• Title/Summary/Keyword: HgS

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Changes in Blood Pressure and Heart Rate during Decompressive Craniectomy

  • Jo, Kwang Wook;Jung, Hyun-Ju;Yoo, Do Sung;Park, Hae-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.957-965
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    • 2021
  • Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.

Early Clinical Outcome and Doppley Echocardiographic Data after Cardiac Valve Replacement with the ATS prosthesis (ATS 인공 판막의 조기 임상성적 및 도플러 심에코 검사 소견)

  • 박계현;박승우
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.663-669
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    • 1997
  • This is a report on the clinical outcome and hemodynamic profile of the ATSwcardiac valve prosthesis, which is a recently introduced pyrolytic carbon bileaflet prosthesis. We retrospectively reviewed the early outcome of 100 consecutive patients who underwent isolated cardiac valve replacement with the ATS(w prosthesis from October 1994 through June 1996 at our hospital. All patients were evaluated with Doppler echocardiography before discharge from the hospital. The mean age of the patients was 48.6 years(range: 2 to 74). A tota of 124 prosthesis were implanted; 71 mitral, 46 aortic, and 7 tricuspid. The two most frequently used sizes were 27 mm(40.8%) and 29 mm(35.2%) in the mitral position, and 23 mm(30.4%) and 21 mm(28.3%) in the aortic position. There was no early or late death. The total follow-up period was 950 patient-months with 99% follow-up rate. Serious late morbidity occurred in three patients; reoperation in two patients for late rupture of Sinus of Valsava in one and for endocarditis with prosthetic dehiscence in the other, and intracranial hemorrhage due to hypertension in one patient. There has been no thromboembolic complication or structural valval deterioration. In the mitral position, the average values of peak and mean transprosthetic pressure gradients and valve area calculated from pressure half time were 6.9$\pm$2.8 mmHg, 2.6$\pm$ 1.5 mmHg, and 2.7 $\pm$0.8 cm2 respectively. In the aortic position, the peak and mean pressure gradients'were 26.4 $\pm$ 15.9 mmHg and 14.2 $\pm$ 7.9 mmHg. For the mitra prostheses larger than 25-mm size, there was no significant difference among prosthetic sizes in terms of transprosthetic gradients, whereas there was a significant negative correlation between the prosthesis size and the transprosthetic gradients for the aortic valves. The peak and mean Pressere pradients were 52.2 $\pm$ 17.6 tmHg and 26.9$\pm$ 7.4 mmHg across the 19-mm aortic Prostheses, and 27.1 $\pm$ 11.9 mmHg and 13.3$\pm$6.6 mmHg across the 21-mm size. Above results can lead to the conclusion that the early clinical outcome of the ATS valve prosthesis is quite satisfactory, And the hemodynamic characteristics are comparable, if not better, with other bileaflet prostheses.

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A Study on Minimizing of Condenser Pressure Loss according to the Temperature Rise of the Seawater for Korean Standard Coal-fired Power Plants (표준석탄화력 발전소 해수온도 상승에 따른 복수기 압력 손실 최소화 방안)

  • An, Hyo-Yoel;Moon, Seung-Jae
    • Plant Journal
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    • v.11 no.2
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    • pp.45-51
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    • 2015
  • In this paper, studied condenser operating management which is affecting power plants efficiency considering the cost of poor quality. Sea water temperature and condenser pressure have clear correlation in S power plants. As the sea water temperature changes, condenser pressure changed -1.7~+20 mmHg from design condenser pressure(38.1 mmHg). Use the heat rate correction curve from manufactory company, realized that efficiency and cost of poor quality changed 0.0201%, 12,830 won/h at Unit #1,2 but 0.0155%, 9,832 won/h when condenser pressure 1 mmHg rise. Also, checked that it is changed depend on seasonal corresponding operation, plant ageing and the point of preventive maintenance like overhaul maintenance. This study said if we considered complying with management range and planning overhaul maintenance, then it could help reducing operating maintenance losses minimum 2.5 billion won per 1 year (case : Unit #1, forty days maintenance).

