• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.715-723
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• 2000

Background : Obstructive sleep apnea syndrome (OSAS) affects systemic blood pressure and cardiac function. The development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac rhythm, suggests that recurrent hypoxia and arousals from sleep may increase a sympathetic nervous system activity. Continuous positive airway pressure (CPAP) therapy has been found to be an effective treatment of OSAS. However, only a few studies have investigated the cardiovascular and sympathetic effects of CPAP therapy. We evaluated influences of nasal CPAP therapy on the cardiovascular system and the sympathetic activity in patients with OSAS. Methods : Thirteen patients with OSAS underwent CPAP therapy and were monitored using polysomnography, blood pressure, heart rate, presence of arrhythmia and the concentration of plasma catecholamines, before and with CPAP therapy. Results: The apnea-hypopnea index (AHI) was significant1y decreased (p<0.01) and the lowest arterial oxygen saturation level was elevated significantly after applying CPAP (p<0.01). Systolic blood pressure tended to decrease after CPAP but without statistical significance. Heart rates during sleep were not significantly different after CPAP. However, the frequency and number of types of arrhythmia decreased and sinus bradytachyarrhythmia disappeared after CPAP. Although there was no significant difference in the level of plasma epinephrine concentration, plasma norepinephrine concentration significantly decreased after CPAP (p<0.05). Conclusion : CPAP therapy decreased the apnea-hypopnea index, hypoxic episodes and plasma norepinephrine concentration. In addition, it decreased the incidence of arrhythmia and tended to decrease the systemic blood pressure. These results indicate that CPAP may play an important role in the prevention of cardiovascular complications in patients with OSAS.

• 대한예방의학회:학술대회논문집
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• 2004.10a
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• pp.57-58
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• 2004

• Journal of Chest Surgery
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• v.30 no.2
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• pp.119-124
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• 1997

Using isolated rat heart preparations, we observed the protective effe ts of verapamil cardioplegia on ischemic myocardial injury. Isolated rat hearts were subjected to global ischemia at $25^{\circ}C$ Twenty four isolated Sprague Dawley rat hearts underwent 30 minutes of the retrograde nonworking perfusion with Krebs-Henseleit buffer solution followed by $25^{\circ}C$ cardioplegic solution (St. Thomas'Hospital Cardioplegic Solution) for 60 minutes. Before ischemic arrest, rat hearts were treated with cold cardioplegic solution in control group (n=12) and cold cardioplegic solution with verapamil (1 mg/L) in experimental group (n=12). After 60 minutes of ischemia, hemodynamic and biochemical parameters such as heart rate, left ventricular pressure (LVP), + dp/dt max, coronary flow and creatine phosphokinase (CPK) were measured before giving cardioplegia and 30 minutes after reperfusion. Verapamil group exhibited greater recovery of heart rate, LVP, +dpldt max, coronary flow and CPK than control group (p < 0.05).

• Journal of Chest Surgery
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• v.29 no.7
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• pp.723-727
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• 1996

An adequate exposure is important in thoracoscopic procedures. The insufflation of $CO_2$has been demonstrated to aid in compressing lung parenchyma, and act as a retractor when combined with changes in patient's position. However, a recent study demonstrated that $CO_2$insufflation during thoracoscopy in the pig has adverse hemodynamic consequences. We prospectively studied 12 patients undergoing thoracoscopy to evaluate the effect of $CO_2$insufflation in the clinical setting. The mean arterial pressure, heart rate, central venous pressure, arterial oxygen saturation, and end-tidal $CO_2$pressure were monitored. Measurements were determined at baseline, at the initiation of one-lung ventilation, and at intrapleural pressure of 5, 10, 15 mmHg and following results were obtained. 1) The insufflation of 5 to 15 mmHg of $CO_2$had no significant effect on the mean arterial pressure, heart rate, arterial oxygen saturation. 2) The end-tidal $CO_2$pressure rose from 31.00$\pm$1.67 mmHg to 38.49$\pm$1.82 mmHg at an intrapleural pressure of 15 mmHg(p<0.05). 3) The central venous pressure rose from 7.75$\pm$0.76 mmHg to 12.83$\pm$1.64 mmHg and 16.16$\pm$l.97mmHg at an intrapleural pressure of 10 and 15 mmHg(p<0.05). 4) The low pressure (<10 mmHg) insufflation is a safe adjunct to the conduct of thoracoscopic surgical procedures.

