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Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Repeatability and Reproducibility in Effective Porosity Measurements of Rock Samples (암석시험편 유효공극률 측정의 반복성과 재현성)

  • Lee, Tae Jong;Lee, Sang Kyu
    • Geophysics and Geophysical Exploration
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    • v.15 no.4
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    • pp.209-218
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    • 2012
  • Repeatability and reproducibility in solid weight and effective porosity measurements have been discussed using 8 core samples with different diameters, lengths, rock types, and effective porosities. Further, the effect of temperature on the effective porosity measurement has been discussed as well. Effective porosity of each sample has been measured 7 times with vacuum saturation method with vacuum pressure of 1 torr and vacuum time of 80 minutes. Firstly, effective porosity of each sample is measured one by one, so that it can provide a reference value. Then for reproducibility check, effective porosity measurements with vacuum saturation of 2, 4, and 8 samples simultaneously have been performed. And finally, repeated measurements for 3 times for each sample are made for repeatability check. Average deviation from the reference set in solid weight showed 0.00 $g/cm^3$, which means perfect repeatability and reproducibility. For effective porosity, average deviations are less than 0.07% and 0.05% in repeatability and reproducibility test sets, respectively, which are in good agreement too. Most of porosities measured in reproducibility test lies within the deviation range in repeatability test sets. Thus, simultaneous vacuum saturation of several samples has little impact on the effective porosity measurement when high vacuum pressure of 1 torr is used. Air temperature can cause errors on submerged weight read and even effective porosity, because it is closely related to the temperature, density, and buoyancy of water. Consequently, for accurate measurement of effective porosity in a laboratory, efforts for maintaining air or water temperature constant during the experiment, or a temperature correction from other information are needed.

Effects of Various Ventilation Systems on the Carbon Dioxide Concentration and Fruiting Body Formation of King Oyster Mushroom (Pleurotus eryngii) Grown in Culture Bottles (새송이버섯 병재배에서 환기방법이 이산화탄소 농도 및 자실체형성에 미치는 영향)

  • Lee, Hyun-Uk;Ahn, Mi-Jeong;Lee, Shin-Woo;Lee, Cheol-Ho
    • Journal of Life Science
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    • v.17 no.1 s.81
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    • pp.82-90
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    • 2007
  • In an attempt to establish the appropriate ventilation device for the bottle culture of king oyster mushroom (Pleurotus eryngii), we investigated carbon dioxide concentration and fruiting body formation according to the various ventilation systems within the mushroom house. In addition to, the efficiency of air circulation and growth rate as well as the appearance of physiologically abnormal phenotypes during their growth stage were also evaluated. four different ventilation devices, parallel-pressure type, positive-pressure type, negative-pressure type, and positive- and negative-pressure type were applied in this study. The positive-and negative-pressure type showed the highest efficiency of air circulation as $CO_2$ concentration was 800 ppm and the level of air current was relatively low compared to the other types (the $CO_2$ concentration of parallel-pressure type was 1,400 ppm). Moreover, the stipe length, the cap diameter, yield, and general quality grown in positive- and negative type ventilation device were also better than in the other three devices though it took slightly longer period for harvesting (18.4 days) than the others (17.6, 17.9 and 18.3 days). The appearance of physiologically abnormal phenotypes such as fruiting body lump, soft rot, and brown rot were significantly decreased in positive-and negative type compared to other types, while the appearance rates were not much different for other symptoms of bacterial ooze, stipe limb and stipe bumpy. In summary, we propose that the optimal ventilation system for the bottle culture of king oyster mushroom is positive- and negative type, and this device is expected to increase the total quality as well as yield all year around.

