• Title/Summary/Keyword: 이완시간

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Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Establishment of Featal Heart Surgery with an Improvement of the Placental Blood Flow in Cardiopulmonary Bypass Using Fetal Lamb Model (양태아를 이용한 심폐우회술에서의 태반혈류개선을 통한 태아심장수술의 기반기술 확립)

  • 이정렬;박천수;임홍국;배은정;안규리
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.11-18
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    • 2004
  • Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

Dipyridamole Induced Transient Left Ventricular Dysfunction in the Tl-201 Gated Myocardial SPECT (Tl-201 게이트 심근 SPECT에서 디피리다몰 부하로 유도된 일시적 좌심실 기능이상)

  • Won, Kyoung-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.153-161
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    • 2003
  • Purpose: Recently the occurrence of dipyridamole stress-induced short term stunning was proven and it is reported that Bland Altman analysis by repeated acquisition Tl-201 gated myocardial SPECT (gSPECT) revealed the 95% limit of agreement for LVEF was 10.3 %. The purpose of this study was to investigate the clinical value of dipyridamole induced transient LV dysfunction on Tl-201 gSPECT. Materials and Methods: Total 93 patients were included and coronary angiography was peformed in all patients less than 2 month from gSPECT. The patients with myocardial infarction were excluded. All patients underwent both dipyridamole stress and 4-h redistribution Tl-201 gSPECT. Forty nine patients of total 93 showed normal coronary arteries (Group 1) and the remaining 44 patients had coronary artery disease (Group 2). We compared LV EF, EDV and ESV during post-stress and 4-h redistribution period calculated by gSPECT using quantitative gated SPECT software and the incidence of dipyridamole induced transient LV dysfunction between group 1 and 2. The criteria for transient LV dysfunction was defined more decrease ${\geq}11%$ of LVEF during post-stress than 4-h redistribution according to previous reported Bland Altman analysis. Results: During post-stress and 4-h redistribution average of 3.1% increment in LVEF, 6.6% increment in LVEDV and 0.7% decrement in LVESV were shown after stress in Group 1, whereas 4.1% decrement, 9.7% increment and 7.2% increment in Group 2 respectively. Dipyridamole induced transient LV dysfunction was only detected in group 2 (18.2%) and not in group 1. It was more frequently observed in triple vessel disease and left main disease (31.8%, N=22) than one and two vessel disease (4.5%, N=22). Conclusion: As with Tc-99m myocardial agent post-stress LV dysfunction was observed in dipyridamole Tl-201 gSPECT. It was only detected in CAD and more frequently occurred in multivessel disease. Thus this finding seems to provide additional information in the diagnosis of coronary artery disease and prediction of prognosis.

Embryonic Development and Early Life History of the Northern Loach, Cobitis pacifica (Pisces: Cobitidae) (북방종개 Cobitis pacifica(Pisces: Cobitidae)의 배 발생과 초기생활사)

  • Lee, Wan-Ok;Kim, Kyeong-Hwan;Baek, Jae-Min;Kang, Young-Jin;Jeon, Hyoung-Zoo;Kim, Chi-Hong
    • Korean Journal of Ecology and Environment
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    • v.44 no.1
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    • pp.1-8
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    • 2011
  • We investigated developmental stages of embryo and early life history of the Korean indigenous fish, the northern loach, Cobitis pacifica in 2009 in order to understand fundamental knowledges for conservation of this species. Eggs were obtained after hormones injections (LHRH-a, HCG) and were artificially fertilized by the dry method. The embryo was spherical, separative demersal, faint white, and averaged $1.09{\pm}0.04\;mm$ (n=20) in diameter. The hatching of the embryo took place in about 48 hours after fertilization under water temperature of $21.0{\sim}24.0^{\circ}C$ and the newly hatched larvae averaged $2.87{\pm}0.05\;mm$ (n=20) in total length (TL). Four days after hatching, the larvae grew up to $6.86{\pm}0.10\;mm$ (n=10) in TL and york sac absorption, mouth and anus opening were shown. Fourteen days after hatching, most of fin-rays appeared at $10.71{\pm}0.34\;mm$ (n=10) in TL and color spots on the body surface were attained. Twenty six days after hatching, the larvae grew up to $14.88{\pm}0.45\;mm$ (n=10) in TL, and all their fin-rays were formed. Therefore, according to current study regarding the morphological development of Cobitis pacidica, the conversion from larval to juvenile stages occurred at 26 days after hatching. Eighty days after hatching, the larvae were $33.3{\pm}1.25\;mm$ (n=10), and their body shape and color pattern were similar to adult fish. In this study, embryonic development and early life history of the northern loach, Cobitis pacifica show morphological characteristics of Cobitidae family. We expected that our results can be used as an fundamental knowledges for restoration study of indigenous fish species.

