• 대한핵의학회:학술대회논문집
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• 1999.05a
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• pp.205-208
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• 1999

Percutaneous Transluminal Coronary Angioplasty (PTCA) remains limited by restenosis that occurs in 30 to 50% of patients with coronary artery disease. During the last decade, numerous agents have been used to prevent restenosis. Despite positive results in animal models, no pharmacological therapy has been found to significantly decrease the risk of restenosis in humans. These discrepancies between animal models and clinical situation were probably related to an incomplete understanding of the mechanism of restenosis. Neointimal thickening occurs in response to experimental arterial injury with a balloon catheter. Neointimal formation involves different steps: smooth muscle cell activation, proliferation and migration, and the production of extracellular matrix. The factors that control neointimal hyperplasia include growth factors, humoral factors and mechanical factors. Arterial remodeling also plays a major role in the restenosis process. Studies performed in animal and human subjects have established the potentials for "constrictive remodeling" to reduce the post-angioplasty vessel area, thereby indirectly narrowing the vessel lumen and thus contributing to restenosis. The reduction of restenosis rate in patients with intracoronary stent implantation has been attributed to the preventive effect of stent itself for this negative remodeling. In addition to these mochanisms for restenosis, intraluminal or intra-plaque thrombus formation, reendothelialization and apoptosis theories have been introduced and confirmed at least in part.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.132-140
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• 2007

This study compared the histological patency rates of anastomoses of the femoral artery. Twelve rabbits weighing about 2 kg were studied. Both the right and left femoral arteries were cut. The control group had no damage to the vessel, saline irrigation, and micro-anastomosis. Experimental group I had a crush injury to the vessel, saline irrigation, and micro-anastomosis. Experimental group II had a crush injury, saline irrigation, 100 U/ml heparin irrigation, and micro-anastomosis. Experimental group III had the same treatment as experimental group II plus the systemic application of 100 U/kg heparin iv. The histological patency rates were compared. The patency rates of the control group 30 min and 3 days after the anastomosis were 100 and 83%, respectively. The respective rates for experimental groups I and II 30 min and 3 days after the anastomosis were 100% in all cases. The respective rates in experimental group III were 100 and 83%. In this study, no significant correlation was observed between the patency rate and the effects of local irrigation or the systemic application of heparin on the microvascular anastomosis of the rabbit femoral artery. However, the patency rate tended to decrease concomitantly with an increase in surgery time. Increased bleeding was observed after the systemic application of heparin. Obvious damage to the crush-injured vascular endothelium was detected on histologic examination of the micro-anastomosed area. In addition, some vessels subjected to crush injury contained thrombi attached to the vascular endothelium. No preventive effect of heparin on thrombus formation was observed.

• Archives of Pharmacal Research
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• v.20 no.1
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• pp.17-23
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• 1997

A saline suspension of Lumbricus rubellus earthworm powder (EWP) was administered to rats (1 g/kg/day) orally for 15 days to evaluate an oral effectiveness for thrombotic disorders. Blood was drawn at 2-day interval after the administration. Several parameters for antithrombotic, anticoagulant and fibrinolytic activities were measured, including platelet aggregation, clotting time, plasmin activity and the levels of FDP (fibrin/fibrinogen degradation products), D-dimer, and t-PA antigen. It did not affect platelet aggregation induced by ADP and collagen but anticoagulant activity (aPTT and TT) was gradually increased to two-folds for the first 5 days of administration and back to normal. Fibrinolytic activity of euglobulin fraction was highest on the 11 th day after the administration. The level of FDP was elevated to be comparable to the positve control$ (5-10 {\mu}g/ml)$ after 9-day treatment. Oral administration of the EWP could also reduce the formation of venous thrombus induced with viper venom. Complete blood count (CBC) profiles were within normal ranges except for a slight increase in white blood cells after the oral administration for 15 days. These results suggested that the EWP may be valuable for the prevention and/or treatment of thrombotic diseases.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.844-853
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• 1990

