• Title/Summary/Keyword: Retrograde

Search Result 500, Processing Time 0.031 seconds

Use of Intermittent Antegrade Warm Blood Cardioplegia in CABG (관상동맥 우회로조성술에서 간헐적 전방 온혈 심정지액의 이용)

  • 김정택;백완기;김영삼;윤용한;김혜숙;이춘수;임현경;김현태;김광호
    • Journal of Chest Surgery
    • /
    • v.36 no.11
    • /
    • pp.828-833
    • /
    • 2003
  • Background: It has been reported that the recently developed intermittent antegrade warm blood cardioplegia (IAWBC) has better myocardial protective effects during coronary artery bypass surgery than cold blood cardioplegia or continuos retrograde cold blood cardioplegia. The aim of this study is to evaluate the safety and usefulness of IAWBC by comparing it retrospectively with intermittent retrograde cold blood cardioplegia (lRCBC). Material and Method: From April 2001 to Feb. 2003, fifty seven patients who underwent isolated coronary surgery were divided into two groups (IAWBC vs. IRCBC). The two group had similar demographic and angiographic characteristics. There were no statistical differences in age, sex, Canadian Cardiovascular Society Functional Classification for angina, ejection fraction, and number of grafts. Result: Aortic cross clamping time and total pump time in IAWBC (99$\pm$23 and vs. 126$\pm$32 min) were shorter than those of IRCBC (118$\pm$32 min. and 185$\pm$48 min.)(p<0.05). The reperfusion time (13$\pm$7 min) in IAWBC was shorter than that of IRCBC (62$\pm$109 min.)(p<0.05). CKMB at 12 hours and 24 hours (16$\pm$15 and 9$\pm$13) in IAWBC was lower than that of IRCBC (33$\pm$47 and 17$\pm$26)(p<0.05). The awakening time in IAWBC (2$\pm$1 hour) was shorter than that of IRCBC (4$\pm$3)(p<0.05). The number of spontaneous heart beat recovery in IAWBC (85%) was more than that of IRCBC (35%)(p<0.05). The cardiac index after discontinuing cardio-pulmonary bypass was significantly elevated in the IAWBC group. The prevalence of perioperative myocardial infarction in IAWBC (4%) was lower than that of IRCBC group (20%)(p<0.05). Conclusion: Intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique for myocardial protection. It can also provide simpler and economic way than the retrograde cold cardioplegia by shortening of cardiopulmonary bypass time and avoiding retrograde cannulation for coronary sinus.

Studies of the Effects of Acupuncture Stimulation at Huatuo Jiaji(EX B2) Points on Axonal Regeneration of Injured Sciatic Nerve in the Rats (화타협척혈 침자극에 의한 손상 말초신경의 재생효과에 관한 연구)

  • Kim, Dae-Feel;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.18 no.4
    • /
    • pp.39-61
    • /
    • 2008
  • Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods: Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, Dil fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and Dil-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increase in regeneration-associated protein levels appeared to be related with increase cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased Dil-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of Dil labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.

Clinical evaluation of tooth replantation and transplantation of old patients (노인 환자에 있어서 치아 재식술 및 이식술의 임상적 고찰)

  • Ha, Jung-Hong;Jin, Myoung Uk
    • The Journal of the Korean dental association
    • /
    • v.50 no.8
    • /
    • pp.507-515
    • /
    • 2012
  • The purpose of this article is to discuss the effect of aging on the treatment of replantation and transplantation of teeth in old patients. I case of replantation and 2 cases of transplantations in old patients are reported in this article. Patients aged 65 and over are included. They had several problems such as periapical lesion, crack or foot fractures. In those cases, the replantation and transplantation were treatment of choice. White ProRoot MTA was used in apical retrograde filling and perforation repair. After replantation and transplantation of teeth, follow-up visits showed signs of healing in 3 cases. Considerations and indications for replantation and transplantation are not much affected by age. Old patients are aware that replantation and transplantation can be performed comfortably and that age is not a factor in prediction success.

The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer (췌·담도암 진단에 있어서 내시경초음파의 역할)

  • Kim, Kook Hyun
    • Journal of Yeungnam Medical Science
    • /
    • v.33 no.2
    • /
    • pp.77-84
    • /
    • 2016
  • Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.

