• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.221-227
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• 2015

Background: Endotracheal intubation induces clinically adverse cardiovascular changes. Various pharmacological strategies for controlling these responses have been suggested with opioids being widely administered. In this study, the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses to fiberoptic nasotracheal intubation was evaluated. Methods: Thirty patients, aged 18-63 years, scheduled for elective surgery were included. Anesthesia was induced with a propofol and remifentanil infusion via target-controlled infusion (TCI). Remifentanil infusion was initiated at 3.0 ng/mL, and the response of each patient determined the Ce of remifentanil for the next patient by the Dixon up-and-down method at an interval of 0.5 ng/mL. Rocuronium was administered after propofol and remifentanil reached their preset Ce; 90 seconds later fiberoptic nasotracheal intubation was initiated. Non-invasive blood pressure and heart rate (HR) were measured at pre-induction, the time Ce was reached, immediately before and after intubation, and at 1 and 3 minutes after intubation. The up-and-down criteria comprised a 20% change in mean blood pressure and HR between just prior to intubation and 1 minute after intubation. Results: The median effective effect-site concentration ($EC_{50}$) of remifentanil was $3.11{\pm}0.38ng/mL$ by the Dixon's up-and-down method. From the probit analysis, the $EC_{50}$ of remifentanil was 3.43 ng/mL (95% confidence interval, 2.90-4.06 ng/mL). In PAVA, the EC50 and EC95 of remifentanil were 3.57 ng/mL (95% CI, 2.95-3.89) and 4.35 ng/mL (95% CI, 3.93-4.45). No remifentanil-related complications were observed. Conclusions: The $EC_{50}$ of remifentanil for minimizing the cardiovascular changes and side effects associated with fiberoptic nasotracheal intubation was 3.11-3.43 ng/mL during propofol TCI anesthesia with a Ce of 4 ug/mL.

• The Korean Journal of Physiology
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• v.30 no.2
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• pp.237-247
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• 1996

This study was carried out to determine the effect of $-6^{\circ}$ head-down bedrest on the cardiovascular and hormonal responses to orthostasis and to evaluate the mechanism of orthostatic intolerance. Ten healthy young men were changed the body position from $-6^{\circ}$ head-down or supine bedrest for 2 hr to $70^{\circ}$ head-up tilt for 20 min. During the bedrest, there were no differences in hemodynamic and hormonal changes between the head-down and the supine positions. However, the tendency of decreased end-diastolic volume and increased cardiac contractility during the later period of 2 hr showed that the cardiovascular adaptation could be accelerated within a relatively short period in the head-down bedrest. During the head-up tilt, presyncopal signs were developed in five subjects of the supine bedrest, and one of the same subjects of the head-down bedrest. In the tolerant subjects, the increase in cardiac contractility and plasma epinephrine level during the bend-up tilt was greater following the head-down bedrest than that following the supine bedrest to compensate for reduced venous return. The intolerant subjects showed the greater decrease in end-diastolic and stroke volume, and the greater increase in heart rate during the head-up tilt than the tolerant subjects. Cardiac contractility and plasma epinephrine level were remarkably increased. However, arterial pressure was not maintained at the level for the appropriate compensation of the reduced venous return. It seems that the tolerance to orthostasis is more effective after the short-term head-down bedrest than after the supine bedrest, and the secretion of epinephrine induces the higher cardiac performance as a compensatory mechanism fur the reduced venous return during the orthostasis following the head-down bedrest than the supine bedrest.

• Journal of Ginseng Research
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• v.44 no.3
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• pp.483-489
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• 2020

Background: Korean Red Ginseng (KRG) has been known to possess many ginsenosides. These ginsenosides are used for curing cardiovascular problems. The present study show the protective potential of KRG against doxorubicin (DOX)-induced myocardial dysfunction, by assessing electrocardiographic, hemodynamic, and biochemical parameters and histopathological findings. Methods: Animals were fed a standard chow and adjusted to their environment for 3 days before the experiments. Next, the rats were equally divided into five groups (n = 9, each group). The animals were administered with KRG (250 and 500 mg/kg) for 10 days and injected with DOX (20 mg/kg, subcutaneously, twice at a 24-h interval) on the 8th and 9th day. Electrocardiography and echocardiography were performed to study hemodynamics. Plasma levels of superoxide dismutase, catalase, glutathione peroxidase, and malondialdehyde were measured. In addition, the dose of troponin I and activity of myeloperoxidase in serum and cardiac tissue were analyzed, and the histopathological findings were evaluated using light microscopy. Results: Administration of KRG at a dose of 250 and 500 mg/kg recovered electrocardiographic changes, ejection fraction, fractional shortening, left ventricular systolic pressure, the maximal rate of change in left ventricle contraction (-dP/dt_max), and left ventricle relaxation (-dP/dt_max). In addition, KRG treatment significantly normalized the oxidative stress markers in plasma, dose dependently. In addition, the values of troponin I and myeloperoxidase were ameliorated by KRG treatment, dose dependently. And, KRG treatment showed better histopathological findings when compared with the DOX control group. Conclusion: These mean that KRG mitigates myocardial damage by modulating the hemodynamics, histopathological abnormality, and oxidative stress related to DOX-induced cardiomyopathy in rats. The results of the present study show protective effects of KRG on cardiac toxicity.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.27-33
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• 1989

The relationship between angiographic findings and those of $^{67}Ga$ scan was evaluated in 30 patients with primary hepatocellular carcinoma diagnosed by either pathological examination or laboratory, radiologic findings. Twenty-three cases revealed hot activities on $^{67}Ga$ scan and definite tumor stains on angiography. Main findings of $^{67}Ga$ scans of 7 cases were isoactivity in 5 and cold area in 2, 5 of which revealed faint or no tumor stain on angiography. Cold areas within the primary hepatocellular carcinoma were noted in 9 cases by $^{67}Ga$ scan. In 6 cases these were due to tumor necrosis. Remaining 3 cases had arterioportal shunt, portal vein thrombosis and one had necrosis as well. These results indicate that gallium uptake of primary hepatocellular carcinoma seems to be relatively correlated with tumor stains on angiography. It is well known that the necrotic portion of primary hepatocellular carcinoma does not uptake gallium and it's the main cause of cold areas on $^{67}Ga$ scan. And we suspect that the hemodynamic changes of primary hepatocellular carcinoma such as large arterioportal shunt, portal vein thromosis may cause the decreased activity on $^{67}Ga$ scan.

