• Title/Summary/Keyword: Stroke volume

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A Case Report of a Patient with Voiding Dysfunction Caused by Cerebral Infarction Treated with Dangguishaoyao-san-hap-Jeoryeong-tang (뇌경색 이후 발생한 배뇨곤란 환자에 대한 당귀작약산 합 저령탕 치험 1례)

  • Sun-woo Kwon;Choong-hyun Park;Ji-yoon Lee;Hye-soo Youn;Eun-chang Lee;Jung-min Son;Yi-jae Kwon;Hyo-jeong Lee;Jung-eun Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1041-1049
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    • 2023
  • Objectives: The aim of this study is to describe the effects of treatment with traditional Korean medicine on a patient with voiding dysfunction caused by cerebral infarction. Methods: The patient was treated with herbal medicine, moxibustion, acupuncture, and electroacupuncture. The effects of these treatments were evaluated using the Korean version of the Modified Barthel Index and a post-void residual volume. Results: In this study, the Korean medicine Dangguishaoyao-san-hap-Jeoryeong-tang resulted in improvements in this patient with post-stroke urinary retention and successful removal of the indwelling catheter. Conclusion: The results suggest that traditional Korean medicine may be effective in ameliorating dysfunction caused by cerebral infarction.

A Basic Study on a Magnetic Fluid Driven Artificial Heart (자성유체에 의해 구동되는 인공심장에 관한 기초연구)

  • Kim, Dong-Wook;MITAMURA, Yoshinoro
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.7 no.5
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    • pp.940-947
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    • 2006
  • A variety of actuators fur an implantable artificial heart have been studied. They, all, however, share the disadvantages of a complicated energy conversion mechanism and of the need to use bearings. A ferrofluidic actuator directly drives magnetic fluids by applying a magnetic field to these fluids; it does not require bearings. In this study, the feasibility of a ferrofluidic actuator for an implantable artificial heart was studied. An way of two Poles of ring solenoids was mounted near the acrylic tube $({\phi}\;7.4mm)$. A rubber sack (volume : $2m{\ell}$ was connected to both ends of the acrylic tube. The sack were encased in a rigid chamber that had inlet and outlet ports. The acrylic tube and the rubber sack were filled with water encased in a rigid chamber magnetic fluid and the iron cylinder were immersed in the water. Two experiment method was conducted. 1) distance between stoppers were 72mm and 2) distance between stoppers were 104mm. A stroke volume was stability and $0.96m{\ell}$ was obtained in the experiment 1 and $1.92m{\ell}$ in the experiment 2. The energy efficiency of Experiment method 2 is about five times than Experiment method 2. A magnetic fluid-driven blood pump could be feasible if the magnetic fluid with high magnetization (3 times yester than the current value) is developed.

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Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Assessment of Parameters Measured with Volumetric Pulmonary Artery Catheter as Predictors of Fluid Responsiveness in Patients with Coronary Artery Occlusive Disease (관상동맥 질환을 가진 환자에서 폐동맥카테터로 측정한 전부하 지표들은 수액부하 반응을 예상할 수 있는가?)

  • Lee, Ji-Yeon;Lee, Jong-Hwa;Shim, Jae-Kwang;Yoo, Kyung-Jong;Hong, Seung-Bum;Kwak, Young-Lan
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.41-48
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    • 2008
  • Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.

Comparison of Left Ventricular Volume and Function between 46 Channel Multi-detector Computed Tomography (MDCT) and Echocardiography (16 채널 Multi-detector 컴퓨터 단층촬영과 심초음파를 이용한 좌심실 용적과 기능의 비교)

  • Park, Chan-Beom;Cho, Min-Seob;Moon, Mi-Hyoung;Cho, Eun-Ju;Lee, Bae-Young;Kim, Chi-Kyung;Jin, Ung
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.45-51
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    • 2007
  • Background: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. Material and Method: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 20 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. Result: Average LVEDVI ($80.86{\pm}34.69mL$ for MDCT vs $60.23{\pm}29.06mL$ for Echocardiography, p<0.01), average LVESVI ($37.96{\pm}24.52mL$ for MDCT vs $25.68{\pm}16.57mL$ for Echocardiography, p<0.01), average SVI ($42.90{\pm}15.86mL$ for MDCT vs $34.54{\pm}17.94mL$ for Echocardiography, p<0.01), average LVMI ($72.14{\pm}25.35mL$ for MDCT vs $130.35{\pm}53.10mL$ for Echocardiography, p<0.01), and average EF ($55.63{\pm}12.91mL$ for MOCT vs $59.95{\pm}12.75ml$ for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI $(r^2=0.74,\;p<0.0001)$, LVESVI $(r^2=0.69,\;p<0.0001)$ and SVI $(r^2=0.55,\;p<0.0001)$ showed high relevance, LVMI $(r^2=0.84,\;p<0.0001)$ showed very high relevance, and $EF (r^2=0.45,\;p=0.0002)$ showed relatively high relevance. Conclusion: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.

