• Journal of Chest Surgery
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• 제22권4호
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• pp.601-608
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• 1989

We sought the relationship between the pulmonary artery development and cardiac performance from the analysis of the 36 cyanotic congenital heart disease patients [mainly TOF] who were operated and indwelled the pulmonary artery and left atrial pressure monitoring catheters for the postoperative care at the department of Thoracic and Cardiovascular Surgery SNUH in 1988. They were pre-evaluated of the pulmonary artery index from the cineangiographic films and post-operatively, calculated the cardiac index from the arterial and mixed venous blood gas and also measured the mean left atrial pressure and total inotropic supporting amount after operation. The post-operative cardiac indices were 3.46 * 1.03 1/min/M2 [immediate postoperative], 3.31 [ 1.08 [postoperative 6 hrs], 3.29 [ 1.01 [12 hrs], 3.54 * 1.02 [24 hrs], 3.92 * 1.14 [48 hrs], respectively. We divided the patients the group A and group B from the size of the pulmonary artery index, that is, group A was below 200 mm2/M2 and group B above 200 mm2/M2 of the pulmonary artery index. The cardiac indices and left atrial pressure between the group A and B were not different in the view of the statistical significance but the total post-operative inotropic amount of group A was more than group B and it was significant statistically. We concluded that the smaller the pulmonary artery index is, the more postoperative supportive treatment [for example, inotropics] for the enhancement of cardiac performance is needed, and indirectly, which means that the pulmonary artery index was correlated with the postoperative cardiac performance in cyanotic congenital heart disease.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.71-80
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• 1989

The adverse effect of diving on the fetus may extend beyond n gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestatred $PO_2$ level, the following question about the effect of exposing a pregnant female to high partial pressure of inspired oxygen has been raised. 'What effect does an increased maternal $PIO_2$ have on fetal arterial $PO_2$ and therefore on possible fetal oxygen poisoning?' This study was carried out to observe the effects of maternal hyperoxia on gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestation. The treatment groups were subjected to either the high concentration of oxygen, or the high atmospheric pressure. On day 21 of gestation, laparotomy was performed to examine for number and distribution of implantations and live and resorbing embryos. Fetuses were weighed, and examined for gross malformations. Subsequently, they were fixed, measured in physical parameters, and examined for visceral anomalies. Minor visceral anomalies and anatomical variation was not found. Similarily, there were no significant differences when number of resorptions, mean fetal weights, pregnancy interruption rate were compared by analysis of variance. These results indicate that exposing rats to oxygen at increased atmospheric pressure doese not affect fetal health or survival.

• The Korean Journal of Physiology and Pharmacology
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• 제21권6호
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• pp.667-674
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• 2017

Angiotensin II (Ang II) is metabolized from N-terminal by aminopeptidases and from C-terminal by Ang converting enzyme (ACE) to generate several truncated angiotensin peptides (Angs). The truncated Angs have different biological effects but it remains unknown whether Ang-(4-8) is an active peptide. The present study was to investigate the effects of Ang-(4-8) on hemodynamics and atrial natriuretic peptide (ANP) secretion using isolated beating rat atria. Atrial stretch caused increases in atrial contractility by 60% and in ANP secretion by 70%. Ang-(4-8) (0.01, 0.1, and $1{\mu}M$) suppressed high stretch-induced ANP secretion in a dose-dependent manner. Ang-(4-8) ($0.1{\mu}M$)-induced suppression of ANP secretion was attenuated by the pretreatment with an antagonist of Ang type 1 receptor ($AT_1R$) but not by an antagonist of $AT_2R$ or $AT_4R$. Ang-(4-8)-induced suppression of ANP secretion was attenuated by the pretreatment with inhibitor of phospholipase (PLC), inositol triphosphate ($IP_3$) receptor, or nonspecific protein kinase C (PKC). The potency of Ang-(4-8) to inhibit ANP secretion was similar to Ang II. However, Ang-(4-8) $10{\mu}M$ caused an increased mean arterial pressure which was similar to that by 1 nM Ang II. Therefore, we suggest that Ang-(4-8) suppresses high stretch-induced ANP secretion through the $AT_1R$ and $PLC/IP_3/PKC$ pathway. Ang-(4-8) is a biologically active peptide which functions as an inhibition mechanism of ANP secretion and an increment of blood pressure.

