• Title/Summary/Keyword: clamping

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Changes of Interleukin-10 level in Patients Undergoing cardiopulmonary Bypass (체외순환에 따른 혈중 Interleukin-10의 변화)

  • 홍남기;이동협;정태은;이정철;한승세
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.648-654
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    • 2000
  • Background: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. Mateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and `5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays(ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was 171$\pm$41.4 min and aortic cross clamp time was 118$\pm$36.5 min. Peak IL-10 level was achieved at 10 min after ACC(361.0$\pm$52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time(p=0.011); however, it did not correlated with bypass time(p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89$\pm$107.69 pg/ml and was significantly higher than that of coronary artery bypass group(205.67$\pm$192.70 pg/ml)(p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group(p<0.01), however, bypass time was not(p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted(p=0.19). Conclusion: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.

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Treatment of Atrial Fibrillation with Microwave (Microwave를 이용한 심방세동의 치료)

  • 조광현;최강주;강도균;전희재;윤영철;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.329-334
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    • 2003
  • Backgound: Cryoablation and radiofrequency ablation have been used to treat the atrial fibrillation. Some reports insisted that the microwave ablation Is a better method for a deep and extensive lesion. Material and Method: From December 2001 to July 2002, we peformed 8 microwave ablations in patients who needed mitral valve surgery (7 MVR, 1 MVR+AVR). There were 3 men and 5 women, and their mean age was 43.4$\pm$8.3 years and mean follow up period was 5.6$\pm$2.4 months respectively. The microwave was applied on endocardium or epicardium by Lynx (Afx, inc.) using a power of 45 watts for 25 seconds. We studied the left atrial dimension, the left atrial function and the sinus conversion with echocardiography and electro-cardiography at three times; 1) before the operation, 2) immediately after the operation, and 3) 6 months after the operation. Result: There was no complication and no mortality. The mean aortic clamping time was 104.6$\pm$25.0 minutes, and the mean total bypass time was 130.5$\pm$28.7 minutes. The rate of sinus conversion was 75%, A wave across the mitral valve was a mean of 77.0$\pm$24.8 cm/sec, and the AVE was a mean of 0.46$\pm$0.17 at 5.6 months postoperatively Conclusion: There was no difference in the early result of microwave ablation compared to other methods. The microwave ablation was an acceptable method due to its convenient application especially in beating heart.

Clamp and Sew Technique without Distal Perfusion for the Management of Traumatic Descending Thoracic Aortic Rupture (외상성 흉부 하행 대동맥 파열에서 원위부 관류 없이 시행한 겸자 봉합술)

  • Seok, Yang-Ki;Lee, Jong-Tae;Kim, Gun-Jik;Park, Il;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.558-563
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    • 2007
  • Background: Traumatic aortic rupture is a highly fatal condition in which a patient's outcome is strongly affected by other associated injuries. Selection of the appropriate surgical timing and the management plan is important. Material and Method: The medical records of the 15 traumatic descending thoracic aortic rupture patients who underwent the clamp & sew technique were retrospectively reviewed and checked for the presence of associated injuries and the postoperative course. Result: The hospital mortality was 6.07% (one patient). This patient died intra-operatively and the cause of the death was delayed hemoperitoneum. The mean operative time and aortic clamp time were $231{\pm}53.1$ and $13.1{\pm}5.3$ minutes, respectively. One patient complained the bowel obstructive symptoms at postoperative 10 days. We found the mechanical bowel obstruction on computed tomography of the abdomen, and segmental bowel resection was done. Conclusion: Although several surgical strategies may be appropriate for managing traumatic aortic rupture, the clamp & sew technique is a safe and effective method for the treatment of traumatic aortic injury.

Estimation of Shear Strength Along Concrete Construction Joints Considering the Variation of Concrete Cohesion and Coefficient of Friction (콘크리트 시공줄눈 면에서 점착력 및 마찰계수의 변화를 고려한 전단내력 평가)

  • Yang, Keun-Hyeok;Kwon, Hyuck-Jin;Park, Jong-Beom
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.21 no.6
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    • pp.106-112
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    • 2017
  • This paper presents a mathematical model derived from the upper-bound theorem of concrete plasticity to rationally evaluate the shear friction strength of concrete interfaces with a construction joint. The upper limit of the shear friction strength was formulated from the limit state of concrete crushing failure on the strut-and-tie action along the construction joints to avoid overestimating the shear transfer capacity of a transverse reinforcement with a high clamping force. The present model approach proposed that the cohesion and coefficient of friction of concrete can be set to be $0.27(f_{ck})^{0.65}$ and 0.95, respectively, for rough construction joints and $0.11(f_{ck})^{0.65}$ and 0.64, respectively, for smooth ones, where $f_{ck}$ is the compressive strength of concrete. From the comparisons with 155 data compiled from the available literature, the proposed model gave lower values of standard deviation and coefficient of variation of the ratios between predictions and experiments than AASHTO and fib 2010 equations, indicating that the proposed model has consistent trends with test results, unlike the significant underestimation results of such code equations in evaluating the shear friction strength.

