• 제목/요약/키워드: Cardiac factor

검색결과 306건 처리시간 0.027초

무마취 가토 신장기능에 미치는 Atrial Natriuretic Factor의 영향 (Effect of Atrial Natriuretic Factor on the Renal Function and Renin Release in Unanesthetized Rabbit)

  • 이준규;조경우
    • The Korean Journal of Physiology
    • /
    • 제20권1호
    • /
    • pp.103-124
    • /
    • 1986
  • Since it has been suggested that atrial receptor may be involved in the mechanism of extracellular volume regulation, it was shown that the granularity of atrial cardiocytes can be changed by water and salt depletion, and that an extract of cardiac atrial tissue, when injected intravenously into anesthetized rats, was shown to cause a large and rapid increase in renal excretion of sodium. Various natriuretic peptides were isolated and synthetized, and the effects were investigated by many workers. Most studies, however, have been carried out under anesthesia and there have teen some controversies over direct effect of the factor on the renal function. Therefore, it was attempted in this study to access the effects of an atrial extract and a synthetic natriuretic factor in unanesthetized rabbits. Intrarenal arterial infusion of atrial extract caused a rapid increase of urinary volume and excretion of sodium. Glomerular filtration rate and renal plasma flow were both increased with no change in filtration fraction. The ventricular extract produced no change in urinary excretion of electrolytes, nor in renal hemodynamics. Intrarenal infusion of synthetic atrial natriuretic factor caused increases of renal excretory rate of sodium, chloride and potassium, and $FE_{Na}$. Glomerular filtration rate, renal plasma flow increased. And free water clearance also increased. Accentuated excretory function correlated well with increased glomerular filtration rate and renal plasma flow during infusion and for 10 minutes following the cessation of the infusion. Renin secretion rate decreased during constant infusion of atrial natriuretic factor. However, no correlation was found with the changes in glomerular filtration rate, renal plasma flow, or urinary excretion of sodium. These results suggest that atrial extract or atrial natriuretic factor induces changes in renal hemodynamics, as in excretion of electrolytes either indirectly through hemodynamic changes or directly by inhibiting tubular reabsorption. At the same time, renin secretory function is affected by the factor possibly through an unknown mechanism.

  • PDF

Reliability and Validity of the Greek Version of the Job Content Questionnaire in Greek Health Care Workers

  • Alexopoulos, Evangelos C.;Argyriou, Evangelia;Bourna, Virginia;Bakoyannis, Giorgos
    • Safety and Health at Work
    • /
    • 제6권3호
    • /
    • pp.233-239
    • /
    • 2015
  • Background: The Job Content Questionnaire (JCQ), which is based on the Demand-Control-Support model, is designed to measure the psychosocial characteristics of the respondent's work, and has been identified to predict health and psychological outcomes. The purpose of this study was to investigate the psychometric properties of this instrument and the subsequent adaptation of its scales to the population of Greek health workers. Methods: The Greek version of the JCQ was developed by using forward- and back-translation in accordance with the JCQ policy. The reliability and validity of the measure were investigated in a sample of health workers working in a hospital in Athens, Greece. The internal consistency of the scales was examined based on Cronbach ${\alpha}$ coefficients, and the validity was evaluated subjecting the items of the three main scales of the JCQ (decision latitude, psychological job demands, and social support) to exploratory and confirmatory factor analysis. Results: The reliability of the scales was found to be acceptable for all the scales, except for the skill discretion subscale. Confirmatory factor analysis confirmed a slightly modified version of the original construct including several items to more than one factor. Conclusion: Our findings suggest that the Greek JCQ is reliable and valid for investigating psychosocial job characteristics among Greek health workers.

관상동맥질환자를 위한 위험요인관리 프로그램 분석 (The Analysis of Risk Factor Management Programs for Patients with Coronary Artery Disease)

  • 방소연;박미영
    • 재활간호학회지
    • /
    • 제16권1호
    • /
    • pp.27-36
    • /
    • 2013
  • Purpose: This study was performed to analyse the trends of risk factor management programs for patients with coronary artery disease. Methods: Using PubMed, 35 intervention studies related to risk factor management programs among randomized controlled trials searched with the key words of coronary artery disease and coronary heart disease. Collected studies were analysed according to the characteristics of studies and participants, method and content of intervention, and outcome indicator and its effects. Results: The mean period of intervention was $28.7{\pm}26.8$ weeks, the mean frequency was $3.0{\pm}2.0$ times per week, and the duration of one session was below 60 minuets in 65.8% of the reviewed studies. The interventions were counselling, exercise, education, and cognitive behavior therapy. Counselling was applied most frequently in previous studies. The outcomes of intervention had been measured with anthropometric, physical, physiological, psychological, behavioral, and cognitive aspects, but the effect of the intervention was inconsistent among the studies. Conclusion: Based on the results of this study, systematic and comprehensive cardiac rehabilitation program consisted of counselling, exercise, and education should be developed and performed for health management and relapse prevention of patients with coronary artery disease.

