• The Korean Journal of Pain
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• v.18 no.2
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• pp.165-170
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• 2005

Background: It is difficult to treat tourniquet-induced hypertension despite adequate anesthesia, and the mechanism of that is not known. And it may be possible that intraoperative continuous infusion of opioid induces preemptive analgesia postoperatively. We investigated the effect of intraoperative continuous i.v. fentanyl on tourniquet induced cardiovascular changes and postoperative preemptive analgesia in total knee replacements. Methods: Sixty patients were randomly assigned to two groups; In study group ($1.5{\mu}g/kg$ loading and $0.5{\mu}g/kg/hr$ continuous infusion of fentanyl before skin incision and tourniquet inflation) and control group (no treatment). Anesthesia was maintained with enflurane (1-2 MAC) and 50% nitrous oxide in oxygen. Arterial pressure and heart rate were compared between two groups. They received postoperative pain treatment with patient-controlled analgesia (PCA) with fentanyl during the postoperative 48 hours after total knee replacement. Visual analog scale (VAS) scores at either rest or movement were used to assess pain. Total fentanyl dose delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. Results: There were no significant differences between the two groups on cardiovascular changes by tourniquet induced pain effect. VAS, PCA delivered dose and PCA demands at movement in the 24-48 hour decreased in study group compared with control group (P < 0.05). But there were no significant differences between the two groups on the other time periods except 24-48 hour's patient satisfaction and adverse events. Conclusions: We suggest that intraoperative continuous i.v. fentanyl infusion dose not affect cardiovascular change by tourniquet induced pain. But it may induce preemptive analgesia postoperatively.

• The Korean Journal of Pharmacology
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• v.15 no.1_2 s.25
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• pp.29-37
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• 1979

The tension-length relationships and reactivity of vascular smooth muscle in longitudinal strips from portal vein ana in helical strips from thoracic aorta and pulmonary artery of normotensive control and cadmium-hypertensive rabbits were studied in vitro. 1. The mean arterial pressures of non-poisoned control rabbits was $87.0{\pm}4.7 mmHg$. However, Cd-poisoned group revealed the significant increase in pressure by $109.04{\pm}2.8 mmHg$ (p<0.005). 2. By tension-length studies, strips from portal vein of Cd-poisoned group stretched a greater percent increase in length in response to an applied resting force from 0.25 to 5 g than did those from non-poisoned group. On the contrary, strips from thoracic aorta of Cd-poisoned group showed less compliant than those from control, i.e. the former underwent a less percent increase in length than the latter. Passive tension-length relations of pulmonary artery was unaffected by Cd-hypertension. 3. The force of contraction(active tension) was significantly lowered in strips from aorta of Cd-hypertensive group throughout the range of $0.5{\sim}2g$ passive tension. However, there was no significant difference in the development of active tension of portal vein or pulmonary artery of both groups. 4. The $K^+$-contraction in the portal vein, aorta and pulmonary artery of Cd-poisoned group made no difference in the active force from those of control group. 5. The force of contraction in the strips from aorta of Cd-poisoned group was significanty decreased compared to that of control. The results suggested that the alterations in vascular reactivity to contracting substances and in distensibility to passive tension were induced in the Cd-hypertensive rabbits.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.350-358
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• 1997

We studied the effects of adding a single bolus(500 mg) of sodium thiopental to a continuous infusion of low-dose fentanyl on plasma beta-endorphin immunoreactivity(iBE) responses to cardiopulmonary bypass(CPB) in 28 patients undergoing elective coronary artery bypass grafting or valve procedures. Thiopental was injected just prior to the initiation of CPB. The iBE levels and the hemodynamic indices such, as mean arterial pressure, cardiac output and systemic vascular resistance were measured before CPB, at 30 min and again at 60 min after the initiation of the bypass. The results were as follows. After the initiation of CPB, iBE levels increased at 30 min and 60 min(P=0.006, P=0.004 respectively) in the control group, but not in the thiopental group. There were significant differences in the changes of iBE levels between the groups(F=8.7, G-G=0.002, P=0.001). The hemodynamic indices were similar in both groups. In conclusion, pretreatment with thiopental just before the initiation of CPB prevents the stress-induced beta-endorphin response to CPB.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.115-132
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• 1969

