• Title/Summary/Keyword: perfusion

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Studies on the Hemodilution Perfusion with Rygg-Kyvsgaard Oxygenator (혈액희석 체외순환법에 관한 임상적 관찰 -상온하 Rygg-Kyvsgaard 산화기 및 Sigmamotor pump 사용예를 중심으로-)

  • 손광현
    • Journal of Chest Surgery
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    • v.3 no.2
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    • pp.73-90
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    • 1970
  • Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

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Understanding of Perfusion MR Imaging (관류자기공명영상의 이해)

  • Goo, Eun-Hoe
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.1
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    • pp.27-31
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    • 2013
  • Perfusion MR imaging is how to use exogenous and endogenous contrast agent. Exogenous perfusion MRI methods which are dynamic susceptibility contrast using $T2^*$ effect and dynamic contrast-enhanced using T1 weighted image after injection contrast media. An endogenous perfusion MRI method which is arterial spin labeling using arterial blood flow in body. In order to exam perfusion MRI in human, technical access are very important according to disease conditions. For instance, dynamic susceptibility contrast is used in patients with acute stroke because of short exam time, while dynamic susceptibility contrast or dynamic contrast enhancement provides the various perfusion information for patients with tumor, vascular stenosis. Arterial spin labeling is useful for children, women who are expected to be pregnant. In this regard, perfusion MR imaging is required to understanding, and the author would like to share information with clinical users

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Diagnostic Value of Pulmonary Perfusion Scan in Patients of Airway Foreign Body (기관지 이물 환자에서 폐장관류주사(pulmonary perfusion scan)의 적용 의의)

  • 최종욱;정광윤;민헌기;황찬승;김혜정
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.75-81
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    • 1995
  • To evaluate the diagnostic value of pulmonary perfusion scan, we obtained 99mTc MAA per-fusion lung scan from 25 cases of airway foreign bodies. The results were as follows. 1) Significant changes in blood gases were not observed after the establishment of regional hypoperfusion caused by airway foreign body. 2) Near total or total defect was noted on perfusion scan from most of the airway foreign body. 3) There was correspondance of findings of perfusion lung scan and duration of airway foreign body. 4) After the removal of airway foreign bodies, perfusion scan abnormalities were reversed in parallel with the recovery of pulmonary blood flow. We concluded that pulmonary perfusion scan may be valuable for detection of foreign body and reversible hypoperfusion.

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The Usefulness of Deconvolution Perfusion CT in Patients with Acute Cerebral Infarction : Comparison with Diffusion MRI (급성 뇌경색 환자에서 Deconvolution perfusion CT의 유용성 : Diffusion MRI와 비교)

  • Eun, Sung-Jong;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.25-31
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    • 2003
  • This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), and mean transit time(MTT) maps were created. The created lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion sire were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging(DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable CT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI(7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that m map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

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Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease (어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가)

  • Lee, D.S.;Hyun, I.Y.;Wang, K.C.;Cho, B.K.;Chung, J.K.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.314-324
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    • 1998
  • Purpose: This study was performed to evaluate the outcome of encephalo-duro-arterio-synangiosis (EDAS) surgery with rest/acetazolamide Tc-99m HMPAO SPECT in moyamoya disease. Materials and Methods: Rost/acetazolamide subtraction SPECT with consecutive acquisition were done before and 2 months after 21 EDAS surgeries in 18 patients. Perfusion decrease was graded visually for 14 areas of each hemisphere as 0 (normal) to 3 (defect) using 4 point scoring system. Postoperative rest perfusion or perfusion reserve was compared with preoperative ones. Results: Among 294 areas of 21 hemispheres, rest perfusion abnormality was found in 91 areas of 15 hemispheres. Decrease of perfusion reserve was found in 146 areas of 18 hemispheres. Six hemispheres having normal rest perfusion and 12 of 15 hemispheres having rest perfusion abnormality showed reserve decrease. Three having rest perfusion defect did not change after acetazolamide in preoperative SPECT. After operation, 16 patients (89%) demonstrated clinical improvement. Fifteen among 18 hemispheres (83%) with decreased reserve improved. Rest perfusion abnormality improved in 6 among the 15 hemispheres (40%). The areas having rest perfusion and/or reserve decrease improved in 87 among 146 areas (60%). Decrease of reserve, improved in 85% (68/80). However, areas without reserve decrease also improved in 29% (19/66). The better was preoperative rest perfusion in involved areas or the more decreased vascular reserve, the more improved perfusion and reserve after operation. Conclusion: We conclude that assessment of perfusion and Perfusion reserve using rest/acetazolamide brain perfusion SPECT predict the surgical outcome in patients with moyamoya disease.

