• Title/Summary/Keyword: Hypothermia

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Effect of Intracarotid Cold Saline Infusion during Cerebral Ischemia on Brain Edema in the Rabbit (뇌허혈기동안 경동맥으로 냉각 생리식염수 주입이 허혈후 뇌부종에 미치는 영향)

  • Kim, Sae-Yeon;Choi, Kyu-Taek
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.260-268
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    • 1995
  • Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild brain hypothermia which was induced by infusion with cold saline into the carotid artery, during brief episodes of transient global ischemia on postischemic brain edema in rabbit. Eight rabbits were anesthetized with halothane and mechanically ventilated with oxygen. For isolated cerebral perfusion, polyethylene catheter was inserted left carotid artery for infusion of cold saline, external carotid artery was ligated, vertebral arteries were cautherized, right carotid artery was snared for ischemia and femoral artery and vein were also canulated for monitoring and drug treatment. At 3 hours After transient global ischemia, specific gravity of cerebral cortex and hippocampus was compared with no-perfusion group , perfusion with cold saline group and normal group. There was no significant differences in physiologic variables among the groups before transient global ischemia. But during transient global ischemia, brain temperature of perfusion group was decreased when compared to no perfusion group. Specific gravity of cerebral cortex and hippocampus of no-perfusion group and perfusion group was statistically significant when compared to normal group (p<0.01). The results of this study suggested that mild brain hypothermia with intracarotid cold saline infusion during brief episodes of transient global ischemia had decreased postischemic brain edema in rabbit.

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Resection and Prosthetic Replacement of Aneurysm of Aortic Arch (대동맥궁 동맥류 -치험 1례 보고-)

  • Ahn, Hyuk;Kim, Young-Jin;Rho, Joon-Rhang
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.274-279
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    • 1980
  • A 21 years old male student was admitted because of mediastinal mass that was noticed in routine physical examination. He complained progressive hoarseness, mild dysphagia, and anterior chest pain on deep respiration. This mediastinal mass was diagnosed as aortic aneurysm involving ascending, transverse, and descending thoracic aorta with aid of aortogram. Total prosthetic replacement of aneurysm was performed successfully using extracorporeal circulation and hypothermia. For myocardial protection during aortic cross clamping, cardioplegic solution was used and topical myocardial cooling was also adapted For simplicity of cardiopulmonary bypass, Y-shaped connectors took cerebral perfusion catheters to the main perfusion line beyond the arterial pump. Total bypass time was 219 minutes, and aortic cross clamp time was 104 minutes. Recovery was uneventful except respiratory insufficiency for first 4 days. Isotope aortogram checked on post operative 30th day showed normal aortic configuration. He was discharged on post operative 35th day. A follow-up chest X-ray study 5 months later showed nearly normal anatomy.

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Effects of the Heated-Humidified Breathing Circuit Applied on the Body Temperature, Shivering, and Thermal Comfort of General Anesthesia Patients (가온가습호흡회로 적용이 전신마취 환자의 체온, 전율, 온도 편안감에 미치는 효과)

  • Son, Won Mi;Park, Jung Suk
    • Journal of East-West Nursing Research
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    • v.26 no.2
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    • pp.149-156
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    • 2020
  • Purpose: The purpose of this study was to identify the effects of the heated-humidified breathing circuit applied on the body temperature, shivering, and thermal comfort of general anesthesia patients. Methods: The participants were patients who received general anesthesia at University Hospital K located in City B, with 25 patients in the experimental group and 25 patients in the control group. The period of this study was from Mar 19 to Apr 26, 2019. The experimental equipment included a heated-humidified breathing circuit, which connects the intubation tube with the anesthesia machine for mechanical ventilation after airway intubation in general anesthesia patients. Results: The body temperature, shivering, and thermal comfort after surgery were significantly different between the two groups (p<.001). However, the body temperature during surgery was slightly different between the experimental group and the control group. Conclusion: A heated-humidified breathing circuit may be actively used in a warming method to prevent the hypothermia of general anesthesia patients.

Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue

  • Ku, Min Jung;Kim, Su Wan;Lee, Seogjae;Chang, Jee Won;Lee, Jonggeun
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.258-262
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    • 2020
  • Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31). Results: Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26℃ were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A. Conclusion: Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.

