• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.353-360
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• 2019

Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO₂) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO₂ monitoring did not present with sufficient benefits over the risk and cost.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.367-370
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• 2014

The study was to observe hemodynamic alterations of cardiac function to design a model of canine mitral valve insufficiency (MVI) based on chordae tendinae rupture (CTR). Ten healthy beagles with normal heart function were used in this study. To measure hemodynamics, the patient monitor was equipped for invasive blood pressure and a Swan-Ganz catheter. Hemodynamic alterations were checked promptly during CTR procedures. MVI model was made by transection of the chordae tendinae with small arthroscopy hook knife through $5^{th}$ intercostal open chest. Color Doppler at the level of the mitral valve showed high-velocity regurgitant flow immediately after CTR at intraoperative echocardiography. In hemodynamic measurements, pulmonary capillary wedge pressure (PCWP) was significantly increased, while mean arterial pressure (MAP), venous pressure (VP), pulmonary arterial pressure (PAP), cardiac output (CO) and cardiac index (CI) were significantly decreased after CTR. It was known that the left atrium was overloaded by regurgitant volume from the left ventricle. In conclusion, the MVI model induced by CTR technique in this study should be used as suitable one for the effective research of canine mitral valve disease. Further study should be needed to measure the chronic alternation of mitral valve in the model.

• Advances in Traditional Medicine
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• v.7 no.5
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• pp.494-500
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• 2008

Ginseng has been traditionally used to recover vital energy from Qi deficiency in oriental countries. Recent reports suggested that ginseng could regulate blood pressure (BP), but much controversy still remain. Therefore, we intended to assess the anti-hypertensive effect of some ginseng species on Koreans and Chinese. This is a randomized, double blinded controlled clinical trial. The study subjects were recruited from the mild hypertensive patients who belonged prehypertension(120/80 to 139/89 mmHg) and stage I hypertension (140/90 to 159/99 mmHg) in Korea and China. After assigning the subjects into a Korean, a Chinese, and an American ginseng group by randomization, we prescribed ginseng with the dose of 4.5 g per a day for 4 w. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication by 24 h Ambulatory Blood Pressure Monitor (24 h ABPM). We also monitored adverse effect and laboratory findings to secure the subjects' safety. There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, and 64 treated with American ginseng. All of the ginseng species reduced subjects' BP. Especially, Korean and Chinese ginseng showed more excellent effects. The secondary analysis on the subjects' nationality revealed that all of the ginseng species showed more significant anti-hypertensive effect in Chinese than in Koreans. We suggest ginseng could be useful for mild hypertension regardless of its species. And it would be safe within the dosage of 4.5 g per a day.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.315-319
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• 1996

We have developed a prototype patient monitoring system including module-based bedside units, interbed network, and central stations. A bedside unit consists of a color monitor and a main CPU unit with peripherals including a module controller. It can also include up to 3 module cases and 21 different modules. In addition to the 3-channel recorder module, six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmogaph are provided as parameter modules. Modules and a module controller communicate with up to 1Mbps data rate through an intrabed network based on RS-485 and HDLC protocol. Bedside units can display up to 12 channels of waveforms with any related numeric informations simultaneously. At the same time, it communicates with other bedside units and central stations through interbed network based on 10Mbps Ethernet and TCP/IP protocol. Software far bedside units and central stations fully utilizes gaphical user interface techniques and all functions are controlled by a rotate/push button on bedside unit and a mouse on central station. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances. In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we are developing a relational database server dedicated to the patient monitoring system. We are also developing a clinical workstation with which physicians can review and examine the data from patients through various kinds of computer networks far diagnosis and report generation. Portable bedside units with LCD display and wired or wireless data communication capability will be developed in the near future. New parameter modules including cardiac output, capnograph, and other gas analysis functions will be added.