Efficiency Estimation for Desalination System of Seawater Using Reverse Osmosis Membrane (역삼투압막 해수담수화 장치의 미네럴 분리 성능평가)

  • Moon, Deok-Soo;Jung, Dong-Ho;Kim, Hyeon-Ju;Shin, Phil-Kwon
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.8 no.2
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    • pp.60-66
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    • 2005
  • When external pressure higher than osmosis pressure is reversely derived into solution, its solvent is moved into the solution having lower concentration, which is called 'reverse osmosis'. We investigated the desalination application of deep ocean water using reverse osmosis pressure of $40-70\;kgf/cm^2$ We observed how to operational factor j like flow rate, water temperature and pressure have effect on efficiency of reverse osmosis membrane and salts rejection. Fluxes of reverse osmosis membrane are directly proportional to water temperature and pressure. However, salts rejection rates are positively correlated with pressure and inversely proportional to water temperature. Separation efficiencies of osmosis membrane for major elements such as $Mg^{2+},\;Ca^{+2},\;Na^+\;and\;K^+$ are as follows in a strong electrolysis solution like seawater; $Ca^{2+},\;Mg^{2+}>K^+>Na^+$. Rejection rates of $Mg^{2+}\;and\;Ca^{2+}$ that have high electric charges are over 99% and show positively correlation with water temperature. Rejection rates of $Na^+$ having low electric charge is observed to be 98%-99%, which rates is much lower than those of $2^+$ charged ions like $Ca^{2+}\;and\;Mg^{2+}$. Ion rejection rates of boron, B, are much low because boron is present il free state or gas phase in seawater. Boron concentration in desalination water is over criteria of Korean drinking water, 0.3 mg/L. However, we could satisfied with the criteria of drinking water under the operation condition like temperature $5^{\circ}C$ and pressure $70kgf/cm^2$, using the relationship that rejection rates of boron is proportional to pressure and is inversely proportional to water temperature

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The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과)

  • Koh, Youn-Suck;Lim, Chae-Man;Lee, Ki-Man;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1223-1235
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    • 1998
  • Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.

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The Differences in Resting Pulmonary Function in Relation to the Nutritional status of Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자의 영양상태에 따른 안정시 폐기능 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Park, Jong-Won;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Kim, Jung-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.570-578
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    • 2001
  • Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.

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Echocardiographic Follow-up after Arterial Switch Operation for Transposition of the Great Arteries (동맥전환술을 시행한 대혈관전위 환자에서 심초음파를 이용한 술후 추적)

  • 한승세;정태은;이동협;오정훈;이정철
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.754-762
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    • 2001
  • Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

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A Comparison of the Effects of Histidine-tryptophan-ketoglutarate Solution versus Cold Blood Cardioplegic Solution on Myocardial Protection in Mitral Valve Surgery (승모판막수술 시 히스티딘를 함유한 결정성 심정지액(Histidine-tryptophan-ketoglutarate Solution)과 저온 혈성 심정지액이 심근기능 보존에 미치는 영향 비교)

  • Choi, Yong-Seon;Bang, Sou-Ouk;Chang, Byung-Chul;Lee, Sak;Park, Chol-Hee;Kwak, Young-Lan
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.399-406
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    • 2007
  • Background: Ischemia-reperfusion injury related to unsuccessful myocardial protection affects postoperative ventricular function and mortality during open-heart surgery. We prospectively compared the effects of administration of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia (CBC) on myocardial protection and clinical outcome in patients undergoing mitral valve surgery. Material and Method: Seventy patients with mitral regurgitation (MR) undergoing mitral valve surgery were randomly divided into the HTK group (n=31) and the CBC group (n=31 ): eight patients were excluded. Perioperative hemodynamics, cardiac medications, pacing, postoperative outcomes and complications were recorded during the hospital stay. All patients received follow-up for at least 6 months postoperatively for morbidity and mortality. Resuか: There were no significant differences in the hemodynamics between the groups during the study period, except for the mean pulmonary artery pressure (MPAP), PCWP and CVP that were lower in the HTK group at 15 min after weaning of CBP. There were no differences for inotropic support and pacing during the 12 hrs postoperatively between the groups. CK-MB values on day 1 and day 2 were $77{\pm}54$ and $41{\pm}23$ for the HTK group and $70{\pm}69$ and $44{\pm}34$ for the CBC group, respectively (p=NS). Postoperative clinical outcomes were similar in both groups for at least 6 months during the follow-up period. Conclusion: These results suggest that the use of HTK solution is as safe as cold blood cardioplegia in terms of myocardial protection.