An Integrative Review and Meta-analysis of Oncology Nursing Research : 1985-1997.2 (국내 암환자와 관련된 연구논문의 메타분석 - 실험연구를 중심으로 -)

  • 임선옥;홍은영
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.857-870
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    • 1997
  • The purposes of this study were to describe 12 years of patient-related oncology nursing research in Korea, identifying various nursing interventions, and assesing the effectiveness of the interventions, through analysis and synthesis of the accumulated research papers. One hundred and seventy-nine studies were selected for this study and these were mostly descriptive in design (69.2%). Of the 179 studies, 25 met the criteria for meta-analytic treatment. Twenty-five experimental studies were found in theses and dissertations (68%), 92% used convenience sample, and the median sample size was 40. Subjects were predominantly in treatment and rehabilitation (76%). Most studies(68%) were not derived from a theory base, with only 8% reporting use of a nursing theory. Results of the meta-analysis are as follows. The effect size of the nursing intervention type was found to be significantly effective. The standardized mean difference ranged from a high positive of 2.55 to a low negative of -0.22. Direct personal nursing intervention method was more effective than indirect group method. Two nursing intervention methods were more effective than one. The greatest effect size was thyxical intervention. The greatest mean effect size was scalp hypothermia technique. Teaching was a frequent intervention after 1990, although a wide range of treatments were studied. Effect size of intervention for symptom management was largest in relieving pain. Effective intervention method for relieving anxiety was exercise.

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Short-Term Cold Exposure May Cause a Local Decrease of Neuropeptide Y in the Rat Hypothalamus

  • Park, Joong Jean;Lee, Heung Kyung;Shin, Min Woo;Kim, Sung Jin;Noh, Seung Yeon;Shin, Jin;Yu, Woo Sung
    • Molecules and Cells
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    • v.23 no.1
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    • pp.88-93
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    • 2007
  • Neuropeptide Y (NPY) is an orexigenic and hypothermic peptide. To understand its role in hypothermic conditions, male rats were placed in a $24^{\circ}C$ or $4^{\circ}C$ air chamber for 1.5 h. The expression of c-Fos protein, and NPY mRNA and protein, was analyzed in the hypothalamus 1 h-2 h later. The cold treatment increased the number of c-Fos-immunoreactive cells in the paraventricular hypothalamic nucleus (PVN) and arcuate nucleus (ARC). At the same time it decreased the density of NPY-immunoreactive components in the PVN, dorsomedial hypothalamic nucleus and ARC, as well as of NPY transcripts in the PVN and ARC. No colocalization of c-Fos with NPY was detected. These results suggest that short-term cold exposure should reduce indirectly NPY production in some hypothalamic nuclei to facilitate thermogenesis without inducing feeding behavior.

봉독약침을 이용한 반사성 교감신경 이영양증의 치료 -치료 전후 적외선체열영상 비교-

  • Lim, Myung-Jang;Kang, In;Song, Joo-Hyun;An, Keon-Sang;Jang, Hyoung-Seok
    • Journal of Pharmacopuncture
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    • v.9 no.3 s.21
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    • pp.139-145
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    • 2006
  • Objectives : The purpose of this case in so report the patient with Reflex sympathetic dystrophy, who is improved by Bee venom. Method : We treated the patient with Bee venom who was suffering from Reflex sympathetic dystrophy, using Digital Infrared Thermographic Imaging and Verbal Numerical Rating Scale(VNRS) to evaluate the therapeutic effects. We compared the temperature of the patient body before and after treatment. Result and Conclusion : We found that Bee venom had excellent outcome to relieve pain, atrophy and ankle joint ROM, and that Bee venom also had clinical effect on hypothermia on the Digital Infrared Thermographic Imaging.

