline and 3-isobutyl-1-methyl-xanthine increased $I_{Ca}$ in euthyroid and hyperthyroid conditions, and acetylcholine blocked the increase of $I_{Ca}\;in\;T_3$ loaded cells. The amplitude of $I_{Ca}$ was much larger after perfusing cGMP than cGMP in both conditions, whereas the degree of increase of $I_{Ca}$ was greater after perfusing cAMP than cGMP in $T_3$ loaded cells. The degree of increase of $I_{Ca}$ after perfusing isoprenaline or IBMX also was greater in $T_3$ loaded cells than in control cells. Background current induced by isoprenaline also increased in $T_3$ loaded cells. The Ca release dependent inward current was increased in amplitude but its activation and inactivation time course was not changed in $T_3$ loaded cells. Activation of Na pump current was not changed in $T_3$ loaded cells. From the above results it is suggested that thyroid hormone induced increase in the contractile state of cardiac myocytes are accompanied by augmented $I_{Ca}$ and the increase of Ca release from sarcoplasmic reticulum and the permissive action of thyroid hormone to catecholamines could induce arrhythmias through the increase of $I_{Ca}$ and background current.

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Ischemia에 의해 유발된 흰쥐의 적출 심장 손상에 대한 Cyclobuxine D의 보호효과 (Effects of Cyclobuxine D on the Derangement Induced by Ischemia and Reperfusion in the Isolated Rat Heart)

  • 이종화;문창규;권준택;조병헌;김유재;김종배;김창호;차영덕;김영석
    • 대한약리학회지
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    • 제26권1호
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    • pp.7-12
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    • 1990
  • 흰쥐로 부터 심장을 적출하여 Langendorff 관류장치에 현수하여 Krebs-Hensleit 영양액으로 분당 12ml속도로 30분간 관류시킨 후 관류 속도를 분당 1ml로 줄여(ischemia)60분간 관류시키면, 적출심장의 수축력이 현저히 감소되었고, resting tension이 현저히 증가되었다. 또 적출심장으로부터 유출되는 관류액의 250nm에서의 UV흡광치는 증가되었으며, 좌심실내의 칼슘의 농도는 대조군보다 상당히 증가되었다. 본 실험에서는 흰쥐에서 항염증작용, 혈압강하 및 서맥 작용, 평활근 및 심장근에서 근이완작용을 나타내는 cyclobuxine D의 ischemia에 의해 유도된 심장손상에 대한 보호효과를 관찰하였다. Cyclobuxine D(100ng/ml)는 ischemia에 의해 유발된 적출심장의 수축력 감소와 resting tension의 증가를 유의하게 억제하였으며, 심장으로부터의 ATP metabolites의 유출과 좌심실내의 칼슘 축적을 억제시켰다. 이상의 결과는 Cyclobuxine D가 ischemia에 의해 유발된 손상으로 부터 심장을 보호할 수 있음을 나타내며, 이는 cyclobuxine D의 심장세포내의 칼슘 유입 억제작용에 기인하는 것으로 사려된다.

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흰쥐 적출심장의 Norepinephrine 유발 양성 변력성작용에 미치는 Strontium의 영향 (Effect of Strontium on Norepinephrine Induced Positive Intoropic Effect of Isolated Perfused Rat Hearts)

