• 한국임상수의학회지
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• 제28권3호
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• pp.291-296
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• 2011

돼지에서 medetomidine-ketamine (MK) 합제에 대한 마취효과와 이 합제에 대한 atipamezole (MKA) 과 yohimbine (MKY)의 길항효과를 비교하였다. 24 마리 Landrace - Yorkshire 혼혈 종 돼지를 사용하였다. Medetomidineketamine 는 한 주사기로 근육주사 하였고 atipamezole 과 yohimbine 은 마취 후 20 분에 정맥 주사 하였다. 평균마취시간, 평균흉와시간, 평균기립시간 및 평균보행시간은 MKA와 MKY군에서 MK군보다 유의적으로 짧았다. 그러나 MKA군과 MKY군간의 유의적인 차이는 없었다. 평균혈압은 MKA와 MKY군에서 MK군보다 유의적으로 낮았다. 결론적으로 Medetomidine-ketamine 에 의한 마취 및 혈압 상승 효과는 atipamezole과 yohimbine 에 의해 안전하고 빠르게 길항되었다. 따라서 atipamezole과 yohimbine은 돼지에서 Medetomidine-ketamine 마취를 길항하는 데 안전하고 효과적으로 사용될 수 있다.

• Journal of Chest Surgery
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• 제19권1호
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• pp.50-57
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• 1986

Sixty-nine patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] prosthesis between 1979 and 1985. Their ages ranged from 2 months to 39 years [mean$\pm$SD: 5.2$\pm$7.4, median: 3.3 years]. Diagnosis included the following: Tetralogy of Fallot, 45: Double outlet right or left ventricle, 11: Single ventricle, .5: Transposition of great vessels, 4: Tricuspid atresia, 3 and Pulmonary atresia with intact ventricular septum, 1. Forty-eight patients had subclavian-pulmonary artery anastomosis, 12 patients aorta-right pulmonary artery anastomosis, 6 patients aorta-main pulmonary artery anastomosis, and 3 patients descending aorta-pulmonary artery anastomosis. The PTEE graft of 3 mm in diameter was used in 1, 4 mm in 29, 5 mm in 35 and 6 mm in 4 patients. Ten patients were died within 30 days after operation [mortality rate: 14.5%]. Among them, 6 patients were operated in urgency due to cardiac arrest or severe anoxic spell after cardiac catheterization, and so surgical mortality of elective operation is 9.5%. The 59 survivors showed improvement of the arterial oxygen saturation [65.4% - 9.8%] and hemoglobin [18.8 gm/dl - 16.0 gm/dl] values [V<0.01]. The follow up period ranged from 1 month to 67 months, [752 patient-months] and during this periods there were 4 late shunt failures after 3 months postoperatively with 4 mm graft, and 2 with 5 mm graft. The over-all patency rate of 4 mm PTFE was 85.9$\pm$9.2% [SEM] in 12 months and 40.9$\pm$22.5% in 24 months. The over-all patency rate of 5 mm PTFE was 87.5$\pm$9.6% in 12 months and 58.3$\pm$24.6% in 36 months. The lowest systolic pressure in death group was 64.9$\pm$15.0 mmHg and in survival group, 86.4$\pm$12.1 mmHg [P<0.001]. We think that the PTFE graft is useful in palliative shunt operation, but the effectiveness of the 4 mm PTFE graft may be limited. The blood pressure also may play an important role in patency of Prosthesis.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.1-10
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• 2022

Pulmonary hypertension (PH) is a condition of increased blood pressure in the pulmonary arteries and is diagnosed with an increased a mean pulmonary artery pressure ≥25 mm Hg. This condition may be associated with multiple clinical situations. Based on pathophysiological mechanisms, clinical presentation, hemodynamic profiles, and treatment strategies, the patients were classified into five clinical groups. Although there have been major advances in the management of PH, it is still associated with significant morbidity and mortality. The diagnosis and treatment of PH have been performed mainly by following European guidelines, even in Korea because the country lacks localized PH guidelines. European treatment guidelines do not reflect the actual status of Korea. Therefore, the European diagnosis and treatment of PH have not been tailored well to suit the needs of Korean patients with PH. To address this issue, we developed this guideline to facilitate the diagnosis and treatment of PH appropriately in Korea, a country where the consensus for the diagnosis and treatment of PH remains insufficient. This is the first edition of the guidelines for the diagnosis and treatment of PH in Korea, and it is primarily based on the '2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.' with the acceptance and adaptation of recent publications of PH.