Design & Animal Experiment of Artificial Oxygenator (인공폐(산화기) 제작과 실험)

  • 김형묵
    • Journal of Chest Surgery
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    • v.15 no.2
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    • pp.259-265
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    • 1982
  • We have designed a new type of bubble oxygenator (KOREA-KIM VENOTHERM OXYGENATOR) made of PVC sheet and deforming mesh incorporated in the heat exchanger, and evaluated in experimental animal for the analysis of it`s efficiency. The Oxygenator has low priming volume with high flow rate up to 6 L/rain, and efficiency of heat exchanger was excellent as 1-$1.5^{\circ}C.$ using total cardiopulmonary bypass method under moderate to deep hypothermia. Average priming volume of 1317 ml with 30% hemodilution method was perfused with an average of 1.1-3.0 L/min.$M^2$of arterial blood and pure oxygen at a rate of 2-3.4 L/min for 49.6 minutes continuously in average. During total cardiopulmonary bypass, average $PaO_2$ was $159.8{\pm}60$mmHg, $PaCO_2$ $41.0{\pm}3$mmHg respectively under $SaO_2$ over 96% with systolic arterial pressure of 70 mmHg and CVP of 5-10 cm$H_2O$. Plasma free Hemoglobin was $7.0{\pm}4$ mg/dl with 25% drop of hemoglobin and hematocrit at the end of cardiopulmonary bypass. This KKV Oxygenator was observed to have excellent capabillty of oxygen and carbon dioxide gas transfer with small amount of blood trauma, and the efficiency of heat exchanger was satisfactory during cooling and rewarming of the bubbled blood. Disadvantages have included the somewhat poor deforming effect due to loose PVC fiber mesh, the extracompact character of Teflon filters, and the rough inner surface of the heat exchanger copper pipes.

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A Comparative Study of Antegrade Cardioplegia Versus Retrograde Cardioplegia for Myocardial Protection during the Open Heart Surgery (순행성 관관류법과 역행성 관관류법의 임상적 비교연구)

  • 조완재
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.609-619
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    • 1989
  • During aortic valve surgery, cardioplegic solution is delivered through direct cannulation of both coronary ostia. Since this approach may cause an intimal injury leading to acute dissection or late ostial stenosis, this study was undertaken to evaluate myocardial protective effect of retrograde perfusion of cardioplegia [RCSP <% RRAP] in 18 clinical cases, which were compared with antegrade perfusion of cardioplegia in 27 clinical cases. This study were investigated 1] cease and return of electromechanical activity after cardioplegia infusion 2] the myocardial temperature during operation 3] the aortic cross clamping time and total bypass time 4] frequency of DC shock for defibrillation 5] need for inotropic drugs after operation 6] electrocardiographic evidence of myocardial infarction or ventricular arrhythmia after operation 7] the enzymes activity during preoperative and postoperative period as an evaluation of myocardial ischemic injury and 8] operative mortality rate The combination of retrograde cardioplegia and topical cooling with ice slush yielded promptly hypothermia of myocardium and shorter aortic cross-clamping time compared with antegrade cardioplegia [P < 0.05]. The temperature of the interventricular septum was maintained below 20oC by continuous perfusion or intermittent perfusion of cold blood cardioplegia and other results were no statistically significant difference between the two methods [P >0.05]. This technique provides clear operative field and avoids some serious complications which are caused by coronary ostial cannulation. These results suggested that the retrograde perfusion of cardioplegia is a simple, safe, and effective means of myocardial protection during open heart surgery.

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Budd-Chiari Syndrome Resulting from a Membranous Obstruction of the Inferior Vena Cava -8 Case Report- (하공정맥 막성폐쇄에 의한 Budd-Chiari증후군의 치료)

  • Kim, Dong-Won;Kim, Jun-U;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.268-273
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    • 1995
  • Budd- chiari syndrome resulting from a membranous obstruction of the inferior vena cava[IVC is a rare congenital anomaly. From January 1989 to December 1993, 8 cases of IVC obstruction was treated in Kyung Hee Univ. Hospital. There were 2 male and 6 female patients between 34 and 66 years of age[mean 47.3$\pm$11.9 years of age . 4 patients were treated with angioplasty by balloon catheter and 4 patients were treated with operative correction using cardiopulmonary bypass, profound hypothermia and total circulatory arrest. These 4 patients were repaired the constricted IVC with autologous pericardial patch. In surgically treated patients, all of the specimens were confirmed to be membranous web histopathologically. Postoperative outcome in operative correcting patients was uneventful and postoperative angiography showed unobstructed flow through the IVC with filling of the hepatic veins.The above 8 patients were followed up from 10 months to 56 months [ mean 36.43 17.24 months and recurrent IVC obstruction or stenosis was not seen.

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