  • 권오철;이광윤
    • Journal of Yeungnam Medical Science
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    • 제5권2호
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    • pp.59-69
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    • 1988
  • Strontium은 calcium파 같은 2가 양이온으로서 평활근에서 calcium과 치환되어 평활근을 수축시킬 수 있으며, 골격근에서도 calcium과 치환되어 이를 수축시킬 수 있는 것으로 알려져 있다. 그러나 심근에서는 strontium이 calcium과 치환되어 심근을 수축시킬 수 있다는 보고가 있으나 그 기전에 대해서는 잘 알려져 있지 않다. 이에 저자는 심근에서 strontium이 calcium과 치환되어 사용될 수 있는지를 관찰하고, 그 기전을 알아보기 위해서 다음과 같은 실험을 하였다. 체중 200 g m 내지 230 g m의 흰쥐(Sprague-Dawley)의 심장을 적출하여 Langendorff씨 심관류 장치에 현수한 후 자율 수축운동을 하는 적출심장의 좌심실 내에 balloon을 넣어 수축성, 좌심실압 및 심박동수의 변화를 측정하였다. 먼저 strontium 치환용액의 관류시 나타나는 좌심실압, 수축성 및 심박동수의 변화를 관찰하였다. 그리고 심근을 흥분시키는 norepinephrine과 억제하는 verapamil이 포함된 strontium 치환용액을 관류할 때 나타나는 수축성, 좌심실압 및 심박동수의 변화를 관찰하여 다음과 같은 결과를 얻었다. 1. 저 calcium 관류용액을 관류 하였을 때 심근수축력은 현저히 억제되었으며, strontium을 첨가하여 calcium파 strontium의 농도의 합이 정상 관류용액의 calcium농도 (2.43mM)가 되게 하여 관류 하였을 때 심근 수축력은 정상 calcium농도의 관류용액을 관류했을 때의 심근 수축력에 비해 억제되지 않았다. 2. 관류용액 내의 calcium을 strontium으로 완전치환시 심정지가 유발되었으며, 이때 관류용액내에 calcium이나 strontium을 첨가 했을 때도 심근수축력은 회복되지 않았다. 3. Norepinephrine 유발 양성변력성 작용은 정상관류용액, 저calcium 관류용액 및 strontium 치환용액 모두에서 농도에 비례한 증가 양상을 보였다. Strontium 치환용액에서는 정상 관류용액에서와 차이가 없었으나, 저calcium용액에서는 고농도의 norepinephrine의 수축력 증가작용은 정상 용액에서와 차이가 없었고 저농도의 norepinephrine의 수축력 증가작용은 정상용액에서 보다 유의하게 낮았다. 4. verapamil은 calcium 용액 뿐만 아니라 strontium 치환용액에서도 심근 수축력을 현저히 감소시켰다. 이상의 실험 결과로 미루어 볼 때 strontium은 calcium과 대치되어 심근을 수축시킬 수 있으며 calcium과 같은 자격으로 norepinephrine 유발 양성 변력성작용에 참여하고 verapamil에 의해서는 calcium과 같은 양상으로 그 이동이 억제된다고 사료된다.

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NecroX-5 protects mitochondrial oxidative phosphorylation capacity and preserves PGC1α expression levels during hypoxia/reoxygenation injury

  • Vu, Thi Thu;Kim, Hyoung Kyu;Le, Thanh Long;Nyamaa, Bayalagmaa;Song, In-Sung;To, Thanh Thuy;Nguyen, Quang Huy;Marquez, Jubert;Kim, Soon Ha;Kim, Nari;Ko, Kyung Soo;Rhee, Byoung Doo;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • 제20권2호
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    • pp.201-211
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    • 2016
  • Although the antioxidant and cardioprotective effects of NecroX-5 on various in vitro and in vivo models have been demonstrated, the action of this compound on the mitochondrial oxidative phosphorylation system remains unclear. Here we verify the role of NecroX-5 in protecting mitochondrial oxidative phosphorylation capacity during hypoxia-reoxygenation (HR). Necrox-5 treatment ($10{\mu}M$) and non-treatment were employed on isolated rat hearts during hypoxia/reoxygenation treatment using an ex vivo Langendorff system. Proteomic analysis was performed using liquid chromatography-mass spectrometry (LC-MS) and non-labeling peptide count protein quantification. Real-time PCR, western blot, citrate synthases and mitochondrial complex activity assays were then performed to assess heart function. Treatment with NecroX-5 during hypoxia significantly preserved electron transport chain proteins involved in oxidative phosphorylation and metabolic functions. NecroX-5 also improved mitochondrial complex I, II, and V function. Additionally, markedly higher peroxisome proliferator-activated receptor-gamma coactivator-$1{\alpha}$ ($PGC1{\alpha}$) expression levels were observed in NecroX-5-treated rat hearts. These novel results provide convincing evidence for the role of NecroX-5 in protecting mitochondrial oxidative phosphorylation capacity and in preserving $PGC1{\alpha}$ during cardiac HR injuries.