• Journal of Acupuncture Research
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• 제19권1호
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• pp.147-158
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• 2002

Objective : The aim of the present study is to investigate the effect of stimulation on different sites of the body on MBP(mean blood pressure) and HR(heart rate). Methods : Six healthy men have participated in this study. Before and after 10 min, exercise on a running machine of l0km/hr, acupressure, plain acupuncture and electroacupuncture(50Hz) stimulation was practiced on GV20, LI4, ST36, BL40 and non-acupoints on T4 and T10 respectively for 20 min. and in a control group without any treatment. The changes of MBP and HR after exercise have been observed for 20 min. at 5 minute intervals. Results : Compared with control, no significant difference was observed in research of the blood pressure measurement regardless of methods nor sites of stimulation. But there were trends of reduction in the heart rates in all experimental groups. Especially, in the group of acupressure on T10 before exercise, GV20, T10 after exercise and electroacupuncture on GV20, LI4, BL40 after exercise there was statistically significant decreases in heart rates. Conclusion : From the present experiment, it is concluded that somatic stimulation has effect on the heart rates but not on the blood pressures, and the presence of effective sites on the decreases of heart rates suggest that this effect may depend on sites of stimulation.

• The Korean Journal of Physiology
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• 제29권1호
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• pp.91-102
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• 1995

The role of neurohumoral mechanisms in the regulation of cardiovascular functions and the effects of ethanol (EOH) on these mechanisms were examined in hemorrhaged conscious Wistar rats. The rats were bled at a constant rate (2 ml/kg/min) through the femoral artery until mean arterial pressure (MAP) was reduced by 30 mmHg. We studied the responses to hemorrhage 1) under normal conditions (Normal), and after pretreatments with 2) neural blockade (NB), pentolinium, 3) arginine vasopressin V1-receptor antagonist (AVPX) + NB, 4) angiotensin II ATI-receptor antagonist (AngIIX) + NB, 5) combined humoral blockade (HB), and 6) neurohumoral blockade. Intravenous administration of 30% EOH (6.3 ml/kg) attenuated the baroreceptor reflex sensitivity, and enhanced the depressor action of AngIIX. During hemorrhage, NB produced a faster fall ill MAP than Normal both in the saline and EOH groups. However, HB accelerated the rate of fall in MAP only in the EOH group. The recovery from hemorrhagic hypotension was not different between NB and Normal rats, but was attenuated in HB rats in the saline group. Under NB, AngIIX, but not AVPX, retarded the recovery rate compared with NB alone. EOH attenuated the recovery of MAP after hemorrhage in Normal rats, but completely abolished the recovery in HB rats. We conclude that 1) the maintenance of MAP during hemorrhage is mediated almost entirely by the autonomic functions, 2) angiotensin II plays an important role in the recovery from hemorrhagic hypotension, but AVP assumes little importance, 3) AVP release largely depends on the changes in blood volume, whereas renin release depends on the changes in blood pressure rather than blood volume, and 4) EOH increases the dependence of cardiovascular regulation on angiotensin II and impairs the recovery from hemorrhagic hypotension through the attenuation of autonomic functions.

• 대한약침학회지
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• 제22권3호
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• pp.160-165
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• 2019

Objectives: The aim of this study was to evaluate the effect of Ribes khorasanicum (R. khorasanicum); a plant growing in north Khorasan of Iran; on cardiovascular and stress oxidative in acute hypertension induced by N-nitro-l-arginine methyl ester (L-NAME), anitric oxide synthase inhibitor. Methods: Rats were divided into Control, L-NAME (10 mg/kg), Sodium Nitroprusside (SNP) (50 mg/kg) + L-NAME and three treated groups with R. khorasanicum (4, 12 and 24 mg/kg) groups + L-NAME. L-NAME and SNP were injected intravenously and extract intraperitoneal. In R. khorasanicum groups, L-NAME was injected 30 min after injection of the extract. Systolic blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR) were recorded continuously using power lab software. At the end of study oxidative stress parameters including of total thiol content (SH), malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in heart and aorta of all groups were also measured. Results: In groups 4 and 24 mg/kg extract +L-NAME, there was a non-significant decrease in SBP and MAP compared to L-NAME group but dose 12 mg/kg significantly attenuate the effect of L-NAME(P < 0.05). In L-NAME group the heart and aorta tissues antioxidant enzymes levels decreased, while in treated rats these enzymes significantly increased. Conclusion: The extract of R. khorasanicum in dose 12 mg/kg show anti-hypertensive effect that is mediated by an effect on NO system or antioxidant parameters.