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A Case Report for the Effects of the Modified Fasting Therapy (Gamrosu) on Obese Patients with Hypertension (감로수 절식요법을 적용한 고혈압 비만환자 증례보고)

  • Kim, Dong-Hwan;Oh, Dal-Seok;Shin, Seung-Uoo;Shin, Hyun-Taeg
    • Journal of Korean Medicine for Obesity Research
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    • v.16 no.1
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    • pp.70-77
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    • 2016
  • Gamrosu was originally conceptualized from Jeho-tang, a selected thirst quencher of the kings in Chosun Dynasty and Saeng-Maek-san, a qi-vigorating summer beverage recommended by Dongeuibogam. It is a modified fasting therapy beverage which is manufactured from the single herbal medicines composed of those two prescriptions. This study was conducted on 6 obese patients with hypertension. A modified fasting therapy with Gamrosu was practised on them for 10 consecutive days. After the therapy, their average blood pressures were descended from 148/89 mmHg to 119/79 mmHg. The modified fasting therapy with Gamrosu is supposed to be more effective than general diet program or dietary sodium reduction on controlling hypertension. And, Gamrosu improves anti-hypertensive effect by reducing the side effects, such as fatigue, electrolyte imbalance, heartburn, nausea, and headache, during the modified fasting therapy.

A Study on Hemodynamic Characteristics at the Occlusion on Radial Artery (Radial artery occlusion 시 혈류역학적 특성변화)

  • Lee, Yu-Jung;Lee, Jeon;Ryu, Hyun-Hee;Kim, Jong-Yeol
    • Proceedings of the KIEE Conference
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    • 2008.07a
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    • pp.1989-1990
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    • 2008
  • 한의학에서 맥진은 한의사가 손가락으로 환자의 손목의 요골동맥을 짚어 맥박이 손가락에 닿는 느낌에 근거하여 병세를 감별하는 진찰방법으로 인체의 건강상태를 살피고, 정상인의 평맥(平脈)으로부터 환자의 병맥(病脈)을 분석하는 진단법이다. 손목에 있는 요골 경상돌기(styloid preocess) 부근의 볼록한 지점을 고골(高骨)이라하는데 이 돌기를 기준으로 맥이 느껴지는 위치를 검지, 중지, 약지를 이용해 진맥위치를 잡는다. 맥진 시 한의사는 맥진위치에 압력을 서서히 가하면서 손끝에 느껴지는 감각을 이용해 진단한다. 이 과정에서 맥진위치 요골동맥의 혈관이 서서히 occlusion 된다. 본 논문에서는 맥진과정 시 요골동맥의 혈류역학적인 변화를 초음파를 이용해 분석해보고자 한다. 건강한 남자 피험자(34세)를 대상으로 초음파 장비(Voluson 730Pro, GE Medical, U.S.)를 이용해 맥진 위치의 혈관특성을 관찰한다. 혈압계를 이용해 혈관에 압력을 0에서 130mmHg까지 10mmHg씩 단계별로 가압한 후 초음파를 측정한다. 그 결과, 요골동맥에 압력을 가할수록 혈류속도가 서서히 감소함을 알 수 있었으며, 회귀식을 분석할 수 있었다(y = -0.3509x +44.323, $R^2$ = 0.9547). 또한, 가압 단계를 0$\sim$10mmHg, 20$\sim$40mmHg, 50$\sim$70mmHg, 80$\sim$100mmHg 110$\sim$130mmHg으로 가압단계를 나누어 보면, 각 단계별로는 42.32cm/sec, 33.08cm/sec, 24.8cm/sec, 14.3cm/sec, 0cm/sec로 혈류속도가 변화를 보였다. 각 단계별로 혈류속도가 평균 10.58cm/sec의 차이를 보임을 알 수 있다. 본 연구를 통해 가압력에 대한 맥진위치의 혈류변화를 관찰하였다. 그러나 직접 맥진위치를 가압하면서 초음파를 통해 혈류속도를 측정할 수 있는 방법이 없어, 맥진 위치 바로 위쪽을 가압하고 초음파 측정을 하였다. 직접 혈관을 가압하고 그때의 혈류속도를 측정하면 보다 정확히 맥진시의 혈류역학적 특성을 분석할 수 있을 것으로 판단된다. 장비의 고안을 통해 다음 연구에서는 직접적인 가압 후 혈슈속도를 측정해 봄으로써 본 결과와 비교 분석해 보고자 한다.