Contradictory Effects of Superoxide and Hydrogen Peroxide on $K_{Ca}3.1$ in Human Endothelial Cells

  • Choi, Shinkyu;Na, Hye-Young;Kim, Ji Aee;Cho, Sung-Eun;Suh, Suk Hyo
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.3
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    • pp.181-187
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    • 2013
  • Reactive oxygen species (ROS) are generated in various cells, including vascular smooth muscle and endothelial cells, and regulate ion channel functions. $K_{Ca}3.1$ plays an important role in endothelial functions. However, the effects of superoxide and hydrogen peroxide radicals on the expression of this ion channel in the endothelium remain unclear. In this study, we examined the effects of ROS donors on $K_{Ca}3.1$ expression and the $K^+$ current in primary cultured human umbilical vein endothelial cells (HUVECs). The hydrogen peroxide donor, tert-butyl hydroperoxide (TBHP), upregulated $K_{Ca}3.1$ expression, while the superoxide donors, xanthine/xanthine oxidase mixture (X/XO) and lysophosphatidylcholine (LPC), downregulated its expression, in a concentration-dependent manner. These ROS donor effects were prevented by antioxidants or superoxide dismustase. Phosphorylated extracellular signal-regulated kinase (pERK) was upregulated by TBHP and downregulated by X/XO. In addition, repressor element-1-silencing transcription factor (REST) was downregulated by TBHP, and upregulated by X/XO. Furthermore, $K_{Ca}3.1$ current, which was activated by clamping cells with 1 ${\mu}M$ $Ca^{2+}$ and applying the $K_{Ca}3.1$ activator 1-ethyl-2-benzimidazolinone, was further augmented by TBHP, and inhibited by X/XO. These effects were prevented by antioxidants. The results suggest that hydrogen peroxide increases $K_{Ca}3.1$ expression by upregulating pERK and downregulating REST, and augments the $K^+$ current. On the other hand, superoxide reduces $K_{Ca}3.1$ expression by downregulating pERK and upregulating REST, and inhibits the $K^+$ current. ROS thereby play a key role in both physiological and pathological processes in endothelial cells by regulating $K_{Ca}3.1$ and endothelial function.

Effect of Clamping Pressure on Surface Properties of Gas Diffusion Layer in PEFCs (체결압이 고분자연료전지 기체확산층의 표면성질에 미치는 영향)

  • Ahn, Eun-Jin;Park, Gu-Gon;Yoon, Young-Gi;Park, Jin-Soo;Lee, Won-Yong;Kim, Chang-Soo
    • Journal of the Korean Electrochemical Society
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    • v.10 no.4
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    • pp.306-310
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    • 2007
  • Characteristics of GDL (Gas Diffusion Layer) mainly determine the gas diffusion and water removal in a cell, thereby changing the performance and affecting durability of PEFC. To optimize the water management and understand the two phase flow in a GDL, it is important to study the behaviors of GDL micro structure under the real operating condition. In the clamped condition of cell, the GDL beneath the rib is more compressed than beneath the channel. Many researches on physical, electrochemical, mechanical behaviors of gas diffusion layer has been conducted. However, changes in surface properties under clamped condition have rarely studied. In present study, the morphology of broken connections of carbon fibers and detachment of PTFE coatings on the fibers were shown from the microscopic observations. In addition, changes in wetting properties of GDL by compression were investigated by using XPS and liquid uptake methods. The hydrophobic characteristics of GDL surface beneath the rib of the flow field plate are changed due to the deformation of micro structure.

Effect of Doxycycline on the Acute Lung Injury Induced by Gut Ischemia/Reperfusion (장의 재관류로 유도된 급성폐손상에서의 Doxycyclin의 효과)

  • Lee, Young Man;Kwon, Sung Chul;Lee, Sang Chae
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.532-541
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    • 2003
  • Background : Phospholipase $A_2$ ($PLA_2$) has been known to be involved in the pathogenesis of acute lung injury (ALI) including ARDS. Since doxycycline has the property of inhibiting secretory group II $PLA_2$, the therapeutic effect of doxycycline hyclate was investigated for gut ischemia/reperfusion (I/R)-induced ALI in Sprague-Dawley rats. Methods : ALI was induced in Sprague-Dawley rats by clamping of the superior mesenteric artery for 60 min, followed by 120 min of reperfusion. To confirm the pathogenetic mechanisms of this ALI associated with neutrophilic oxidative stress, we measured bronchoalveolar lavage (BAL) protein content and lung MPO, and performed cyto-chemical electron microscopy for detection of free radicals, assay of $PLA_2$ activity and cytochrome-c reduction assay. Results : In gut I/R-induced ALI rats, protein leakage, pulmonary neutrophil accumulation, free radical production and lung $PLA_2$ activity were all increased. These effects were reversed by doxycycline hyclate. Conclusion : Doxycycline appears to be effective in ameliorating the gut I/R-induced ALI by inhibiting $PLA_2$, thereby decreasing the production of free radicals from neutrophils.

