• Journal of Chest Surgery
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• 제17권1호
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• pp.32-40
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• 1984

During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

• Journal of Chest Surgery
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• 제20권3호
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• pp.520-527
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• 1987

Clinical analysis was performed of 89 secundum type atrial septal defect patients operated on during the period from July, 15th, 1981 to March, 1987 in the Thoracic and Cardiovascular Surgery Department of Pusan National University Hospital. Secundum type ASD was 2`I.0% among all of congenital heart diseases operated in the same period. The age distribution of patients ranged from 3 to 41 years and sex ratio, male to female was 1.23 to 1.0. Common symptoms were exertional dyspnea 64.0%, frequent upper respiratory infection 43.8%, cyanosis 10.1% and fatigue 7.9%. The mean value of cardiac catheterization data of the group of ASD combined with another cardiovascular anomalies was compared with that of only ASD group. The amount of shunt showed not statistically significant difference between two groups [P>0.05] but pulmonary arterial pressure and pulmonary vascular resistance of combined group was significantly higher than that of only ASD group [P<0.02, P<0.01]. The difference of mean hemodynamic data between the age group below 20 years and above 21 years was not statistically significant [P>0.05]. All cases were operated under cardiopulmonary bypass. Among these 51 were closed directly and 38 were applied Dacron patch. Two most common associated cardiac anomalies were pulmonary stenosis [8 cases, 9.0%] and VSD [8 cases, 9.0%]. The most frequent postoperative complication was wound infection, One patient died of low cardiac output on 10th postoperative day and the overall operative mortality was 1.1%

• Journal of Chest Surgery
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• 제14권3호
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• pp.187-194
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• 1981

Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권3호
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• pp.169-175
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• 2018

Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

• Tuberculosis and Respiratory Diseases
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• 제39권1호
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• pp.42-54
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• 1992

연구배경 : 내독소 투여시 혈장과 폐의 림프내에 cyclooxygenase 대사물과 lipoxygenase 대사물이 모두 증가하고, cyclooxygenase 차단제로 초기의 혈역학적 변화가 완화되어 내독소에 의한 급성 폐손상의 기전에서 cyclooxygenase 대사물의 역할이 중요시 되고 있다. 그러나 cyclooxygenase 억제약물이 내독소 투여시 후기에 관찰되는 폐혈관 투과성 증가에 미치는 효과에 대해서는 논란이 있는 실정이고 cyclooxygenase 대사과정에 관여하는 peroxidase에 의해서 산소기가 생성된다고 알려져 있어 cyclooxygenase 대사물이 직접 폐손상을 일으키는지 또는 대사과정에서 생성되는 산소기를 통해 간접적으로 관여 하는지는 확실히 규명되어 있지 않은 상태이다. 저자들은 cyclooxygenase 대사물이 내독소에 의한 급성 폐손상의 기전에 직접적 또는 간접적으로 관여하는지를 알아보기 위해 본 연구를 시행하였다. 방법 : 총 8마리의 집돼지를 내독소 투여군(n=3)과 indomethacin 전처치 후 내독소를 투여한 군(n=5)으로 나누어 시간 경과에 따른 혈력학적 지표의 변화, 혈장내 산화 glutathione(GSSG) 및 기관지폐포세척액내의 알부민 농도를 측정하여 indomethacin 전처치가 내독소에 의한 급성 폐손상에 미치는 영향을 관찰하였다. 결과 : 1) 내독소 투여 후 phase 1(0-2 hr)과 phase 2(2-4.5 hr)에 걸쳐서 심박출양은 감소되고 평균 폐동맥압, 폐혈관저항, 폐포동맥간산소분압차는 증가되었으며 indomethacin 전처치로 두 phase의 변화가 모두 완화되었다. 2) phase 2에서 내독소에 의해 GSSG가 기저치에 비해 유의하게 증가했는데 indomethacin 전처치로는 완화되지 않았다. 3) 기관지폐포세척액내 알부민농도와 투과성지표는 내독소 투여군에 비해 indomethacin 전처치군에서 유의하게 낮았다. 결론 : 이상의 결과로 내독소에 의한 돼지의 급성 폐손상에는 cyclooxygenase 대사물이 초기와 후기 모두에 관여할 것으로 생각되고 indomethacin이 산소기에 의한 산화반응에 영향을 미치지 않는 것으로 보아 산소기를 통한 간접작용보다는 cyclooxygenase 대사물이 직접 병인론적 기전에 관여할 것으로 사료된다.