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Isolation of $\alpha$-Amylase Hyperproducing Strain HG4 from Bacillus sp. and Some Properties of the Enzyme ($\alpha$-Amylase 생산성이 높은 Bacillus sp. HG4의 분리 및 효소 특성)

  • 김무성;오평수
    • Microbiology and Biotechnology Letters
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    • v.19 no.5
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    • pp.464-469
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    • 1991
  • An $\alpha$-amylase producing bacterium, strain 2B, was isolated from soil and identified to genus Bacillus. To enhance $\alpha$-amylase productivity, strain 2B was mutagenized successively with nitrosoguanidine. For an efficient selection of a-amylase hyperproducers, mutants which produced $\alpha$-amylase in the presence of glucose were isolated. The resultant mutant HG4, which was classified as constitutive and catabolite derepressed hyperproducer of a-amylase, produced about 30 folds more $\alpha$-amylase than parental strain in medium containing lactose as carbon source. The strain HG4 grew rapidly and produced enzyme in parallel with cell growth. Moreover, its cell lysis did not occur until time of maximal yield of enzyme, which was considered to be a favorable characteristic for the production and purificiation of enzyme in industrial scale. The enzymatic properties of parental strain 2B and mutant strain HG4 were almost the same. The optimal temperature and pH for enzyme reaction was $70^{\circ}C$ and pH 6.0, respectively, in 'the presence of 0.6mM $Ca^[2+}$ as an effective stabilizer.

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Transgenic Tobacco Plant Expressing Environmental E. coli merA Gene for Enhanced Volatilization of Ionic Mercury

  • Haque, Shafiul;Zeyaullah, Md.;Nabi, Gowher;Srivastava, P.S.;Ali, Arif
    • Journal of Microbiology and Biotechnology
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    • v.20 no.5
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    • pp.917-924
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    • 2010
  • The practicability of transgenic tobacco engineered to express bacterial native mercuric reductase (MerA), responsible for the transport of $Hg^{2+}$ ions into the cell and their reduction to elemental mercury ($Hg^0$), without any codon modification, for phytoremediation of mercury pollution was evaluated. Transgenic tobacco plants reduce mercury ions to the metallic form; take up metallic mercury through their roots; and evolve the less toxic elemental mercury. Transformed tobacco produced a large amount of merA protein in leaves and showed a relatively higher resistance phenotype to $HgCl_2$ than wild type. Results suggest that the integrated merA gene, encoding mercuric reductase, a key enzyme of the bacterial mer operon, was stably integrated into the tobacco genome and translated to active MerA, which catalyzes the bioconversion of toxic $Hg^{2+}$ to the least toxic elemental $Hg^0$, and suggest that MerA is capable of reducing the $Hg^{2+}$, probably via NADPH as an electron donor. The transgenic tobacco expressing merA volatilized significantly more mercury than wild-type plants. This is first time we are reporting the expression of a bacterial native merA gene via the nuclear genome of Nicotiana tabacum, and enhanced mercury volatilization from tobacco transgenics. The study clearly indicates that transgenic tobacco plants are reasonable candidates for the remediation of mercurycontaminated areas.