• Nutrition Research and Practice
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• 제6권2호
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• pp.126-131
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• 2012

The purpose of this study was to determine the effects of beverage temperature and composition on weight retention and fluid balance upon voluntary drinking following exercise induced-dehydration. Eight men who were not acclimated to heat participated in four randomly ordered testing sessions. In each session, the subjects ran on a treadmill in a chamber maintained at $37^{\circ}C$ without being supplied fluids until 2% body weight reduction was reached. After termination of exercise, they recovered for 90 min under ambient air conditions and received one of the following four test beverages: $10^{\circ}C$ water (10W), $10^{\circ}C$ sports drink (10S), $26^{\circ}C$ water (26W), and $26^{\circ}C$ sports drink (26S). They consumed the beverages ad libitum. The volume of beverage consumed and body weight were measured at 30, 60, and 90 min post-recovery. Blood samples were taken before and immediately after exercise as well as at the end of recovery in order to measure plasma parameters and electrolyte concentrations. We found that mean body weight decreased by 1.8-2.0% following exercise. No differences in mean arterial pressure, plasma volume, plasma osmolality, and blood electrolytes were observed among the conditions. Total beverage volumes consumed were $1,164{\pm}388$, $1,505{\pm}614$, $948{\pm}297$, and $1,239{\pm}401$ ml for 10W, 10S, 26W, and 26S respectively ($P$ > 0.05). Weight retention at the end of recovery from dehydration was highest in 10S ($1.3{\pm}0.7kg$) compared to 10W ($0.4{\pm}0.5kg$), 26W ($0.4{\pm}0.4kg$), and ($0.6{\pm}0.4kg$) ($P$ < 0.005). Based on these results, carbohydrate/electrolyte-containing beverages at cool temperature were the most favorable for consumption and weight retention compared to plain water and moderate temperature beverages.

• The Korean Journal of Physiology and Pharmacology
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• 제4권3호
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• pp.253-261
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• 2000

Head-out water immersion induces marked increase in the cardiac stroke volume. The present study was undertaken to characterize the stroke volume change by analyzing the aortic blood flow and left ventricular systolic time intervals. Ten men rested on a siting position in the air and in the water at $34.5^{circ}C$ for 30 min each. Their stroke volume, heart rate, ventricular systolic time intervals, and aortic blood flow indices were assessed by impedance cardiography. During immersion, the stroke volume increased 56%, with a slight (4%) decrease in heart rate, thus cardiac output increased ${\sim}50%.$ The slight increase in R-R interval was due to an equivalent increase in the systolic and diastolic time intervals. The ventricular ejection time was 20% increased, and this was mainly due to a decrease in pre-ejection period (28%). The mean arterial pressure increased 5 mmHg, indicating that the cardiac afterload was slightly elevated by immersion. The left ventricular end-diastolic volume index increased 24%, indicating that the cardiac preload was markedly elevated during immersion. The mean velocity and the indices of peak velocity and peak acceleration of aortic blood flow were all increased by ${\sim}30%,$ indicating that the left ventricular contractile force was enhanced by immersion. These results suggest that the increase in stroke volume during immersion is characterized by an increase in ventricular ejection time and aortic blood flow velocity, which may be primarily attributed to the increased cardiac preload and the muscle length-dependent increase in myocardial contractile force.

• Clinical and Experimental Pediatrics
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• 제59권6호
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• pp.262-270
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• 2016

Purpose: Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF. Methods: The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the sildenafil (S) group (MCT 60 mg/kg+ sildenafil 30 mg/kg/day for 28 days). Masson Trichrome staining was used for heart tissues. Western blot analysis and immunohistochemical staining were performed. Results: The mean right ventricular pressure (RVP) was significantly lower in the S group at weeks 1, 2, and 4. The number of intra-acinar arteries and the medial wall thickness of the pulmonary arterioles significantly lessened in the S group at week 4. The collagen content also decreased in heart tissues in the S group at week 4. Protein expression levels of B-cell lymphoma-2 (Bcl-2)-associated X, caspase-3, Bcl-2, interleukin (IL)-6, matrix metalloproteinase (MMP)-2, endothelial nitric oxide synthase (eNOS), endothelin (ET)-1 and ET receptor A (ERA) in lung tissues greatly decreased in the S group at week 4 according to immunohistochemical staining. According to Western blotting, protein expression levels of troponin I, brain natriuretic peptide, caspase-3, Bcl-2, tumor necrosis factor-${\alpha}$, IL-6, MMP-2, eNOS, ET-1, and ERA in heart tissues greatly diminished in the S group at week 4. Conclusion: Sildenafil alleviated right ventricular hypertrophy and mean RVP. These data suggest that sildenafil improves right ventricular function.