산조인탕이 수면박탈 흰쥐 심장의 혈역학적 기능에 미치는 영향 (Effects of Sanjointang on Hemodynamic Functions of Isolated Rat Heart Induced by Sleep Deprivation)

  • 신유정;김덕곤
    • 대한한방소아과학회지
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    • 제24권3호
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    • pp.106-120
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    • 2010
  • Objectives: Sanjointang has been clinically used much for treating sleeplessness. However, the effects of Sanjointang in artificial sleep deprivation situations are not known. The purpose of this study is to evaluate the heart rate, left ventricular systolic pressure, left ventricular diastolic pressure, +dp/dt maximum, -dp/dt maximum, and -dp/dt / +dp/dt ratio which are related to the hemodynamic functions of the heart by using sleep-deprived Sparague-Dawley rats, in order to clarify the impact of Sanjointang on hemodynamic functions of the heart of sleep deprived rats. Methods: Eighteen hearts were removed from the male Sparague-Dawley rats weighting about 180g were perfused by the Langendorff technique with modified 37 Krebs-Henseleit's buffer solution at a constant perfusion pressure (60mmHg). They were randomly assigned to one of the following three groups, 1) Normal group (those which did not have sleep deprivation and received normal saline administration), 2) Control group (sleep deprived and normal saline administered), 3) Sample group (sleep deprived and Sanjointang was administered). Control and sample groups rats were deprived 96 hours of sleep by using the modified multiple platform technique. Heart rate, left ventricular systolic pressure, left ventricular diastolic pressure, +dp/dt maximum, -dp/dt maximum, -dp/dt / +dp/dt ratio were evaluated at baseline after the administration of either normal saline or Sanjointang. Results: The heart rate and -dp/dt / +dp/dt ratio was significantly decreased in rats with 96 hours of sleep deprived significantly decreased. The change in the heart rate after administering Sanjointang did not show any significant difference. The left ventricular systolic pressure of the removed heart significantly decreased due to Sanjointang administration, while the left ventricular diastolic pressure significantly increased (p<0.05). The +dp/dt maximum and -dp/dt maximum both significantly decreased in the removed heart after administering Sanjointang. (p<0.05). There was no significant difference observed in the -dp/dt / +dp/dt ratio after administering Sanjointang. Conclusions: According to the results above, sleep deprivation significantly decreases heart rate and -dp/dt / +dp/dt ratio. This is considered as a result of exhaustion due to accumulation of fatigue. Meanwhile, Sanjointang reduced left ventricular systolic pressure and raised left ventricular diastolic pressure, and relieved the contractility and relaxation of the myocardium. Consequently, this reduces the burden of the heart and creates a relatively stabilized heart condition similar to a sleeping condition.

Isoproterenol 투여로 유발된 심근세포 손상에 미치는 diltiazem의 영향 (Effects of Diltiazem on Isoproterenol-induced Myocardial Cell Wounding in the Rabbit)

  • 김현;장대영;라봉진;김호덕
    • Applied Microscopy
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    • 제27권2호
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    • pp.121-130
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    • 1997
  • It has been demonstrated that majority of cells in the mammalian body such as myocytes and epithelial cells of skin and intestine respond to mechanical force or environmental factors and exhibit partial disruption of cell membrane, i. e., cell wounding, even in a physiological condition. Myocardial cells are rather apt to be wounded than other cells since they are definitely exposed to mechanical stress by contraction-relaxation and blood flow. However, the mechanism how myocardial cells protect themselves against cell wounding is not yet clarified. On this background, the present study was performed to elucidate whether albumin leakage is related to cell wounding and to assess whether diltiazem, a potent calcium channel blocker, is beneficial in isoproterenol-induced cell wounding in the heart. Hearts isolated from New Zealand White rabbits ($1.5\sim2.0kg$ body weight, n=20) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to bolus administration of isoproterenol and diltiazem as following order: $1.6{\mu}M$ isoproterenol at zero min (the beginning point): $16{\mu}M$ diltiazem at 20min; $1.6{\mu}M$ isoproterenol at 25min; $16{\mu}M$ isoproterenol at 45 min; $160{\mu}M$ diltiazem at 65 min; $16{\mu}M$ isoproterenol at 70 min. During all experiments, the left ventricular function was recorded, albumin leakage in the coronary effluents was analyzed by electrophoresis and Western blot, and myocardial cell membranes were examined by conventional transmission electron microscopy. Data were analyzed by t-test and linear regression test. Isoproterenol significantly increased the inotropic and chronotropic contractions, coronary flow, and frequency of arrhythmia, however, diltiazem did not influence on hemodynamics except decrease in the frequency of arrhythmia and a slight decrease in contractility. Isoproterenol also resulted partial disruption of myocardial cell membrane and inclose in albumin leakage, while diltiazem pretreatment showed number of electron-dense plaques in the cell membrane and a tendency of decrease in albumin leakage. These results indicate that albumin leakage may be an indirect index of cell wounding in the heart and diltiazem nay be beneficial to protect myocardial cells against isoproterenol-induced cell wounding. It is likely that diltiazem promotes resealing process of the cell membrane.

