• Journal of Chest Surgery
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• v.17 no.3
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• pp.418-423
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• 1984

Appreciation of the large volume deficits which may occur in surgical or trauma patients due to blood loss has led to vigorous transfusion techniques designed to overt hypovolemic shock and ischemic damage to vital organs which may develop in minutes during the hypovolemic state. In a significant proportion of patients treated with massive rapid blood or fluid transfusion, hypervolemia occurs and life threatening pulmonary edema may develop. Especially, hypervolemia may occur during transfusion for preventing development of the so-called low output syndrome following cardiac surgery. However, the most effective indicator which reveals the adequate level of transfusion is not settled yet. The present study was aimed to compare the effectiveness of the indicators suggested thus far and to determine the most sensitive one. Eight dogs were experimentally studied in terms of left atrial pressure, pulmonary arterial systolic pressure, central venous pressure, mean systemic arterial pressure and heart rate before and after induced hypervolemia with infusion of 600ml heparinized homologous blood. Immediately after induced overtransfusion of the blood, pulmonary arterial systolic pressure increased 75.0%, in omparison with the control before transfusion, left atrial pressure 58.8%, central venous pressure 44.6%, and mean systemic arterial pressure 10.1%, one hour after transfusion, pulmonary arterial systolic pressure 40.0%, left atrial pressure 21.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, respectively. Heart rate showed no significant change throughout the experiment. These result suggested that the changes of the pulmonary arterial systolic pressure is the most sensitive indicator for detection of hypervolemia during blood transfusion.

• The Korean Journal of Physiology
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• v.3 no.2
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• pp.25-31
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• 1969

Effects of graded increase of positive lung inflation upon heart rates and arterial blood pressure were observed in the anesthetized dogs to analyze the mechanical and neural regulatory factor in response to the positive inflation of the lung. The results obtained were summarized as followings: 1) When the low grade of positive lung inflation was employed under the mild to moderate anesthesia, central venous pressure was linearly increased while heart rate was decreased. After bilateral vagotomy, central venous pressure was obviously increased while heart rate was constant. 2) When the high degree of positive lung inflation was employed, changes of central venous pressure and heart rate were not significant. 3) The low grade of intrapulmonary pressure increase caused reflex tachycardia in phase 2 and overshooting in phase 4 in response to the systemic arterial blood pressure change. 4) On the other hand, the high degree of intrapulmonary pressure increase caused paradoxical bradycardia in phase 2 and lack of overshooting in phase 4 in response to the systemic arterial blood pressure change. 5) It may be noted that the experimental model employed in the present study is a useful tool to evaluate and analyze the neural and mechanical regulatory factor in response to the graded increase of the positive lung inflation.

• Journal of Veterinary Clinics
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• v.33 no.6
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• pp.321-324
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• 2016

The present study compared two indirect blood pressure methods at thoracic limb, pelvic limb, and coccygeal sites. For measurement of blood pressure, 48 client-owned dogs in a clinical setting were used. When comparing the results obtained by doppler and oscillometric methods, there were significant differences in blood pressure of the thoracic and pelvic limbs. The Doppler machine produced significantly higher blood pressure value than oscillometry measured at thoracic and pelvic limbs. The difference in blood pressure between the two methods was not significant when measured in the tail. Comparison of blood pressure measured at three different sites by doppler, blood pressure measured at pelvic limb was higher than at thoracic limb and tail. In case of oscillometry, there were no significant differences between the three sites. The results of this study indicate that mechanical and positional differences were existed in blood pressure measurements at the canine thoracic limb, pelvic limb and tail.

• Korean Journal of Acupuncture
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• v.33 no.3
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• pp.121-130
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• 2016

Objectives : Recently, people who have normal brachial blood pressure(BP) are being threatened by high-risk disease such as stroke. The aim of this study is to suggest that new method to assess systemic circulation. It can be performed by analyzing optimal blood pulse wave on 3 sites belonging to subjects that have normal BP. Methods : We respectively extracted main peaks(h1) of optimal blood pulse wave on left/right temporal artery(LR1=h1), radial artery(LR2=h1) and dorsalis pedis artery(LR3=h1). We obtained h1 from 30 subjects who are discreetly chosen and have normal BP. Main peak(h1) can be extracted by using 3D pulse imaging analyser(DMP-1000+, DAEYOMEDI Co., Korea) that has 5-level pressure method. We analyzed the ratio of [LR1/LR2] and [LR3/LR2]. Results : In the case of male group, the results are [LR1/LR2=0.7100.177] and [LR3/LR2=0.9290.317]. In the case of female group, the results are [LR1/LR2=0.6680.121] and [LR3/LR2=0.7050.195]. Especially, it is statistically verified that the result of ratio [LR3/LR2] is much higher in male group than in female group(p<0.05). Conclusions : We suggested the standard ratio of [LR1/LR2] and [LR3/LR2] for normal subjects, respectively. It can be adopted as a new method to evaluate the systemic circulation.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.807-814
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• 2005

