• Title/Summary/Keyword: cardiovascular monitoring

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Anesthetic Effect of Different Ratio of Ketamine and Propofol in Dogs

  • Lee, Mokhyeon;Kim, Sohee;Moon, Chawnghwan;Park, Jiyoung;Lee, Haebeom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.234-240
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    • 2017
  • Use of ketamine and propofol combination (so-called Ketofol) anesthesiain a fixed ratio (1:1 mg/ml) was reported in dogs. The use of ketofol reduced cardiovascular suppression, but respiratory-related side effects was not significantly different from propofol alone. In this study, we evaluated the quality of ketofol anesthesia and changes in cardiopulmonary function according to the ratio of ketamine to propofol. The experimental groups were divided into three groups: propofol alone (P group), 3:7 ketofol group (PK1 group) and 1:1 ketofol group (PK2). For each group, the dose of 0.8 ml/kgwas administered intravenously at a constant rate until the tracheal intubation was possible and anesthesia was maintained with isoflurane for 120 minutes after induction of anesthesia. There was no significant difference in the anesthetic quality among three groups. Also, there was no difference in respiratory rate, tidal volume, end-tidal carbondioxide, and oxygen saturation. In group P, heart rate was not changed significantly during anesthesia, but arterial blood pressure decreased, while heart rate and arterial blood pressure increased significantly in group PK2. In the PK1 group, heart rate and arterial blood pressure during anesthesia remained similar to pre-anesthetic values. In conclusion, ketofol might be used as induction agent, and 3:7 ratioof ketofol showed more safe and effective anesthetic effect in dogs. Additionally, 1:1 ketofol may be used in patients with severe bradycardia orhypotension with close monitoring during anesthesia.

Comparative Study on the Health Promotion Policy in Korea and Japan (한국과 일본의 건강증진정책 비교)

  • 남은우;조은주;남정자
    • Korean Journal of Health Education and Promotion
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    • v.21 no.3
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    • pp.19-33
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    • 2004
  • The focus of this paper is to critically evaluate the contemporary health promotion policy of g Korea and Japan. The primary purpose of this comparative research project is to stimulate policy debate and to strengthen the design and implementation of evidence-based policies that improve population health and reduce health related disparities. For the purpose of the research object we adopted analysis of health promotion(HP) sources. The HP Source which is still under development in Europe, is a potentially valuable tool for global use. This European Commission funded project lead by the London School of Hygiene and Tropical Medicine has brought together organisations from all of the European Union Member States, plus Norway, Iceland, Latvia, Switzerland and the Czech Republic to contribute their data. The findings of this research will be conclude by making recommendations for further comparative studies and in particular how EUHPID and the HP Source tool and database can be expanded for use at global level through the IUHPE. The result as follows: 1. The Health Promotion Act enacted 1995 in Korea and 2000 in Japan. The government has a national document on HP titled Health Plan 2010 and Healthy Korea 2010 in Korea and Healthy Japan 21 in Japan. 2. The Health Plan 2010 of Korea contains 14 goals, i.e. life expectancy, smoking, nutrition, mental health, dental health, reproductive health, hypertension, cerebrovascular diseases, arthritis, diabetes mellitus, cardiovascular diseases, and cancer. It should be emphasized that the Korean HP national document adds 3 goals of health expectancy, reproductive health, and arthritis to its Japanese counterpart. Health Plan 2010 of Korea specifies 37 objectives in 14 goals, and Healthy Japan 21 proposes 48 objectives and 80 targets in 9 goals. 3. Health Plan 2010 and Healthy Japan 21 have not been evaluated yet, and no regular systematic monitoring reporting of HP policies is available in Korea and Japan yet. 4. National Health Promotion Fund is a financial source of HP programs at the national level in Korea. Its annual amount is 736 billion Won(equivalent to approximately 640 million US$), otherwise no specific Health Promotion Fund in Japan.

