• Korean Journal of Radiology
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• v.22 no.9
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• pp.1525-1536
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• 2021

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7-18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959-0.991; p < 0.001) as well as right (0.755-0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion: The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.224-236
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• 1999

Background: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. Material and Method: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. Result: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7${\pm}$7.2%, 9.3${\pm}$3.2%, 16.8${\pm}$8.6%, and 23.1${\pm}$9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1${\pm}$4.6% and 17.7${\pm}$9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34${\pm}$2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5${\pm}$2.7%, systolic left ventricular pressure by 15.8${\pm}$2.5% and the elevation of left ventricular end-diastole pressure by 54.3${\pm}$15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5${\pm}$1.8% and 3.1${\pm}$1.1%, 5.7${\pm}$3.6%, and 6.9${\pm}$4.4%, respectively, whereas LVEDP decreased by 11.7${\pm}$4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. Conclusion: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.

• The Korean Journal of Physiology
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• v.1 no.1
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• pp.103-120
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• 1967

As pointed out by many previous investigators, the cardio-pulmonary system of well trained athletes is so adapted that they can perform a given physical exercise more efficiently as compared to non-trained persons. However, the time course of the development of these cardio-pulmonary adaptations has not been extensively studied in the past. Although the development of these training effects is undoubtedly related to the magnitude of an exercise load which is repeatedly given, it would be practical if one could maintain a good physical fitness with a minimal daily exercise. Hence, the present investigation was undertaken to study the time course of the development of cardio-pulmonary adaptations while a group of non-athletes was subjected to a daily 6 to 10 minutes running exercise for a period of 4 weeks. Six healthy male medical students (22 to 24 years old) were randomly selected as experimental subjects, and were equally divided into two groups (A and B). Both groups were subjected to the same daily running exercise (approximately 1,000 kg-m). 6 days a week for 4 weeks, but the rate of exercise was such that the group A ran on treadmill with 8.6% grade for 10 min daily at a speed of 127 m/min while the group B ran for 6 min at a speed of 200 m/min. In order to assess the effects of these physical trainings on the cardio-pulmonary system, the minute volume, the $O_2$ consumption, the $CO_2$ output and the heart rate were determined weekly while the subject was engaged in a given running exercise on treadmill (8.6% grade and 127 m/min) for a period of 5 min. In addition, the arterial blood pressure, the cardiac output, the acid-base state of arterial blood and the gas composition of arterial blood were also determined every other week in 4 subjects (2 from each group) while they were engaged in exercise on a bicycle ergometer at a rate of approximately 900 kg m/min until exhaustion. The maximal work capacity was also determined by asking the subject to engage in exercise on treadmill and ergometer until exhaustion. For the measurement of minute volume, the expired gas was collected in a Douglas bag. The $O_2$ consumption and the $CO_2$ output were subsequently computed by analysing the expired gas with a Scholander micro gas analyzer. The heart rate was calculated from the R-R interval of ECG tracings recorded by an Offner RS Dynograph. A 19 gauge Cournand needle was inserted into a brachial artery, through which arterial blood samples were taken. A Statham $P_{23}AA$ pressure transducer and a PR-7 Research Recorder were used for recording instantaneous arterial pressure. The cardiac output was measured by indicator (Cardiogreen) dilution method. The results may be summarized as follows: (1) The maximal running time on treadmill increased linearly during the 4 week training period at the end of which it increased by 2.8 to 4.6 times. In general, an increase in the maximal running time was greater when the speed was fixed at a level at which the subject was trained. The mammal exercise time on bicycle ergometer also increased linearly during the training period. (2) In carrying out a given running exercise on treadmill (8.6%grade, 127 m/min), the following changes in cardio·pulmonary functions were observed during the training period: (a) The minute volume as well as the $O_2$ consumption during steady state exercise tended to decrease progressively and showed significant reductions after 3 weeks of training. (b) The $CO_2$ production during steady state exercise showed a significant reduction within 1 week of training. (c) The heart rate during steady state exercise tended to decrease progressively and showed a significant reduction after 2 weeks of training. The reduction of heart rate following a given exercise tended to become faster by training and showed a significant change after 3 weeks. Although the resting heart rate also tended to decrease by training, no significant change was observed. (3) In rallying out a given exercise (900 kg-m/min) on a bicycle ergometer, the following change in cardio-vascular functions were observed during the training period: (3) The systolic blood pressure during steady state exercise was not affected while the diastolic blood Pressure was significantly lowered after 4 weeks of training. The resting diastolic pressure was also significantly lowered by the end of 4 weeks. (b) The cardiac output and the stroke volume during steady state exercise increased maximally within 2 weeks of training. However, the resting cardiac output was not altered while the resting stroke volume tended to increase somewhat by training. (c) The total peripheral resistance during steady state exercise was greatly lowered within 2 weeks of training. The mean circulation time during exorcise was also considerably shortened while the left heart work output during exercise increased significantly within 2 weeks. However, these functions_at rest were not altered by training. (d) Although both pH, $P_{co2}\;and\;(HCO_3-)$ of arterial plasma decreased during exercise, the magnitude of reductions became less by training. On the other hand, the $O_2$ content of arterial blood decreased during exercise before training while it tended to increase slightly after training. There was no significant alteration in these values at rest. These results indicate that cardio-pulmonary adaptations to physical training can be acquired by subjecting non-athletes to brief daily exercise routine for certain period of time. Although the time of appearance of various adaptive phenomena is not identical, it may be stated that one has to engage in daily exercise routine for at least 2 weeks for the development of significant adaptive changes.

