Experimental Studies of the Blood Gas Transport during Normothermic Hemodilution Perfusion

Kwack, Moon Sub,Kim, Se Wha,Lee, Hong Kyun CATHOLIC MEDICAL CENTER 1979 Bulletin of the Clinical Research Institute Vol.7 No.1

Hemodilution perfusion has been initially designed to avoid the homologous blood syndrome or to save the blood. Neptune, Zuhdi, Long and Cooley have already performed intentional hemodilution perfusion using low molecular weight dextran, 5% dextrose in water or 0.9% normal saline solution as priming material.

Influence of Suture Materials on Growth and Stricture of Tracheal Anastomosis in Growing Rabbits

Kwack, Moon Sub,Cho, Deog Gon CATHOLIC MEDICAL CENTER 1993 Bulletin of the Clinical Research Institute Vol.21 No.2

A primary tracheal resection and end-to-end anastomosis is considered to be the most dependable and efficient way of regaining anatomic and functional continuity of trachea in the patients with tracheal lesions. However, high incidence of stenosis or granuloma at the suture line may be developed when the chidren grow up. We compared the influence off polypropylene (Prolene^�, group Ⅰ), polyglactin 910 (coated Vicryl^�, group Ⅱ ) and polydioxanone (PDS^�, group Ⅲ) by evaluating the stenosis and the growth of the tracheal anastomotic sites after complete transection and end to end anastomosis in growing rabbits. The results were as follows; 1. There was a 197% increase in body weight to 3.3±0.18 kg and no significance in growth of body weight among the groups. 2. The growth of the lateral diameters was significantly less than anteroposterior diameter’s in each group. 3. In a comparison of nonabsorbable verses absorbable suture materials (group Ⅰ verses group Ⅱ and group Ⅲ) at the time of death of the animals, the growth of the both internal diameters and the cross sectional areas in group Ⅰ was significantly less than those of other groups (p<0.05). 4. In a comparison of these two absorbable suture materials (group Ⅱ verses group Ⅲ), the growth of the both internal diameters and the cross sectional areas at the time of death of the animals in group Ⅲ were significantly greater than that in group Ⅱ (p<0.05). 5. Histologic analysis showed that intense inflammatory reaction and fibrosis around nonabsorbed Prolene sutures in group I was more frequent than in other two groups, and revealed a more intense inflammatory reaction surrounding multifilament coated Vicryl sutures with more rapid resorption and greater subsequent fibrosis ralative to the reaction seen with PDS sutures. In conclusion, although there was little evidence of respiratory impairment, the transection of the trachea with end to end anastonnosis resulted in stenosis and retardation of growth at the anastomosis site in growing rabbits. The nonabsorbable suture material (Prolene) induced more remarkable stenosis of anastomoses than the absorbable suture marterials (coated Vicryl and PDS). And the degree of stenosis was significantly less w hen monofilament absorbable suture material (PDS) was used.

Pulmonary Hemodynamic Alterations following Radical Hilar Stripping

Kwack, Moon Sub,Lee, Hong Kyun CATHOLIC MEDICAL CENTER 1975 Bulletin of the Clinical Research Institute Vol.3 No.1

The roles of hilar tissues in supporting pulmonary hemodynamics was studied by radical hilar stripping. Loss of nerve innervation had a influence, in some extent, to the decrease of oxygen uptake and the increase of pulmonary vascular resistance and pulmonary artery pressure. There can be little question that denervation does impair the pulmonary hemodynamics, however, intact pulmonary nerve innervation is not absolutely essential for survival of the animal.