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이식을 위한 가토심장의 장기 보존방법에 관한 비교 연구 (Comparative Study of Prolonged Preservation Methods in Rabbit Heart for Transplantation)

  • 조형곤;김수현;김송명
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.1-10
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    • 1997
  • 심장이식 수술의 성공의 관건은 공여자와 수혜자의 적절한 조합과 이미 정립된 수술수기와 합께 적출된 심장의 효과적인 기능 보존에 달려있다. 심장 보존에 있어서 괄목할 만한 발전이 있었음에도 불구하고 최근의 가장 진보된 방법으로 심 허 혈 상태의 최대 허용기간은 약 4~6시간정도이다 저자는 이식을 위한 적출 심장의 보존 용액 이 갖추어야 할 적정 요건에 대한 자료를 축적하고자, 단순 저온 침적방법에 의거하여, H/S용액(I군)을 대조군으로 하여 저자가 고안한 CK용액(W군)을 기존의 MEC용액( ll군) 및 MUW용액(E군)과 비교 실험하였다. 적출된 가토의 심장을 실험 대상으로 하고 정압형 Langendorff실험모형을 사용하여, 20분간의 평형 상태, 4시간동안의 심장 저장 및 20분간의 재관류시기를 거치게 한 후, 심근 조직을 절제하여 냉동 보관하였다. 실험 계획에 따라 관관류량,좌심실압, 압력 미분치를 측정하였고, 동결 심근조직내의 효소치를 정량 분석하였다. 결론적으로, 저자의 비교 실험에서 MUW용액과 CK용액의 심근보호 능력이 우수하였고, MEC용액은 대조군에 비해 저조하였다. potassium의 농도가 MVW용액보다 낮고()4.2nM/L), 문헌상에서 \ulcorner\ulcorner보호에 유익한 것으로 보고된 각종의 substrate을 첨가하여 제작된 CK용액의 성적이 MUW용액 과 비슷한 수준으로 우수하였는데, 이는 심장보존용액의 전해질 농도의 조정과 첨가물질의 선택 및 조정에 있어서 지속적인 연구와 발전이 필요함을 시사한다고 할 수 있다.

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적출 쥐 심장에서 장시간의 심장보존시 허혈성 전조건화가 심근보호에 미치는 영향 (Cardioprotective Efficacy of Ischemic Preconditioning on Long-Term Myocardial Preservation in Isolated Rat Heart)

  • 허동명;장봉현
    • Journal of Chest Surgery
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    • 제33권8호
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    • pp.605-612
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    • 2000
  • Background: Ischemic preconditioning enhances the tolerance of myocardium against ischemia/reperfusion injury, with the enhancement of the recovery of post-ischemic myocardial function. This study was disigned to assess whether the protective effect of ischemic preconditioning could provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rate heart. Material and method: Fourty four Spargue-Dawley rats, weighing 300~450gm, were divided into four groups. Group 1(n=7) and group 3(n=12) were subjected to 30 minutes of aerobic Langendorff perfusion without ischemic preconditioning and then preserved in saline solution at 2~4$^{\circ}C$ for 4 hours and 5 respectively. Group 2(n=7) and group 4(n=18) were perfused in the same way for 20 minutes, followed by 3 minutes of global mormothermic ischemia and 10 minutes of perfusion and then preserved in the same cold saline solution for 4 hours and 5 hours respectively. Heart rate, left ventricular developed pressure(LVDP), and coronary flow were measured at 15 minutes during perfusion as baseline. Spontaneous defibrillation time was measured after reperfusion. Heart rate, LVDP, and coronary flow were also recorded at 15 minutes, 30 minutes, and 45 minutes during reperfusion. Samples of the apical left ventricular wall were studied using a transmission electron microscope. Result: Time of spontaneous defibrillation(TSD) was significantly longer in group 4 than in group 1(p<0.001), and TSD in group 1 was significantly longer in comparision to that of group 2(p<0.05). Heart rate at 45 minutes was significantly higher in group 1 than in group 4(p<0.05). Heart rate at 15 min was significantly higher in group 2 than in group 1(p<0.001) and in group 4 than in group 3(p<0.05). Left ventricular developed pressure(LVDP) at 30 minutes and 45 minutes was higher in group 1 than in group 4(p<0.01), LVDP at 45 minutes was higher in group 4 than in group 3(p<0.05). Rate-pressure product(RPP) at 30 minutes and 45 minutes was higher in group 1 than in group 4(p<0.05). RPP at 15 minutes was higher in group 2 than in group 1(p<0.01). RPP at 30 minutes and 45 minutes was higher in group 4 than in group 3(p<0.05). Group 2 showed relatively less sarcoplasmic edema and less nuclear chromatin clearance than group 1. Group 4 showed less myocardial cell damage than group 3, group 4 showed less myocardial cell damage than group 3, group 4 showed more myocardial cell edema than group 1. Conclusion: Ischemic preconditioning enhanced the recovery of postischemic myocardial function after 4 hours and 5 hours preservation. However, it was not demonstrated that ischemic preconditioning could definitely provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rat heart.

