• Title/Summary/Keyword: pressure difference

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Mitral Valvuloplasty using New Mitral Strip (Mitracon^{(R)}$) (새로운 Strip (Mitracon^{(R)}$)을 이용한 승모판막 성형술)

  • Kang, Seong-Sik;Kim, Sang-Pil;Song, Meong-Gum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.320-328
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    • 2008
  • Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.

The Changes of Plasma Catecholamines Concentration during Waking and Sleep in Obstructive Sleep Apnea Syndrome Patients with Systemic Hypertension (전신성 고혈압을 동반한 폐쇄성 수면 무호흡증후군 환자에서 각성시와 수면중의 혈장 Catecholamines 농도 변화)

  • Moon, Hwa Sik;Lo, Dae Guen;Choi, Young Mee;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.600-612
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    • 1996
  • Background : Recent studies deported that untreated patients with obstructive sleep apnea syndrome had high long-term mortality rates, and cardiovascular complications of these patients clad a major effect on mortality. Several data indicates that obstructive sheep apnea syndrome contributes to the development of diurnal systemic hypertension. But the pathophysiological mechanism of the development of systemic hypertension in these patients is still uncertain. This study was performed to evaluate the possible role of sympathetic nervous system activity for the development of systemic hypertension in patients with obstructive sleep apnea syndrome. Method : 35 patients with obstructive sleep apnea syndrome(OSAS) and 13 Control subjects(control) were included in this study. 21 patients of OSAS were normotensives(OSAS-NBP), and 14 patients of OSAS were hypertensives(OSAS-HBP). Full night polysomnography was undertaken to all subjects. We measured plasma norepinephrine(NE) and epinephrine(EP) concentrations during waking and sleep, using high performance liquid chromatography, in all patients and control subjects. Results : In OSAS, OSAS-NBP and control, plasma NE and EP concentrations during sleep were lowed than during waking(p<0.01). But, in OSAS-HBP, these was no difference between during waking and sleep. Plasma NE concentrations during sleep of OSAS, OSAS-NBP and OSAS-HBP were higher than Control(p<0.05). In OSAS-HBP, daytime systolic blood pressure correlated with plasma NE concentration during sleep(r=0.7415, p<0.01), arid correlated inversely with mean arterial oxygen saturation(r=-0.6465, p<0.05) or arterial oxygen saturation nadir(r=-0.6) 14, p<0.05) during sleep. Conclusion : The sympathetic activity during sleep of obstructive sleep apnea syndrome patients was higher than control subjects. In obstructive sleep apnea syndrome patients with systemic hypertension, there was no diurnal variation of sympathetic activity, and there was correlation between daytime systolic blood pressure and sympathetic activity during sleep. These data suggests that chronic hyperactivity of sympathetic nervous system may contribute to the development of diurnal systemic hypertension in patients with obstructive sleep apnea syndrome.

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Relationship of Compliance and Oxygen Transport in Experimental Acute Respiratory Failure during Positive End-Expiratory Pressure Ventilation (실험적 급성호흡부전에서 호기말양압에 의한 폐유순도와 산소운반의 변화 및 상관관계 - 호흡부전의 기전에 따른 차이 -)

  • Lee, Sang-Do;Yoon, Se-Jin;Lee, Bok-Hee;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.6-15
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    • 1993
  • Background: Positive end, expiratory pressure (PEEP) has become one of the standard therapies for adult respiratory distress syndrome (ARDS). Total static compliance has been proposed as a guide to determine the size of PEEP ('best PEEP') which is of unproven clinical benefit and remains controversial. Besides increasing functional residual capacity and thus improving oxygenation, PEEP stimulate prostacyclin secretion and was proposed for the treatment of acute pulmonary embolism. But little is known about the effect of PEEP on hemodynamic and gas exchange disturbances in acute pulmonary embolism. Methods: To study the validity of total static compliance as a predictor of 'best PEEP' in ARDS and acute pulmonary embolism, experimental ARDS was induced in mongrel dog with oleic acid and acute pulmonary embolism with autologous blood clot. Then hemodynamic and gas exchange parameters were measured with serial increment of PEEP. Results:In ARDS group, total static compliance and oxygen transport were maximal at 5 cm$H_2O$, and decreased thereafter (p<0.05). With increment of PEEP, arterial oxygen tension ($PaO_2$) and arterial carbon dioxide tension ($PaCO_2$) increased and cardiac output and physiological shunt decreased. In pulmonary embolism group, total static compliance, oxygen transport, physiological shunt and cardiac output decreased and $PaO_2$ and $PaCO_2$ increased with increment of PEEP (p<0.05). Comparing the change induced by increment of PEEP by 1 cm$H_2O$ in ARDS group with that in pulmonary embolism group, there was no significant difference between two groups except cardiac output which decreased more in pulmonary embolism group (p<0.05). In ARDS group, oxygen transport and total static compliance increased after PEEP application, and total static compliance was maximal at the PEEP level where oxygen transport was maximal. However in pulmonary embolism group, oxygen transport and total static compliance decreased after application of PEEP. There was significant correlation between change of total static compliance and change of oxygen transport in both groups. Conclusion: In both ARDS and acute pulmonary embolism, it can be concluded that total static compliance is useful as a predictor of 'best PEEP'.

