• Title/Summary/Keyword: peak-flow

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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The Differences in Resting Pulmonary Function in Relation to the Nutritional status of Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자의 영양상태에 따른 안정시 폐기능 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Park, Jong-Won;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Kim, Jung-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.570-578
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    • 2001
  • Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.

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Effect of Hypothermia on the Prevention of Ventilator-Induced Lung Injury in Rats (백서에서 저체온 전처치가 환기기유발폐손상 억제에 미치는 효과)

  • Lim, Chae-Man;Hong, Sang-Bum;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.540-548
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    • 2001
  • Backgrounds : Because ventilator-induced lung injury is partly dependent on the intensity of vascular flow, we hypothesized that hypothermia may attenuate the degree of such an injury through a reduced cardiac output. Methods : Twenty-seven male Sprague-Dawley rats were randomly assigned to normothermia ($37{\pm}1^{\circ}C$)-injurious ventilation (NT-V) group (n=10), hypothermia ($27{\pm}1^{\circ}C$)-injurious ventilation (HT-V) group (n=10), or nonventilated control group (n=7). The two thermal groups were subjected to injurious mechanical ventilation for 20 min with peak airway pressure 30 cm $H_2O$ at zero positive end-expiratory pressure, which was translated to tidal volume $54{\pm}6\;ml$ in the NT-V group and $53{\pm}4\;ml$ in the HT-V group (p>0.05). Results : Pressure-volume (P-V) curve after the injurious ventilation was almost identical to the baseline P-V curve in the HT-V group, whereas it was shifted rightward in the NT-V group. On gross inspection, the lungs of the HT-V group appeared smaller in size, and showed less hemorrhage especially at the dependent regions, than the lungs of the NT-V group. [Wet lung weight (g)/body weight (kg)] ($1.6{\pm}0.1$ vs $2.4{\pm}1.2$ ; p=0.014) and [wet lung weight/dry lung weight] ($5.0{\pm}0.1$ vs $6.1{\pm}0.8$ ; p=0.046) of the HT-V group were both lower than those of the NT-V group, while not different from those of the control group($1.4{\pm}0.4$, $4.8{\pm}0.4$, respectively). Protein concentration of the BAL fluid of the HT-V group was lower than that of the NT-V group($1,374{\pm}726\;ug/ml$ vs $3,471{\pm}1,985\;ug/ml$;p=0.003). Lactic dehydrogenase level of the BAL fluid of the HT-V group was lower than that of the NT-V group ($0.18{\pm}0.10\;unit/ml$ vs $0.43{\pm}0.22\;unit/ml$;p=0.046). Conclusions : Hypothermia attenuated pulmonary hemorrhage, permeability pulmonary edema, and alveolar cellular injuries associated with injurious mechanical ventilation, and preserved normal P-V characteristics of the lung in rats.

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Bronchial Responsiveness in Patients with Mitral Valvular Heart Disease (승모판 심장질환 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ho-Cheol;Kim, Min-Gu;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.752-759
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    • 1995
  • Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.

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Loss of FHIT Expression in Non-Small Cell Lung Cancer; The Clinical Significance and Effects on Apoptosis and Cell Proliferation Cycle (비소세포 폐암에서 FHIT 유전자의 발현소실의 임상적의의 및 세포고사 및 세포분열주기에 미치는 영향)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.610-620
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    • 2003
  • Background : 3p deletion has been shown to be the most frequently occurring change in lung cancers, suggesting the presence of a tumor suppressor gene in this region. Recent attention has focused on a candidate 3p14.2 tumor suppressor gene, FHIT. Therefore, the association of the expression of FHIT, with apoptosis, cell proliferation cycle and the clinicopathological features, including survival, were investigated Materials and Methods : 83 patients with non-small cell lung cancer, who underwent curative operation, between Jan. 1996 and Aug. 2000, at the Wonkwang university hospital, were analyzed. The expression of the FHIT was identified by immunohistochemical staining, and rate of apoptosis and cell proliferation cycle by flow cytometry. Results : 43% (36/83) of patients exhibited no FHIT expression. The rates of FHIT loss were 52% (28/54), 22% (5/23), 50% (3/6); 30% (11/37), 48% (16/33), 69% (9/13); 54% (30/56) and 22% (6/27), in squamous cell cancers, adenocarcinomas, large cell cancers, TNM stages I, II and III, smokers and non-smokers, respectively. All the differences in FHIT loss rates, according to the histopathology, TNM stages and smoking habits, were statistically significant. The median survival time and 2-year survival rate of the FHIT(-) group were 24 months and 44%, and those of the FHIT(+) group were 25 months and 51% (p>0.05), respectively. The apoptotic rate of the FHIT(-) and FHIT(+) groups were 50.72 (${\pm}13.93$) and 59.38 (${\pm}14.33$)%, respectively (p=0.01). The S- and G1-phase fractions of the FHIT(-) and FHIT(+) groups were 13.93 (${\pm}7.35$) and $51.50({\pm}23.15$)% and 15.65(${\pm}6.59$) and 54.16 (${\pm}20.25$)%, respectively (p>0.05). Conclusion : The loss of FHIT expression was increased to a greater extent with advancing TNM stage, smoking habits and squamous cell cancer compared to the adenocarcinomas. However, no survival differences were found according to the expression of FHIT. The apoptotic rate of the FHIT(+) group was greater than in the FHIT(-) group, but differences in the S- and G1-phase fractions, according to the expression of the FHIT, were not found.