• 대한임상독성학회지
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• 제16권1호
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• pp.9-14
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• 2018

Purpose: Intravenous lipid emulsion (ILE) has been shown to have significant therapeutic effects on calcium channel blocker overdose in animal studies and clinical cases. In this preliminary experiment, we investigated the hemodynamic changes and survival in a rat model of verapamil intoxication. Methods: Fourteen male Sprague-Dawley rats were sedated and treated with ILE or normal saline (control), followed by continuous intravenous infusion of verapamil (20 mg/kg/h). Mean arterial pressure and heart rate of rats were monitored during the infusion. In addition, the total dose of infused verapamil and the duration of survival were measured. Results: Survival was prolonged in the ILE group ($32.43{\pm}5.8min$) relative to the control group ($24.14{\pm}4.3min$) (p=0.01). The cumulative mean lethal dose of verapamil was higher in the ILE group ($4.3{\pm}0.7mg/kg$) than in the control group ($3.2{\pm}0.5mg/kg$; p=0.017). Conclusion: ILE pretreatment prolonged survival and increased the lethal dose in a rat model of verapamil poisoning.

• Journal of Chest Surgery
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• 제23권3호
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• pp.474-481
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• 1990

We have experienced 44 cases of coarctation of aorta in the age of infancy and children from April 1986 to September 1989 at Seoul National University Children`s hospital. Patients were thirty males and fourteen females, and their age ranged from one month to ten years[mean 23.84 $\pm$33.06 months] with thirty-two infant cases. In the infantile age, congestive heart failure was the most common chief complaint[18/32], and above that age, frequent upper respiratory infection was most common[8/12]. We experienced thirteen cases of isolated COA, twenty-two cases of COA with VSD, eight cases of COA with VSD, eight cases of COA with intracardiac complex anomalies and one case of COA with atrial septal defect. The associated intracardiac complex anomalies were three Taussig-Bing type double outlet right ventricle, one single ventricle, one transposition of great arteries, one atrioventricular septal defect, one hypoplastic aortic arch with left heart hypoplasia, and one Tetralogy of Fallot. Operative techniques of COA were twenty-three subclavian flap arterioplasty, 12 resection and end to end anastomosis, eight onlay patch angioplasty, and I direct angioplasty after resection of web. Among the cases with other cardiac anomalies, staged operation was done in twenty-nine patients, and single stage total correction was performed only in three patients. There were seven operative mortality[15.9%], all being in infantile age group, and among fourteen cases associated with large VSD[Qp/Qs>2.0, mean pulmonary arterial pressure>50mmHg], four patients were died, but there was no mortality in patients with small VSD. With above results, we are intended to discuss about the interval between staged operation, the fate of VSD after coarctoplasty in case of COA with VSD, causes of death, complications etc.

• Journal of Chest Surgery
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• 제31권5호
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• pp.456-465
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• 1998