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The Change of The Effect on The Subcutaneous Fat Area and Visceral Fat Area by The Functional Electrical Stimulation and Aerobic Exercise (기능적 전기 자극과 유산소 운동이 복부비만의 피하지방과 내장지방에 미치는 효과)

  • Oh Sung-tae;Lee Mun-hwan;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.85-123
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    • 2004
  • Back ground : Subcutaneous fat area is the main factor involved in replacement disease and arteriosclerosis. Simple weight control is the appropriate medical treatment. It's understood that weight reduction does not only reduce the fat concentrations in blood but also reduces blood pressure, improves glucose levels in diabetes patients and reduces incidents of heart disease. there are several methods for reducing fat in the abdominal region but their effectiveness is not folly understood. one method is electrical stimulation of the problem areas. Method : From May 1st 2002 to October 31st. The 15 subjects who received medical examination were aged between 25 and 53 and were of mixed gender. The subjects were divided into two groups one to received functional electrical stimulation and the other a control group. Using Broca's criterion for judging fat grades. I analysed the differences between the two groups before and after the treatment. Subjects received functional electrical stimulation on the abdominal muscle intensity 50Hz. They received this treatment 4 days a week for 40 minutes a day. In the case of aerobic exercise, at the Treadmill, we used it with the intensity of $75\%$ maximum heart rate (220-age). Result 1)After functional electrical stimulation in the case of male subjects, the weight was reduced 1.93kg, obesity $2.60\%$, fat mass 2.73kg, Percent body fat $4.40\%$, waist circumference 6.53cm, circumference of hips 5.53cm. On the other side, the quality of muscle was increased at the rate of 1.03kg, but it's not attentional level. The subcutaneous fat area was reduced by $26.63cm^2$, the visceral fat area was reduced by $43.00cm^2$, In the female subjects, we can see the reduction of fat grade by $26.63cm^2$, the quantity of body fat by 1.5kg, percent body fat by $1.77\%$, circumference of waist by 4.02cm, circumference of hips by 3.67cm, weight by 1.40kg but was increased 0.72kg at the quantity of muscles. We can see the reduction also in the subcutaneous fat area $24.03cm^2$, the visceral fat area by $25.36cm^2$. 2)After aerobic exercise, on the male subjects, we can see reduction of weight by 3.36kg, obesity by $4.00\%$, fat mass by 2.83kg and we can see increase at the soft lean mass by 2.96kg, but we can see reduction, the percent body fat by $3.03\%$, fat distribution by $0.023\%$, circumference of waist by 3.10cm, circumference of hips by 2.23cm. The female subjects show a reduction in the weight by 2.48kg, percent body fat by $2.20\%$, show an increase in the soft lean mass by 1.54kg. We can see a reduction in the quantity of fat mass by 2.32kg, the percent body fat by $2.80\%$, the circumference of waist by 2.16cm, the circumference of hips by 2.68cm, the fat distribution by $0.016\%$, the subcutaneous fat area by $15.25cm^2$ the visceral fat area by $11.52cm^2$. After aerobic exercise, we can't see the attentional change at the total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. 3)After the application of functional electrical stimulation and aerobic exercise, in result of measurement on the body ingredient, we could see the weight reduction and increase the quantity of muscle with the male group who exercised aerobic. We can see the attentional rate on the electrical stimulation about abdominal fat rate, circumference of waist, circumference of hips. The other hand, I couldn't see the attentional differences between the two groups in the rate of fatness and quantity of body fat and the rate of body fat. There isn't any attentional difference in the area of fat under skin, on the contrary, There is attentional difference in the fat in the internal organs area at the electrical stimulation site. We can't see the attentional change of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol between electrical stimulation and aerobic exercise. 4)After execution of functional electrical stimulation and aerobic exercise, in result of measurement on change of body ingredient among female objects, We could see weight reduction, increase at muscle quantity in the aerobic exercise group. We could see the attentional differences in the rate of fatness, the rate of abdominal region, the circumference which received electrical stimulation. But, we couldn't see the attentional differences between two groups in the quantity of body fatness, the circumference of hips. The subcutaneous fat area doesn't show the attentional differences. On the Contrary, we could see lots of differences in the visceral fat area of the electrical stimulation group. Conclusion The results show that functional electrical stimulation and aerobic exercise have insignificant differences when if comes to total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. Though there is affirmative change in body ingredient after both electrical stimulation and aerobic exercise. Functional electrical stimulation is more effective on the subcutaneous fat area and in changing visceral fat area. There fore. It is concluded that the physical therapy is more effective in the treatment of abdominal fatness.