Effects of Dipsaci Radix on Muscle Fiber Atrophy and MyoD Expression in Gastrocnemius of MeAO Rats (속단(續斷)이 중풍모델 흰쥐 비목근의 근섬유위축 및 MyoD 발현에 미치는 영향)

  • Han, Sang-Woo;Ryu, Sa-Hyun;Shim, Eun-Sheb;Lee, Dong-Eun;Park, Min-Hee;Kim, Bum-Hoi;Choi, Hyun;Jung, Hyuk-Sang;Sohn, Nak-Won;Sohn, Young-Joo
    • The Korea Journal of Herbology
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    • v.23 no.2
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    • pp.159-168
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    • 2008
  • Objectives : The present study has been undertaken to investigate the effects of Dipsaci Radix on Muscle Fiber Atrophy and MyoD Expression in Gastrocnemius of MCAO Rats Methods : In order to investigate effects of Dipsaci radix on the skeletal muscle atrophy following stroke, cerebral infarct was induced by the middle cerebral artery occlusion (MCAO) in the rats. Water extract of Dipsaci radix (184.4 mg/100 g) was treated for 4 weeks, once a day orally, after the MCAO. Effects were evaluated with muscle fiber type composition and cross-sectioned area of muscle fibers in gastrocnemius of the unaffected & affected hind limbs. And MyoD protein expression in gastrocnemius was demonstrated with immunohistochemistry and western blotting. Results : Obtained results were as follows; 1. Infarct volume was not attenuated by Dipsaci radix treatment in the MCAO rats. 2. At the affected-side hind limb of the MCAO rats, the increase of type-I fibers and the decrease of type-II fibers were induced by Dipsaci radix treatment. 3. At the affected-side hind limb of the MCAO rats, decreases of cross-sectioned areas of type-I and type-II fibers were attenuated by Dipsaci radix treatment. 4. At the affected-side hind limb of the MCAO rats, MyoD positive cells were increased by Dipsaci radix treatment. 5. At the affected-side hind limb of the MCAO rats, MyoD expressions were increased by Dipsaci radix treatment. Conclusions : These results suggest that Dipsaci radix has a protective effect against muscle atrophy, through the inhibition of the muscle cell apoptosis, following the central nervous system demage.

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The Age-Related Trend in Blood Pressure and the Prevalence of Hypertension in Korean Adults (한국 성인의 연령에 따른 혈압변화 양상과 고혈압 유병률)

  • Lee, Dae-Taek;Lee, Yong-Soo
    • Journal of Life Science
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    • v.22 no.2
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    • pp.148-155
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    • 2012
  • A cross-sectional analysis of blood pressure (BP) changes and the current prevalence and distribution of hypertension among age groups in Korea were conducted. Systolic (SBP), diastolic (DBP), and pulse (PP) pressures were evaluated. Residents visiting a local Community Health Center for a health check-up and/or participating in the Health Promotion Program were included for the analyses. A total of 6,570 subjects (2,809 men, 3,761 women) were divided into five age groups: 30-39, 40-49, 50-59, 60-69, and $70\leq$ years. Comparisons were made between sex and among age groups. SBP and DBP were continuously elevated, while men showed higher levels than women until their mid-60s; then, the trend was reversed. DBP in men became elevated from their 30s, reaching the highest in the 40s then slowly decreasing. DBP in women increased up to their 40s and 50s, then reached a plateau. PP increased rapidly from the 50s in both sexes. The major contributor of age-related BP elevation may be large artery stiffness in men, particularly from their 50s, while the blood pressure elevation of women may relate to diverse factors including large artery stiffness, stroke volume, and ventricular ejection rate. The rapid elevation of PP after the 50s in both men and women could represent a risk of cardiovascular or coronary mortality, particularly with increasing age. The current data showed a higher rate of hypertension in both sexes compared to previous reports. When those with both high-normal BP and hypertension are looked at in combination, BP management of the target population should be drastically elevated.

Effects of Ovarian Cycle on Hemodynamic Responses during Dynamic Exercise in Sedentary Women

  • Choi, Hyun-Min;Stebbins, Charles L.;Nho, Hosung;Kim, Mi-Song;Chang, Myoung-Jei;Kim, Jong-Kyung
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.6
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    • pp.499-503
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    • 2013
  • This study tested the hypothesis that effects of the menstrual cycle on resting blood pressure carry over to dynamic exercise. Eleven healthy females were studied during the early (EP; low estrogen, low progesterone) and late follicular (LP; high estrogen, low progesterone) menstrual phases. Stroke volume (SV), heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), and total vascular conductance (TVC) were assessed at rest and in response to mild and moderate cycling exercise during EP and LP. During EP, compared to LP, baseline SBP ($111{\pm}1$ vs. $103{\pm}2$ mmHg), DBP ($71{\pm}2$ vs. $65{\pm}2$ mmHg) and mean arterial pressure (MAP) ($84{\pm}2$ vs. $78{\pm}1$ mmHg) were higher and TVC ($47.0{\pm}1.5$ vs. $54.9{\pm}4.2$ ml/min/mmHg) was lower (p<0.05). During exercise, absolute values of SBP (Mild: $142{\pm}4$ vs. $127{\pm}5$ mmHg; Moderate: $157{\pm}4$ vs. $144{\pm}5$ mmHg) and MAP (Mild: $100{\pm}3$ vs. $91{\pm}3$ mmHg; Moderate: $110{\pm}3$ vs. $101{\pm}3$ mmHg) were also higher, while TVC was lower (Mild: $90.9{\pm}5.1$ vs. $105.4{\pm}5.2$ ml/min/mmHg; Moderate: $105.4{\pm}5.3$ vs. $123.9{\pm}8.1$ ml/min/mmHg) during EP (p<0.05). However, exercise-induced increases in SBP, MAP and TVC at both work intensities were similar between the two menstrual phases, even though norepinephrine concentrations were higher during LP. Results indicate that blood pressure during dynamic exercise fluctuates during the menstrual cycle. It is higher during EP than LP and appears to be due to additive effects of simultaneous increases in baseline blood pressure and reductions in baseline TVC.