The normal physiological values of Korean mongrel dogs were studied, comparing them with foreign references, on the basis of control physiological data measured on 110 cases out of the dogs submitted to the experiments in our department. The hemodynamic measurements varied widely between the both limits of reported normal control data, with the mean value of heart rate $140.4{\pm}26.6$/min., and both the systolic and diastolic arterial blood pressures $137.2{\pm}31.7$mmHg and $104.7{\pm}14.4$ mmHg, as well as the venous pressure of $9.11{\pm}2.18$ cm.$H_2O$. Hematologically, the number of red blood cells $4,571,000{\pm}767,000$per cu.mm., the amount of hemoglobin $11.57{\pm}3.74$ gm/dl and the hematocrit $37.3{\pm}7.2$ per cent, were equally the values a little lower than the reported normal means. However, the white blood cells were within the reported normal limits both in number, $10,384{\pm}4,877$ per cu. mm and their differential counts with slightly broader ranges of variation. The platelet count was $149,800{\pm}47,000 $per cu. mm and was also far below the normal, while the coagulation time $9.03{\pm}2.69$min. and the prothrombin time $13.17{\pm}6.52$sec were within normal limits, though a little prolonged. The serum electrolytes, Na $146.6{\pm}10.44$mEq/L.,K $4.46{\pm}0.84$mEq/L., CI $118.3{\pm}7.88$mEq/L. and Ca $11.45{\pm}5.62$mg./dl, and the blood glucose level of $94.9{\pm}31.79$mg./dl were essentially not different from the reported normal values. The serum proteins, total protein $7.15{\pm}1.41$gm/dl., albumin $4.09{\pm}0.77$gm./dl. and globulin $3.18{\pm}0.88$gm/dl. were included near the higher limits of the reported normal levels. The thymol turbidity 0.1-3.04 units were normal in 10 cases, and the cephaline flocculation was within normal range except 2 cases out of 26 dogs, showing two positive in 24 hours. And the nitrogen series, NPN $34.61{\pm}10.29$mg/dl. and BUN $12.77{\pm}6.37$mg./dl. were normal. It may be concluded that from the point of view of hereby measured physiological data compared with the foreign references, the Korean mongrel dogs have a compatible laboratory data with only the special regards to their tendency toward anemia in red blood cell series.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.138-143
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• 1999

Background: The endothelium-dependent vasorelaxation has been largely accounted for by the release of nitric oxide (NO). Three distinct isoforms of NO synthases (NOS) have been characterized, i.e., brain(bNOS), inducible (iNOS), and endothelial constitutive (ecNOS). Although hypertension hasbeen associated with a vascular endothelial dysfunction, changes in the vascular expression of NOS isoforms have not been established. The present study was aimed at exploring the vascular expression of NOS isozymes in hypertension. Material and Method: Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were induced in rats. The expression of different NOS isozymes in the thoracic aorta was determined by Western blot analysis. The vascular tissue contents of nitrites were measured by colorimetric assay. Result: Arterial blood pressure was significantly higher in experimental groups of 2K1C and DOCA-salt rats compared with their corresponding control rats. The vascular expression of bNOS as well as that of ecNOS was decreased in both models of hypertension. iNOS was not changed in DOCA-salt hypertension, but was also decreased in 2K1C hypertension. The vascular contents of nitrites were significantly decreased in DOCA-salt as well as in 2K1C hypertension. Conclusion: These results suggest that 2K1C and DOCA-salt hypertension are associated with decreases in the vascular expression of NOS isozymes and nitrite contents.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.319-329
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• 2018