Retrieval of a dislodged and dismounted coronary stent; using a rendezvous and snare technique at the brachial artery level via femoral approach

  • Jeong, Min-Woong;Sohn, Chang-Bae;Kim, Su Hong;Park, Jong-Ik;Park, Se-Ryeong;Min, Jun-Sik
    • Journal of Yeungnam Medical Science
    • /
    • v.33 no.2
    • /
    • pp.138-141
    • /
    • 2016
  • Coronary stent dislodgement during percutaneous coronary intervention, which occurs when the stent is passed through tortuous and calcified lesions, is not a rare complication. Without proper treatment, such as fixing with another stent in the coronary artery or removing the undeployed stent from the coronary artery or systemic artery system, this complication can cause serious problems. We experienced the unusual situation of a dismounted and dislodged coronary stent, in which retrograde retrieval to the radial artery was impossible during transradial coronary intervention. We report on use of a rendezvous and snare technique at the brachial artery level via femoral puncture, which resulted in resolution without surgery.

TIDAL EVOLUTION OF GLOBULAR CLUSTERS: THE EFFECTS OF GALACTIC TIDAL FIELD, DIFFUSION AND BLACK HOLES

  • OH KAP SOO
    • Journal of The Korean Astronomical Society
    • /
    • v.27 no.1
    • /
    • pp.61-76
    • /
    • 1994
  • We investigate the dynamical evolution of globular clusters under the diffusion, the Galactic tide, and the presence of halo black holes. We compare the results with our previous work which considers the diffusion processes and the Galactic tide. We find the followings: (1) The black holes contribute the expansion of the outer part of the cluster. (2) There is no evidence for dependence on the orbital phase of the cluster as in our previous work. (3) The models of linear and Gaussian velocity distribution for the halo black holes do not show any significant differences in all cases. (4) The perturbation of black holes reduces the number of stars in lower energy regions. (5) There is a significant number of stars with retrograde orbits beyond the cutoff radius especially in the case of diffusion and the perturbation of black holes.

  • PDF

Difficult airway management in a patient with a parapharyngeal tumor

  • Ji, Sung-Mi
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.15 no.3
    • /
    • pp.153-156
    • /
    • 2015
  • A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

Junctional rhythm with severe hypotension following infiltration of lidocaine containing epinephrine during dental surgery

  • Jeon, Younghoon;Shim, Jihye;Kim, Hyunjee
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.20 no.2
    • /
    • pp.89-93
    • /
    • 2020
  • We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.

Regulation of BDNF release in dopaminergic neurons

  • Jeon, Hong-Seong
    • 한국생물공학회:학술대회논문집
    • /
    • 2003.04a
    • /
    • pp.743-746
    • /
    • 2003
  • The major pathological lesion in Parkinson's disease(PD) is selective degeneration and loss of pigmented dopaminergic neurons in substantia nigra (SN). Although the initial cause and subsequent molecular signaling mechanisms leading to the dopaminergic cell death underlying the PD process is elusive, the potent neurotrophic factors (NTFs), brain derived neurotrophic factor (BDNF) and glial cell line derived neurotrophic factor (GDNF), are known to exert dopaminergic neuroprotection both in vivo and in vitro models of PD employing the neurotoxin, MPTP. BDNF and its receptor, trkB are expressed in SN dopaminergic neurons and their innervation target. Thus, neurotrophins may have autocrine, paracrine and retrograde transport effects on the SN dopaminergic neurons. This study determined the BDNF secretion from SN dopaminergic neurons by ELISA. Regulation of BDNF synthesis/release and changes in signaling pathways are monitored in the presence of free radical donor, NO donor and mitochondrial inhibitors. Also, this study shows that BDNF is able to promote survival and phenotypic differentiation of SN dopaminergic neurons in culture and protect them against MPTP-induced neurotoxicity via MAP kinase pathway.

  • PDF

Clinical Report of two TGA cases (일과성 전기억상실증으로 진단된 환자 치험 2례)

  • Oh, Kyong-Min;Yang, Dong-Ho;Cho, Youn-Song;Kim, Bo-Kyong
    • Journal of Oriental Neuropsychiatry
    • /
    • v.19 no.3
    • /
    • pp.265-276
    • /
    • 2008
  • Transient global amnesia(TGA) is a clinical syndrome characterized by sudden, temporary dysfunction of anterograde and recent retrograde memory without other neurologic deficits. Different hypotheses have been considered for its etiology, but it still remains obscure. Recently the diffusion-weighted magnetic resonance imaging(DWI), has been considered as the sensitive tool to detect small punctate hyperintense lesions in the hippocampus in transient global amnesia(TGA). We report two TGA cases, all of them answers to TGA clinical criteria, and one of them showed two dot like high signal intense foci in Rt. hippocampus on DWI.

  • PDF