• Journal of Chest Surgery
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• 제20권2호
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• pp.384-392
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• 1987

The occlusive coronary artery disease presents a potential threat to a significant population in the United State. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. We experienced one case of coronary artery disease. He was a 68 year old male who had been suffered from hypertension since 1 5 years ago, and had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain on exertion, but this symptom was relieved on rest. Pre-operative EKG finding revealed no any other ischemic sign. Significant S-T segment depression was noted at lead II, aVF, V3, V4, and V5, and inverted T wave in V5 and V6 after Master`s test. Simple chest X-ray finding showed emphysematous field, bilaterally. Final pre-operative diagnosis was made by coronary angiogram, which showed almost 90% degree of occlusive lesion in the proximal part of left main coronary artery above the origin LAD artery. He was treated successfully by aorta-coronary saphenous vein graft under extra-corporeal circulation in May, 1987. He has been followed up with uneventful course.

• 순환기질환의공학회:학술대회논문집
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• 순환기질환의공학회 2003년도 제3회 학술대회
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• pp.8-9
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• 2003

• Journal of Chest Surgery
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• 제30권11호
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• pp.1132-1135
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• 1997

충북대학교병원 흉부외과에서는 좌전행지에 99%, 제2대각지에 90%, 우측 관상동맥에 50% 이하의 협착과 경피적 관상동맥 풍선 성형술 시행도중 동정지와 계속적인 서맥, 심방 및 심실조기박동의 부정맥을 보인 63 세의 여자 환자와 좌전행지의 근위부에서 원위부위까지 95% 정도의 협착과 제1대각지의 분지부위에 95% 이상의 협착을 가진 75세의 남자환자를 인공심폐기를 사용하지않고 심장이 박동되는 상태에서 정중 흉골절개를 통해 얻은 좌측 내유동맥과 우측 복재정맥을 이용해 좌전행지와 대각지에 성공적으로 관상동맥우회술을 시행하였다.

• 한국식품과학회지
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• 제26권3호
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• pp.213-220
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• 1994

본 연구는 고혈압을 비롯한 순환기 질환의 예방이나 치료의 목적을 위해 민간요법으로 전수되어 사용되고 있는 천마의 효능에 대한 사실성을 확인하고, 나아가서는 이러한 효능에 대한 천마의 작용기전을 유추하려고 하였다. 현재까지 천마 extracts에 대한 유효성분의 분석이 이루어져 있지 않기 때문에, 본 연구는 SD 실험쥐와 선천성 고혈압의 소질을 지닌 SHR 실험쥐를 이용하여 천마의 water-extracts나 ethanol-extracts의 심장 및 관상 순환기능에 대한 약리적인 효능을 과학적으로 구체적인 실험방법을 통해서 조사하였다. 천마 extracts는 추출과정에 사용된 용매, 추출기간 및 실험쥐 model에 따라 관상 순환기능에 대한 작용효과가 상반된 현상으로 나타났다. 물이나 50% ethanol에 16시간 추출된 extracts는 사용된 농도에서 SD 실험쥐의 관상 혈관저항을 저하시켜 혈관확장의 효과를 가져왔지만, SHR 실험쥐에서는 ethanol에 추출된 extracts는 사용된 농도에서 심장기능 그 자체에 유의적인 독성효과를 주지 않는다는 것을 말해준다. 본 연구결과는 천마의 water-extracts에 의해서 나타난 혈관확장작용이 일반적으로 국소적인 혈관확장에 관여한다는 lactate 생성의 증가에 기인하는 것보다는 오히려 extracts에 의한 대사적 acidosis 현상에 기인한다는 사실을 제시하고 있다. 본 연구에서 천마의 수용성 extracts가 혈관확장작용 또는 혈압강하작용을 나타낸다는 사실이 제시된 것은 심장이나 순환기 질환을 예방하고 치료하기 위한 천마의 임상적인 활용측면에서 매우 중요한 성과이다. 그러나, 천마의 순환기능에 대한 약리적 효능을 나타내는 성분추출은 조사되어야 할 과제로 아직 남아 있다. 또한, 천마를 한방에서 약재로써 이용되는 반면에 천마를 식이로 이용하기 위해서 식이성 천마에 대한 효능을 연구해야 할 필요가 있다. 이러한 연구결과로써, 천마는 혈관순환기질환의 예방이나 치료에 이용되는 생약으로써 활용될 뿐만 아니라 안전성을 가진 건강식품으로 개발되어 국민보건 향상에 이바지하리라 기대된다.

• Journal of Chest Surgery
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• 제21권5호
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• pp.877-881
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• 1988

A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2002년도 학술대회지
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• pp.717-720
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• 2002

The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

• Advances in biomechanics and applications
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• 제1권4호
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• pp.279-292
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• 2014

This paper presents some simulations of fluxes and pressures in the coronary network, in the case of very severe coronary disease (several stenoses on the left branches and total occlusion of the right coronary artery). In that case, coronary artery bypass graft surgery is the commonly performed procedure. However, the success of the intervention depends on many factors. Modeling of the coronary circulation is thus important since it can help to understand the influence of all these factors on the coronary haemodynamics. We previously developed an analog electrical model that includes the eventual presence of collateral flows, and can describe the different revascularization strategies (two grafts, three grafts, ...). The aim of the present work is to introduce in our simulations the time-dependence of the coronary microvascular resistances, in order to better represent the effect of the systolic ventricular contraction (which induces an elevation of the resistances because the vessels are squeezed).

• Journal of Mechanical Science and Technology
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• 제19권6호
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• pp.1313-1320
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• 2005

Stenosed coronary artery may play an important role in various coronary heart diseases. However, it has not been known how much stenosed coronary artery affects coronary circulation system, quantitatively. The present study developed a mathematical model for microcirculation in the left common coronary artery (LCCA) with adopting a previously measured morphological data and mechanical properties of the coronary vessels. We examine the effect of percent diameter stenosis on blood flow rate and shear stress for two cases. Case I comprised of one-stenosed element at $10^{th}$ order ($\%$ diameter stenosis are 10, 30, and 50, respectively). Case II consisted of completely occluded element at $10^{th}$ order (number of occluded elements are 0, 1, and 2 out of 8, respectively). As the level of stenosis becomes severe, the shear stress increases significantly but the flow rate reduction was relatively small. However, for the occluded case, there was linearly proportional reduction of flow rate according to number of occluded elements. Either such high shear stress associated with coronary artery stenosis or reduced flow rate due to occlusion may cause atherosclerosis and myocardial ischemia.

• International Journal of Vascular Biomedical Engineering
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• 제2권1호
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• pp.25-30
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• 2004

Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Uses of catheters during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. Catheters in blood vessels cause pressure gradient rise and blood flow drop during the measurements. In this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter obstructions during the coronary angioplasty. The computer simulation models are generated by the data, which are measured by coronary angiogram, and the blood is treated as non-Newtonian fluid. The velocity, pressure, and wall shear stress variations are observed for the estimate of damages of blood vessel. This study is also extended to investigate the effects of stenotic vessel size, and shape and catheter size and location.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.80-83
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• 2016

Isolated anomalous right coronary artery originating from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that is asymptomatic and discovered incidentally in most cases. ARCAPA is generally not considered a fatal defect in infancy or childhood, although cases of sudden death have been reported. Here, we report a 2-month-old female infant who presented with a prolonged fever that was determined to be caused by rhinovirus infection. Myocardial ischemia of the left ventricular posterior wall was already seen on echocardiography, and ARCAPA was discovered incidentally. The patient underwent successful surgical reimplantation of the right coronary artery to the aortic root to re-establish dual ostial circulation.