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허혈 및 재관류가 흰쥐 및 고양이 심장에 미치는 영향에 관한 형태계측학적 연구 (A Quantitative Ultrastructural Study on the Effects of Ischemia and Reperfusion on the Rat and Cat Hearts)

  • 박영식;엄창섭;서영석
    • Applied Microscopy
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    • 제22권1호
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    • pp.42-54
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    • 1992
  • To understand the structural changes of the myocardial myocytes and endothelial cells in ischemic and reperfused heart, and to elucidate their roles in those conditions, the authors observed cat and rat myocardium ultrastructurally and evaluated them with morphometric techniques. In cat, mild ischemia and moderate degree reperfusion injury was induced by ligation of the anterior interventricular branch of left coronary artery and reperfusion. In rat, severe ischemia and irreversible reperfusion iniury was made using in vitro Langendorff techniques. In normal cat myocytes, the volume densities of cytoplasm, myofibrils, mitochondria, sarcoplasmic reticulum and T tubules were $0.11{\pm}0.013,\;0.51{\pm}0.096,\;0.25{\pm}0.082,\;0.09{\pm}0.008,\;0.02{\pm}0.010$ (Mean${\pm}$S.D.) respectively, and the myofibril/mitochondria ratio was $2.33{\pm}1.379$. The numerical density and average volume of mitochondria were $0.76{\pm}0.210/{\mu}m^3$ and $0.33{\pm}0.057{\mu}m^3$ respectively. In normal cat endothelial cells, the volume densities of cytoplasm, cytoplasmic vesicles, tubular systems (including endoplasmic reticulum and Golgi apparatus) and mitochondria were $0.43{\pm}0.023,\;0.28{\pm}0.007,\;0.22{\pm}0.021,\;0.03{\pm}0.014$ respectively. The mean thickness of endothelial cells was $230{\pm}45.2{\mu}m$. The numerical density and average volume of cytoplasmic vesicles were $508{\pm}55.0/{\mu}m^3,\;578{\pm}104.8nm^3$ respectively. In cat myocytes which received mild ischemic injury, the volume densities of organelles were not changed significantly in ischemic and reperfusion states. In reperfusion group myocytes, the numerical density of mitochondria was decreased significantly and the average volume was increased significantly. In endothelial cells, the volume density of tubular system in ischemic group and the average volume of cytoplasmic vesicles in reperfusion group were increased significantly. In rat myocytes which received severe ischemic injury, the volume density and average volume of mitochondria were increased significantly, and the volume density of sarcoplasmic reticulum and numerical density of mitochondria were decreased significantly in both ischemic and reperfusion groups. In ischemic and reperfused endothelial cells, the volume density and numerical density of cytoplasmic vesicles, the volume density of cytoplasm were decreased significantly. The volume densities of tubular system were increased significantly in both ischemic and reperfused groups. The volume density of mitochondria in ischemic group and the average volume of cytoplasmic vesicles in reperfusion group showed significant increase. The authors, based on the above observations, conclude that the mitochondria of myocytes and the cytoplasmic vesicles of endothelia are the first group of targets in ischemic and reperfusion injury and in this respect, the degree of ischemic insult is not significant. The role of myocyte mitochondria in reperfusion injury may be insignificant, but endothelial cells may contribute actively to reperfusion injury.

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