• Tuberculosis and Respiratory Diseases
• /
• v.46 no.3
• /
• pp.338-349
• /
• 1999

Polymorphonuclear leukocytes(PMN) are the predominant inflammatory cells recruited in acute lung injury such as adult respiratory distress syndrome, pneumonia and also chronic lung disease such as idiopathic pulmonary fibrosis and pulmonary emphysema. Interleukin-8(IL-8) is an 8,000 D protein produced by many cells and has potent neutrophil chemoattractant and activating properties. The GRO, also called melanoma growth-stimulatory activity(MGSA), referring to a peptide of 73 amino acids, was reported to be mitogenic for cultured human melanoma cells. Mature GRO/MGSA has marked sequence similarity to IL-8. In view of the structural similarities to IL-8, it was of particular interest to test GRO for neutrophil activating and chemotactic properties. We found a significant release of IL-8 and GRO/MGSA from the cultured human umbilical vein endothelial cell(HUVEC) which was stimulated either with TNF$\alpha$ or IL-1$\beta$ and also found the expression of IL-8 and GRO/MGSA mRNA. Neutrophil chemotactic activity was enhanced in accordance with the increased IL-8 and GRO/MGSA. Our study also suggest that the IL-8 is more important in the increased neutrophil chemotactic activity than GRO/MGSA when endothelial cell is stimulated with TNF$\alpha$ or IL-1$\beta$ in vitro.

• Journal of Chest Surgery
• /
• v.32 no.3
• /
• pp.249-254
• /
• 1999

Background: Recovery of the left atrial contractile function after the Cox-Maze procedure is related to the size of the left atrium. We have postulated that if too wide area of the atrium were isolated electrically, then the atrial contractile function would be impaired postoperatively. We have modified the Cox-Maze procedure to dissect each pair of the pulmonary veins separately instead of the conventional pulmonary vein encircling incision, and compared the atrial contractile function after each procedure. Material and Method: From February 1995 to October 1997, 55 cases of the Cox-Maze procedure were performed in mitral valvular heart disease. We excluded the cases that did not covert to sinus rhythm. The patient groups were divided according to the interpulmonary vein distance(IPVD) and the procedure performed. Group I was IPVD under 6.5 cm(n=30), group II was IPVD over 6.5cm and the conventional Cox-Maze III procedure was performed(n=16), and group III was IPVD over 6.5cm and the modified Cox-Maze procedure was performed(n=9). Result: Atrial contractile function was evaluated by the echocardiography follow-up between 6 months to 12 months. The right atrial contractile function recovered gradually, the recovery rate after long-term follow-up was 90% in group I, 81% in group II, and 100% in group III(p>0/05). In the left atrium the recovery rate was 63% in group I, 31% in group II(p=0.03), and 66% in group III(p>0.05). Conclusion: The modified Cox-Maze procedure may have beneficial effects on the recovery of the left atrial contractile function, however, there are no statistically significant values. Therefore, further evaluation of this procedure is necessary.

• Journal of the Korean Society of Radiology
• /
• v.13 no.6
• /
• pp.879-887
• /
• 2019

The purpose of this study is to establish a physiological injection protocol according to body weight, in order to minimize amount of contrast medium and optimize contrast enhancement in pediatric patients performing thoracic CT examinations. The 80 pediatric patients under the age of 10 were studied. Intravenous contrast material containing 300 mgI/ml was used. The group A injected with a capacity of 1.5 times its weight, and groups B, C and D added 5 to 15 ml of normal saline with a 10% decrease in each. The physiologic model which can be calculated by weight about amount of injection of contrast medium and normal saline, flow rate and delay time were applied. To assess image quality, measured average HU value and SNR of superior vena cava, pulmonary artery, ascending and descending aorta, right and left atrium, right and left ventricle. CT numbers of subclavian vein and superior vena cava were compared to identify the effects of reducing artifacts due to normal saline. Comparing SNR according to the contrast medium injection protocol, significant differences were found in superior vena cava and pulmonary artery, descending aorta, right and left ventricle, and CT numbers showed significant differences in all organs. In particular, B group with a 10% decrease in contrast medium and an additional injection of saline showed a low degree of contrast enhancement in groups with a decrease of more than 20%. In addition, the group injected with normal saline greatly reduced contrast enhancement of subclavian vein and superior vena cava, and the beam hardening artifact by contrast medium was significantly attenuated. In conclusion, the application of physiological protocol for injection of contrast medium in pediatric thoracic CT examinations was able to reduce artifacts by contrast medium, prevent unnecessary use of contrast medium and improve the effect of contrast enhancement.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.6
• /
• pp.504-511
• /
• 2021