• The Korea Journal of Herbology
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• v.23 no.2
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• pp.225-233
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• 2008

Objectives : The purpose of the present study was to development of neuroprotective antioxidant agents. For the purpose, we investigated the neuroprotective effect of anti oxidant herb, the root of Polygonum cuspidatum on transient focal cerebral ischemia in rats. Methods : The roots of Polygonum cuspidatum were extracted by 85% MeOH (PCE). Radical scavenging effects were investigated using DPPH assay and TBARs (Thiobarbituric acid reaction substance) assay in brian homogenates. Neuroprotective effect was investigated using transient focal cerebral ischemia rat model (2 h of ischemia, 22 h of reperfusion) by behavioral test and measurement of brain damage using 2, 3, 5-triphenyltetrazolium chloride staining. Results : PCE showed potent and dose dependent radical scavenging effects in DPPH and TBARs assay. Oral administration of PCE reduced brain infarct volume by 29.7% and improved the sensory motor functional deficit by 29% compared with vehicle treated group. Conclusions : PCE showed radical scavenging effects and neuroprotective effect on stroke rat model. Therefore, Polygonum cuspidatum could be a candidate for the development of neuroprotective-antioxidant agents.

• Journal of Life Science
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• v.22 no.4
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• pp.532-537
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• 2012

We investigated the effect of smoking on cardiovascular responses during acute dynamic exercise. Eleven college students who had been smoking (duration of smoking: $7.45{\pm}0.90$ years; number of cigarettes per day: $17.72{\pm}1.22$) participated in this study. All subjects completed a graded exercise testing to determine the relative exercise intensity. The cardiovascular responses were measured at rest, and during mild and moderate exercise immediately, 24, and 48 hours after smoking. The same procedures were repeated during 24-h smoking withdrawal. All subjects were continuously instrumented to measure systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO), and total vascular conductance (TVC) at rest and during exercise. The results showed that compared to the nicotine abstention, SBP, DBP, MAP, and HR were significantly higher at 24 and 48 hours after smoking ($p$<0.05), and CO was significantly higher at rest and during moderate exercise ($p$<0.05). There were no differences in SV and TVC before and after smoking. Thus, the results suggest that smoking is associated with an exaggerated sympathetic nerve activity during dynamic exercise. Consequently, smoking cessation may help reduce cardiac events, such as stroke and heart attack, during exercise.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.425-446
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• 1988