• 대한약침학회지
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• 제22권2호
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• pp.95-101
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• 2019

Objectives: Angiotensin II (AngII), a major product of renin-angiotensin system (RAS) has important role in induction of hypertension and antihypertensive effect of several medicinal plant was mediated by effect on this agent. Therefore, this study examined the possible effect of hydroalcoholic extract of Crocus sativus (C. sativus) on hypertension induced by AngII. Methods: Six groups (n = 6) of rats were used as follow: 1) Control, 2) AngII (300 ng/kg), 3) Losartan (Los, 10 mg/kg) + AngII and 4-6) C. sativus extract (10, 20 & 40 mg/kg,) + AngII. The femoral artery and vein were cannulated for recording cardiovascular parameters and drugs administration, respectively. All drugs were injected intravenously (i.v). Los and all doses of C. sativus injected 10 min before AngII. Systolic blood pressure (SBP), mean arterial blood pressure (MAP) and heart rate (HR) were recorded throughout the experiment and those peak changes (${\Delta}$) were calculated and compared to control and AngII. Results: AngII significantly increased ${\Delta}MAP$, ${\Delta}SBP$ and ${\Delta}HR$ than control (P < 0. 01 to P < 0.001) and these increments were significantly attenuated by Los. All doses of C. sativus significantly reduced peak ${\Delta}MAP$, ${\Delta}SBP$, and ${\Delta}HR$ than AngII group (P < 0. 05 to P < 0.001). In addition, peak ${\Delta}MAP$, ${\Delta}SBP$ in doses 10 and 20 were significant than Los + AngII group (P<0.05 to P< 0.01) but in dose 40 only MAP was significant (P<0.05). Peak ${\Delta}HR$ in all doses of C sativus was not significant than Los+ AngII. Conclusion: Regarding the improving effect of the C. sativus extract on AngII induced hypertension, it seems that this ameliorating effect partly mediated through inhibition of RAS.

• 한국임상수의학회지
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• 제21권2호
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• pp.168-171
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• 2004

The effects of alterations of dose of xylaznie (X) and Zoltil$\circledR$ (TZ) on canine anesthesia were examined. Experimental groups were divided into three (Group 1: X 1.1 mg/kg and TZ 10 mg/kg, Group 2: X 1.65 mg/kg and TZ 7.5 mg/kg, Group 3: X 2.2 mg/kg and TZ 5 mg/kg), and each had 5 dogs. A femoral artery was catheterized for measurement of blood pressure, and baseline value was measured. The dogs were sedated with xylazine intramuscularly, then after 10 minutes TZ were injected intravenously. Mean arterial blood pressures (MAP), duration of analgesia, mean arousal time (MAT) and mean walking time (MWT) after TZ injection were measured, and the depth of analgesia and the quality of recovery were scored. The values of MAP were recorded from the time of pre-xylazine injection to arousal. Duration of analgesia and was assessed by tail clamping test, and which were done at 10 minutes intervals after TZ injection. The decreases of MAP from 40 minutes after TZ injection were significant (p<0.05). In group 2, MAP at 20 minutes, and from 40 minutes to arousal were significantly decreased (p<0.05). In group 3, MAP were significantly decreased from 40 minutes. MAT were 62.2$\pm$9.2 minutes in group 1, 60.2$\pm$7.5 minutes in group 2, and 71.0$\pm$6.9 minutes in group 3. MAT in group 3 was significantly increased compared with group 2 (p<0.05), and the differences of MWT among each groups were not significant (p>0.05). The scores of quality of recovery were significantly lowered in group 3 compared with group 1 or group 2, which means the side effects of recovery were less occurred. Thus, it was considered that the combination X 2.2 mg/kg IM and TZ 5 mg/kg IV is more effective to surgical procedures and to prevent long and rough recovery of Zoletil anesthesia.

• Journal of Chest Surgery
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• 제21권4호
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• pp.672-680
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• 1988

Munro is generally considered the first person to have demonstrated, in 1888, in an infant cadaver, the feasibility of dissection and ligation of a persistently patent ductus arteriosus. In august, 1938, Robert Gross reported first successful division and suture of the patent ductus of 7 year old girl. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. Seventy-eight consecutive cases of closure of patent ductus arteriosus were operated from June 1980 to June 1988 in the department of thoracic and cardiovascular surgery in Maryknoll Hospital. Retrospective clinical analysis of the patients were 1. There were 24 males, 54 females. 2. The age range of the patients were from 7 months to 32 years with the mean age 9.8 years. 3. Chief complaints of the patients were frequent URI[70.5%], dyspnea on exertion[36.9%], palpitation[10.3%], but 15 patients[19.2%] had no subjective symptoms. 4. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 66 patients[84.6%]. The other 12 patients made systolic murmur. 5. Radiographic findings of the Chest P-A were cardiac enlargement in 55 patients[70%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 68 patients[87%]. 6. Electrocardiographic findings of the patients were within normal limit in 23 patients[36%], LVH in 38 patients[48.7%], RVH in 7 patients[9%], biventricular hypertrophy in 5 patients[6%]. 7. Cardiac catheterization performed in 62 patients. Mean Qp/Qs=2.5, mean pulmonary arterial pressure=45 mmHg. 8. 73 patients were operated through left posterolateral thoracotomy: Closure of the ductus by ligation in 64 cases, division with suture in 6 cases, and division with aortopatch in 3 cases. Ligation through median sternotomy under cardiopulmonary bypass were 5 cases. 9. There was no death associated with operation, but one case was experienced with intraoperative tearing of ductus resulting in massive bleeding. The other complications were transient hoarseness in 2 patients, chylothorax in 2 patients.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.206-215
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• 2007