Purpose: This study examined the difference between the drainage volume, blood loss, transfusion rate, volume, and complications with or without an intra-articular (IA) tranexamic acid (TXA) injection among patients who underwent simultaneous bilateral total knee arthroplasty (SBTKA) with bilateral knee joint osteoarthritis, including patients who have contraindications of intravenous administration. Materials and Methods: Among patients who underwent SBTKA from April 2016 to December 2018, 139 patients injected with 3 g of TXA in each side through a drainage tube after joint capsule repair (group T), and 57 patients (group A) who underwent the procedure without TXA between October 2007 and August 2010 were tested. No significant difference in age and sex was observed between the two groups (p=0.572, 0.474). TXA was injected in patients with contraindications of intravenous administrations. Patients who underwent SBTKA with inflammatory arthritis were excluded from this study. The average amount of drainage, blood loss, transfusion rate, volume and daily average transfusion rate, and hemoglobin (Hb) change by the postoperative day were compared. Complications, such as deep vein thrombosis, pulmonary thromboembolism, myocardial infarction, cerebral infarction, and infection, were investigated. Results: The average total blood losses in groups A and T were 2195.32±1175.63 ml and 1145.09±382.95 ml, respectively, and the average total drain volume was 1,178.30±48.59 ml and 774.19±310.06 ml, respectively; both were significantly lower in group T (p=0.002, <0.001). The transfusion rates were 77.2% (44/57) and 0.7% (1/139), which were significantly lower in group T (p<0.001). The total average transfusion volume in groups A and T were 735.44±550.83 ml and 4.60±54.28 ml, respectively, which were significantly lower in group T (p<0.001). Hb tended to increase for three or four days after surgery in group A and group T. Regarding complications, deep vein thrombosis was encountered in two cases (1.4%), and pulmonary thromboembolism was noted in three cases (2.2%) in group T, but there were no cases in group A. No infections, cerebral infarction, or myocardial infarction occurred. Conclusion: In SBTKA, IA injections of TXA reduced the average drain volume, blood loss, transfusion rate, and volume significantly and did not increase the incidence of complications, even in patients with contraindications of intravenous administration.

• Journal of Chest Surgery
• /
• v.38 no.8 s.253
• /
• pp.523-528
• /
• 2005

Background: Investigation of the change of ventricular function and mitral regurgitation after surgical repair of patient with anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is key issue for the better surgical outcome. Material and Method: From April 1986 to July 2002, 12 patients presented with ALCAPA. The median age at repair was 4 months. Surgical methods included left coronary artery transfer to the aorta (10), Takeuchi procedure (1), saphenous vein free graft bypass (1). Mitral valve was repaired in 1. Result: There were 2 hospital death $(16.7\%)$. The mean follow-up period was $7.1\pm4.1$ years (range, 7 months to 13 years). Four patients required postoperative circulatory assist for $2.2\pm1.1$ days and one needed left ventricular assist device (LVAD) for 1day. Postoperative echocardiography demonstrated significant improvements in mean fractional shortening $(33.4\pm9.1\%\;vs\;17.7\pm9.6\%,\;n=10,\;p<0.05);$ left ventricular end diastolic dimension $(33.4\pm7.3\;mm\;vs\;44.8\pm7.0\;mm,\;n=10,\;p<0.05)$ and systolic dimension $(22.2\pm7.5\;mm\;vs\;33.4\pm7.9\;mm,\;n=10,\;p<0.05)$. Severities of mitral regurgitation decreased in all survivors at 1st and 4th year follow-up echocardiography. There were 2 reoperation due to residual MR and right ventricular outflow obstruction (Takeuchi case). Conclusion: Anatomic repair of anomalous left coronary artery from the pulmonary artery offered an excellent surgical results, especially in terms of the recovery of left ventricle function and mitral regurgitation. However, preoperative indications for mitral procedure is to be evaluated.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.34-40
• /
• 2008

Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.