We have performed 27 cases of orthotopic homologous cardiac transplantation using Korean mongrel dogs and one case of sham operation for the evaluation of harmful effect of cardiopulmonary bypass itself on the dog from April, 1989 to June, 1990. Our previous reports have already demonstrated basal hemodynamic and hematologic data on the canine homologous heart transplantation and the fundamental principles of transplantation of the heart. The mean body weight of recipients was 13.2$\pm$1.2kg with a rage of 11 ~ 15kg, and the hemodynamic and hematologic pictures were almost same as the result of previous reports from our hospital, except marked decrease in postoperative platelet count[from 3.18 $\pm$0.80x106/mm3 to 1.41$\pm$0 37x 106/mm3]. Mean survival time was 24.82$\pm$49.40 hours with the longest survival of 264 hours. Donor cardiectomy included coronary vasodilatation with diltiazem, potassium arrest, and the rapid cooling of the heart suspending in the specially designed ice-bath. Median sternotomy provided excellent exposure of the surgical field. 6 \ulcorner0 prolene suture was used for the anastomosis of both atrial cuffs and the great arteries, and we found the fact that stenosis, bleeding, thrombus formation around the anastomotic site could be decreased with the use of everted horizontal mattress suture techniques. Immunosuppression was done with a combination of lower dose Cyclosporin-A, Azathioprine, methyl-prednisolone, but our cases still showed too short survival to worry about graft rejection. Still poor was our quality control of experimental animal, we had much difficulties in postmortem evaluation of the dogs. Low cardiac output due to biventricular failure, intractable supraventricular or ventricular tachyarrhythmia, postoperative massive bleeding, sepsis were most frequent findings that could be thought as a cause of death. A few cases showed subendocardial patch hemorrhage in both ventricular cavity or atrial septum at autopsy, suggesting acute subendocardial infarction. Although our team overcome most of the technical problems of orthotopic heart transplantation, we should pile up further knowledges about donor heart preservation, quality control of animal, infection, rejection, the effect of the cardiopulmonary bypass to improve the results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.397-418
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• 1994

Microvascular surgery has been widely used in the clinical field of replantation and reconstructive surgery. Since the last 20 years, microsurgical techniques and instruments have been rapidly developed and the success rate is remarkably increased. But thrombotic occlusion of vessels remains the major reason for clinical failure. The change of vessel wall is the most important factor in thrombus formation. If we can reduce the traumatic changes in the vessel walls during surgery, the success rate can be markedly increased. For this study, femoral arteries and veins of 36 Sprague-Dawley rats with average weights of 300gm were used. The author observed the histological changes and healing process in the anastomostic site after 1 hour, 24 hours, 1, 2, 3 and 4 weeks under light microscopy and scanning electron microscopy. The results were as follows : 1. The patency rate was 100% in femoral arteries and 85% in femoral vein. 2. At the early stages after microvascular anastomosis, the loss of endothelial cell in the vessel walls was observed in the wide area including anastomotic site. In scanning electron microscopic finding the anastomotic site was covered with much fibrin, many red blood cells and some platelets. 3. At 1st week, new endothelial cells were formed toward anastomotic site and at 3rd week, the anastomotic site was completely covered by new endothelial cells. At 4th week, the complete endothelialization over the threads was observed. 4. The media extended from the anastomotic site toward the end of the specimen. At later stages, the extent of media necrosis was markedly decreased. But the media necrosis of anastomotic site was not regenerated till 4th week. 5. Intimal hyperplasia appeared at 1st week and increased till 4th week. The layer consisted of endothelialization the most luminal layers and smooth muscle in the deeper layers. But in veins, the response was less pronounced than in arteries. 6. Foreign body granuloma remained during 4 weeks and aneurysm was observed at 3rd week in artery. In aneurismal wall, media necrosis, loss of elastic lamina and intimal hyperplasia were seen.

• The Journal of Internal Korean Medicine
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• v.20 no.1
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• pp.198-209
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• 1999

A thrombus is a mass formed from the constituents of the blood within the vessels or the heart during life. The process of its formation is known as thrombosis, It has been generally accepted that Holotrichia is an useful medicine for thrombosis. The rate of fibrinolysis of Holotrichia extracts increase as incubation times. Especially 52 days, the effect on the extracts has an maximum increased fibrinolytic activity, Heat-and-pH-stability of the extract on fibrinolysis is relative to temperature, At $37^{\circ}C$, it has activating effect between pH 4 and pH 12. At higher temperature, especially $80^{\circ}C$, an excessive increase in temperature has a deactivating effect on the extracts. Optimal pH of the extract on fibrinolysis is between pH 7.0 and pH 8.5, it is effective within a relatively broad pH range. In experiments of various inhibitors of Holotrichia extracts fibrinolytic activity, there are strong inhibitive effect on SBTI and Aprotinin, and a few inhibitive effect on DFP and t-AMCHA, no effect on PSMB and TLCK. Holotrichia extracts mixing with fibrinogen are observed Electron microscopy. it shows partially erosive-shaped fibrinolytic activity. In a SDS-PAGE of the extract having the fibrinolytic activity, three bands are found, protein 1, 2 and 3 having a molecular weight of 30,000, 45,000 and 60,000 Dalton.

• Korean Journal of Pharmacognosy
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• v.51 no.3
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• pp.151-157
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• 2020

When blood vessels are damaged, a rapid hemostatic reaction occurs to minimize blood loss and maintain normal circulation. Platelet activation and aggregation is essential in this process. However, excessive platelet aggregation or abnormal platelet aggregation may be the cause of cardiovascular disease, such as thrombosis, stroke and atherosclerosis. Therefore, it is important to prevent and treat cardiovascular disease by finding substances that can regulate platelet activation and suppress aggregation reactions. Isoscopoletin, which is mainly found in the roots of plants Artemisia or Scopolia, has been reported to have potential pharmacological effects on anticancer and Alzheimer's disease, but its role and mechanisms for platelet aggregation and thrombus formation are unknown. This study confirmed the effect of isoscopoletin on major regulation of collageninduced human platelet aggregation, TXA₂ production and intracellular granular secretion (ATP and serotonin release). In addition, the effects of isoscopoletin on phosphorylation of phosphorylated proteins PI3K/Akt and MAPK involved in signal transduction in platelet aggregation was studied. As a result, isoscopoletin significantly inhibited the phosphorylation of PI3K/Akt and MAPK, significantly inhibiting platelet aggregation through TXA₂ production and intracellular granular secretion (ATP and serotonin release). Therefore, we suggest that isoscopoletin is an anti-platelet substance that regulates phosphorylation of phosphorus proteins such as PI3K/Akt and MAPK and is valuable as a preventive and therapeutic agent for platelet-derived cardiovascular disease.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.696-700
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• 2007

We report here on the midterm results after a Starnes operation for a severely symptomatic neonate with Ebstein's anomaly. A one-day-old baby presented with cyanosis and severe cardiomegaly. We peformed patch closure of the tricuspid valve with a central shunt after failure of tricuspid valve repair with vertical plication of the atrialized ventricle at her age of 19 days. The coronary sinus was drained into the right ventricle. She underwent bidirectional cavopulmonary shunt and extracardiac conduit Fontan operation at her age of 16 and 30 months, respectively. She is now 56 months old and is doing very well. The recent follow-up study revealed that she was in normal sinus rhythm and had a normal sized left ventricle with good function and the small right ventricle without thrombus formation.

• Journal of Biomedical Engineering Research
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• v.13 no.3
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• pp.225-234
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• 1992

In order to use a low cost polymer valve in our total artificial heart and ventricular assist device, we have developed a slit-type bileaflet polymer valve[BPV 1. The aim of this study is to determine the hydrodynamic effectiveness of the newly-designed BPV and its feasibility for temporary use in the blood pumps. For hydrodynamic comparison, we investigated in-vitro the pressure drop across the valve, the leakage volume, the flow rate and the flow pattern of the BPV, two mechanical valves and a trileaflet polymer valve. We employed the ventriculo-pulmonary bypassing method for in-vivo tests of the BPV's together vilh our electrohydraulic left venIn ricular assist device in mongrel dogs. The BPV showed adquate gydrodynamic performances and in the preliminary animal bests, there was no xvi dence of thrombus formation on the valve leaflets and around the struts. Detailed results obtained from the animal tests will be separately reported. This report involves the design criteria, fabrication and hydrodynamic charateristics of she BPV, and the basic merits and demerits of the valve are dis- cussed from the hydrodynamic point of view.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.77-88
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• 1992

Recently, diabetic patients are increasing in the field of microvascular surgery. Diabetes melltius is known to be related to arterial damage, platelet malfunction and thrombus formation. After microvascular anastomosis, delayed repair and vascular occlusion occurred more frequently in diabetic state. This study was performed to investigate the patency rate and process of endothelial healing after microvascular anastomosis of femoral artery in diabetic rat by scanning electron microscope. The animals were divided into two groups, 20 diabetic-induced and 20 non-diabetic groups. Diabetes was induced with a injection of Streptozotocin(50mg/kg b.w., Sigma Chemical Co.) to tail vein. The results obtained were as follows: 1. Macroscopically, anastomotic site was intact except a few cases showed minimal inflammatory sign around the wound site. But the inflammatory change was frequently occurred in diabetic-induced group. 2. The patency rate was 95% (19/20) in non-diabetic group and 65% (13/20) in diabetic-induced group. 3. In the non-diabetic group, anstomotic region was mostly endothelized by the alignment along the long axis of vessel but stitchs were not covered with endothelial cells. The thichkening of vessel wall was not observed. 4. In the diabetic-induced group, anastomotic region was not endothelized but covered with blood cellular components and connective tissue instead of endothelial cells. The thickening of the vessel wall was prominent in some diabetic-induced rats. These results suggest that diabetes was related to delayed regeneration of endothelium of vessels after microsurgical anastomosis.