Safety and Efficacy of Hypothermia (34℃) after Hemicraniectomy for Malignant MCA Infarction

  • Park, Hyun-Seok;Choi, Jae-Hyung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.267-276
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    • 2018
  • Objective : The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. Methods : From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at $34^{\circ}C$ after hemicraniectomy in malignant MCA infarction (hypothermia group). The indication of hypothermia included acute cerebral infarction >2/3 of MCA territory and a Glasgow coma scale (GCS) score <11 with a midline shift >10 mm or transtentorial herniation sign (a fixed and dilated pupil). We retrospectively collected 27 patients, as the control group, who had undergone hemicraniectomy alone and simultaneously met the inclusion criteria of hypothermia between January 2010 and September 2012, before hypothermia was implemented as a treatment strategy in Dong-A University Hospital. We compared the mortality rate between the two groups and investigated hypothermia-related complications, such as postoperative bleeding, pneumonia, sepsis and arrhythmia. Results : The age, preoperative infarct volume, GCS score, National institutes of Health Stroke Scale score, and degree of midline shift were not significantly different between the two groups. Of the 20 patients in the hypothermia group, 11 patients were induced with hypothermia immediately after hemicraniectomy and hypothermia was initiated in 9 patients after the decision of hypothermia during postoperative care. The duration of hypothermia was $4{\pm}2days$ (range, 1 to 7 days). The side effects of hypothermia included two patients with arrhythmia, one with sepsis, one with pneumonia, and one with hypotension. Three cases of hypothermia were discontinued due to these side effects (one sepsis, one hypotension, and one bradycardia). The mortality rate of the hypothermia group was 15.0% and that of the control group was 40.7% (p=0.056). On the basis of the logistic regression analysis, hypothermia was considered to contribute to the decrease in mortality rate (odds ratio, 6.21; 95% confidence interval, 1.04 to 37.05; p=0.045). Conclusion : This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis.

INVESTIGATION OF RUNNING BEHAVIORS OF AN LPG SI ENGINE WITH OXYGEN-ENRICHED AIR DURING START/WARM-UP AND HOT IDLING

  • Xiao, G.;Qiao, X.;Li, G.;Huang, Z.;Li, L.
    • International Journal of Automotive Technology
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    • v.8 no.4
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    • pp.437-444
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    • 2007
  • This paper experimentally investigates the effects of oxygen-enriched air (OEA) on the running behaviors of an LPG SI engine during both start/warm-up (SW) and hot idling (HI) stages. The experiments were performed on an air-cooled, single-cylinder, 4-stroke, LPG SI engine with an electronic fuel injection system and an electrically-heated oxygen sensor. OEA containing 23% and 25% oxygen (by volume) was supplied for the experiments. The throttle position was fixed at that of idle condition. A fueling strategy was used as following: the fuel injection pulse width (FIPW) in the first cycle of injection was set 5.05 ms, and 2.6 ms in the subsequent cycles till the achieving of closed-loop control. In closed-loop mode, the FIPW was adjusted by the ECU in terms of the oxygen sensor feedback. Instantaneous engine speed, cylinder pressure, engine-out time-resolved HC, CO and NOx emissions and excess air coefficient (EAC) were measured and compared to the intake air baseline (ambient air, 21% oxygen). The results show that during SW stage, with the increase in the oxygen concentration in the intake air, the EAC of the mixture is much closer to the stoichiometric one and more oxygen is made available for oxidation, which results in evidently-improved combustion. The ignition in the first firing cycle starts earlier and peak pressure and maximum heat release rate both notably increase. The maximum engine speed is elevated and HC and CO emissions are reduced considerably. The percent reductions in HC emissions are about 48% and 68% in CO emissions about 52% and 78%; with 23% and 25% OEA, respectively, compared to ambient air. During HI stage, with OEA, the fuel amount per cycle increases due to closed-loop control, the engine speed rises, and speed stability is improved. The HC emissions notably decrease: about 60% and 80% with 23% and 25% OEA, respectively, compared to ambient air. The CO emissions remain at the same low level as with ambient air. During both SW and HI stages, intake air oxygen enrichment causes the delay of spark timing and the increased NOx emissions.