• The Korean Journal of Physiology and Pharmacology
• /
• v.18 no.5
• /
• pp.431-439
• /
• 2014

The aim of the present study was to investigate whether ginsenoside-Rb2 (Rb2) can affect the secretion of catecholamines (CA) in the perfused model of the rat adrenal medulla. Rb2 ($3{\sim}30{\mu}M$), perfused into an adrenal vein for 90 min, inhibited ACh (5.32 mM)-evoked CA secretory response in a dose- and time-dependent fashion. Rb2 ($10{\mu}M$) also time-dependently inhibited the CA secretion evoked by DMPP ($100{\mu}M$, a selective neuronal nicotinic receptor agonist) and high $K^+$ (56 mM, a direct membrane depolarizer). Rb2 itself did not affect basal CA secretion (data not shown). Also, in the presence of Rb2 ($50{\mu}g/mL$), the secretory responses of CA evoked by veratridine (a selective $Na^+$ channel activator ($50{\mu}M$), Bay-K-8644 (an L-type dihydropyridine $Ca^{2+}$ channel activator, $10{\mu}M$), and cyclopiazonic acid (a cytoplasmic $Ca^{2+}$-ATPase inhibitor, $10{\mu}M$) were significantly reduced, respectively. Interestingly, in the simultaneous presence of Rb2 ($10{\mu}M$) and L-NAME (an inhibitor of NO synthase, $30{\mu}M$), the inhibitory responses of Rb2 on ACh-evoked CA secretory response was considerably recovered to the extent of the corresponding control secretion compared with the inhibitory effect of Rb2-treatment alone. Practically, the level of NO released from adrenal medulla after the treatment of Rb2 ($10{\mu}M$) was greatly elevated compared to the corresponding basal released level. Collectively, these results demonstrate that Rb2 inhibits the CA secretory responses evoked by nicotinic stimulation as well as by direct membrane-depolarization from the isolated perfused rat adrenal medulla. It seems that this inhibitory effect of Rb2 is mediated by inhibiting both the influx of $Ca^{2+}$ and $Na^+$ into the adrenomedullary chromaffin cells and also by suppressing the release of $Ca^{2+}$ from the cytoplasmic calcium store, at least partly through the increased NO production due to the activation of nitric oxide synthase, which is relevant to neuronal nicotinic receptor blockade.

• Korean Journal of Clinical Pharmacy
• /
• v.23 no.2
• /
• pp.151-157
• /
• 2013

Purpose: Warfarin is the most widely used anticoagulant drug for preventing cardiovascular diseases after ischemic stroke and thromboembolism related to atrial fibrillation, artificial heart valves, deep vein thrombosis, and pulmonary embolism. Warfarin is commonly used in combination with other drugs such as diuretics in order to treat the comorbidity. Although several warfarin-diuretics interactions have been reported, the results are conflicting. Therefore, the initial aim of this study was to identify the effects of diuretics on the warfarin response in patients with atrial fibrillation. Methods: One hundred forty six patients with atrial fibrillation who were on anticoagulation therapy with warfarin and maintained INR levels of 2-3 for three consecutive times were followed up, retrospectively. Stable warfarin doses and INR per stable warfarin dose were compared according to age, gender, comorbidity, and concurrent medication. The stable warfarin dose was defined as the maintenance dose of warfarin of the measured patient whose INR was within the target INR range more than 3 times consecutively. Results: The differences of stable warfarin doses in patients with ($3.22{\pm}1.21$ mg/day) and without ($3.58{\pm}1.14$ mg/day) diuretics were marginally significant (P=0.069). On the other hand, stable warfarin doses were $2.97{\pm}1.10$ mg/day in patients with thiazide (n=36) and $3.58{\pm}1.14$ mg/day in patients without diuretics (n=82), which was statistically significant (p=0.009). INR values per stable warfarin dose in patients with diuretics and thiazide were $0.84{\pm}0.31$ and $0.90{\pm}0.34$, respectively, which were statistically different from those without diuretics ($0.72{\pm}0.21$, P=0.010 and P=0.006, respectively). Age, gender, and concurrent use of thiazide diuretics were found to have significant influence on the warfarin response from multivariate analysis. Conclusion: Our study showed that the concurrent use of thiazide diuretics could increase the response of warfarin in patient with atrial fibrillation. Therefore, clinicians should be aware that warfarin dose needs to be adjusted when it is used with thiazide diuretics concomitantly.

