• Journal of Chest Surgery
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• v.21 no.2
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• pp.223-230
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• 1988

Emax, end-systolic pressure-volume relationship, has been established as a new concept which can be representative of ventricular contractility itself since 1970s. Comparing to ejection fraction[EF], Emax is independent of preload and afterload. However Emax has not been proved precisely in non-thoracotomized condition because current methods have limitation in measuring ventricular chamber volume accurately in in viva state. The Dynamic Spatial Reconstructor[DSR], high speed computerized tomography, can measure ventricular chamber volume accurately throughout cardiac cycle in non-thoracotomized state. So Emax and EF of the left ventricle was tried to measure precisely in in vivo condition with DSR. Emax was compared to EF to estimate its ability to evaluate ventricular contractility. 5 mongrel dogs, weighing 15-16kg, were used for measuring Emax and EF of the left ventricle in 3 or 4 different loading conditions using DSR. Emax value in 5 dogs was from 2.62 to 10.49. Each dog has one Emax value regardless of loading conditions. However EF in 5 dogs varies depending on loading conditions. The conclusions are that Emax is useful in in viva state and EF varies depending on loading conditions. So Emax should be tried to use in clinical situation rather than EF because it is always representative of contractility itself regardless loading conditions in in viva state.

• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.33-37
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• 1987

Attenuated end-diastolic and end-systolic left ventricular counts which obtained from cardiac gated blood pool scan were corrected using experimentally calculated attenuation coefficient $(\mu=0.13/cm)$ and depth of center of left ventricle. This method was confirmed to be correct experimentally using phantom balloon. To compare the accuracy of attenuated and attenuation-corrected left ventricular volume measurement, authors studied 10 patients with ischemic heart disease who underwent both gated blood pool scan and X-ray contrast ventriculography within a week. The attenuated and attenuation-corrected left ventricular volume measured by count method correlated with contrast ventriculographic volumes; however, attenuation corrected measurement was correlated more closely.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.336-339
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• 1996

Stellate ganglion block which usually practiced in pain clinics may combined with hemodynamic changes because it blocks sympathetic nerve chains. We measured the hemodynamic changes with NCCOM3-$R7^{(R)}$ (BOMED, U.S.A.) which applicated bioimpedance method in twenty-two patients. Mean arterial pressure, heart rate, cardiac output, ejection fraction and left ventricle end diastolic volume (LEDV) were measured before stellate ganglion block (control), 1, 3, 5, 10 and 20 minutes after stellate ganglion block with 8 ml of 0.25% bupivacaine. The results were as follows: Mean arterial pressure decreased significantly (p<0.05) in 10, 20 minutes after stellate ganglion block comparing to control, but not clinically significant. Heart rate, cardiac output, ejection fraction and LVEDV showed no significant change compared to control value. These results showed that stellate ganglion block is a safe technique without significant hemodynamic changes.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.38 no.2
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• pp.106-111
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• 2005

We studied the cardio-respiratory properties in the Japanese amberjack (Seriola quinqueradiata) during acute hypoxia exposure. Fish were exposed to three levels of hypoxia (80, 60 or 50 mmHg) for 60 min at $25^{\circ}C$. Cardiovascular parameters (cardiac output; Q, heart rate; HR, stroke volume; SV, blood pressure; $P_{DA}$) changed little from pre-exposure values during both 80 and 60 mmHg of hypoxia. During 50 mmHg of hypoxia, the fish showed a bradycardia which significantly affected Q, whereas no change in SV. $P_{DA}$ increased transiently. Arterial oxygen partial pressure ($PaO_2$) immediately reduced along with a decrease of the water oxygen partial pressure ($P_WO_2$). Arterial $O_2$ content ($CaO_2$) decreased significantly only after 60 min of 50 mmHg of hypoxia. Arterial pH (pHa) and hematocrit value (Hct) did not change significantly. Comparing the effects of different levels of hypoxia, oxygen delivery to the tissues ($Q\;{\times}\;CaO_2$) should be maintained a constant over a broad range of $P_WO_2$, however, severely depressed below 50 mmHg of hypoxia.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.664-667
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• 2002

Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• Journal of Korean Academy of Nursing
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• v.41 no.2
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• pp.191-196
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• 2011

Purpose: We investigated the effects of group III mechanoreceptors to cardiovascular responses in both pre-menopausal woman and post-menopausal woman during passive ankle dorsiflexion (PAD). Methods: Twenty healthy volunteers (10 post-menopausal women and 10 pre-menopausal women) were recruited for this study. Stroke volume (SV), heart rate (HR), cardiac output (CO), and total vascular conductances (TVC) were measured continuously throughout the experiment. To stimulate the group III mechanoreceptors, PAD was performed for one minute. Results: The results showed that mean arterial pressure (MAP) mediated by the mechanoreflex activation was significantly increased in both groups. However, this pressor response was significantly higher in post-menopausal women. This reflex significantly increased both SV and CO in pre-menopausal women, while there were no differences in post-menopausal women. There was no difference in HR in either group. The mechanoreflex significantly decreased TVC in post-menopausal woman, while there was no difference in pre-menopausal woman. Conclusion: The results indicate that the excessive pressor response mediated by the mechanoreflex occurs due to overactivity of group III mechanorecptors and the mechanism is produced mainly via peripheral vasoconstriction in post-menopausal women.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.108-114
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• 1993

The risks of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. This is a report concerning 29 consecutive adult with no blood conservation patients (Group I) who had an elective cardiac operations. A similar group of 29 patients operated on 1992 but with blood conservation (Group II). In I of Group I patients and 15 of Group II patients, no homologous blood products were required. Group II patients used significantly less fresh frozen plasma (2.05${\pm}$0.68 unit versus 6.52${\pm}$0.72 unit, p<0.05) and the homologous blood transfusion (0.42${\pm}$0.9 unit versus 3.64${\pm}$0.17 unit, p<0.05) than Group I patients. Group II patients had also significantly less postoperative bleeding (338${\pm}$39.9 ml versus 585${\pm}$93.0 ml, p<0.05) than Group I patients. Group II patients recieved 460${\pm}$62.6 ml of mediastinal shed blood in acquired group. In conclusion, a simple and inexpensive blood conservation program, mainly combining autologous blood removal before bypass, retransfusion of the volume remaining in the oxygenator, and consistent autotransfusion of mediastinal shed blood has enabled us to avoid infusion of homologous blood in 15/29 patients of Group II patients. No side effects or complicatinos could be related to the blood conservation program.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.656-663
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• 1994

Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

• Journal of Biomedical Engineering Research
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• v.14 no.2
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• pp.163-167
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• 1993

We developed a ventricular assist device(VAD) to be used as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial function after cardiac surgery. It is a pneumatic and diaphragm-type VAD and its stroke volume is 90 cc. The upper housing and diaphragm is made of a segmented polyurethane and the lower back plate is made of a polycarbonate. Two Carbomedics$^R$ mechanical valves are used as inlet and outlet valves. It was tested in vitro and the cardiac output of the VAD was 7 L/min at a heart rate of 70 bpm. The line pressure from a pressure transducer inserted in the pneumatic line was recorded and compared with the ideal pressure tracing.