Background: Bronchoalveolar lavage (BAL) is a necessary procedure for diagnosis of various lung diseases. High-flow nasal cannula (HFNC) oxygen delivery was recently introduced. This study aimed to investigate the safety and effectiveness of HFNC oxygen supply during BAL procedure in patients with acute respiratory failure (ARF). Methods: Patients who underwent BAL while using HFNC at a partial pressure of oxygen in arterial blood/fraction of inspired oxygen ($PaO_2/FiO_2$; PF) ratio of 300 or below among patients who had been admitted from March 2013 to May 2017 were retrospectively investigated. Results: Thirty-three BAL procedures were confirmed. Their baseline PF ratio was $166.1{\pm}46.7$. $FiO_2$ values before, during, and after BAL were $0.45{\pm}0.12$, $0.74{\pm}0.19$, and $0.57{\pm}0.14$, respectively. Flow (L/min) values before, during, and after BAL were $26.5{\pm}20.3$, $49.0{\pm}7.2$, and $40.8{\pm}14.2$, respectively. Both $FiO_2$ and flow during and after the procedure were significantly different from those before the procedure (both p<0.001). Oxygen saturation levels before, during, and after BAL measured by pulse oximeter were $94.8{\pm}2.9$, $94.6{\pm}3.5$, and $95.2{\pm}2.8%$, respectively. There were no significant differences in oxygen saturation among the three groups. Complications of BAL procedure included transient hypoxemia, hypotension, and fever. However, there was no endotracheal intubation within 24 hours. Baseline PF ratio in "without HFNC" group was significantly higher than that in "with HFNC" group. There were no differences in complications between the two groups. Conclusion: The use of HFNC during BAL procedure in ARF patients was effective and safe. However, there were no significant differences in oxygen saturation level and complications comparing "without HFNC" group in mild ARF. More studies are needed for moderate to severe ARF patients.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.226-232
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• 2012

This study was performed to evaluate the sedative and analgesic effects of intravenous (IV) administration of detomidine (D) and tramadol (T) to horses. Six warmblood horses each received D (10 ${\mu}g/kg$), T (2 mg/kg), and a combination of DT (10 ${\mu}g/kg$ and 2 mg/kg). No significant differences in the heart rate, respiratory rate, rectal temperature, indirect arterial pressure, and gastrointestinal motility between D and DT were observed. The sedative effect was evident within 5 min after D and DT administration, but no significant difference between D and DT was observed. D and DT induced a similar analgesic effect up to 50 min after injection and DT maintained a longer analgesic effect than D. A significant increase in blood glucose was shown for D after the injection, but not for DT. A horse with T and DT showed an excited behavior within 5 min of the injection. This study suggests that the DT combination could be used for diagnostic procedures and simple surgeries in standing horses, with caution for excitement in the early phase after the administration.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.297-300
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• 2012

In the present study, we investigated and compared the oxidant-antioxidant status of dogs undergoing open and laparoscopic cholecystectomy. Ten male beagle dogs, 4-6 years old, weighing 7-12 kg were used. The animals were randomly assigned to one of two groups according to the type of surgical procedure; open (group 1, n = 5) or laparoscopic cholecystectomy (group 2, n = 5). Heart rate, mean arterial pressure, end-tidal carbon dioxide, peripheral oxygen saturation, and respiratory rates were measured. Plasma total oxidant status (TOS) and total antioxidant status (TAS) levels for the evaluation of oxidative stress were measured. The ratio of the TOS to the TAS gave oxidative stress index (OSI), which is an indicator of the degree of oxidative stress. TOS, OSI and TAS levels were significantly changed after surgery in comparison to levels of before anesthesia. There were no significant different between groups. In the present study, we showed that oxidative stress parameters were found similar in dogs underwent laparoscopic or open cholecystectomy.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.158-164
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• 1994

Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of PAS positive lipoproteinaceous material in the alveolar spaces sparing septum. The therapy which has enjoyed the greatest success is whole lung lavage. The authors reported here, a case of 44 year old male patient with pulmonary alveolar proteinosis, and this is the 7th case in Korea. The patient underwent whole lung lavage but expired due to brain edema complicated by the procedure. He complained exertional dyspnea and cyanotic lips, and presented fine inspiratory crackle at both lower lung fields, decreased arterial oxygen pressure, and diffuse infiltration at whole lung field. Light microscopic finding of lung tissue obtained by transbronchial lung biopsy revealed PAS positive amorphous, granular material filled in the alveolar spaces, and electron microscopy of bronchoalveolar lavage fluid concentrate showed many electron-dense multi-lamellated structures. To treat the disease, the authors tried whole lung lavage of left lung with $37^{\circ}C$ isotonic saline under general anesthesia. However, he expired due to brain edema probably due to dilutional hyponatremia complicated by the procedure, 11 days after the procedure. Whole lung lavage is known relatively safe, but fatal complication may occur like this case.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.604-608
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• 2004

A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of $39^{\circ}C$, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still $39^{\circ}C$ despite the aggressive therapy of community-acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.