Color Change and Consumer Preferences towards Color of Heat-Treated Korean White Pine and Royal Paulownia Woods

  • Hidayat, Wahyu;Qi, Yue;Jang, Jae Hyuk;Park, Byung Ho;Banuwa, Irwan Sukri;Febrianto, Fauzi;Kim, Nam Hun
    • Journal of the Korean Wood Science and Technology
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    • v.45 no.2
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    • pp.213-222
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    • 2017
  • Heat treatment of wood is an attractive alternative environmentally-friendly treatment to add value of less valuable woods by improving color, dimensional stability, and natural durability. To improve the color properties of Korean white pine (Pinus koraiensis) and royal paulownia (Pauwlonia tomentosa), we treated the woods at $160^{\circ}C$, $180^{\circ}C$, $200^{\circ}C$, and $220^{\circ}C$ for 2 hours. Color change after heat treatment was evaluated using the CIE-Lab color system and survey was conducted to determine the consumer preferences towards color of heat-treated wood. Lightness ($L^*$) decreased with increasing temperature and the higher degree of change was obtained in royal paulownia. The red/green chromaticity ($a^*$) in both wood decreased after heat treatment at $160^{\circ}C$, and constantly increased after heat treatment at $180^{\circ}C$ to $220^{\circ}C$. Yellow/blue chromaticity ($b^*$) in Korean white pine tended to increase after heat treatment at $160^{\circ}C$, then decreased gradually afterwards. In royal paulownia, $b^*$ values linearly increased with increasing temperature. Overall color change (${\Delta}E^*$) increased with increasing temperature with higher degree obtained in royal paulownia. Samples with the clamps in both wood species showed lower degree of the change in $L^*$, $a^*$, b and ${\Delta}E^*$. The results of the consumer preferences test showed that the darker colors of heat-treated woods were more preferred by consumers compared to the lighter colors of untreated woods. Consequently, heat treatment could enhance the color properties of Korean white pine and royal paulownia woods for value added products.

Long-term Survival after Coronary Artery bypass Surgery (관상동맥 우회술의 장기 생존율)

  • Lee Mi Kyung;Jeong Eun Taik;Choi Jong Bum
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.139-145
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    • 2005
  • Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

Efficacies of the Modified Ultrafiltration and Peritoneal Dialysis in Removing Inflammatory Mediators After Pediatric Cardiac Surgery (소아 개심술 후 변형 초여과법과 복막투석의 염증 매개체 (inflammatory mediator)의 감소에 대한 효과)

  • 성시찬;정민호
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.745-753
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    • 2001
  • capillary leak syndrome and organ dysfunction in infants. Removing harmful cytokines and complement anaphylatoxins after cardiopulmonary bypass may attenuate this response. This study was conducted to see if the modified ultrafiltration and postoperative peritoneal dialysis can reduce plasma inflammatory mediators in pediatric cardiac surgery. Material and Method: 30 infants (age 1.1 to 12.6 months) who underwent closures of ventricular septal defect using cardiopulmonary bypass (CPB) were enrolled in this study. These patients were divided into three groups; 10 patients selected randomly underwent modified ultrafiltration (Group U), 10 with small body weights ($\leq$5 kg) received postoperative peritoneal dialysis (Group P), and 10 patients did not undergo modified ultrafiltration nor receivcd peritoneal dialysis (Group C). Serum samples were obtained before and after CPB, and after peritoneal dialysis. Effluents sample were also obtained after modified ultrafiltration or peritoneal dialysis. C3a and interleukin-6 (IL-6) were measured by radioimmunoassay and enzyme-linked immunosorbent assay respectively. Result: There was no differences in CPB time, aortic cross-clamping title, and lowest temperature during CPB. The effluents of peritoneal dialysis contained significant amount of C3a and IL-6, but there was no definitive decrease of serum concentration of C3a and IL-6. The effluents of modified ultrafiltration had some amount of C3a and negligible IL-6, and there was no decrease of serum concentration of these (actors. Conclusion: The effluents of peritoneal dialysis contained significant amount of proinflammatory cytokine, IL-6 and complement, C3a. However this study failed to elucidate the decrease in serum levels of these factors. The modified ultrafiltration also was not able to reduce the serum levels of C3a or IL-6 in our study as well.

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