• Title/Summary/Keyword: Arterial

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The Effect of Positioning with Mechanically Ventilatory Acute Respitatory Failure Patients on Arterial Oxygen Partial Pressure and Alveolar-arterial Oxygen tension (인공호흡기를 부착한 급성 호흡부전 환자에서 폐병변 부위에 따른 체위적용이 동맥혈 가스분압 및 폐포동맥간 산소 분압차에 미치는 영향)

  • Hwang, Hee Joung;Park, Hye Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.234-244
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    • 2000
  • It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure($PaO_2$), alveolar arterial oxygen tension difference($AaDO_2$), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the $PaO_2$ in the left lateral decubitus and prone position were $126.8{\pm}30.8$ mmHg and $106.7{\pm}36.8$ mmHg, respectively(p=0.0001). 2) With group 2 patients, the $PaO_2$ in the prone and the right lateral decubitus position were $121.7{\pm}44.7$ mmHg and $118.5{\pm}31.7$ mmHg, respectively (p=0.0018). 3) With group 3 patients, the $PaO_2$ was $143.6{\pm}36.6$ mmHg in the prone position (p=0.0001). 4) With group 1 patients, the $AaDO_2$ in the left lateral decubitus and the right lateral decubitus position were $178.1{\pm}29.7$ mmHg and $233.1{\pm}24.4$ mmHg, respectively(p=0.0001). 5) With group 2 patients, the $AaDO_2$ in the prone and the left lateral decubitus postion were $184.0{\pm}39.5$ mmHg and $231.0{\pm}23.9$ mmHg, respectively(p=0.0019). 6) With group 3 patients, the $AaDO_2$ in the prone and the supine postion were $377.1{\pm}35.6$ mmHg and $435.7{\pm}13.1$ mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.

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High-Resolution Contrast-Enhanced 3D-Spoiled Gradient-Recalled Imaging for Evaluation of Intracranial Vertebral Artery and Posterior Inferior Cerebellar Artery in Lateral Medullary Infarction (고해상도 조영증강 삼차원 회손기울기 회상 영상을 이용한 측면연수경색 환자의 두개내 척추동맥 및 뒤아래소뇌동맥 평가)

  • Yoon, Youngno;Ahn, Sung Jun;Suh, Sang Hyun;Park, Ah Young;Chung, Tae-Sub
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.17-24
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    • 2014
  • Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

Cross-Sectional Relations of Arterial Stiffness and Inflammatory Markers in Korean Adults Aged 50 Years and Older (지역사회 거주 50세 이상 성인의 동맥경직도와 염증반응인자와의 관련성)

  • Ryu, So-Yeon;Shin, Min-Ho;Lee, Young-Hoon;Rhee, Jung-Ae;Choi, Jin-Su;Park, Kyeong-Soo;Nam, Hae-Sung;Jeong, Seul-Ki;Kweon, Sun-Seog
    • Journal of agricultural medicine and community health
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    • v.36 no.2
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    • pp.101-112
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    • 2011
  • Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.

Influences of Histamine on Permeability across Blood-brain Barrier (혈액-뇌장벽 투과성에 대한 히스타민의 영향)

