• Title/Summary/Keyword: Blood Pressure Reduction

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Effect of Unilateral Renal Arterial Infusion of Angiotensin II on Renal Function and Renin Secretion in Unanesthetized Rabbit (신동맥내 투여한 Angiotensin II가 신장기능 및 Renin 분비에 미치는 영향)

  • Kim, Jong-Hun;Kang, Nam-Poo;Kim, Young-Jin;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.23 no.2
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    • pp.363-375
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    • 1989
  • It has been well known that peripheral infusion of angiotensin II results in an increase of blood pressure, and an elevation of aldosterone secretion, and an inhibition of renin relase. However, the direct effect of angiotensin II on renal function has not been clearly established. In the present study, to investigate the effect of angiotensin II on renal function and renin release, angiotensin II (0.3, 3 and 10 ng/kg/min) was infused into a unilateral renal artery of the unanesthetized rabbit and changes in renal function and active and inactive renin secretion rate (ARSR, IRSR) were measured. In addition, to determine the relationship between the renal effect of angiotensin II and adenosine, the angiotensin II effect was evaluated in the presence of simultaneously infused 8-phenyltheophylline (8-PT, 30 nmole/min), adenosine A 1 receptor antagonist. Angiotensin II infusion at dose less than 10 ng/kg/min decreased urine flow, clearances of para-amino-hippuric acid and creatinine, and urinary excretion of electrolytes in dose-dependent manner. The changes in urine flow and sodium excretion were significantly correlated with the change in renal hemodynamics. Infusion of angiotensin II at 10 ng/kg/min also decreased ARSR, but it has no significant effect on IRSR. The change in ARSR was inversely correlated with the change in IRSR. The plasma concentration of catecholamine was not altered by an intarenal infusion of angiotensin II. In the presence of 8-PT in the infusate, the effect of angiotensin II on renal function was significantly attenuated, but that on renin secretion was not modified. These results suggest that the reduction in urine flow and Na excretion during intrarenal infusion of angiotensin II was not due to direct inhibitions of renal tubular transport systems, but to alterations of renal hemodynamics which may partly be mediated by the adenosine receptor.

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Vacuum Assisted Wound Closure Appliance and Continuous Irrigation on Infected Chronic Wound (감염된 만성창상에서 국소음압세척치료의 이용)

  • Jeong, Jin-Wook;Kim, Jun-Hyung;Jung, Yung-Jin;Park, Mu-Sik;Son, Dae-Gu;Han, Ki-Hwan
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.227-232
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    • 2010
  • Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.

A Clinical Study of Management In Myasthenia Gravis (중증 근무력증 환자의 임상적 고찰)

  • Kim, Hun;Lee, Du-Yeon;Jo, Beom-Gu;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.112-127
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    • 1987
  • Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

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An Adaptive Polling Algorithm for IEEE 802.15.6 MAC Protocols (IEEE 802.15.6 맥 프로토콜을 위한 적응형 폴링 알고리즘 연구)

  • Jeong, Hong-Kyu
    • Journal of Korea Multimedia Society
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    • v.15 no.5
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    • pp.587-594
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    • 2012
  • IEEE 802.15.6 standard technology is proposed for low-power wireless communication in, on and around body, where vital signs such as pulse, blood pressure, ECG, and EEG signals are transmitted as a type of data packet. Especially, these vital signs should be delivered in real time, so that the latency from slave node to hub node can be one of the pivotal performance requirements. However, in the case of IEEE 802.15.6 technology data retransmission caused by transmission failure can be done in the next superframe. In order to overcome this limitation, we propose an adaptive polling algorithm for IEEE 802.15.6 technology. The proposing algorithm makes the hub to look for an appropriate time period in order to make data retransmission within the superframe. Through the performance evaluation, the proposing algorithm achieves a 61% and a 73% latency reduction compared to those of IEEE 802.15.6 technology in the environment of 70% traffic offered load with 10ms and 100ms superframe period. In addition, the proposing algorithm prevents bursty traffic transmission condition caused by mixing retransmission traffic with the traffic reserved for transmission. Through the proposing adaptive polling algorithm, it will be possible to transmit time-sensitive vital signs without severe traffic delay.

Effect of NPK Fertilization on the Yields and Effective Components of Chrysanthemum boreale M. (산국의 수량과 유효성분에 대한 NPK의 효과)

  • Yang, Min-Suk;Jung, Yeun-Kyu;Sohn, Bo-Kyoon;Cho, Ju-Sik;Lee, Seong-Tae;Kim, Pil-Joo;Lee, Kyung-Dong
    • Applied Biological Chemistry
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    • v.46 no.2
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    • pp.134-139
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    • 2003
  • To establish the fertilization condition to increase the productivity of Chasanthemum boreale M. with high quality, the effects of three nutrients (N, P, K) on the yields and the effective components were investigated in the pot scale. NPK was applied by chemical fertilizers with $(N-P_2O_5,-K_2O=250-160-160\;kg/ha)$ as a main treatment, and NP $(N-P_2O_5,-K_2O=250-160-160\;kg/ha)$, NK $(N-K_2O =250-160\;kg/ha)$, and PK $(P_2O_5K_2O=160-160\;kg/ha)$ treatments were settled as comparison. Dry yields of C. boreale M. was increased significantly to 4 fold higher by nitrogen. Nitrogen increased apparently plant growth and inorganic nutrient uptake. In the flower, which is most useful and edible part as a herbal medicine, main amino acids were glutamic acid and aspartic acids, and the total content was increased significantly by three elements of application. In addition, the content of cumambrin A, which is known to have the effect of blood-pressure reduction, was increased source to 6.2 times by nitrogen higher than that in PK treatment. Potassium was more effective in biosynthesis of cumambrin A than phosphorus, but the biological pathway was not clear, still.