• 한국노년학
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• v.31 no.4
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• pp.969-983
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• 2011

The purposes of this study were to identify the degree of postprandial blood pressure reduction and the prevalence of postprandial hypotension by 3 different mealtimes of elderly people diagnosed with hypertension in nursing homes. After the informed and written consent, a total of 187 elderly people were recruited in the study. Systolic BP, diastolic BP were measured with ambulatory BP monitor every 15 minutes interval from 30 minutes before a meal until 120 minutes after each meal. The maximum SBP reduction was significantly bigger at breakfast than lunchtime or dinnertime. Among 187 elders, 137(73.4%) showed PPH at breakfast, 103(54.2%) at lunchtime, and 96(50.2%) at dinnertime. The most prevalent time point of PPH was 90 minutes after the initiation of a meal in all of 3 mealtimes. Among 8 measurement times, the prevalence of PPH was significantly higher in breakfast (3.0±2.7 times) than both lunchtime (2.1±2.5 times) and dinnertime (1.9±2.4 times). Although the occurrence of PPH by every mealtime should be taken into account in caring for the elderly, postprandial BP measurements need more attention after breakfast. Nurses should develop appropriate nursing interventions that can prevent postprandial blood pressure reduction in elderly people with hypertension.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1065-1077
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• 1999

Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

• Journal of IKEEE
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• v.28 no.2
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• pp.221-227
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• 2024

This paper presents a smartphone-attachable vascular compliance monitoring module. The proposed sensor module measures photoplethysmogram (PPG) and reconstructs an accelerated PPG waveform. The feature points are extracted from the accelerated PPG waves, and vascular compliance is estimated using these extracted features. The module is powered via the smartphone's USB terminal and transmits the acquired waveforms along with vascular compliance values through Bluetooth. The transmitted waveforms and vascular compliance value are displayed through the smartphone application. This work proposes an assessment method for consistency of PPG instrumentation, and it was implemented in a processor of sensor module. The proposed sensor module can be easily attached to smartphone that does not support PPG instrumentation, providing simple measurment and numerical analysis of vascular compliance. To verify the performance of the implemented sensor module, we acquired vascular compliance and pulse pressure data from 29 subjects. Pulse pressure, which serves as a representative indicator of vascular compliance, was obtained using a commercial blood pressure monitor. The analysis results showed that the Pearson coefficient between vascular compliance and pulse pressure was 0.778, confirming a relatively high correlation between two metrics.

• 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 the Korean Dietetic Association
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• v.16 no.4
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• pp.369-377
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• 2010

This study was conducted to investigate the effects of food consumption monitoring based on a digital photography method using a mobile phone on food consumption and weight reduction. Eighteen female college students (>30% body fat) participated in the weight control program using a mobile-phone for 4 wks. The energy intake was reduced significantly after 3 wks compared to baseline (P<0.05, baseline: 1,453.0 kcal, 3rd wk: 1,171.1 kcal, 4th wk: 1,130.8 kcal). The subjects lost 2.8 kg of body weight, 1.4% of % body fat, and 1.1 $kg/m^2$ of body mass index (BMI) after 4 wks. There were also significant differences in blood pressure (P<0.001) and serum cholesterol (total cholesterol: P<0.05, LDL-cholesterol: P<0.01) before and after the self-regulated diet program. In this study, the digital photography method using a mobile-phone influenced weight control through trained consumption monitoring, which helps individuals reduce discrepancies between perceived and actual consumption levels. Therefore, effective monitoring by taking food pictures using a mobile-phone can lead individuals to rely more heavily on easy-to-monitor visual cues.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.497-502
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• 2011

Objective : This study was conducted to compare the effect of etomidate with that of thiopental on brain protection during temporary vessel occlusion, which was measured by burst suppression rate (BSR) with the Bispectral Index (BIS) monitor. Methods : Temporary parent artery occlusion was performed in forty one patients during cerebral aneurysm surgery. They were randomly assigned to one of two groups. General anesthesia was induced and maintained with 1.5-2.5 vol% sevoflurane and 50% $N_2O$. The pharmacological burst suppression (BS) was induced by a bolus injection of thiopental (5 mg/kg, group T) or etomidate (0.3 mg/kg, group E) according to randomization prior to surgery. After administration of drugs, the hemodynamic variables, the onset time of BS, the numerical values of BIS and BSR were recorded at every minutes. Results : There were no significant differences of the demographics, the BIS numbers and the hemodynamic variables prior to injection of drugs. The durations of burst suppression in group E ($11.1{\pm}6.8$ min) were not statistically different from that of group T ($11.1{\pm}5.6$ min) and nearly same pattern of burst suppression were shown in both groups. More phenylephrine was required to maintain normal blood pressure in the group T. Conclusion : Thiopental and etomidate have same duration and a similar magnitude of burst suppression with conventional doses during temporary arterial occlusion. These findings suggest that additional administration of either drug is needed to ensure the BS when the temporary occlusion time exceed more than 11 minutes. Etomidate can be a safer substitute for thiopental in aneurysm surgery.