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Effects of Compositions of Saponin Fraction from Korean Red Ginseng in the Relaxation of Rabbit and Rat Corpus Cavernosum (토끼와 흰쥐 음경해면체 이완작용에 미치는 홍삼사포닌 분획별 효과)

  • Choi Young Deuk;Park Jin Ah;Choi Hyung Ki;Nam Ki Yeul
    • Journal of Ginseng Research
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    • v.23 no.1 s.53
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    • pp.13-20
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    • 1999
  • We previously reported that Korean red ginseng (KRG) has a relaxation effect on the smooth muscles of corpus cavernosum via nitric oxide (NO) pathway and calcium and potassium channels. However, it is suggested that the active ingredients of KRG might be different depending on the sources of preparation, and there might be differences in actions for different compositions. We first investigated the composition of KRG saponins according to the extractions of the various sources of KRG, then with these extractions the relaxation effects were evaluated in vitro and hemodynamical in vivo using New Zealand white rabbit and rat corpus cavernosum. The total compositions of ginsenoside $(G-Rb_1,\;-Rb_2,\;-Rc,\;-Rd,\;G-Re,\;-Rf,\;-Rg_1)$ in fractionated KRG saponin designated as TS-1, TS-2, TS-3 were $41\%,\;40\%,\;and\;62\%,$ respectively, and the ratios of PD saponin and PT saponin (PD/PT) were 1,55, 1.72, 2.25, and 2.61, the values of which were statistically significant. In vitro studies using the rabbit corpus cavernosal muscle strips, the KRG saponin relaxed cavernosal strips in a dose-dependent manner, and same results were observed in in vivo studies, that KRG saponin increased the intracavernosal pressure in the rat. There was difference in the efficacy according to fractionation techniques. The differences in the total contents of ginsenosides did not affect relaxation, rather PT saponin content was statistically related to the degree of cavernosal relaxation, and this action presumed to be mediated by NO pathway and calcium and potassium channels. In conclusion, KRG exerts relaxation which is a key step in erection via combination of effects on NO system or calcium and potassium channels. The efficacy of this action is different to the sources of ginseng, which is affected by the different composition of ginsenosides $(G-Rb_1,\;-Rb_2,\;-Rc,\;-Rd,\;G-Re,\;-Rf,\;-Rg_1).$ Thus the further studies on the active ingredients such as minor ginsenosides and non-saponin components of red ginseng with maximum potency should be sought.

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Design of a pilot-scale helium heating system to support the SI cycle (파이롯 규모 SI 공정 시험 설비에서의 헬륨 가열 장치 설계)

  • Jang, Se-Hyun;Choi, Yong-Suk;Lee, Ki-Young;Shin, Young-Joon;Lee, Tae-Hoon;Kim, Jong-Ho;Yoon, Seok-Hun;Choi, Jae-Hyuk
    • Journal of Advanced Marine Engineering and Technology
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    • v.40 no.3
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    • pp.157-164
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    • 2016
  • In this study, researchers performed preliminary design and numerical analysis for a pilot-scale helium heating system intended to support full-scale construction for a sulfur-iodine (SI) cycle. The helium heat exchanger used a liquefied petroleum gas (LPG) combustor. Exhaust gas velocity at the heat exchanger outlet was approximately 40 m/s based on computational thermal and flow analysis. The maximum gas temperature was reached with six baffles in the design; lower gas temperatures were observed with four baffles. The amount of heat transfer was also higher with six baffles. Installation of additional baffles may reduce fuel costs because of the reduced LPG exhausted to the heat exchanger. However, additional baffles may also increase the pressure difference between the exchanger's inlet and outlet. Therefore, it is important to find the optimum number of baffles. Structural analysis, followed by thermal and flow analysis, indicated a 3.86 mm thermal expansion at the middle of the shell and tube type heat exchanger when both ends were supported. Structural analysis conditions included a helium flow rate of 3.729 mol/s and a helium outlet temperature of $910^{\circ}C$. An exhaust gas temperature of $1300^{\circ}C$ and an exhaust gas rate of 52 g/s were confirmed to achieve the helium outlet temperature of $910^{\circ}C$ with an exchanger inlet temperature of $135^{\circ}C$ in an LPG-fueled helium heating system.