Consideration on Application of Modified Monitored Anesthetic Care in Plastic Surgery (성형외과 영역의 수술 시 마취하 감시관리의 응용에 대한 고찰)

  • Cho, Geon;Suh, In-Suck;Choi, Young-Ryong;Chung, Mi-Hwa;Tak, Kyoung-Seok;Park, Young-Kyu;Kim, Jae-Hyun;Ko, Eung-Yeol;Sung, Ha-Min
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.7-14
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    • 2011
  • Purpose: Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. Methods: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods. Results: The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia. Conclusion: The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.

The Effect of 4-Week Health Promotion Summer Camp on the Metabolic Syndrome and Insulin Resistance among Obese Elementary Students (비만 초등학생의 4주 여름 건강증진캠프 참여가 대사증후군 및 인슐린저항성에 미치는 효과)

  • Kim, Hee-Jung;Jekal, Yoonsuk
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.4
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    • pp.1117-1128
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    • 2021
  • The purpose of the current study was to investigate the effects of 4-week health promotion intervention program consisting of high-intensity aerobic exercise to improve energy consumption and cardiorespiratory capacity, circuit training to strengthen muscular strength and endurance and education for lifestyle changes on the obesity level, physical fitness, insulin resistance and metabolic syndrome among overweight or obese elementary school students. Twenty three overweight or obese children as obese group and 15 normal body weight children as normal group were recruited. The health promotion program consisted of two exercise sessions and one education session, 3days/week in 4-week. Obesity level(body mass index, waist circumference, %body fat), physical fitness(muscular strength, muscular endurance, flexibility, cardiopulmonary fitness), insulin resistance(homeostasis model assessment of insulin resistance) and metabolic syndrome risk factors(blood pressure, fasting glucose, triglycerides, high density lipoprotein cholesterol) were measured. There was not significant decrease in obesity level; however, there were significant improvement in physical fitness, insulin resistance and metabolic syndrome risk factors after program participation among obese children. As a result, through participation in the summer camp consisting mainly of exercise, the improvement of the physical fitness level and the decrease of insulin resistance had an effect on the reduction of the metabolic syndrome frequency.

The Changes of the Heart Rate, Hand Function, and Health related Quality of Life of the People with Intellectual Disability through the Increase of the Auditory Stimulation (청각자극 증가에 따른 지적장애인의 심박수와 손 기능, 건강관련 삶의 질의 변화)

  • Son, Sung-Min;Kang, Jin-Ho;Bak, Ah-Ream
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.5
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    • pp.217-227
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    • 2020
  • The purpose of the study is to analyze the changes of the heart rate, hand function, and health related quality of life of the people with intellectual disability through the increase of the auditory stimulation. The subjects were 16 people with intellectual disability. The increase of the auditory stimulation was modulated through the music sound and the intensity was consisted of 60dB, 65dB and 70dB. The wist heart rate and blood pressure monitor was used to measure the heart rate during the application of the auditory stimulation increase. The hand function of right and left hand was measured by the Purdue pegboard. Health related of quality of life was measured by the short form-8 health survey. As the results, the increase of the heart rate was showed by the increase of the auditory stimulation and the decrease of the hand function and health related quality of life was showed. For these, the increase of the auditory stimulation acts as a psychological distress, thereby the increase of the heart rate and the reduction of the hand function and health relate quality of life showed. Thus, to decrease of the heart rate and increase the hand function and the health related quality of life of the people with intellectual disability, the intensity of the auditory stimulation should be considered in the environmental stimulation.

Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study (혈액투석 유지요법 환자에서 투석 전후의 좌심실 Doppler 심초음파를 이용한 기능지표의 변화)

  • Kang, Dong-Oh;Lee, Du-Ha;Kim, Hyun-Seo;Kim, Hyun-Su;Kim, Sung-Rok;Park, Jong-Seon
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.309-317
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    • 1999
  • Background: Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function. we performed M-mode and Doppler echocardiographic studies before and after hemodialysis. Methods: The study population consisted of 30 patients(15 patients were male, mean age $45{\pm}10$ years) with CRF on maintenance hemodialysis. They have normal left ventricular systolic function(Fractional shortening>30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction (EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxation time(IVRT), deceleration time(DT). and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance (IMP) was calculated from each of the Doppler velocity indices. Results: The weight reduction after hemodialysis was $2.1{\pm}1.0kg$(p<0.0001), After hemodialysis, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant reduction in peak E velocity, E/A ratio(p<0.0001. p<0.001), and significant increase in IVRT and IMP(p<0.05, p<0.0001) were noted. Conclusion: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And an increased IMP suggests that diastolic function may be aggravated after hemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

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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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