The Usefulness of Transesophageal Echocardiography During Heart Surgery (개심술을 시행하는 환자에서 경식도 심초음파의 이용)

  • 조규도;김치경
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1205-1213
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    • 1997
  • This study reviewed useful aspects of the intraoperative transesophageal echocardiography among the patients in whom heart surgery were undertaken between January 1996 and July 1996 at St.Pauls hospital, Medical College of Catholic University, Seoul, Korea. During that period, 61 patients were operated on because of valvular heart disease(25 patients), coronary artery disease(22 patients), congenital heart disease(13 patients), and combined coronary artery disease and valvular heart disease(1 patient). Two patients(1 redo-VSD and 1 valvular heart diease) needed repeated aortic cross clamping and complementary procedures because of incomplete initial procedures. There was no incidence of air embolism. We could observe significant relationship of cardiac output monitoring methods either by thermodilution technique and transesophageal echocardiography by linear regression analysis(p<0.001). We tested myocardial response(percentage of systolic wall thickness, PSWT) with low dose dobutamine challenge to predict post-CABG myocardial perfusion. And the test showed statistically significant resp.onse(sensitivity 76%, specificity 94.7%, positive predictive value 95%, negative predictive value 75%). These results suggest that cardiac surgeon could draw more benefits by intraoperative transesophageal echocardiography.

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The inhibition of Hypertension-related Response by $17\beta$-estradiol and the Increase of $17\beta$-estradiol Activity by Electrical Stimulation ($17\beta$-estradiol의 고혈압 유도반응 억제와 인체적용 전기자극의 $17\beta$-estradiol 활성 증가)

  • Kim, Jung-Hwan
    • The Journal of Korean Physical Therapy
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    • v.21 no.2
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    • pp.109-116
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    • 2009
  • Purpose: $17\beta$-estradiol is the most active endogenous estrogen, which is related to favorable changes in the plasma lipid profile, to relaxation of the coronary vessels, and to a decrease in platelet aggregation and vascular smooth muscle cell migration. However, although the beneficial effect of estrogens on plasma lipoproteins (ie, lowering low-density lipoprotein and increasing high-density lipoprotein cholesterol) contributes to cardiovascular protection, it does not fully account for the protective effect, particularly in the application of physical therapy, including low frequency electrical stimulation. Methods: The aim of this study was to demonstrate the inhibition of stressors, such as endothelin-1 (ET-1), serotonin (5-hydroxytryptamine, 5-HT), prostaglandin $F2\alpha$ ($PGF2\alpha$), and a protein kinase C (PKC) activator 12-deoxyphorbol 13-isobutyrate (DPB), induced isometric tension by $17\beta$-estradiol in vascular smooth muscle strips, respectively. In addition, the effects of low frequency electrical stimulation at the meridian points (CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52) on the indirect antihypertensive effect were examined by monitoring the changes in the serum $17\beta$-estradiol concentration in healthy volunteers. Results: Isometric tension analysis showed that the responses of inhibited tension by $17\beta$-estradiol were similar to the same stressors in rat aortic smooth muscle strips. Furthermore, although the continued amplitude modulation (AM) type of electrical stimulation was not increased significantly by electrical stimulation, the current of the frequency modulation (FM) type of low frequency electrical stimulation increased the serum $17\beta$-estradiol concentration in normal volunteers. Conclusion: These results, in part, suggest that $17\beta$-estradiol has the capacity to supress stressor-induced muscle tension, and electrical stimulation, particularly current of the FM type, has a modulatory effect on the sex steroid hormones, particularly $17\beta$-estradiol, in healthy volunteers.