Mock-up Test of Temperature Crack Reduction Method Application by Setting Time Control of Mat Foundation Mass Concrete (응결시간조정에 의한 매트기초 매스 콘크리트의 온도균열저감 공법적용의 Mock-up Test)

  • Han, Cheon-Goo;Lee, Jae-Sam;Noh, Sang-Kyun
    • Journal of the Korea Institute of Building Construction
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    • v.9 no.4
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    • pp.55-61
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    • 2009
  • Recently, the number of high-rise buildings being built in Korea by major construction companies for residential and commercial use has been increasing. When constructing a high-rise building, it is necessary to apply massive amounts of concrete to form a mat foundation that can withstand the huge load of the upper structure. However, it is of increasing concern that due to limitations in terms of the amount of placing equipment, available job-sites and systems for mass concrete placement in the construction field, it is not always possible to place a great quantity of concrete simultaneously in a large-scale mat foundation, and for this reason consistency between placement lift cannot be secured. In addition, a mat foundation Is likely to crack due to the stress caused by differences inhydration heat generation time. To derive a solution for these problems, this study provides test results of a hydration heat crack reduction method by applying placement lift change and setting time control with a super retarding agent for mass concrete in a large-scale mat foundation. Mock-up specimens with different mixtures and placement liftswere prepared at the job-site of a newly-constructed high-rise building. The test results show that slump flow of concrete before and after adding the super retarding agent somewhat Increases as the target retarding time gets longer, while the air content shows no great difference. The setting time was observed to be retarded as the target retarding time gets longer. As the target retarding time gets longer, compressive strength appears to be decreased at an early stage, but as time goes by, compressive strength gets higher, and the compressive strength at 28 days becomes equal or higher to that of plain concrete without a super retarding agent. For the effect of placement lift change and super retarding agent on the reduction of hydration heat, the application of 2 and 4 placement lifts and a super retarding agent makes it possible to secure consistency and reduce temperature difference between placement lifts, while also extending the time to reach peak temperature. This implies that the possibility of thermal crack induced by hydration heat is reduced. The best results are shown in the case of applying 4 placement lifts.

Characteristics of the Rainfall-Runoff and Groundwater Level Change at Milbot Bog located in Mt.Cheonseong (천성산 밀밭늪의 강우 유출 및 지하수위 변동 특성)

  • Jung, Yu-Gyeong;Lee, Sang-Won;Lee, Heon-Ho
    • Journal of Korean Society of Forest Science
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    • v.99 no.4
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    • pp.559-567
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    • 2010
  • This study was conducted to investigate the hydrological characteristics of groundwater level change and rainfall hydrological runoff processes caused by tunnel construction at Milbot bog located in Mt. Cheonseong. Data were collected from July 2004 to May 2008. The results were summarized as follows: The occurrence time of the direct runoff caused by unit rainfall at the Milbot bog were tended to be slower than those at general mountainous basin. Also, runoff did not sensitively respond to amount of rainfall at the most of the long and short term hydrograph. The annual runoff rates from 2004 to 2008 were 0.26, 0.13, 0.16, 0.25 and 0.27, respectively, slightly increased after 2005 regardless of the tunnel construction. Thus, the function of Milbot bog will be weakened, and it supposed to be changed to land in the future because of increasing annual runoff. The annual runoff rate for 4 years was 0.19, which is greatly lower than that of general mountainous basin. The recession coefficient of the direct runoff in short term hydrograph was ranged to 0.89~0.97, which is much larger than that of the general mountainous basin, 0.2~0.8. The recession coefficient of base flow ranged from 0.93 to 0.99, which are similar to general mountainous watershed's values. Groundwater level of Milbot bog increased or decreased in proportion to rainfall intensity, and in the descending time after the groundwater level was reached at peak point, it tends to be decreased very slowly. Also, groundwater level increased or decreased maintaining relatively high value after precedent rainfall. Groundwater level was highest during summer with heavy rainfall, but was lowest during winter. Average groundwater levels decreased annually from 2004 to 2008, -8.48 cm, -14.60 cm, -20.46 cm, -20.11 cm, -28.59 cm, respectively. Therefore, it seems that the Milbot bog is becoming dry and losing its function as a bog.