• The Korean Journal of Nuclear Medicine
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• v.8 no.1_2
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• pp.13-24
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• 1974

The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using $^{131}I$-ortho-iodohippurate and hippuran renogram was analysed by means of quantitative and qualitative methods in 26 patients of Korean hemorr hagic fever. The results obtained with this study were as follows; 1. During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairement of renal function and grave prognosis than the group with obstructive pattern of renogram. 2. During the diuretic phase, the renogram showed obstructive or dysfunction or normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3. During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunnction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4. The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5. There was significant correlationship between the pattern of renogram and the decreace of renal plasma flow in the patients with Korean hemorrhagic fever. The decreace of renal plasma flow was maked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairement, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2322-2328
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• 2013

The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.6
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• pp.571-578
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• 1999

This study evaluated the effects of PKC activation using phorbol 12-myristate 13-acetate (PMA) and PKC inhibition using the isoquinoline sulfomide derivative H-7 on hemodynamics and glucoregulation in the isolated perfused rat liver. Livers were isolated from fed male Holtzman rats and perfused with Krebs Ringer bicarbonate solution under a constant flow of 50 ml/min at $35^{\circ}C.$ Portal vein pressure, glucose and lactate concentrations in the medium and oxygen consumption rates were continuously monitored by a Grass polygraph, YSI glucose and lactate monitors, and a YSI oxygen monitor, respectively. PMA at concentration of 2 to 200 nM increased the portal vein pressure, glucose and lactate production, but decreased oxygen consumption rate in a dose-dependent fashion. H-7 $(200\;{\mu}M)$ attenuated PMA (50 nM)-induced vasoconstriction $(15.1{\pm}1.36\;vs\;10.56{\pm}1.17\;mmHg),$ glucose production rate $(91.3{\pm}6.15\;vs\;71.8{\pm}2.50\;{\mu}moles/g/hr),$ lactate production rate $(72.4{\pm}6.82\;vs\;53.6{\pm}4.82\;{\mu}moles/g/hr)$ and oxygen consumption rate $(33.7{\pm}1.41\;vs\;27.9{\pm}1.75\;{\mu}l/g/min).$ The effects of PMA were blocked either by addition of verapamil $(9\;{\mu}M)$ or perfusion with $Ca^{2+}-free$ KRB. These results suggest that the hemodynamic and glucoregulatory changes in the perfused rat liver are mediated by protein kinase C activation and require $Ca^{2+}$ influx from the extracellular fluid.

• Journal of Korean Biological Nursing Science
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• v.14 no.4
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• pp.275-281
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• 2012

Purpose: This study was performed to evaluate the effect of low-dose lidocaine on fentanyl-induced cough and hemodynamic changes under general anesthesia. This research was a randomized trial design and performed using a double-blind method. Methods: Data collection was performed from October 22, 2008, to May 4, 2009. One hundred and thirty two patients were randomly assigned to control group (Con G) and experimental group (Exp G) using a table of random numbers. Exp G (n=66) were administered 0.5 mg/kg lidocaine and Con G (n=66)) were administered saline. The occurrence of cough and vital sign were recorded within one minute after fentanyl bolus by an anesthesiologist. Collected data were analyzed using Repeated measures ANOVA using SPSS for Windows (Version 17.0). Results: The incidence of cough in Exp G was 13.6%, while Con G was 53%. The incidence cough in Exp G was significantly lower compared to Con G (p<.001). Lidocaine seemed not to suppress mean arterial pressure (p=.145), heart rate (p=.508), and oxygen saturation (p=.161). Conclusion: Intravenous administration of 0.5 mg/kg lidocaine seems to suppress fentanyl-induced cough without affecting mean blood pressure, heart rate and oxygen saturation. Therefore, we recommend intravenous 0.5 mg/kg lidocaine administration to suppress fentanyl-induced cough under general anesthesia.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.203-206
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• 2012

Treatment for heart failure is directed to reduce atrial volume overload by diuretic agents, to lessen ventricular pressure overload by vasodilatory agents and to increase myocardial performance through inotropic agents. Of those cardiac therapeutics, diuretic agents are the most important to control heart failure in dogs, although long-term use often causes detrimental side-effects such as acute renal failure and electrolyte abnormalities. Thus, this study was designed to find a new diuretic agent from medicinal herbs which has better diuretic effect and less unfavorable complications in dogs. In a preliminary study performed with 5 normal healthy dogs, the extract from Akebia quinata Decaisne showed mild to moderate diuretic effect (0.3-0.5 potency of furosemide 2 mg/kg) and minimal changes in serum chemistry and electrolyte. Although the study population was not large enough and study period was not sufficient enough, this study found a good alternative diuretic agent which can replace or reduce the use of furosemide in dogs with heart failure.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.166-169
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• 1997

Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISB) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred $39{\pm}18$ min after sitting position and $22{\pm}18$ min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-parish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex.