• Title/Summary/Keyword: Vascular resistance

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Surgical correction of Total Anomalous Pulmonary Venous Connection - Review of 37 Cases treated surgically during 10 years (총폐정맥환류이상증에 대한 외과적 요법 및 장기 성적)

  • 나명훈
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.695-705
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    • 1987
  • This report provides follow - up data on 37 patients, aged 7 days to 25 years [median: 6.5 months], who underwent repair of total anomalous pulmonary venous connection at Seoul national University Hospital between May, 1978 and June, 1987. The patients were 22 males and 17 females and the sex ratio was 1.6 to 1, showing a male predominance. Sixteen patients had supracardiac, 13 cardiac, 3 infracardiac and 5 had a mixed type. The duration of follow up was from 1 month to 60 months [median: 14 months] There were eight early and one late deaths, and the overall mortality was 24%. The deaths during 1 year of life were eight [89%] and only one death [11%] occurred above 1 year of age. The mortality of cardiac type was unusually high, accounting for 56 percent of the total death, which was probably due to the preoperative poor clinical condition such as pulmonary edema and congestive heart failure. The major cause of death was the perioperative myocardial failure, and the survival was closely related to the preoperative clinical status, age and moderately elevated pulmonary arterial pressure, the sign of the elevated pulmonary vascular resistance and pulmonary venous obstruction. Early diagnosis and early application of surgical intervention is essential to the improved postoperative survival

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Resistance to Cisplatin Renders High Metastatic Potential in Human Non-Small Cell Lung Cancer Cell Line (Cisplatin 내성을 보이는 비소세포폐암 세포주에서의 전이 능력 증가)

  • 차대원;김진국;손동섭;조대윤;양기민
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.377-385
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    • 2001
  • 배경: Cisplain과 같은 세포돗성 약제에 대한 내성은 폐암 치료 실패의 중요한 원인이다. 이러한 항암제에 대한 내성의 발생기전은 복잡하고 아직 완전히 알려져 있지 않지만 불량한 예후의 원인으로 생각된다. 특히 약제 내성이 발생한 환자의 경우 기존의 종양의 급속한 성장뿐 아니라 새로운 전이 병소가 급속히 발생 및 진단됨은 약제 내성을 가진 종양이 전이에의 용이성을 획득하는게 아닌가 의심케한다. 이를 규명하기 위해 Cisplatin에 내성을 지닌 비소세포폐암 세포주 H460/CISm이 전이 능력을 Cisplatin에 민감한 비소세포폐암 세로주 H460과 비교하고자 한다. 대상 및 방법: 약제 내성 세포주를 확보하기 위하여 H460세포에 cisplatin을 점차적으로 증가시켜 처리한 후 배양하였다. H460 세포와 H460/CIS 세로에서의 혈관신생인자와 성장관련인 자의 발현양상, gelatin zymography 분석 그리고 in vivo 실험으로 nude 마우스에서의 자발적 전이 능력의 차이를 비교하였다. 결과: H460 세포를 이식한 마우스에 폐에서는 종양이 형성되지 않았으나 H460/CIS세포를 이식한 마우스 10마리중 8마리에서 종양이 형성되었다. 또한 H460/CIS 세포주에서 전이 관련 유전자로 알려진 angiopoietin-1, vascular endothelial growth factor, basic fibroblast growth factor, matrix metalloproteinase 2 등이 더 발현되었고, 전이의 침습성을 유발하는 gelatinase의 활성이 증가된 것을 확인할 수 있었다. 결론: 본 여구 결과를 통해 cisplatin에 내성을 가진 비소세포폐암세포에서 전이 능력이 증가될 수 있다고 여겨지며 이러한 사실을 토대로 초기 비소세포폐암 환자의 수술 전 항암약물요법의 타당성에 대해서 이야기 하기 위해서는 많은 임상적 연구가 필요하리라 생각된다.

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Deep Vein as a Graft Conduit (도관으로 사용된 심부정맥)

  • Yie, Kil-Soo;Cheon, Sung-Bin;Oh, Won-Sub;Ryu, Se-Min;Lee, Bong-Ki;Kim, Hyung-Rae;Kim, Keun-Woo
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.441-446
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    • 2010
  • The ideal graft requires acceptable size, less tissue toxicity, resistance to infection, and long-term durability. Great saphenous veins are gaining popularity as acceptable graft conduits, but they require time to grow in caliber. We report 2 cases of graft bypass and reconstruction using superficial femoral veins to acheive immediate high-flow patency.

Higenamine Reduced Mortalities in the Mouse Models of Thrombosis and Endotoxic Shock (마우스의 혈전증 및 내독소 쇼크 모델에 있어서 Higenamine에 의한 사망률 저하효과)

  • YunChoi, Hye-Sook;Kim, Moon-Hee
    • YAKHAK HOEJI
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    • v.38 no.2
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    • pp.191-196
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    • 1994
  • Higenamine is a tetrahydroisoquinoline alkaloid which was isolated as a cardiotonic principle from Aconiti tuber. 1.v. injection of higenamine was reported to increase the cardiac output and heart rate and to decrease the blood pressure and the systemic vascular resistance presumably by stimulating the adrenergic ${\beta}-receptors$. The anti-platelet and anti-thrombotic effects of higenamine were investigated in this paper. Higenamine(0.5 mg/ml) showed mild inhibitory effect against collagen induced platelet aggregation in vitro and the inhibito교 effect was increased with the pre-incubation$(5{\sim}30\;min)$ of platelet rich plasma(PRP) with higenamine. With the 30 min incubation, the platelet aggregation was almost completely inhibited. And the oral administration of higenamine$(50{\sim}200\;mg/kg)$ enhanced the survival in the mouse model of thrombosis and that of endotoxic shock. The anti-thrombotic and anti-septic effects of higenamine thus appear to be due to the ${\beta}-agonistic$ and the anti-platelet effects of this compound.

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Results of Fontan Operation - 45 Cases Report - (Fontan 수술성적에 대한 보고 - 45례 -)

  • 원용순
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.25-31
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    • 1989
  • Forty-five patients, aged 16 months to 15.5 years mean 69 months, with a wide variety of cardiac malformations underwent the modified Fontan operation between Sep. 1986 to Aug. 1988. Nineteen patients had previously undergone palliative operations mainly modified B-T shunt. Twenty patients had a mean pulmonary artery pressure greater than 15 mmHg, with nine operative deaths. Thirteen patients had anomalies of systemic venous connection and seven patients had anomalies of pulmonary venous connection. There were eighteen patients under the age 4 years and fifteen of them survived [83.3%]. Eighteen patients had a pulmonary vascular resistance [PVR] more than 2.5U/m, and nine died [50%] whereas two of twenty-three with a PVR less than 2.5U/m died[8.6%]. PVR and anomalies of pulmonary venous connection had a significant influence on survival, but age and anomalies of systemic venous connection did not. Amount of pleural effusion drained postoperatively and PVR had positive linear correlation. Pulmonary artery pressure was not an independent predictor of outcome and pulmonary artery pressure alone should not contraindicate a Fontan procedure if PVR is low. In general, the Fontan operation should be done at a younger age less than 4 year to avoid ventricular dysfunction due to long-standing exposure to hypoxia.

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Simulation Study of Blood Perfusion according to Outflow Cannulation Site of Left Ventricular Assist Device (좌심실보조장치의 출구 캐뉼라의 삽관 위치에 따른 혈액관류에 대한 시뮬레이션 연구)

  • Jee, In Hyeog;Kim, Hyeong Gyun;Lim, Ki Moo
    • Journal of Biomedical Engineering Research
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    • v.36 no.4
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    • pp.135-142
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    • 2015
  • Outflow cannulation site of left ventricular assist device(LVAD) chosen by considering anatomical structure of thoracic cavity and vascular system. Though outflow cannulation site influences blood perfusion at each branch, there is no standard rule or quantitative data. In this study, we computed the amount of blood perfusion at each arterial branch numerically according to outflow cannulation sites(ascending aorta, aortic arch, descending aorta). We generated computational meshes to the three-dimensionally reconstructed arterial system. Clinically measured arterial pressure were used for inlet boundary condition, porous media were applied to mimic blood flow resistance. Blood perfusion through left common carotid artery was 2.5 times higher than other cases, and that through right common carotid artery was 1.1 times higher than other branches. Although this is simulation study, will be useful reference data for the clinical study of LVAD which considers blood perfusion efficiency.

Surgical Management of Ventricular Septal Defect in Infancy (영아기의 심실중격결손에 대한 이라완전교정술과 단계교정술의 비교)

  • 김병호
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.24-30
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    • 1994
  • Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

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Treatment of Vasodilatory Shock after Cardiac Surgery : Low Dose Arginine Vasopressin Therapy - Three cases report - (개심술후 발생한 Vasodilatory Shock의 치료 : Arginine Vasopressin의 소량투여요법 - 3례 보고 -)

  • 이교준;김해균;정은규;김도형;강두영;이응석
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.227-230
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    • 2002
  • The vasodilatory shock after cardiopulmonary bypass is defined as the condition involving severe and persistent form of hypotension, tachycardia, normal or increased cardiac output and decreased systemic vascular resistance. Because of the unsuccessful response to infusion of fluids or catecholamine vasopressors, a sustained systemic shock state occurs and results in a high morbidity and mortality. We successfully treated this syndrome of 3 patients after open heart surgery with low dose of arginine vasopressin(AVP). Therefore, we report these cases with a review of related articles.

Effects of Exercise on the Physiological Changes of Aging Skeletal Muscle (운동이 노화로 인한 골격근의 생리적 변화에 미치는 영향)

  • Song, Ju-Young;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.5 no.1
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    • pp.63-78
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    • 1998
  • The decrease of muscle power and muscle size between twenties and seventies was about 30% and 40% respectively. The loss of muscle mass by aging resulted in the decrease of muscle power. The loss of muscle mass was due to the decrease of number of Type I fiber and Type II fiber and size of each muscle fiber. The aging skeletal muscle didn't show the loss of glycolysis capacity but showed 20% decrease of the oxidative enzymes and muscle vascularization. The vigorous endurance exercise training with graded intensity played a role in the vascular proliferation, increase of activity of oxidative enzymes and improvement of $VO_2$ max. The graded resistance exercise also played a role in the muscle hypertrophy and increase of muscle power, if it performed with adequate intensity and period. The exercise adaptation of aging skeletal muscle prevented it from sarcopenia, provided the activity of daily living with great effect and provided the aging related disease, that is Type II diabetes mellitus, arteriosclerosis, hypertension, osteoporosis and obesity, with great effect.

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LUDWIG'S ANGINA IN PATIENT WITH DIABETIC MELLITUS;REPROT OF CASE (당뇨병을 가진 LUDWIG'S ANGINA 환자에 대한 치험례;증례보고)

  • Ryu, Soo-Jang;Yang, Young-Cheol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.311-318
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    • 1997
  • Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.

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