Retrograde Cerebral Perfusion during Profound Hypothermic Circulatory Arrest

Kwack, Moon Sub,Kim, Yong Hwan CATHOLIC MEDICAL CENTER 1993 Bulletin of the Clinical Research Institute Vol.21 No.2

The use of total circulatory arrest with profound hypothermia in the surgical treatment of aortic aneurysm and aortic dissection has been reported as popular surgical methods. However the safe period of prolonged circulatory arrest with hypothermia remains controversial. Retrograde cerebral perfusion during profound hypothermic circulatory arrest is a simplified technique that obviates dissection of the arch tributaries. The results were as follows: 1. The difference in oxygen content and PaCO_2 between perfused and retruned blood was appeared the provision of substrate and the washout of metabolites. 2. Intraoperative eletroencephalography estimated brain activity and revealed no electrical Impulse throughout the period of circulatory arrest and retrograde cerebral perfusion. This condition is defined electrical cerebral silence. 3. The microscopic findings of brain tissue showed mild brain edema, but no evidence of tissue necrosis or hemorrhage. We concluded the retrograde cerebral perfusion during hypopthermic circulatory arrest is a simplified thechnique that may have a excellent brain protection.

기관지 확장제 아루펜트의 외과적 응용과 효과

곽문섭,김세화 한국의 현대의학사 1970 한국의 현대의학 Vol.2 No.2

Effect if Indomethacin and Colchicine on Paraquat Induced Pulmonary Toxicities in Rat

Moon, Seok Whan,Kwack, Moon Sub,Kim, Se Wha,Lee, Hong Kyun CATHOLIC MEDICAL CENTER 1991 Bulletin of the Clinical Research Institute Vol.19 No.1

Paraquat, a widely used herbicide, is known as a pneumotoxin and causes dose-dependent lung injuries resulting in a sequence of pathologic changes that resemble adult respiratiory distress syndrome. Paraquat induced pulmonary toxicities in rat lungs are thought to result from its specific accumulation in lung tissue and direct cytotoxic effects on alveolar epithelium. Acute paraquat induced lung injury is mainly caused by prostaglandin and polymorphonuclear leukocyte. Indomethacin is a potent inhibitor of prostaglandin synthesis and colchicine inhibits acute inflammation such as a gout by inhibiting migration of polymorphonuclear leukocytes. In order to evaluate the effects of indomethacin and colchicine on paraquat-induced pulmonary toxicities. Four groups of rats (n=80) weighing about 100 gm were studied: In group Ⅰ, as a control (n=20) normal saline was injected intramuscularly for 14 days; in gorup Ⅱ(n=20), paraquat (10 mg/kg/d) was simultaneously injected for 3 days and for group Ⅲ & Ⅳ in the same manners; in group Ⅲ (n=20), indomethacin (2 mg/kg/day) was injected intramuscularly after paraquat injection for 14 days; in group Ⅳ (n=20), colchicine (20 ㎍/rat/day) was provided as drinking water to paraquat exposed rats for 14 days. The lungs of rats all were sacrificed 14 days later and were examined for evaluation for toxicities and histologic effects. Indomethacin or colchicine treatment in paraquat exposed rats ameliorated toxic effects of paraquat: In indomethacin treated group, lesser 1ethalily and lesser reduction of body weight were observed and lesser ratio of lung wet-to-dry weight suggesting lesser degree of pulmonary edema were revealed in correlation with mild destruction of lung architecture. And in colchicine treated group were toxic and histologic findings observed like indomethacin treatment. The clear difference between colchine and indomethacine were not observed but in septal thickness was lesser in colchcine group. We concluded that paraquat induced pulmonary toxicities could be prevented with indomethacin and colchicine by inhibiting prostaglandin synthesis and transcelluar migration respectively.

血栓樣 左心房粘液腫

郭文燮 최신의학사 1988 最新醫學 Vol.31 No.3

폐문부박리가 폐혈류 역학에 미치는 영향

곽문섭,이홍균,Kwack, Moon Sub,Lee, Hong Kyun 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.1