  • Kim, Kee-Jin;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.2 no.2
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    • pp.33-43
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    • 1968
  • Histamine, 0.5 mg as histamine base in 4 ml of normal saline solution, was injected into rabbits anesthetized with nembutal and the mean blood pressure was kept in the range of $52{\sim}80\;mmHg$ for over one hour by supplemental additions. Following the injection of the test substances, 300 mg of urea and 200 mg of antipyrine intravenously, serial blood samples were obtained from the femoral artery and the internal jugular vein at $0.5{\sim}3$ minutes interval. The decreasing patterns in the concentrations of arterial and venous blood plasma samples were compared with each other. The ratio of the concentration of brain tissue to that of the final arterial plasma was also studied. By these measures the degrees of penetration of the test substances in the brain in the control and in the histamine treated rabbits were observed. The concentrations of antipyrine and urea in the arterial blood plasma were decreasing exponentially with respect to the time elapsed. The venous concentrations were anticipated to increase initially and to cross the arterial concentration curve in the point of equlibrium between the plasma and the tissue. On the contrary to the expectation venous concentration also revealed the decreasing tendency similar to that of arterial plasma. The similarity between these two curves, arterial and venous, would be atributable to the fact that the cerebral blood flow rate was large enough and the rising phase in the venous concentration curve was instantly over before serial blood samples were taken. Inspite of some similarity in the decreasing tedency in both concentration curves there were appreciable discrepancies between the arterial and venous plasma which would reflect the situation far from the equlibria among several compartments in the brain. Changes in plasma potassium levels caused by the injection of histamine or bleeding were observed, too. Using 8 rabbits as the control and 12 rabbits for the histamine treated group following results were obtained: 1. Both of the concentration curves, arterial and venous, declined rapidly at_first and slowly later on and approached same equilibrium concentration with the passage of time after a single injection. The time at which attained the same concentration was $2.0{\pm}0.54\;min.$ in the control and $4.3{\pm}1.92\;min.$ in the histamine treated group with respect to antipyrine. On the other hand in the case of urea they were $2.4{\pm}0.59\;min.$ in the control and $4.4{\pm}1.31\;min.$ in the histamine group, respectively. In the histamine treated group enlarged spaces for distribution of test substances were postulated. 2. The concentration of antipyrine in the brain tissue water revealed no significant differences between the control and experimental groups, showing $212{\pm}40.2\;mg/l$ in the control and $206{\pm}64.1\;mg/l$ in the histamine treated group. On the other hand urea revealed higher value in the histamine treated group than in the control, showing an enhanced penetration of urea into the tissue after injection of histamine. Urea concentration in the brain water was $32.3{\pm}3.36\;mg%$ in the control and $39.2{\pm}4.25\;mg%$ in the histamine treated group. 3. The distribution ratio of antipyrine in the brain tissue was very close to unity in the histamine treated animals as well as in the control. 4. The average of the distribution ratio of urea in the control animals was 0.77 and it showed the presence of blood-brain barrier with regard to urea. However in the histamine treated animals the distribution ratios climbed up to 0.86 and they were closer to unity than in the control animals. Out of 12 cases 5 were greater than 0.9 and 8 exceeded 0.85. It appeared that histamine enhanced the penetration of urea through the barrier. 5. Histamine injection and or hemorrhage caused an elevation of the concentration of potassium in plasma. In the event that histamine and hemorrhage were applied together the elevation of potassium exceed the elevation seen at the histamine alone. There was no evidence that the leakage of potassium from the brain tissue was dominant in comparison with the general leakage from the whole body.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Effects of Crataegi Fructus on the Vascular Relaxation and Antioxidative Status (산사의 혈관이완 효능과 항산화 작용)

  • Son Chang Woo;Chae Jong Koo;Kim Gil Whon;Shin Heung Mook
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.1
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    • pp.67-71
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    • 2002
  • This study investigated the relaxation effects of Crataegi Fructus(CF, Crataegus pinnatifida Bunge) on the contraction evoked by phenylephrine in rabbit carotid artery, and also analyzes antioxidative status in vitro. CF revealed siginificant relaxation on phenylephrine-induced arterial contraction. It's relaxant effect statistically significant in both in the presence of endothelium and absence of endothelium, but statistically exerted more strong relaxation in the presence of endothelium. CF increased in vitro nitric oxide(NO) production in dose-dependent manner. Also, they reduced malondiaidehyde(MDA) concentrations, phosphatidyl choline-liposome(PCOOH) contents, linoleic acid-induced lipid peroxidation and exerted 1,1-diphenyl-2- picryl-hydrazyl(DPPH) radical scavenging effect, in vitro. These results indicate that Crataegi Fructus would be effective in relaxing arterial contraction and it's antioxidative effects may be involved in endothelium-dependent relaxation of artery via vascular protective properites.