Respiratory Sinus Arrhythmia: Methods of Measurement and Interpretations of Tonic and Dynamic Vagal Cardiac Drive Index in Psychophysiology of Emotions

  • Estate M.Sokhadze;Lee, Jong-Mi;Park, Mi-Kyung;Sohn, Jin-Hun
    • 한국감성과학회:학술대회논문집
    • /
    • 한국감성과학회 2000년도 추계학술대회 논문집
    • /
    • pp.81-87
    • /
    • 2000
  • Beat-to-beat changes in heart period (heart period variability, HPV) are mediated by fluctuations in autonomic activity. Spectral analysis is used to quantify such fluctuations in the range of 0.15-0.40 Hz (high frequency, HF), which are influenced primarily by parasympathetic factors. These fluctuations are often referred to as RSA (respiratory sinus arrhythmia), the physiological phenomenon extracted by spectral analysis and other methods including histograms of heart rate ( HR), deviations of HR etc. Respiratory sinus arrhythmia indexing with peak-to-valley method suggested by Grossman et at., (1981) yields a simple range statistic and is quantified on breath-by-breath basis, thus being quite sensitive and less dependent on recording time as compared to spectral analysis. It is strongly recommended to use at least 1 min epoch to asses HF component of HPV and at least 2 min fer low frequency (LF) of HPV and even 5 min far valid clinical assessment. Peak-to-valley statistic is limited to RSA index only, but has its pragmatic advantages. Most important is possibility of its application far relatively small epoch analysis. We used short periods (20,30, 40 sec only) and off-line analysis of RSA using ECG and respiration curve this method of assessment and proved that this method is more practically effective. The RSA index was not so far dependent on respiration pattern differences and reflected actual vagal control of HR and were accompanied by low HR under some high stress conditions and in an aversive affective visual stimulation experiments. Another factor that might modulate cardiac chronotropic response is the interaction of sympathetic and parasympathetic inputs on sino-atrial (SA) node level, because responses to vagal influences are known to be proportional to ongoing sympathetic activity, that is so called accentuated antagonism. Since sympathetic outflow (increment of influences on SA) under negative emotions or stress was high in almost all physiological responses, vagal effects on HR could be therefore potentiated, leading to masking of output cardiac response seen in HPV, In the case of moderate sympathetic activation, on the other hand, autonomic interactions in cardiac control appear to be minimal. Thus RSA index appears to be an effective alternative method to assess and measure spectral HPV.

  • PDF

Catecholamines에 관(關)하여 -제4편(第四編) : 심실전동발생(心室顫動發生)에 있어서의 catecholamines의 의의(意義)- (Role of Catecholamines in Ventricular Fibrillation)

  • 이우주
    • 대한약리학회지
    • /
    • 제19권1호
    • /
    • pp.15-35
    • /
    • 1983
  • Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

  • PDF

심장수술 시 황산마그네슘 투여의 임상효과 (The Clinical Effect of Administration of Magnesium Sulfate in Cardiac Surgery)

  • 방정희;문성민;김시호;조광조;최필조;우종수
    • Journal of Chest Surgery
    • /
    • 제39권5호
    • /
    • pp.366-375
    • /
    • 2006
  • 배경: 심폐바이패스를 이용한 심장수술에 따른 혈중 마그네슘 결핍 현상은 흔히 발생하는 합병중으로 이 연구의 목적은 심장수술시 인위적으로 첨가한 황산마그네슘의 유익한 임상 효과를 규명함에 있다. 대상 및 방법: 심폐바이패스를 이용하여 심장수술을 시행하기로 예정된 환자들 35명을 무작위로 황산마그네슘 투여군(n=15)과 투여하지 않은 군(n=20)으로 분류한 뒤 마그네슘군은 심폐기 충전액에 황산마그네슘 1g과 심정지액에 황산마그네슘 1g을 각각 첨가하였다. 요골 동맥으로부터 혈액을 채취하여 $Mg^{++}$ 농도, 전해질농도, 동맥혈액 가스분석, 혈액학적 분석, 혈청 총 단백 농도와 albumin 농도, blood urea nitrogen (BUN), creatinine, alanine amino transferase (ALT), aspartate aminotransferase (AST), total bilirubin 농도, tumor nerosis factor-${\alpha}$ $(TNF-{\alpha})$, interleukin-6 (IL-6), interleukin-10 (IL-10), creatine phosphokinase (CpK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), troponin-I (TNI) 농도, prothrombin time (PT)과 activated partial thromboplastin time (aPTT) 등도 측정하였다. 또한 수술 전과 후 정맥 혈액을 채취하여 activated clotting time (ACT)을 측정하였다. 결과: $Mg^{++}$ 농도는 수술 동안 및 후 시기에 마그네슘군이 대조군보다 유의하게 높게 유지되었다(p<0.05). 수술 전 부정맥이 없었던 환자들(대조군=10명, 마그네슘군=17명) 중 수술 후 부정맥 발생 수는 대조군이 10명(100%) 마그네슘군이 8명(46.4%)으로 마그네슘군이 대조군보다 유의하게 적었다(p=0.050). 결론: 심장수술 시 저용량의 황산마그네슘의 투여는 수술 중과 수술 후 저마그네슘 혈증의 예방과 부정맥의 빈도를 낮춰줄 것으로 생각한다.