The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation (기관내삽관이 뇌압변동에 미치는 영향)

  • Kim, Heung-Dae;Chi, Yong-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.45-51
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    • 1985
  • It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and It may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylcholine injections. Intracranial pressure and MAP were measured in 13patients who underwent cramotomy. All the patients were monitored cerebral epidural ICP and intra-arterial pressure pre-operatively. The results were as follow: 1. Intracranial pressure was increased of $7.1{\pm}7.23mmHg$. 2. Arterial pressure was increased of $43.5{\pm}25.46mmHg$. 3. Cerebral perfusion pressure was increased of $33.3{\pm}27.53mmHg$. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.

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Hemodynamic study of Pneumatic Artificial Heart Implanted in Calves (송아지에 이식한 공기구동형 인공심장의 혈역학적 연구)

  • 박표원
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.438-451
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    • 1990
  • Pneumatic total artificial heart[TAH] has been clinically applied for the purpose of permanent or temporary use followed by cardiac transplantation in the patients with end stage heart diseases. In spite of the good durability of the pneumatic TAH, thrombus formation, bleeding and infection resulted in death. The Tomasu heart, which is a type of pneumatic TAH, was used in this study. This model is a modified Jarvik heart and consists of atrial cuffs, outflow vascular grafts and thin-layer seamless diaphragm type of ventricles. Cardiac outputs of the left artificial heart were measured by Donovan`s mock circulation under variable conditions of driving parameters, and an experimental artificial heart implantation was performed in 4 calves to observe the changes of hemodynamic parameters in early postoperative period and hematologic and bio-chemical changes in a long-term survival case. In the mock circulation test, cardiac output of the heart was increased with the increase of the left atrial pressure and left driving pressure. Maximum cardiac output was obtained at the heart rate of 120 to 130/min and percent systole of 40 to 45Zo under the condition of a constant left driving pressure of 180mmHg and left atrial pressure of 10mmHg. During the first 24 hours of TAH pumping, driving pressure ranged from 178$\pm$5mmHg to 187$\pm$8mmHg for the left heart and from 58$\pm$6mmHg to 78$\pm$28mmHg for the right heart. The Mean arterial pressure significantly increased between 2 and 8 hours after the start of pumping. The survival time ranged from 27 hours to 46 days. The causes of death were respiratory failure in 2 cases, mechanical valve failure in one, and left ventricular outflow obstruction due to thrombus in a 46-day survival case. This study demonstrated that Tomasu artificial heart operated effectively during the first 24 hours of artificial heart pumping, but thrombus formation around the valve holding area was the main problem in long-term survival case.

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Surgical treatment of Supravalvular Aortic Stenosis (판막상부 대동맥협착증의 외과적 요법)

  • 장우익;오삼세;이정렬;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.763-769
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    • 1998
  • Background: Supravalvular aortic stenosis is a rare form of congenital cardiac anomaly involving ascending aorta distal to coronary orifice. Materials and methods: We operated 12 cases of supravalvular aortic stenosis between July 1986 and March 1997. Age ranged from 4 to 17(mean 10.2) years and 11 of them were male. Nine patients had clinical features of Williams syndrome. We experienced two types of supravalvular aortic stenosis, including 10 hour glass type and 2 diffuse type. Results: Preoperative transaortic pressure gradient ranged from 40 to 180(mean 92) mmHg by cardiac catheterization. Pulmonary stenosis was associated in 5 and 2 of them required angioplasty. Operative techniques included 6 standard aortoplasty with elliptical patch, 4 extended aortoplasty with inverted Y shaped patch, and 2 modified Brom's repair. There were no operative deaths. Postoperative echocardiographic evaluation was done at a mean interval of 12 months. Grade I or II aortic regurgitation was found in 3 cases. Postoperative cardiac catheterization revealed a mean transaortic pressure gradient of 26 (range 0 to 75) mmHg. A mean pressure drop was 78(range 30 to 114) mmHg. All patients were followed up for a mean of 40(range 1 to 67) months with uneventful clinical course. Conclusions: Our data proved the low mortality and excellent hemodynamic improvement after surgical relief of supravalvular aortic stenosis in children.

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