Comparative Study of Two Anesthetic Combinations (Zoletil/Midazolam and Zoletil/Xylazine) in Pigs (돼지에서 Zoletil/Midazolam과 Zoletil/Xylazine의 2가지 병용마취에 대한 비교 연구)

  • Jee, Hyun-Chul;Lee, Jae-Yeon;Jeong, Seong-Mok;Lee, Soo-Jin;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.330-335
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    • 2010
  • This study was performed to compare the anesthetic and cardiorespiratory effects of the tiletamine/zolazepam/xylazine (TZX) combination and tiletamine/zolazepam/midazolam (TZM) combination. Eight healthy Landrace $\times$ Yorkshire pigs were randomly assigned to two groups. Each group was composed of four pigs. The pigs in group 1 (TZX) received tiletamine/zolazepam (2 mg/kg, IM) and xylazine (2 mg/kg, IM). The pigs in group 2 (TZM) received tiletamine/zolazepam (2 mg/kg, IM) and midazolam (0.5 mg/kg, IV). Induction time, anesthesia time and standing time were recorded for each pig. The scores of anesthetic effects were subjectively evaluated every 15 minutes during anesthesia. Cardiopulmonary parameters (heart rate, arterial blood pressure, respiratory rate and rectal temperature) were monitored and recorded 0, 5, 15, 30, 45 and 60 minutes after administration of drugs. Arterial blood gases ($pH_a$, $P_aCO_2$ and $P_aO_2$) and oxygen saturation ($SO_2$) were analyzed at same times. The scores of anesthetic effects decreased in the TZX group compare with the TZM group. From 5 to 85 minutes the mean heart rate in the TZX group was significantly lower than those in the TZM group. Mean arterial blood pressure in the TZX group was significantly higher than those in the TZM group at 5, 15 and 30 minutes. Both drug combinations provided a smooth induction and good immobilization. Scores of anesthetic effects in the TZM group were better than those in the TZX group. The effects to the cardiorespiratory function and temperature were lesser in the TZM group than those in the TZX group. In conclusion, when the two drug combinations were compared, the TZM group showed better anesthetic effects and less cardiorespiratory effects.

An Association of Changed Levels of Inflammatory Markers with Hematological Factors during One-time Aerobic Exercise in Twenty-aged Young Men (20대 젊은이들에 있어 1회성 유산소운동 시 염증 표지자와 혈액변인들 간의 상관관계)

  • Hyun, Kyung-Yae
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1658-1665
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    • 2009
  • This study was carried out on thirty men to define the association of inflammatory markers with physiological factors on one-time aerobic exercise (for 15 min. Post-exercise interleukin-6 (IL-6), mean corpuscular hemoglobin concentration (MCHC), heart rate (HR), systolic blood pressure (SBP), and pulsatility and resistance index of middle cerebral artery (PI and RI, respectively) levels were elevated compared to those measured pre-exercise. Total leukocyte and platelet counts, high-sensitivity C-reactive protein (hs-CRP), free radical (FR), and low density lipoprotein cholesterol (LDL) levels tended to decrease after exercise. Pre-exercise IL-6 levels were positively correlated with pre-exercise SBP levels, while post-exercise IL-6 level was positively correlated with post-exercise PI and RI levels. Post-exercise, hs-CRP levels were negatively related to SBP and HR. Pre-exercise, FR levels were positively associated to SBP, DBP, and HR. Post-exercise FR levels were negatively related to the post-exercise blood flow velocity in middle cerebral artery. Pre-exercise erythrocyte indices (RBC, MCV, MCH, and MCHC levels) were in inverse proportion to pre-exercise IL-6 levels. Post-exercise FR levels were inversely related to post-exercise total leukocyte, lymphocyte, monocyte, and MCH levels. Pre-exercise $Mg^{++}$ levels were in inverse proportion to pre-exercise IL-6, hs-CRP, or FR levels. These findings suggest that one-time aerobic exercise offers a significant relationship between inflammatory markers and some biochemical markers or electrolytes. Further studies need to be carried out for investigation of differences between genders or age groups following one-time or regular aerobic exercise.

