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| No. | Article Type | Article Title | Article Page |
|---|---|---|---|
| 1 | Clinical Research | Recommendation for Clinical T Staging in Patients with Non-Small Cell Lung Cancer: Volumetric Measurement: A Retrospective Study from Turkey | 51 - 57 |
| 2 | Commentary | Commentary: Volumetry for Lung Nodule Assessment | 58 - 59 |
| 3 | Case Report | Sternal Reconstruction with Titanium Prosthesis for Complicated Sternal Dehiscence with Right Ventricle Herniation after Cardiac Surgery: A Case Report | 60 - 64 |
| 4 | How-to-do-it | Balloon and Glue Technique: A Modification of Distal Reinforcement to Prevent Anastomotic New Entry, Reducing Replacement Range in Acute Type A Aortic Dissection | 65 - 69 |
| 5 | Commentary | Commentary: The Balloon and Glue Technique in Acute Type A Aortic Dissection: Considerations for Optimization and Clinical Application | 70 - 72 |
| 6 | Historical Note | Historical Perspectives of the Korean Society for Thoracic and Cardiovascular Surgery: Sung Nok Hong (1927–2017) Who Performed the First Coronary Artery Bypass Graft in Korea | 73 - 76 |
| 7 | Correction | Correction: Commentary: Is the Data Strong Enough to Prorocolize the Approach in Diaphragmatic Hernia Repair? Aspects of Technique and the Sample Size of a Longitudinal Single-Center Study | 77 - 77 |
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Korean J Thorac Cardiovasc Surg 1998; 31(6): 553-559
Published online June 5, 1998
Copyright © Journal of Chest Surgery.
Won Gon Kim, M.D.I, Cheong Lim, M.D.I, Hyun Jong Moon, M.D.II ,Tae Hee Won, M.D.III , Yong Jin Kim, M.D.I
IDept. of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, IIDept. of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea ,IIIDDept. of Thoracic & Cardiovascular Surgery, College of Medicine, Ewha Women's University, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management(α-stat versus pH-stat). This study aims to compare α-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below 20℃. The flow rate was set at 2,500 ml/min. Once their temperatures were below 20℃, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either α-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming.
Results & Conclusion: Cooling time was significantly shorter with α-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.
(Korean J Thorac Cardiovasc Surg 1998;31:553-9)
Keywords: Deep hypothermic circulatory arrest , Acid-base management , α-stat , pH-stat
Korean J Thorac Cardiovasc Surg 1998; 31(6): 553-559
Published online June 5, 1998
Copyright © Journal of Chest Surgery.
Won Gon Kim, M.D.I, Cheong Lim, M.D.I, Hyun Jong Moon, M.D.II ,Tae Hee Won, M.D.III , Yong Jin Kim, M.D.I
IDept. of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, IIDept. of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea ,IIIDDept. of Thoracic & Cardiovascular Surgery, College of Medicine, Ewha Women's University, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management(α-stat versus pH-stat). This study aims to compare α-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below 20℃. The flow rate was set at 2,500 ml/min. Once their temperatures were below 20℃, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either α-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming.
Results & Conclusion: Cooling time was significantly shorter with α-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.
(Korean J Thorac Cardiovasc Surg 1998;31:553-9)
Keywords: Deep hypothermic circulatory arrest , Acid-base management , α-stat , pH-stat
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