High molecular weight water-soluble chitosan acts as an accelerator of macrophages activation by recombinant interferon ${\gamma}$ via a process involving $_L$-arginine -dependent nitric oxide production

  • Kim, Hyung-Min
    • Advances in Traditional Medicine
    • /
    • 제1권1호
    • /
    • pp.71-81
    • /
    • 2000
  • High molecular weight water-insoluble chitosan alone has been previously shown to exhibit in vitro stimulatory effect on macrophages nitric oxide (NO) production. However, high molecular weight water-soluble chitosan (WSC) had no effect on NO production by itself. When WSC was used in combination with recombinant $interferon-{\gamma}\;(Rifn-{\gamma})$, there was a marked cooperative induction of NO synthesis in a dose-dependent manner. The optimal effect of WSC on NO synthesis was shown at 24 h after treatment with $rIFN-{\gamma}$. The increased production of NO from $rIFN-{\gamma}$ plus WSC-stimulated RAW 264.7 macrophages was decreased by the treatment with $N^G$ $monomethyl-_L-arginine$. The increase in NO synthesis was reflected, as an increased amounts of inducible NO synthase (iNOS) protein. Synergy between $rIFN-{\gamma}$ and WSC was mainly dependent on WSC-induced nuclear $factor-_KB$ activation. The present results indicate that WSC may provide various activities such as anti-microbial, anti-tumoral, and anti-viral. In addition, since NO has emerged as an important intracellular and intercellular regulatory molecule having functions as diverse as vasodilation, neural communication, cell growth regulation and host defense, it is tempting to hypothesize that this WSC is involved in the local control of the various fundamental processes such as cardiagra, cardiac infarction, impotence etc.

  • PDF

Chronic cold stress-induced myocardial injury: effects on oxidative stress, inflammation and pyroptosis

  • Hongming Lv;Yvxi He;Jingjing Wu; Li Zhen ;Yvwei Zheng
    • Journal of Veterinary Science
    • /
    • 제24권1호
    • /
    • pp.2.1-2.14
    • /
    • 2023
  • Background: Hypothermia is a crucial environmental factor that elevates the risk of cardiovascular disease, but the underlying effect is unclear. Objectives: This study examined the role of cold stress (CS) in cardiac injury and its underlying mechanisms. Methods: In this study, a chronic CS-induced myocardial injury model was used; mice were subjected to chronic CS (4℃) for three hours per day for three weeks. Results: CS could result in myocardial injury by inducing the levels of heat shock proteins 70 (HSP70), enhancing the generation of creatine phosphokinase-isoenzyme (CKMB) and malondialdehyde (MDA), increasing the contents of tumor necrosis factor-α (TNF-α), high mobility group box 1 (HMGB1) interleukin1b (IL-1β), IL-18, IL-6, and triggering the depletion of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Multiple signaling pathways were activated by cold exposure, including pyroptosis-associated NOD-like receptor 3 (NLRP3)-regulated caspase-1-dependent/Gasdermin D (GSDMD), inflammation-related toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)-mediated nuclear factor kappa B (NF-κB), and mitogen-activated protein kinase (MAPK), as well as oxidative stressinvolved thioredoxin-1/thioredoxin-interacting protein (Txnip) signaling pathways, which play a pivotal role in myocardial injury resulting from hypothermia. Conclusions: These findings provide new insights into the increased risk of cardiovascular disease at extremely low temperatures.