Early Life History and Reproductive Ecology of Mandarin Fish, Siniperca scherzeri (Pisces, Centropomidae) in Soyang Lake (소양호산 쏘가리 Siniperca scherzeri (Pisces, Centropomidae)의 산란 생태와 초기 생활사)

  • Lee, Wan-Ok;Lee, Jong-Yun;Son, Song-Jung;Choi, Nack-Joong
    • Korean Journal of Ichthyology
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    • v.9 no.1
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    • pp.99-107
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    • 1997
  • The early life history and reproductive ecology of Siniperca scherzeri were studied to obtain fundamental information in aquaculture and reinforcement of natural population in Soyang Lake, Buk-myon, Chunchon-shi, Kangwon-do from June to October 1996. Symptric species with adult fishes (+1 ages) of Siniperca scherzeri were 11 species belonging to 6 families and 10 genera and those with Juveniles (2~3 months) were 5 species belonging to 4 families and 5 genera. The sex radio of this species were 1 (female, 85) : 1.24 (male, 105). Adult and juvenile of this species were predominantly piscivores. Bluegill, Lepomis macrochirus, Zacco platypus, common carp, Cyprinus carpio, unidentified fish and shrimp were important components of the food items. The spherical eggs were demersal and separative without a colorless transparent chorion and slightly yellowish yolk containing one large oil globule (0.5~0.7mm). The egg just after fertilization were measuring 1.72~2.05mm (n=30), and expanded to 2.27~2.58mm (n=30) in diameter after 30 min. Hatching occurred 130~155 hrs after fertilization at water temperature of $20{\sim}25^{\circ}C$ and newly hatched larvae measuring 5.5~7.1mm in total length. In the newly hatched larvae, numerous branched malanophores were distributed on the yolk and abdomen of caudal peduncle. In ten-day old larvae, the yolk was mostly absorbed and the head spines and the teeth were well developed. All fin rays were formed and total length of the larvae were reached 13.6~15.6mm at 20 days after hatching. In fifty-five day old larvae were similar in both body shape and color to adult. The juvenile stage at 4 months after hatching were attained 86.4~95.3mm (n=7) in total length and 8.77~14.78g (n=7) in body weight.

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The Effect of Doxapram on Cardiopulmonary Function in Dogs under Total Intravenous Anesthesia with Remifentanil and Propofol (개에서 Remifentanil과 Propofol에 의한 완전 정맥 내 마취 시 Doxapram 투여가 심폐기능에 미치는 효과)

  • Yun, Sungho;Kwon, Youngsam
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.491-498
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    • 2015
  • We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.

The Effects of Massage and Static Stretching on Cervical Range of Motion in Their 20s of Normal Adult (마사지 및 정적 스트레칭이 20대 정상 성인의 경부 관절가동범위에 미치는 효과)

  • Kwon, Won-An;Kim, Dong-Dae;Lee, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4346-4353
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    • 2010
  • The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion($2.39^{\circ}$) and extension($38.36^{\circ}$), flexion($54.11^{\circ}$) and extension($69.39^{\circ}$), lateral flexion on left($43.50^{\circ}$) and right($41.28^{\circ}$), rotation on left($66.39^{\circ}$) and right($65.94^{\circ}$) in male and suboccipital flexion($5.14^{\circ}$) and extension($36.47^{\circ}$), flexion($55.92^{\circ}$) and extension($71.22^{\circ}$), lateral flexion on left($43.34^{\circ}$) and right($41.06^{\circ}$), rotation on left($69.38^{\circ}$) and right($68.63^{\circ}$) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

Spatio-temporal Variation of Fish Communities in Open Estuary, Seomjin River Estuary and Gwangyang Bay Coast (열린 하구인 섬진강 하구 및 광양만 연안 어류 군집의 시공간적 변화)

  • Sun Ho Lee;Won-Seok Kim;Jae-Won Park;Hyunbin Jo;Wan-Ok Lee;Tae Sik Yu;Hyo Gyeom Kim;Chang Woo Ji;Ihn-Sil Kwak
    • Korean Journal of Ecology and Environment
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    • v.55 no.2
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    • pp.132-144
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    • 2022
  • The fish community in the Seomjin River-Seomjin River Estuary-Gwangyang Bay coast continuum was investigated three times from March 2019 to October 2019. The collected species at the eight sites during the survey period were 49 species belonging to 31 families, including two endangered species. According to Bray-Curtis similarities, observations were divided into four groups based on the fish community composition; two groups (group 1, 2) and two uncategorized groups (group 3, 4). ANOSIM based on spatial and temporal groupings indicated that the spatial differences in fish communities (R=0.398, P=0.001) were relatively more important than the temporal differences (analysis of similarities, R=0.273, P=0.002). In particular, there were significant differences between groups 1 and 2 (analysis of similarities, R=0.556, P=0.001), and similarity percentage analysis revealed that Argyrosomus argentatus (9.4%), Favonigobius gymnauchen (6.9%) and Konosirus punctatus (5.9%) contributed to these differences of fish assemblages for each group. The fish fauna distributed in the Seomjin River-Gwangyang Bay ecosystem were spatially divided and the number of species and number of individuals showed seasonal differences. This study could be a basis for understanding changes in the fish community and implementing conservation and management strategies on major species within a continuous environment of the river-estuary-ocean continuum.