• Journal of Veterinary Clinics
• /
• v.23 no.3
• /
• pp.320-324
• /
• 2006

The purpose of the present study was to compare pulsatile type(Twin Pulse Life Support; TPLS) with rotary type hemodialyzer(AK95) in order to reduce the dialysis time and to improve dialysis effect. Three healthy dogs(about 30 kg BW) were used. Experimental renal failure was induced by the ligation of bilateral renal artery. A pair of catheters were implanted in jugular vein for dialysis. Daily investigated parameters included clinical signs such as vomiting, fecal appearance and activity, and also laboratory data such as PCV, TP, BUN and creatinine. Hemodialysis was started above 90 mg/100 ml BUN level and, laboratory data were measured every an hour for 4 hours. Heparin was administered 300 IU/Kg before dialysis and 150 IU/Kg via IV route every 90 minutes during dialysis. Clinical signs after induction renal failure were shown severe vomiting, anorexia, diarrhea, mucous feces, ataxia, dilated pupil and episcleral hyperemia. The average of BUN value decreased hourly $99{\pm}12.1,\;84{\pm}12.2,\;72{\pm}8.0,\;58{\pm}7.1,\;48{\pm}5.2,\;and\;39{\pm}3.2mg/100ml$ by hemodialysis. The average of creatinine value decreased $7.8{\pm}0.61,\;6.4{\pm}0.40,\;5.3{\pm}0.42,\;4.5{\pm}0.23,\;4.0{\pm}0.41,\;and\;3.4{\pm}0.42mg/100ml$ according to hemodialysis an hour. There are not significantly differences BUN, creatinine, PCV and TP values between pulsatile and rotary type hemodialysis. These results suggested that effects of hemodialysis with Pulsatile type(TPLS) are not significantly difference as compared with hemodialysis of rotary type(AK95). Further research is needed in order to estimate the influence of cardiovascular and pulmonary system in hemodialysis of pulsatile type.

• Journal of Chest Surgery
• /
• v.32 no.5
• /
• pp.433-437
• /
• 1999

Background: Left main coronary artery (LMCA) angioplasty is another option in the surgical treatment for LMCA disease because of its advantages over the conventional coronary artery bypass grafting (CABG). Material and Method: Between July 1994 and December 1997, 15 patients underwent left main coronary angioplasty for the stenoses of LMCA. There were 8 males and 7 females with the mean age of 53.3${\pm}$8.8 years. The locations of the LMCA stenoses were proximal one-third of the LMCA in 9, middle one-third in 1, distal one-third in 3, and the whole length of the LMCA in 2 cases. Nine patients had peripheral coronary lesions in addition to the LMCA stenosis. The LMCA was approached anteriorly with or without transsection of the main pulmonary artery. The angioplasty was performed with onlay patch widening using an autologous pericardium (14 cases) or saphenous vein (1 case). Additional graftings were required in 9 cases, and both LMCA angioplasty and right coronary ostial angioplasty were done in 1 case. Result: There was no operative mortality. One case needed redo CABG due to the stenosis of the angioplasty site which developed 4 months postoperatively. Coronary angiography was performed in 8 cases one year postoperatively, and revealed good patency of the angioplasty site except for one who showed 50% stenosis at the angioplasty site. No patient complained of angina with a mean follow up of 23${\pm}$11 months. Conclusion: Surgical angioplasty of the LMCA stenosis can be performed in selected cases with safety and good mid-term results.