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A Modification of Maze III Procedure to Improve Left Atrial Function (좌심방 기능회복을 위한 변형된 Maze III술식의 임상 분석)

  • 이재원;송태승;주석중;이상권;신재균;송명근
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.903-909
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    • 1999
  • Background: The current study was undertaken to investigate the results of a modification in the conventional Maze III Procedure devised by the authors. The aim of the technical modification was in improving the left atrial contractility. Material and Method: Between July 1997 and December 1998, 34 patients with chronic atrial fibrillation for more than 1 year duration underwent a modified Maze III procedure. The assessment of the left atrial function was made by various echocardiographic measurements and SA nodal recovery was evaluated by HRV Holter monitoring. Result: All 34 patients were in sinus rhythm. On echocardiography, right atrial contraction was detected in 32 patients(94.1%) and left atrial contraction in 33 patients(97.1%). The echocardiographic A wave at 1, 6, and 12 months or more were 50.5$\pm$31.5, 62.1$\pm$25.1, 66$\pm$20.6 cm/sec, respectively, and the E wave measurements at the same time points were 152$\pm$31.1, 134.4$\pm$35.2, 133$\pm$27.5 cm/sec. The corresponding A/E ratios were 0.32$\pm$0.13, 0.48$\pm$0.18, 0.5$\pm$0.15, showing a rising trend. Treadmill evaluation at 6 months showed a mean 82% increase in heart rate after excising, and the SDNN and SDANN upon HRV Holter at 1 and 3 months postoperatively were 65.3$\pm$28.1/87.8$\pm$27.2 ms, and 60.0$\pm$24.1/83.4$\pm$25.7 ms, respectively, showing a predoinant autonomic recovery in the parasympathetic system(PSDNN = 0.01, PSDANN =0.015). Conclusion: The results of our data suggest that the current modification in the conventional Maze III Procedure was efective in enhancing the postoperative left atrial contractility.

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Perioperative red blood cell transfusion in orofacial surgery

  • Park, So-Young;Seo, Kwang-Suk;Karm, Myong-Hwan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.163-181
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    • 2017
  • In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

Ginsenosides Inhibit HMGB1-induced Inflammatory Responses in HUVECs and in Murine Polymicrobial Sepsis

  • Lee, Wonhwa;Ku, Sae-Kwang;Jeong, Tae Cheon;Lee, Sangkyu;Bae, Jong-Sup
    • Bulletin of the Korean Chemical Society
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    • v.35 no.10
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    • pp.2955-2962
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    • 2014
  • Asian ginseng is used as a treatment for cardiovascular diseases, ischemia, and cancers. High mobility group box 1 (HMGB1) protein acts as a late mediator of severe vascular inflammatory conditions. However, the effect of ginsenosides from Asian ginseng on HMGB1-induced inflammatory responses has not been studied. We addressed this question by monitoring the effects of ginsenoside treatment on lipopolysaccharide (LPS) and cecal ligation and puncture (CLP)-mediated release of HMGB1, and HMGB1-mediated regulation of proinflammatory responses. Ginsenoside treatment suppressed LPS-mediated release of HMGB1 and HMGB1-mediated cytoskeletal rearrangements. Ginsenosides also inhibited HMGB1-mediated inflammatory responses. In addition, ginsenosides inhibited the production of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and activation of protein kinase B (Akt), nuclear factor-${\kappa}B$ (NF-${\kappa}B$), and extracellular-regulated kinases (ERK) 1/2 by HMGB1. Ginsenosides also decreased CLP-induced release of HMGB1, production of interleukin (IL) $1{\beta}/6$, and mortality. These results suggested that ginsenosides may be potential therapeutic agents for treatment of vascular inflammatory diseases through inhibition of the HMGB1 signaling pathway.