• The Korean Journal of Pharmacology
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• v.31 no.3
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• pp.279-284
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• 1995

The aim of the present study was to know whether exogenously administered nitric oxide (NO) may differently modulate muscle mechanics between heart and aorta. We used PIANO method to generate NO. In isolated rat atrial tissues, neither heart rate nor contractility was affected by PIANO $(STZ,\;30{\sim}100\;{\mu}M)$. Only high concentration $(100\;{\mu}M)$ of 8-bromo cyclic GMP slightly depressed cardiac contractility. However, the same concentrations of 8-Br cGMP and PIANO significantly relaxed the rat thoracic aorta contracted with phenylephrine $(0.1\;{\mu}M)$. In isolated rabbit cardiac atrial myocytes, the amplitude of calcium currents were decreased in the whole voltage range by the presence of streptozotocin, which was further potentiated by UV light. Calcium currents were also decreased in those preparations treated with bradykinin, nitroprusside and 8-Br cGMP. These findings suggest that exogenous NO may modulate calcium current in cardiac myocyte. However, it remains why this does not affect myocardial contractility and heart rate. We concluded that NO may differently regulate calcium signal between aorta and heart muscle.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.283-291
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• 2000

The purpose of this study was to compare the sedative effect of three routes of administration - intramuscular, intranasal drop-in, intranasal spray - with midazolam. The twenty two uncooperative children from 23 months to 76 months who required at least three dental appointment. Each patient was assigned randomly to receive intramuscular(Group I, 0.15mg/kg), intranasal drop-in(Group II, 0.20mg/kg), intranasal spray(Group III, 0.20mg/kg) administration at each visit. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale In order to monitor the sedated patients, pulse rate and peripheral oxygen saturation were measured by pulse oximeter during treatment procedures. The results were as follows 1. Pulse rate and peripheral oxygen saturation were stable through all the treatment procedures, and there were no statistically significant differences among three routes of administration(P>0.05). 2. The effect on sleep was, III, II, I, in order, III group was the most effective through all the treatment procedures, except rubber-dam placement and filling phase (P<0.0001). 3. The effects on crying, movement, overall behavior were II, III, I, in order, II group was the most effective through all treatment procedures(P<0.0001).

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.24-33
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• 2002

Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

• Journal of Life Science
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• v.13 no.1
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• pp.42-46
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• 2003

Photoplethysmogram is widely used to measure heart rate and arterial blood oxygen saturation in human. This paper describes radial pulse waves recorded by photoplethysmogram with 940 nm wavelength infra red light. Radial pulse waves were varied according to the recording site. When recorded on the skin over radial artery, the radial pulse wave was inverted, comparing to the photoplethysmogram at fingertip. The mechanism of inverted pulse wave seemed to be caused by the change of the blood volume in the subcutaneous tissue between radial artery and the skin, which was reduced during systolic period and increased during diastolic period of the cardiac cycle. These results suggest that radial arterial wall may reflect infra red ray.

• Child Health Nursing Research
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• v.4 no.2
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• pp.245-254
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• 1998

Prematurity is the main cause for respiratory disorders in neonates. The goal in respiratory management is to maintain respiration with adequate oxygenation. Chest vibration(CV) prior to on dotracheal suctioning(ETS) has been arbitrarily applied to ventilated premature infants without the scientific evaluation of its safety and efficacy. A repeated measure within subjects experimental study was conducted to investigate the effects of CV prior to 875 on oxygenation and lung secretions in twenty-one ventilated premature infants. The independent variable was the type of research protocol, the control type (275 without C.V) and t he intervention(ETS with CV). The dependent variables were oxygen saturation(SpO₂), heart rate (HR), measured by pulse oximeter, and the amount of lung secretions measured in gram. The results showed there was no difference in SpO₂ responses regardless CV employed before ETS. But there was a significant difference in HR responses between the control and the intervention, even without clinical significance. There was a significant difference in the amount of lung secretions retrieved during ETS with CV, compared to ETS without CV. This study suggested the safety of CV by demonstrating no clinically significant changes in SpO₂ and HR in premature infants. The efficacy of CV could be supported by the increases in the amount of sputum during ETS with CV compared to ETS without CV in premature infants.

• Journal of Korean Biological Nursing Science
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• v.17 no.3
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• pp.271-276
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• 2015

Purpose: This study was to evaluate the effects on the heart rate and respiration rate of preterm infants when providing auditory stimulation on them. Methods: The design of this study was a nonequivalent control group pretest-posttest design in a quasi experimental study. Forty preterm infants were assigned to experimental and control groups : 20 in the auditory and 20 in the control group. The data were collected from May 2014 to October. The auditory stimulation was created by using an audio music tape provided 20-minute per day for 7 consecutive days. In data analysis, SPSS WIN 21.0 program was utilized for descriptive statistics, repeated measurement anova and Mann-Whitney. Results: General characteristics of the two groups showed no significant differences, thus two groups were found to be homogenous. There were no significant differences in heart rate and respiration rate between the auditory and control groups. Conclusion: The effect of auditory stimulation for 7 days was not effective in decreasing heart rate or respiration rate in premature infants. Therefore, the type and length of music therapy must be developed for the improvement of vital signs in preterm infants who were hospitalized in a neonatal intensive care unit.