Background: Cardiopulmonary bypass is an essential process to maintain circulation for saving life during the cardiac surgery, But it is a process in which systemic inflammation was evoked inevitably because of the exposure of blood to foreign surface. The injuries to distal organs during the cardiopulmonary bypass were resulted from systemic inflammation and the disturbances of micro-circulations in the organs. We designed this study to research the effects of leukocyte depletion from pump-oxygenator priming solution on the systemic inflammation, and the micro-circulation of gastric mucosa that is suggested by the gastric mucosal $CO_{2}$ partial pressure and acidity. Material and Method: The dogs were divided into three groups according to the different pump-oxygenator priming solutions; non-hemic crystalloid solution; leukocyte-depleted homologous blood; and non leukocyte-depleted homo-logous blood. Each priming solution group contained five dogs. In all three groups, 2 hours of cardiopulmonary bypass, and 4 consecutive hours of general anesthesia was maintained on the mechanical ventilation. Each dog was evaluated for the gastric mucosal pH, $CO_{2}$ partial Pressure, arterial pH, $CO_{2}$ partial pressure, the exhaled air $CO_{2}$ partial pressure and the level of IL-8 on before the cardiopulmonary bypass, 1 hour after the cardiopulmonary bypass, 2 hours after the cardiopulmonary bypass, 2 hours after the restoration of normal circulation, and 4 hours after the restoration of normal circulation after the cardiopulmonary bypass. The levels of IL-8 were measured with ELISA (enzyme linked immunosorbent assay) technique. Result: 1. There were significant differences of gastric mucosal $CO_{2}$ partial pressure between the leukocyte-depleted homologous blood group and other two groups(vs non leukocyte-depleted homologous blood group; P=0.02, vs non-hemic crystalloid solution group; P=0,01). 2. The gastric mucosal pH of leukocyte-depleted homologous blood group was significantly different from non leukocyte-depleted homologous blood group (p=0.01). 3. The levels of IL-8, which examine the systemic inflammation, showed signi- ficantly better results in leukocyte-depleted homologous blood group and non-hemic crystalloid solution group than non leukocyte-depleted homologous blood group (p=0.01, 0.01). Conclusion: Based upon these results, we concluded that the leukocyte depletion from the pump-oxygenator priming solution has a beneficial effects in reducing systemic inflammation and the preserving of gastric mucosal micro-circulation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.2
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• pp.118-125
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• 2017

The purpose of this study is to investigate the blood pressure reducing effect of Qi-Ju-Di-Huang-Wan (QJDHW) in adults with essential hypertension by using methods of systemic review and meta-analysis. Major search engines, such as PubMed, EMBASE, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, KISS, NDSL, RISS, OASIS, DBpia and so on, were used. The search period we used is from the start date of the search engine to October 30, 2016 and no language limits were placed. Randomized controlled trials using QJDHW in adults with essential hypertension were searched and extracted by two independent researchers. Meta-analysis was performed on outcome variables of the total effective rate (TER), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Risk of bias (RoB) of Cochrane was used to assess methodological quality. Thirteen studies were finally selected. We observed that the combined treatment of QJDHW and antihypertensive drug had 3.6 times the odds ratio of TER for blood pressure lowering than a single use of an antihypertensive drug. Additionally, mean differences of SBP and DBP were -8.88 mmHg (95% Confidential Interval (CI) -12.77 mmHg, -5.00 mmHg, P<0.00001), -7.09 mmHg (95% CI -9.93, -4.25, P <0.00001), respectively. Single use of QJDHW did not reduce blood pressure more than an antihypertensive drug. All items of RoB were unclear and the methodological quality was low. Our analysis suggests that the combination of QJDHW and antihypertensive drugs may be more effective in reducing blood pressure than a single antihypertensive drug. But due to low methodological quality, careful interpretation will be needed and systematic long-term clinical trials will be required.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.04a
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• pp.267-267
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• 2009

• Journal of Biomedical Engineering Research
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• v.36 no.5
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• pp.183-190
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• 2015

Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1995.10a
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• pp.115-124
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• 1995

The purpose of the present study was to address whether the in vivo noradrenergic neural activities in the locus coeruleus are involved in the regulation of blood pressure. Two groups of the animals were prepared, 1) SHR and 2) age-matched normotensive control, WKY. At the age of 6 and 16 weeks, blood pressure and the releases of NE from the locus coeruleus in SHR and KWY were measured by in vivo microdialysis at three different conditions: 1) normal, 2) elevated state of blood pressure by systemic injected phenylephrine and 3) increased state of neural activity by perfused phenylephrine into the locus coeruleus. The basal release of NE of SHR were significantly higher than that of WKY, Phenylephrine treatment caused elevation of blood pressure in both SHR and WKY in dose-dependent manner. Following phenylephrine injection, the releases of NE from the locus coeruleus of SHR were significantly decreased, whereas the significant change of NE in WKY was observed in the highest dose of phenylephrine. Phenylephrine perfusion into the locus coeruleus through microdialysis probe caused pressor responses and the pressor response in SHR was greater compared with that in WKY. The results from the present study suggests that the noradrenergic nervous system in the locus coeruleus may contribute as one of the development and maintenance factors for hypertension in SHR.

• The Journal of Internal Korean Medicine
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• v.20 no.1
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• pp.222-231
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• 1999

Uwhangchungsimwon(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arteriosclerosis, autonomic imbalance, mental instablity, etc in Korean traditional hospitals, In particular it is often initialy chosen for emergency care of acute stroke. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics. Using transcranial Doppler ultrasound, we studied changes of mean flow velocity and pulsatility index(PI) of middle cerebral arteries (MCAs) from 11 health young volunteers who were administrated with 1 pill UC and 11 health controls who were not. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with breath-holding index(BHI). Systolic blood pressure, diastolic blood pressure, and heart rate were measured using ambulatory blood pressure monitoring(ABPM). In UC administration group, the evaluation was performed during basal condition. and repeated at 20, 40, and 60 min after administration. In controls, the evaluation was performed at corresponding time intervals. Mean flow velocity in middle cerebral artery, systolic blood pressure, diastolic blood pressure, and heart rate did not change during the observation period and were not different between these two groups. However, administration of UC was associated with decreases in PI by $3.6{\sim}12.4%$ in BHI by $17.9{\sim}24.8%$ compared with pre-administration period. Decreases in PI and BHI with UC were significantly different compared with control group (p<0.05). These results indicate that UC decreases PI and BHI in cerebral artery, which is due to a dilation of cerebral resistance vessels.