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Perfusion Cultivation of Transgenic Nicotiana tabacum Suspensions in Bioreactor for Recombinant Protein Production

  • Lee Sang-Yoon;Kim Dong-Il
    • Journal of Microbiology and Biotechnology
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    • v.16 no.5
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    • pp.673-677
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    • 2006
  • A perfusion culture of transgenic Nicotiana tabacum cell suspensions, transformed to express recombinant glucuronidase (GUS), was successfully performed in a 5-1 stirred tank bioreactor. With 0.1 $day^{-1}$ of perfusion rate, the maximum dry cell weight (DCW) reached to 29.5 g/l in 16 days, which was 2.1-fold higher than the obtained in batch culture (14.3 g/l). In terms of the production of GUS, the volumetric activity could be increased up to 12.8 U/ml by using perfusion, compared with 4.9 U/ml in batch culture. The specific GUS activities in both perfusion and batch cultures were maintained at similar levels, 200-400 U/g DCW. Consequently, a perfusion culture could be a good strategy for the enhanced production of recombinant proteins in a plant cell culture system.

New Imaging Techniques in Myocardial Perfusion SPECT (심근 관류 SOECT의 새로운 방법)

  • Lee, Dong Soo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.1-9
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    • 1998
  • Gated myocardial SPECT and attenuation correction gave birth to new insights into the pathophysiology of ischemic myocardial perfusion and function in clinical routine practice. Gated myocardial Tc-99m-compound SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls as well as myocardial perfusion at the same time. Quantitative and qualitative assessment of myocardial performance and perfusion let us to understand the myocardial physiology in ischemia and infarction. In every patient who underwent gated perfusion SPECT, we will find ejection fraction, left ventricular volumes and regional wall motion. There are hopes to use gated TI-201 SPECT for the same purpose and to use gated SPECT for evaluation of wall motion and thickening at stress or immediate post-stress. Attenuation correction could improve diagnostic accuracy mainly by increasing normalcy ratio or performance of non-expert physicians. Both gated methods and attenuation correction improved specificity of non-expert physicians in diagnosing patients with moderate pretest likelihood. New imaging techniques will fill the desire of cardiologists to examine function and perfusion, and possibly metabolism in their clinical routine practice.

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Stress Testing and Imaging Protocols for Myocardial Perfusion Studies (심근관류영상을 위한 심근부하 방법 및 검사 프로토콜)

  • Kim, Seong-Min
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.179-195
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    • 2009
  • Scince $^{201}$TI was introduced as a myocardial perfusion imaging agent in the early 1970s, scintigraphic evaluation of myocardial perfusion for the diagnosis of coronary artery disease is a valuable noninvasive diagnostic imaging modality. Stress radionuclide myocardial perfusion imaging is widely accepted to have high diagnostic and prognostic use in the assessment of patients with known or suspected coronary artery disease. With wise use of this nonivasive imaging technique, more patients are referred for stress perfusion imaging. Until now various protocols for stress testing and myocardial imaging were developed and used in worldwide. This article presented various protocols of stress testing and myocardial imaging for clinical use.

Relationship between UV-induced MED and Perfusion Value Assessed by Laser Doppler Perfusion Imager (Laser Doppler Perfusion Imager (LDPI)로 측정한 자외선 조사부위의 혈류량과 최소 홍반량(MED)과의 상관관계)

  • Kim, Nam-Soo;Lee, Kyung-Hoon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.31 no.3 s.52
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    • pp.259-263
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    • 2005
  • The aim of the present study is to evaluate relationship between UV-induced MED and perfusion value assessed by Laser Doppler Perfusion Imager. In this study, A increasing linear relationship is seen between perfusion and dose (p<0.05). The dose-response curve show a steep slope in the case of lower MED values group after MED point, For higher MED group, increase with a gentle slope.

Characteristics of Brain Perfusion in Patients of Parkinson's Disease (파킨슨병 환자의 뇌관류 분석)

  • Jeong, Young-Jin;Park, Min-Jung;Kim, Jae-Woo;Kang, Do-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.17-28
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    • 2008
  • Purpose: It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Methods and Materials: Two hundred nineteen patients (M: 70, F: 149, mean age: $62.9{\pm}6.9$ y/o) who were diagnosed as PD without dementia clinically and 55 patients (M:15, F:40, mean age: $61.4{\pm}9.2$ y/o) as normal controls who had no past illness history were performed $^{99m}Tc$-HMP AO brain perfusion SPECT and neuropsychological test. Results: At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood perfusion in 32 (14.7%) of 219 patients with PD, decreased perfusion on the frontal lobe in 45 patients (20.6%), the temporal lobe in 39 patients (17.4%), the parietal lobe in 39 patients (17.9%), the occipital lobe in 40 patients (18.3%), diffuse area in 14 patients (6.4%) and unclassified in 10 patients (4.6%). Fifthly, we compared the results of the neuropsychological test and cerebral perfusion pattern. There was no correlation between two tests except visuospatial function. Conclusion: Various perfusion state were found in patients with PD according to the age and sex. Also we were able to classify perfusion state into several groups and compare the neuropsychological test with cerebral perfusion.