• The Korean Journal of Physiology and Pharmacology
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• 제20권6호
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• pp.621-628
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• 2016

Hypertension can be caused by various factors while the predominant causes include increase in body fluid volume and resistance in the circulatory system that elevate the blood pressure. Consumption of probiotics has been proven to attenuate hypertension; however, the effect is much strain-dependent. In this study, a newly isolated Lactobacillus casei (Lb. casei ) strain C1 was investigated for its antihypertensive properties in spontaneously hypertensive rats (SHR). Lactic acid bacteria (LAB) suspension of 11 log colony-forming unit (CFU) was given to SHR (SHR+LAB, n=8), and phosphate buffer saline (PBS) was given as a control in SHR (SHR, n=8) and in Wistar rats as sham (WIS, n=8). The treatment was given via oral gavage for 8 weeks. The results showed that the weekly systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP) and aortic reactivity function were remarkably improved after 8 weeks of bacterial administration in SHR+LAB. These effects were mostly attributed by restoration of wall tension and tensile stress following the bacterial treatment. Although not statistically significant, the level of malondialdehye (MDA) in SHR+LAB serum was found declining. Increased levels of glutathione (GSH) and nitric oxide (NO) in SHR+LAB serum suggested that the bacterium exerted vascular protection through antioxidative functions and relatively high NO level that induced vasodilation. Collectively, Lb. casei strain C1 is a promising alternative for hypertension improvement.

• The Korean Journal of Physiology
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• 제18권2호
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• pp.171-180
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• 1984

The death of cattle from acute bracken poisoning has been recognized for many years. Acute bracken poisoning is characterized by mucoidal nasal and anal hemorrhage, severe anorexia. pyrexia, gastric ulcer and myocardial damage. In 1958 Evans first suggested that clinical picture of bracken poisoning was very much similar to that of radiation injuries such as aplastic anemia, leucopenia, thrombocytopenia and increased capillary fragility. Bracken has been clearly demonstrated to contain a carcinogen as well as thiaminase. However, the nature of carcinogen in bracken has not definetely elucidated. Also it was warned by several workers that bracken could be a causative factor for stomach cancer in Korean and Japanese. It appears that little is known on the e(feet of bracken on the function of cardiovascular system. Therefore the present study was designed to explore effects of ethanol extract of raw and toiled bracken (RBEE:BBEE) on blood pressure in cats. Also studied was the mechanism underlying changed in blood pressure of cats by bracken. The result obtained were as follows; 1) Mean arterial blood pressure was invariably decreased following administration of either RBEE or BBEE. Tn general depressor responses to RBEE persisted longer than that to BBEE. Generally, depressor responses were proportional to debases of RBEE and BBEE administered. 2) After administration of 60 mg/kg RBEB and BBEE, blood Pressure decreased by $62.1{\pm}1.7mmHg$ and $68.0{\pm}3.0mmHg$, respectively. No change was observed between depressor responses to RBEE and that to BBEE. 3) Depressor responses to BBEE and RBEE were not affected by vagotomy, propranolol and regitine. 4) In atropinized animal depressor responses to BBEE and RBEE were reduced by 30-40% showing part of depressor response was resulted from cholinergic effect of bracken.