After 24 hours of preservation under 15 mmHg perfusion pressure the recovery rates of isolated canine hearts were determined. Preservation was performed in a cold room maintained at 4*C with 4 different types of perfusates bubbled with a mixture of 95% 0y and 5% CO~ using a modified perfusion unit designed in our institute. The perfusates used were as follows; Group 1: Krebs-Henseleit solution, Group 2: Krebs solution added by albumin and PGE1. Group 3: Modified Wicomb*s solution, Group 4: Modified Collin*s solution. The extent of myocardial recovery was evaluated using a modified isolated carmine perfusion model by measuring heart rate, systolic arterial pressure, left atrial pressure[LAP] and cardiac output. In addition to the above hemodynamic parameters, biochemical and enzymatic assays from perfusates and electron microscopic changes of the myocardium were also studied. The results were as follows; 1] The heart recovery rates were 41.6%, 53.4% and 108.9% in groups 1, 2 and 3, respectively, and group 3 elicited the best result[p< 0.001]. The heart beat was never recovered in group 4. 2] Recovered systolic arterial pressures[mmHg] were 63.3% in group 1, 94.9% in group 2 and 94.3% in group 3. 3] LAPs[mmHg] were 20 in group 1, 13.5 in group 2 and 11.2 in group 3, which suggested that the best myocardial preservation was elicited in group 3[p< 0.05]. 4] Cardiac output, the sum of aortic stroke volume and coronary leakage, were 69.1% in group 2, and 90.7% in group 3, but these were not statistically significant[p=0.24]. No aortic stroke output was measured in group 1 and 4. 5] The degree of myocardial edema increase was 17.5` in group 1, 24.6% in group 2, 20.9% in group 3 and 55.3% in group 4. But there were no statistical differences in each group[p= 0.08]. 6] CPK-MB[U/L] levels were increased 750% and 332%[p< 0.05], glucose levels[mg/dl] 60.5% and 78.2% and SGOT[U/L] levels 523% and 333%, in groups 2 and 3, respectively. Biochemical and enzymatic assays could not be performed in group 1 and group 4, because of poor recovery of heart beat. 7] Electron microscopic findings in the myocardium of most groups revealed slight to moderate muscle cell and mitochondrial edema. But all these findings were within the limits of reversible change. From these above results, it is suggested that modified Wicomb*s solution seems to be the most useful physiologic salt solution for preservation of the heart. We propose that after further study and improvement, our portable continuous hypothermic perfusion system will contribute to the development of a better preservation method for donor hearts for human heart transplantation.

• Korean Circulation Journal
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• v.53 no.7
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• pp.425-451
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• 2023

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA₂DS₂-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

• Journal of Cardiovascular Imaging
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• v.31 no.2
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• pp.85-95
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• 2023

BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.451-455
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• 2003

In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of tile International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care which contains both the new recommendations and an in-depth review. The most important changes in the recommendations according to the authors are discontinuation of the pulse-check for lay people, 500 ml instead of 800∼1,200 ml tidal volume during bag-valve-mask ventilation (FiO2 > 0.4) of a patient with an unprotected airway, unifying correct endotracheal intubation size as 8.0 mm, vasopressin (40 units) and epinephrine (1 mg) as comparable drugs to treat patients with ventricular fibrillation, early prehospital survey and intravenous lysis for patients who have suffered coronary artery syndrome and stroke.

• Korean Journal of Materials Research
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• v.4 no.8
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• pp.945-951
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• 1994

In order to elucidate the extrusion characteristics of $SiC_{p}$/6061 Al composite, defomation resistance, $K_{w}$ was determined using the empirical formula suggested by Watanabe et al, and also extrusion pressure was measured using the extrusion press with a capacity of 350 ton. The $K_{w}$ which are propotional to extrudability, was increased with increasing volume fraction of reinforcement, $SiC_{p}$, but decreased with increasing the particle size. The peaks of maximum extrusion pressure in curves of extrusion force vs ram stroke were changed sharply with decreasing the particle size. The elevated extrustion temperature resulted in the decreased $K_{w}$ and extrusion pressure, but caused the surface tearing of extrusion composite bars. The results showed that extrudability of the composite billets is depend on the extrusion conditions as well as the characteristics of reinforcement, $SiC_{p}$.