PREPARATION OF AMORPHOUS CARBON NITRIDE FILMS AND DLC FILMS BY SHIELDED ARC ION PLATING AND THEIR TRIBOLOGICAL PROPERTIES

  • Takai, Osamu
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2000.11a
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    • pp.3-4
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    • 2000
  • Many researchers are interested in the synthesis and characterization of carbon nitride and diamond-like carbon (DLq because they show excellent mechanical properties such as low friction and high wear resistance and excellent electrical properties such as controllable electical resistivity and good field electron emission. We have deposited amorphous carbon nitride (a-C:N) thin films and DLC thin films by shielded arc ion plating (SAIP) and evaluated the structural and tribological properties. The application of appropriate negative bias on substrates is effective to increase the film hardness and wear resistance. This paper reports on the deposition and tribological OLC films in relation to the substrate bias voltage (Vs). films are compared with those of the OLC films. A high purity sintered graphite target was mounted on a cathode as a carbon source. Nitrogen or argon was introduced into a deposition chamber through each mass flow controller. After the initiation of an arc plasma at 60 A and 1 Pa, the target surface was heated and evaporated by the plasma. Carbon atoms and clusters evaporated from the target were ionized partially and reacted with activated nitrogen species, and a carbon nitride film was deposited onto a Si (100) substrate when we used nitrogen as a reactant gas. The surface of the growing film also reacted with activated nitrogen species. Carbon macropartic1es (0.1 -100 maicro-m) evaporated from the target at the same time were not ionized and did not react fully with nitrogen species. These macroparticles interfered with the formation of the carbon nitride film. Therefore we set a shielding plate made of stainless steel between the target and the substrate to trap the macropartic1es. This shielding method is very effective to prepare smooth a-CN films. We, therefore, call this method "shielded arc ion plating (SAIP)". For the deposition of DLC films we used argon instead of nitrogen. Films of about 150 nm in thickness were deposited onto Si substrates. Their structures, chemical compositions and chemical bonding states were analyzed by using X-ray diffraction, Raman spectroscopy, X-ray photoelectron spectroscopy and infrared spectroscopy. Hardness of the films was measured with a nanointender interfaced with an atomic force microscope (AFM). A Berkovich-type diamond tip whose radius was less than 100 nm was used for the measurement. A force-displacement curve of each film was measured at a peak load force of 250 maicro-N. Load, hold and unload times for each indentation were 2.5, 0 and 2.5 s, respectively. Hardness of each film was determined from five force-displacement curves. Wear resistance of the films was analyzed as follows. First, each film surface was scanned with the diamond tip at a constant load force of 20 maicro-N. The tip scanning was repeated 30 times in a 1 urn-square region with 512 lines at a scanning rate of 2 um/ s. After this tip-scanning, the film surface was observed in the AFM mode at a constant force of 5 maicro-N with the same Berkovich-type tip. The hardness of a-CN films was less dependent on Vs. The hardness of the film deposited at Vs=O V in a nitrogen plasma was about 10 GPa and almost similar to that of Si. It slightly increased to 12 - 15 GPa when a bias voltage of -100 - -500 V was applied to the substrate with showing its maximum at Vs=-300 V. The film deposited at Vs=O V was least wear resistant which was consistent with its lowest hardness. The biased films became more wear resistant. Particularly the film deposited at Vs=-300 V showed remarkable wear resistance. Its wear depth was too shallow to be measured with AFM. On the other hand, the DLC film, deposited at Vs=-l00 V in an argon plasma, whose hardness was 35 GPa was obviously worn under the same wear test conditions. The a-C:N films show higher wear resistance than DLC films and are useful for wear resistant coatings on various mechanical and electronic parts.nic parts.

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Early Results of Maze III Operation Without Cryoablation (냉동절제 없이 시행한 Maze III 술식의 조기 결과)

  • 김형수;이원용;오동진;지현근;홍기우;두영철
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.255-261
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    • 1999
  • Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.

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Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery (소아 개심술에 있어서 변형초여과법의 효과)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.591-597
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    • 1997
  • Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

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