Effects of Mixture of Yukgunja-tang and Bambusae Caulis in Liquamen on the Regional Cerebral Blood Flow and Mean Arterial Blood Pressure in Rats (육군자탕(六君子湯)과 죽력(竹瀝) 혼합물이 국소 뇌혈류량 및 평균혈압에 미치는 효과)

  • Lee, Seok-Jin;Jeong, Hyun-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.54-61
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    • 2007
  • The study was designed to investigate the effects of Mixture of Yukgunja-tang and Bambusae Caulis in Liquamen (YTBCL) on the change of regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP) in rats, and further to determine the mechanism of action of YTBCL. The results in rats were as follows ; YTBCL 25 ${\mu}l$ significantly decreased rCBF and MABP compared with basal condition. YTBCL 100 ${\mu}l$ significantly increased rCBF compared with basal condition, but decreased MABP compared with basal condition. YTBCL 50 ${\mu}l$ significantly increased rCBF compared with basal condition, but MABP was somewhat decreased compared with basal condition. The VTBCL 50 ${\mu}l$-induced increase in rCBF was significantly inhibited by pretreatment with methylene blue (10 ${\mu}g$/kg, i.p.), an inhibitor of guanylate cyclase and indomethacin (1 mg/kg, i.p.), an inhibitor of cyclooxygenase. The YTBCL 50 ${\mu}l$-induced decreased MABP significantly increased by pretreatment with methylene blue but was inhibited by indomethacin. This results were suggested that the mechanism of YTBCL was mediated Dy guanylate cyclase.

Therapeutic implications of microRNAs in pulmonary arterial hypertension

  • Lee, Aram;McLean, Danielle;Choi, Jihea;Kang, Hyesoo;Chang, Woochul;Kim, Jongmin
    • BMB Reports
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    • v.47 no.6
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    • pp.311-317
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    • 2014
  • microRNAs (miRNAs) are a class of small, non-coding RNAs that play critical posttranscriptional regulatory roles typically through targeting of the 3'-untranslated region of messenger RNA (mRNA). Mature miRNAs are known to be involved in global cellular processes, such as differentiation, proliferation, apoptosis, and organogenesis, due to their capacity to target multiple mRNAs. Thus, imbalances in the expression and/or activity of miRNAs are involved in the pathogenesis of numerous diseases, including pulmonary arterial hypertension (PAH). PAH is a progressive disease characterized by vascular remodeling due to excessive proliferation of pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells (PASMCs). Recently, studies have evaluated the roles of miRNAs involved in the pathogenesis of PAH in these pulmonary vascular cells. This review provides an overview of recent discoveries on the role of miRNAs in the pathogenesis of PAH and discusses the potential for miRNAs as therapeutic targets and biomarkers of PAH.

A study on non-invasive SaO$_2$ measurement algorithm to improve on effect of the motion artifact (동잡음의 영향을 개선한 비관혈식 산소포화도 측정 알고리즘에 대한 연구)

  • 이준하
    • Progress in Medical Physics
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    • v.11 no.2
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    • pp.101-107
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    • 2000
  • Pulse oximetry is a non-invasive optical method which measures arterial oxygen saturation with two different wavelength. We can obtain the pulsating component of the arterial blood superimposed on DC level attenuated by venous blood, skin and other nonpulsatile components. This study is based on computing algorithm of oxygen saturation using the integral ratio of pulsatile components. In this algorithm, we used the half cycle of the pulsatile signal rely on arterial contraction. It's period is about 1/4 in 1 cycle. In the result, Our algorithm with 1/4 period of 1 cycle is similar to existing model. Because of removal that A part have low amplitude and possession in long term from calculating, the effect of the motion-artifact is decrease.

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Functional Magnetic Resonance Imaging with Arterial Spin Labeling: Techniques and Potential Clinical and Research Applications

  • Kim, Ju Ho;Choi, Dae Seob;Park, Sung Eun;Choi, Ho Cheol;Kim, Seong Hu
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.91-96
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    • 2017
  • Purpose: To describe technical methods for functional magnetic resonance imaging (fMRI) study with arterial spin labeling (ASL) compared to blood oxygenation level-dependent (BOLD) technique and discuss the potential of ASL for research and clinical practice. Materials and Methods: Task-based (n = 1) and resting-state fMRI (rs-fMRI) (n = 20) were performed using ASL and BOLD techniques. Results of both techniques were compared. Results: For task-based fMRI with finger-tapping, the primary motor cortex of the contralateral frontal lobe and the ipsilateral cerebellum were activated by both BOLD and ASL fMRI. For rs-fMRI of sensorimotor network, functional connectivity showed similar results between BOLD and ASL. Conclusion: ASL technique has potential application in clinical and research fields because all brain perfusion imaging, CBF measurement, and rs-fMRI study can be performed in a single acquisition.