THE EFFICACY OF PROGRAMMED CRYO-PRESERVATION UNDER PRESSURE IN RAT PERIODONTAL LIGAMENT CELLS (압력 저속 냉동 방법의 쥐 치아 치주인대세포 보존 효율 평가)

  • Lee, Young-Eun;Kim, Eui-Seong;Kim, Jin;Han, Seung-Hoon;Lee, Seung-Jong
    • Restorative Dentistry and Endodontics
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    • v.34 no.4
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    • pp.356-363
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    • 2009
  • The purpose of this study was to evaluate the viability of periodontal ligament cells in rat teeth using slow cryo-preservation method under pressure by means of MTT assay and WST-1 assay. Eighteen teeth of Sprague-Dawley white female rats of 4 week-old were used for each group. Both sides of the first and second maxillary molars were extracted as atraumatically as possible under Tiletamine anesthesia. The experimental groups were group 1 (Immediate control), group 2 (Cold preservation at $4^{\circ}C$for 1 week), group 3 (Slow freezing), group 4 (Slow freezing under pressure of 3 MPa). F-medium and 10% DMSO were used as preservation medium and cryo-protectant. For cryo-preservation groups, thawing was performed in $37^{\circ}C$water bath, then MTT assay and WST-1 assay were processed. One way ANOVA and Tukey method were performed at the 95% level of confidence. The values of optical density obtained by MTT assay and WST-1 were divided by the values of eosin staining for tissue volume standardization. In both MTT and WST-1 assay, group 4 showed significantly higher viability of periodontal ligament cells than group 2 and 3 (p < 0.05), but showed lower viability than immediate control group. By the results of this study, slow cryo-preservation method under pressure suggests the possibility for long term cryo-preservation of the teeth.

Atmospheric Circulation Patterns Associated with Particulate Matter over South Korea and Their Future Projection (한반도 미세먼지 발생과 연관된 대기패턴 그리고 미래 전망)

  • Lee, Hyun-Ju;Jeong, YeoMin;Kim, Seon-Tae;Lee, Woo-Seop
    • Journal of Climate Change Research
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    • v.9 no.4
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    • pp.423-433
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    • 2018
  • Particulate matter air pollution is a serious problem affecting human health and visibility. The variations in $PM_{10}$ concentrations are influenced by not only local emission sources, but also atmospheric circulation conditions. In this study, we investigate the temporal features of $PM_{10}$ concentrations in South Korea and the atmospheric circulation patterns associated with high concentration episodes of $PM_{10}$ during winter (December-January-February) 2001-2016. Based on those analyses, a Korea Particulate matter Index (KPI) is developed to represent the large-scale atmospheric pattern associated with high concentration episodes of $PM_{10}$. The atmospheric patterns are characterized by persistent high-pressure anomalies, weakened lower-level north-westerly anomalies, and northward shift of the upper-level meridional wind anomalies near the Korean Peninsula. To evaluate the change in occurrence of high concentration episodes of $PM_{10}$ under a possible future warmer climate, we apply KPI analysis to CMIP5 climate simulations. Here, historical and two representative concentration pathway (RCP) scenarios (RCP 4.5 and RCP 8.5) are used. It is found that the occurrence of atmospheric conditions favorable for high $PM_{10}$ concentration episodes tends to increase over South Korea in response to climate change. This suggests that large-scale atmospheric circulation changes under future warmer climate can contribute to increasing high $PM_{10}$ concentration episodes in South Korea.