Effects of Red Ginseng on Neonatal Hypoxia-induced Hyperacitivity Phenotype in Rats

  • Kim, Hee-Jin;Joo, So-Hyun;Choi, In-Ha;Kim, Pitna;Kim, Min-Kyoung;Park, Seung-Hwa;Cheong, Jae-Hoon;Shin, Chan-Young
    • Journal of Ginseng Research
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    • v.34 no.1
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    • pp.8-16
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    • 2010
  • Attention deficit hyperactivity disorder (ADHD) affects 4-12% of chool-age children worldwide and is characterized by three core symptoms: hyperactivity, inattention, and impulsivity. Although standard pharmacological treatments, such as methylphenidate and atomoxetine, are available, concerns about drug-induced psychological and cardiovascular problems, as well as growth retardation and sleep disturbances, highlight the continuing need for new therapeutic interventions. Using a neonatal hypoxia-induced hyperactivity model in rats, the potential positive role that oral administration of red ginseng extract may have in relation to the hyperactive phenotype was investigated. Hypoxia was induced in 2-day-old male Sprague-Dawley (SD) rat pups by placing them in a nitrogen chamber for 15 min. The neonatal hypoxia-induced rats showed a significant increase in hyperactivity phenotype, such as increased movement duration, movement distance, and rearing frequency, which was determined by monitoring their spontaneous locomotor activity using the Ethovision video tracking system. One week of oral treatment with red ginseng extract decreased the hyperactivity phenotype of the neonatal hypoxia-induced rats and increased the locomotor activity of the control rats. In the neonatal hypoxia-induced rats, expression of the norepinephrine transporter in the forebrain was increased, and red ginseng treatment partially prevented its up-regulation, while increasing its level in the control rats. Taken together, these results suggest that red ginseng extract decreased the neonatal hypoxia-induced hyperactivity phenotype, although it increased locomotor activity in normal animals.

Estimation of Ventricular Assist Device Outflow with the Pressures in Air Pressure Line (공압식 박동형 심실보조장치의 공압관 내 압력 측정을 통한 박출량 추정)

  • Kim, Young Il;Her, Keun;Kang, Seong Min;Choi, Seong Wook
    • Journal of Biomedical Engineering Research
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    • v.35 no.5
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    • pp.119-124
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    • 2014
  • A Ventricular assist device (VAD) is one of the most efficient treatments to raise the survivability of the end stage heart failure patient. However, some of LVAD patients have died for the failures and improper control of LVAD. To detect critical dangers in LVAD, the monitoring methods of LVAD outflow have been requested, because it can be affected by patient's hemodynamic states and abnormal conditions of LVAD. In the case of an external pulsatile LVAD, the air movement through the air line can be used to estimate LVAD outflow. In this study, the air movement in the air-line of the extracorporeal pulsatile LVAD was measured with a differential pressure sensor between different points. The precise estimation of air movement could be achieved by additional measurement of air pressure. In a series of in-vitro experiments, the LVAD outflow were changed according to the afterload of LVAD and the differential pressure of LVAD didn't have close correlation with the LVAD outflow that were measured with an ultrasonic flowmeter at the same time. However, new precise estimation with the data from differential pressure and one point pressure in the air-line showed higher correlations with LVAD outflow.

Easy and Safe Catheterization of the Innominate Vein (무명정맥의 쉽고 안전한 삽관)

  • 이흥섭;조창욱
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1401-1404
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    • 1996
  • Central venous line insertion is an essential procedure in a cardiac operation. For this, percuteneous Insertion is usually done in the internal jugular vein or the subclavian vein. However, this method can create such complications as pneumothorax and hemothorax, and repeated failure in inserting the cathet r, especially in infant and child patients, can waste excessive time. Consequently, in our hospital, catheterization of the innominate vein was done after the completion of sternotomy in the cardiac operation of infant and child patients weighing under 1 Okg. During operation, the catheter was placed in the left atrium through the foramen ovate or pulmonary artery to be used for pressure monitoring. When the patient's hemodynamic became stabilized, the catheter was withdrawn to either the right atrium or superior vena casa to be used as the channel for fluid replacement or drug administration. In our hospital, this procedure has been used in 96 cases since 1989. No complications such as pneumothorax and hemothorax occilrred, and neither bleeding after the removal of the catheter was seen.

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