승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰 (Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients)

  • 심형태;윤태진;박정준;정성호;엄주연;장원경;김영휘;고재곤;박인숙;서동만
    • Journal of Chest Surgery
    • /
    • 제40권8호
    • /
    • pp.536-545
    • /
    • 2007
  • 배경: 소아 환자에서의 승모판폐쇄부전은 성인에 비해 상대적으로 드물고 다양한 형태의 병변을 보인다. 또한 수술 기법도 덜 정형화되어 있으며 그 결과에 대한보고는 드물다. 본 연구는 이러한 다양한 원인에 의한 승모판페쇄부전이 있었던 소아 환자에 대해 시행된 승모판성형술의 결과를 후향적으로 분석하고자 하였다. 대상 및 방법: 1993년 12월부터 2006년 8월까지 승모판폐쇄부전으로 수술 받은 18세 이하의 환자 35명을 대상으로 하였다. 수술 당시 평균 연령은 $5.3{\pm}5.3$세였고 평균 체중은 $20.0{\pm}16.3kg$이었다. 술 전 승모판폐쇄부전의 정도는 Grade II가 9예, III, IV가 각각 16예, 10예였다. 18예에서 심장 기형을 동반하고 있었으며 심실중격결손이 9예로 가장 많았고, 주관상동맥-폐동맥 이상 연결증, 좌측 주관상동맥기시부 폐쇄 등도 각각 2예, 1예 있었다. 승모판의 병리적 소견은 판막엽의 탈출증이 17예로 가장 많았고, 판막에 열이 있는 경우가 7예, 짧은 건삭을 보인 경우가 6예, 판막륜의 확장을 보인 경우가 5예, 허혈성유두상근을 보인 경우가 2예, 유두상근형성부전이 1예 있었고, 심내막염에 의한 건삭파열이 1예 있었다. 승모판성형술은 이중입구성형술이 15예로 가장 많이 시행되었고, 봉합판막륜성형술 14예, 판막열 봉합술 7예, 유두상근 분리술 5예, 링을 이용한 판막륜 성형술 4예, 판막엽 절제술 4예, 신건삭 형성술 2예 각각 시행되었다. 술 후 평균 추적 관찰 기간은 $47.5{\pm}39.0$개월($2{\sim}138$개월)이었다. 결과: 수술 후 조기 사망은 없었다. 술 후 승모판폐쇄부전의 정도는 1명의 환자를 제외하고 모두 의미 있는 감소를 보였다. 8명(24.2%)이 재수술을 시행 받았고 이 중 5명은 승모판치환술을 받았다. 재수술의 원인으로는 승모판 협착이 3예, 잔류 승모판폐쇄부전이 5예였다. 승모판협착은 링을 이용하여 수술한 4명의 환자 중에서 2명이 발생하였고, 폐쇄부전은 이중입구성형술을 시행 받은 환자 14명중에서 4명에서 발생하였다. 재수술 후 조기 사망 1명, 만기 사망 1 명이 있었다. 환자들의 5년 생존율은 $93.3{\pm}4.6%$, 5년 재수술의 회피율은 $76.1{\pm}8.2%$, 5년 승모판치환술의 회피율은 $83.6{\pm}6.7%$였다. 통계학적으로 의미 있는 재수술의 위험인자는 발견할 수 없었다. 결론: 승모판폐쇄부전이 있는 소아 환자에서 시행된 승모판 성형술은 양호한 중단기 성적을 보였으나 비교적 높은 재수술의 가능성은 남아 있어 향후 재수술의 원인과 대책에 대한 좀더 깊이 있는 연구가 필요하다고 생각한다.

혈액펌프내 혈액 변성 예측에 대한 Lagrangian 및 Eulerian 기법의 평가 (EVALUATION OF LAGRANGIAN AND EULERIAN APPROACHES FOR PREDICTION OF HEMOLYSIS IN BLOOD PUMPS)

  • 홍성민;손창근;강성원;허남건;김원정;강신형
    • 한국전산유체공학회지
    • /
    • 제20권3호
    • /
    • pp.79-86
    • /
    • 2015
  • A blood pump is an important part of a cardiac assist device. Since the shear rate in blood is known to be a primary factor on hemolysis generation, it has been very important to evaluate hemolysis inside blood pumps for understanding performance and reliability of cardiac assist devices. In this study, hemolysis generation inside blood pumps is analyzed using CFD with power-law based models for the blood damage index(BDI), in order to overcome difficulties in measuring hemolysis by experiment. The BDI values in blood pumps can be evaluated using Lagrangian or Eulerian approaches. In this study, several Lagrangian and Eulerian approaches are compared to estimate the efficiency of the numerical methods in a practice sense. It is found that the Eulerian approaches are advantageous in terms of the efficiency and robustness. Two different Eulerian approaches are used to evaluate the BDI values of a few commercial blood pumps. For the conditions of extracorporeal membrane oxygenator(ECMO) and ventricular assist device(VAD), local generation of hemolysis is analyzed using divided regions of blood pumps, in order to investigate the effects of the pump geometry.