Author has performed experimental study on hemodynamic changes of lung following radical hilar stripping and contralateral pulmonary artery ligation. In view of hemodynamic changes in group 1 (right pulmonary artery ligation only) and group 2(left hilar stripping+right pulmonary artery ligation). group 2 showed remarkable decrease rate in oxygen uptake (P<0.001) and total pulmonary blood flow(P<0.001), and the more increase rate in mean pulmonary artery pressure(P<0.02) and total pulmonary vascular resistance (P<0.001). Meanwhile, the decrease percent of left lung vascular resistance was lower than group 1(P<0.001). The hemodynamic changes in group 1 returned to control range two weeks later. In the group 2, two dogs were expired as a result of atelectasis and pulmonary hypertension. Among allying 8 dogs, five months after operation, follow up studies performed in two dogs, which showed normal pulmonary hemodynamics similar to preoperative data. The altered blood gas values and decreased oxygen uptake are more remarkable in denervated lung, which may due to pulmonary hypertension and partly retained more secretion in bronchial trees than usual. Important factors of raising pulmonary vascular resistance and pulmonary artery pressure are considered as the increased blood flow to remaining left lung and dysfunction of pulmonary vascular bed to accept the increased blood flow after denervation. Loss of nerve innervation had a influence, to some extent, to the decrease of oxygen uptake and the increase of pulmonary vascular resistance and pulmonary artery pressure. There can be little question that denervation does impair the pulmonary hemodynamics, however, intact pulmonary nerve innervation is not absolutely essential for survival of the animal.

두개의 전극도자를 사용하게 된 Permanent Transvenous Pacemaker Implantation: 1례 보고

곽문섭,이홍균,Kwack, Moon-Sub,Lee, Hong-Kyun 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.2

Since cardiac pacemaker was first totally implanted by Chardack, Gage and Greatbatch [1966], the electrical circuity of the cardiac pacemaker has been improved, modified, and refined. The problem of transvenous electrodes, however, is still remained; this may be due to electrode displacement, exit and/or entrance block, lead fracture and insulation defects. In permanent cardiac pacing, Irreversible loss of function of the transvenous electrode catheter eventually requires insertion of new lead. Authors now report one case that disclosed easy displacement of electrode tip in early phase of implantation and then two years and five months later, malfunctioning electrode could not be withdrawn from the cardiovascular system because it has become firmly enclosed by fibrous tissue along its course from the vein tract to the right ventricle. Under such circumstances, the electrode catheter tip was left in tricuspid annulus after being sutured at its entrance and burying the loop of lead in generator pocket. New other one electrode was then reimplantation through left external jugular vein.

The Myocardial Protective Effect of Superoxide Dismutase on Ischemic-Reperfusion Injury in Isolated Rabbit Heart

Cho, Kyu Do,Kwack, Moon Sub CATHOLIC MEDICAL CENTER 1994 Bulletin of the Clinical Research Institute Vol.22 No.1

Reperfusion damage refers to the serious structural, functional, and metabolic derangements commonly observed during restoration of coronary circulation following cardiopulmonary bypass. Damage is believed to result from ischemic injury incurred during aortic cross clamping and unmasked in the recovery period and certain metabolic process is activated during postischemic reperfusion. In isolated rabbit hearts, we tested the hypothesis that improved myocardial protection during cardiac arrest can prevent ischemic-reperfusion damage and investigated the possibility of achieving optimal myocardial protection. Elective cardiac arrests were induced in isolated perfused rabbit hearts under working conditions. We tested two methods of cardioplegic solution, one conventional cold hyperkalemic crystalloid solution (n=7), and another superoxide dismutase (SOD) added cold one (n=7). Hemodynamic functional recovery, the concentration of creatine kinase detected in coronary effluent, and the structural findings were used to evaluate the advantage of SOD added cardioplegic solution. The results were as follows; 1. The SOD in cardioplegic solution enhanced recovery of aortic flow when compared with control group, the percentage recovery after 90 minutes' ischemia being 85.1±5.7% in SOD-treated group and 76.1±6.2% in control group (P<0.05). 2. The increase in concentration of creatine kinase was less in SOD-treated group compared with control group (48.1±5.8 IU/L vs 74.7±7.2 IU/L, P<0.05). 3. The transmission electron microscopic findings revealed more mitochondrial swelling, more depletion of glycogen granules, and some amorphous matrix densities in control group compared with SOD-treated group. We concluded that good tolerance to global ischemic cardiac arrest could be achieved when superoxide dismutase was used as the additive to the cardioplegic solution.