• 생명과학회지
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• 제23권2호
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• pp.157-166
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• 2013

본 연구는 Sprague-Dawley계 숫쥐에서 출생 초기 에탄올에의 노출에 의한 성장 후 뇌혈류 자가조절의 변동을 관찰하고 이러한 변동에 대한 nociceptin의 관여를 관찰하고자 하였다. 실험동물에게 에탄올 2.5 g/kg을 생후 6, 7 및 8일의 3일 동안 2시간 간격으로 1일 2회 피하 주사하였다. 주령 4, 8 및 12주 시기에 단계적 출혈에 의한 저혈압 및 혈액 재주입에 의한 혈압 상승시의 평균동맥혈압의 변동에 따른 국소 뇌혈류 변동을 laser-Doppler flowmetry 방법으로 측정하였고, 경막과 대뇌피질에서 nociceptin-유사 면역반응력의 발현을 면역조직화학법으로 측정하였다. 출생 초기 에탄올 투여는 4, 8 및 12주령 모두에서 국소 뇌혈류 자가조절 기능을 거의 소실시켰다. 에탄올 투여 전에 nociceptin을 전처치한 군에서는 모든 연령군에서 국소 뇌혈류 자가조절 기능이 보존되었으나, nociceptin 수용체 선택적 경쟁적 길항제인 [$Nphe^1$]nociceptin(1-13)$NH_2$를 전처치한 군에서는 보존되지 아니하였다. 출생 초기 에탄올 투여에 의하여 경막 내 nociceptin-유사 면역반응력이 모든 연령군에서 현저히 증가하였고, 7-nitroindazole (7-NINA) 전처치뿐만 아니라 aminoguanidine 전처치에 의하여 모든 주령에서 유의하게 억제되었다. 출생 초기 에탄올 투여에 의하여 대뇌피질 내 nociceptin-유사 면역반응력이 모든 연령군에서 현저히 증가하였고, 7-NINA 전처치와 aminoguanidine 전처치에 의하여 모든 주령에서 유의하게 억제되었다. 모든 실험군의 동맥혈가스분석 결과는 실험 전, 중 및 후에 유의한 차이를 보이지 아니하였다. 이상의 결과로 보아 출생 초기 에탄올 투여는 성장 후 뇌혈류 자가조절에 변동을 초래하고, 이에 대한 보상기전으로서 nociceptin의 발현이 증가하는데, 여기에는 nitric oxide가 깊이 관여하는 것으로 생각된다.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.23-30
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• 2020

Purpose: Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations. Methods: This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups. Results: We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%. Conclusions: Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.

• 대한의용생체공학회:의공학회지
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• 제25권6호
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• pp.605-609
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• 2004

혈압은 심혈관계 질환을 비침습적인 방법으로 진단할 때 사용하는 중요한 생리적 지표 중 하나이다. 보통 동맥 혈압을 측정하기 위해 사용되는 기존의 비침습적인 방법들은 커프를 사용해야 하며. 연속적 혈압 측정이 어렵다. 수축기 혈압과 맥파전달시간은 서로 반비례 관계를 가지고 있다. 실험은 피검자로부터 휴식을 통한 평온한 상태와 운동을 통한 격한 상태로부터 수축기 혈압과 맥파전달시간 데이터를 얻었다. 얻어진 데이터를 이용하여 각 피검자용 회귀식과 전체 피검자용 회귀식을 만들기 위해 선형회귀분석을 하였다. 만들어진 회귀식의 정확도를 검증하기 위해 측정한 수축기 혈압값과 예측한 수축기 혈압값을 비교하였다. 비교 결과, 각 피검자용 회귀식이 혈압계는 오차의 평균과 표준편차가 각각 ±5mmHg, 8 mmHg를 가져야 된다고 규정한 American National Standards Institute of the Association of the Advancement of Medical Instrument (ANSI/AAMI)에 적합하였다. 그러나 전체 피검자용 회귀식은 ANSI/AAMI의 규정에 적합하지 않았다. 이 결과는 맥파전달시간과 각 피검자에 맞는 초기 보정을 통해서 커프를 사용하지 않고, 연속적으로 수축기 혈압을 측정할 수 있음을 의미한다.