개심술후에 영아나 작은 소아에서는 수분의 체내 저류현상이 더욱 심하게 나타난다. 이에 대한 치료법의 하나로 개심술시 변형 초여과법을 적용함으로써 술후 상태에 미치는 영향을 알아 보고자 하였다. 개심술을 받았던 5세이하의 소아를 대상으로 개심술후 변형 초여과법을 적용하였던 환아(초여과군) 10명과 초여과법을 실시하지 않았던 대조군 10명의 2군으로 나누어서 개심술에 따른 조기 성적을 비교 분석하였다. 환아의 연령, 체중, 심폐기 충진액의 총량과 이에 첨가한 혈액의 양, 그리고 체외순환시간과 대동맥차단시간 등의 값들은 모두 양군간에 유의한 차이가 없었다. 변형 초여과법을 적용함에 있어서 관류속도는 평균 171.4ml/min, 관류시간은 평균 18.9분이 소요되었고, 이 동안에 걸러진 수액의 총량은 평균 38.4ml/kg, 심폐기의 혈액을 환자에게 재수혈한 양은 평균 32.1ml/kg였다. 술후 24시간동안의 출혈량은 초여과군에서 평균 14.5ml/kg/24hr, 대조군에서 13.7ml/kg/24hr였고, 같은 기간에 수혈한 양은 초여과군에서 전혈 6.6ml/kg/24hr, 혈장 65.7ml/kg/24hr, 대조군에서는 전혈 15.2ml/kg/24hr, 혈장 59.6ml/kg/24hr이었다. 이는 임상적으로는 초여과군에서 전혈의 수혈량이 대조군에 비하여 훨씬 적어 보였지만 통계학적으로 유의한 차이는 없었다. 술전후 적혈구용적률의 변화는, 초여과군에서는 체외순환 시작후 10분에 평균값이 26.5%로 떨어졌다가 초여과법 종료 5분후에는 37.1%로 급격히 상승하였고, 대조군에서는 체외순환중의 24.7%에서 체외순환이 끝나고 20분이 경과한 후에도 30.5% 수준으로밖에 상승하지 못하였다. 그러므로 적혈구용적률의 변화를 체외순환중의 수치에 대한 상승률(%)로 나타냈을 때, 초여과군은 40%, 대조군은 23%로써 양군간에 통계학적으로 유의한 차이를 보였다(p=0.002). 초여과법 시행에 따른 수축기 및 이완기동맥압의 변화에 있어서는 양군간에 유의한 차이가 없었으며, 평균동맥압의 변화는 양군간에 통계학적으로 유의한 차이는 없었으나(p=0.086), 임상적으로는 상당한 차이를 보였다. 결론적으로, 소아환자에서 개심술후에 변형 초여과법을 적용했을 때, 거의 일률적으로 적혈구용적률과 동맥혈압이 상승함을 볼 수 있었고, 이는 환아를 중환자실로 옮긴 후에도 지속됨으로써 개심술직후 환아관리에 긍정적인 효과를 발휘하는 것으로 평가된다. 따라서 향후 영아나 작은 소아의 개심술에 있어서 변형 초여과법은 보다 많은 빈도로 이용될 것으로 전망된다.

• 한국임상수의학회지
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• 제27권4호
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• pp.330-335
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• 2010

이 연구의 목적은 돼지에 있어서 zoletil/midazolam (TZM)과 zoletil/xylazine (TZX)의 2가지 병용마취를 사용하였을 때의 마취효과와 심혈관계 및 호흡에 미치는 영향을 비교하기 위하여 실시하였다. 총 8 마리의 Landrace $\times$ Yorkshire 교잡종 돼지 ($25.3{\pm}3.3\;kg$)를 사용하였으며, 각 군마다 4 마리씩 2개 군으로 실험을 실시하였다. 첫 번째 군은 xylazine과 tiletamine/zolazepam을 2 mg/kg 용량으로 근육 내 주사하였고(TZX군), 2번째 군은 midazolam 0.5 mg/kg의 용량을 정맥 내 주사 하고 tiletamine/zolazepam 2 mg/kg 용량으로 근육 내 주사하였다(TZM군). 마취시간에 대한 평가로 induction time, anesthesia time과 standing time을 각 돼지마다 측정하였으며, 마취효과에 대한 평가로 진정, 진통, 근 이완, 자세 그리고 청각반응을 점수화 하여 매 15분마다 측정하였다. 심폐기능에 대한 평가로 심박동수와 동맥혈압, 호흡수, 직장체온을 마취 전, 마취직후, 마취 후 5분, 15분, 30분, 45분 및 60분에 각각 측정하였고, 동맥혈 가스 분석을 동일시간대에 실시하였다. 실험 결과 모든 돼지에서의 마취는 성공적이었다. 2가지 병용마취 모두 부드러운 마취 유도와 적절한 운동억제 효과를 보였으나 마취효과점수에서는 TZM군이 TZX군보다 우수하였으며, TZM군이 TZX군 보다 심폐기능 및 체온에 미치는 영향이 적으며 안정적인 것을 확인하였다. 결론적으로, TZM군은 TZX군에 비하여 더욱 양호한 마취효과를 보였으며, 심폐기능에 미치는 영향은 보다 적게 나타내었다.