복와위는 신체 후부 노출이 필요한 척추 수술을 위해 주로 사용되고 있으며 수술부위로의 접근이 용이하고 수술 도중에 척추를 안정적으로 유지해주는 장점이 있다. 하지만 전신마취하에 있는 환자를 앙와위에서 복와위로의 전환은 여러 가지 부작용을 동반하며 특히 순환기계의 변화를 초래할 수 있다. 이를 줄이기 위해 다양한 복와위 전용 수술대들이 연구 개발되어 임상에 사용되고 있다. 이에 저자들은 앙와위에서 복와위로의 체위 변환 시에 Jackson spinal surgery table의 이용이 체위에 의한 압박 때문에 생기는 환자의 순환기계 변화를 얼마나 효과적으로 줄여줄 수 있는지 알아보고자 하였다. 본 연구는 추간판탈출증, 퇴행성척추전방전위증, 척추협착증의 진단 하에 본원 정형외과와 신경외과에서 수술을 받기로 예정된 환자 중 미국 마취과학회 신체등급 분류 1급 또는 2급에 해당하는 성인 환자 30명을 대상으로 하였다. 연구 대상 환자의 성별은 남자가 15명, 여자가 15명이었고, 심혈관계나 호흡기계 질환이 있는 환자는 연구 대상에서 제외하였다. 모든 환자는 마취전투약으로 수술 시작 1시간 전에 glycopyrrolate 0.2 mg, fentanyl $1{\mu}g/kg$을 근주하였으며 수술실에 도착한 후 비침습적 자동 혈압 측정기, 심전도 및 맥박산소 계측기를 거치하였다. Thiopental sodium과 vecuronium으로 마취를 유도하였으며 환자의 의식소실과 충분한 근이완을 확인한 후 기관내 삽관을 시행하였다. Enflurane 1.5-2.0 vol%와 $O_2$, $N_2O$ 각각 2 L/min을 사용하여 마취유지를 하였으며 급격한 활력 징후의 변동으로 마취유지가 용의치 않은 경우는 연구 대상에서 제외시켰다. 환자의 활력 징후 안정 후 요골 동맥에 카테터를 거치하여 지속적으로 동맥압을 측정하였고, 우측 쇄골하 정맥에 중심정맥 카테터를 거치하여 중심정맥압을 측정하였다. 부분재호흡 심박출량 감시기 ($NICO^{(R)}$, Novametrix Medical Systems INC., USA)를 통해 비침습적으로 환자의 심박출량을 측정하였다. 앙와위에서 복와위로 체위변경 직전에 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 앙와위의 값으로 삼았으며, 척추 수술 전용 수술대인 Jackson spinal surgery table을 사용하여 복와위를 취하였다. 복와위로 체위 변경 뒤 심박출 계수, 심박출량, 평균동맥압, 심박수, 중심정맥압을 측정하여 복와위의 값으로 기록하였다. 본 연구 결과 앙와위와 복와위의 혈역학적 지수의 비교시 심박수와 평균동맥압은 별다른 차이가 없었다. 중심정맥압은 유의한 정도는 아니지만 감소 소견을 보여 수술시 출혈의 위험성을 감소시킬 것으로 생각된다. 심박출량과 심박출 계수도 유의한 감소 소견을 보였으나 convex saddle table을 이용한 경우와 kneechest position을 취한 경우보다 적은 변화를 보여 Jackson spinal surgery table의 사용은 유용할 것으로 사료된다. 그러나 Jackson spinal surgery table을 사용하여 복부와 흉부에 과도한 압력이 가해지지 않더라도 유의한 심박출량 감소가 있을 수 있음을 유념해야 할 것이다. 특히 심폐여력이 부족한 환자들에 있어서는 심박출량의 감소는 위험한 결과를 초래할 수 있으므로 복와위에 의한 생리적 변화에 관한 충분한 이해와 함께 마취 시 보다 적극적인 감시와 관리가 요구된다고 여겨진다.