Comparison of micro CT and cross-section technique for evaluation of marginal and internal fit of lithium disilicate crowns (전부 도재관의 변연 및 내면 간극에 대한 micro CT와 절단 시편 측정법의 비교)

  • Ko, In-Seok;Kim, Jeong-Mi;Cho, Hye-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.226-233
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    • 2016
  • Purpose: The purpose of this study was to evaluate the adaptation of lithium disilicate crowns fabricated by CAD-CAM (computer aided design-computer aided manufacturing) and heat-press technique to compare two different measurement methods in assessing fit of the ceramic crowns: micro CT and cross-section technique. Materials and methods: A prepared typodont mandibular molar for ceramic crown was duplicated and ten dies were produced by milling the PMMA (polymethylmethacrylate) resin. Ten vinyl polysiloxane impressions were made and stone casts were produced. Five dies were used for IPS e.max Press crowns with heat-press technique. The other five dies were used for IPS e.max CAD crowns with CAD-CAM technique. Ten lithium disilicate crowns were cemented on the resin dies using zinc phosphate cement with finger pressure. The marginal and internal fits in central buccolingual plane were evaluated using a micro CT. Then the specimens were embedded and cross-sectioned and the marginal and internal fits were measured using scanning electronic microscope. The two measurement methods and two manufacturing methods were compared using Mann-Whitney U test (SPSS 22.0). Results: The marginal and internal fit values using micro CT and cross-section technique were similar, showing no significant differences. There were no significant differences in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique. Conclusion: Both micro CT and cross-section technique were acceptable methods in the evaluation of marginal and internal fit of lithium disilicate crown. There was no difference in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique except occlusal fit.

Investigating the Partial Substitution of Chicken Feather for Wood Fiber in the Production of Wood-based Fiberboard (목질 섬유판 제조에 있어 도계부산물인 닭털의 목섬유 부분적 대체화 탐색)

  • Yang, In;Park, Dae-Hak;Choi, Won-Sil;Oh, Sei Chang;Ahn, Dong-uk;Han, Gyu-Seong;Oh, Seung Won
    • Korean Chemical Engineering Research
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    • v.56 no.4
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    • pp.577-584
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    • 2018
  • This study was conducted to investigate the potential of chicken feather (CF), which is a by-product in poultry industry, as a partial substitute of wood fiber in the production of wood-based fiberboard. Keratin-type protein constituted the majority of CF, and its appearance did not differ from that of wood fiber. When the formaldehyde (HCHO) adsorptivities of CF compared by its pretreatment type, feather meal (FM), which was pretreated CF with high temperature and pressure and then grounded, showed the highest HCHO adsorptivity. In addition, there was no difference between the adsorbed HCHO amounts, which was measured by dinitrophenylhydrazine method, of scissors-chopped CF and CF beated with an electrical blender. Mechanical properties and HCHO emission of medium-density fiberboards (MDF), which were fabricated with wood fiber and 5 wt% CF, beated CF or FM based on the oven-dried weight of wood fiber, were not influenced by the pretreatment type of CF. However, when the values compared with those of MDF made with just wood fiber, thickness swelling and HCHO emission of the MDF were improved greatly with the addition of CF, beated CF or FM. Based on the results, it might be possible to produce MDF with improved dimensional stability and low HCHO emission if CF, beated CF or FM is added partially as a substitute of wood fiber in the manufacturing process of MDF produced with the conventional urea-formaldehyde resin of $E_1$ grade. However, the use of CF or FM in the production of MDF has a low economic feasibility at the current situation due to the securing difficulty and high cost of CF. In order to enhance the economic feasibility, it requires to use CF produced at small to medium-sized chicken meat plants. More importantly, it is considered that the technology developed from this research has a great potential to make provision for the prohibition of animal-based feed and to dispose environmentally avian influenza-infected poultry.

Analysis of a Groundwater Flow System in Fractured Rock Mass Using the Concept of Hydraulic Compartment (수리영역 개념을 적용한 단열암반의 지하수유동체계 해석)

  • Cho Sung-Il;Kim Chun-Soo;Bae Dae-Seok;Kim Kyung-Su;Song Moo-Young
    • The Journal of Engineering Geology
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    • v.16 no.1 s.47
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    • pp.69-83
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    • 2006
  • This study aims to evaluate a complex groundwater flow system around the underground oil storage caverns using the concept of hydraulic compartment. For the hydrogeological analysis, the hydraulic testing data, the evolution of groundwater levels in 28 surface monitoring boreholes and pressure variation of 95 horizontal and 63 vertical water curtain holes in the caverns were utilized. At the cavern level, the Hydraulic Conductor Domains(fracture zones) are characterized one local major fracture zone(NE-1)and two local fracture zones between the FZ-1 and FZ-2 fracture zones. The Hydraulic Rock Domain(rock mass) is divided into four compartments by the above local fracture zones. Two Hydraulic Rock Domains(A, B) around the FZ-2 zone have a relatively high initial groundwater pressures up to $15kg/cm^2$ and the differences between the upper and lower groundwater levels, measured from the monitoring holes equipped with double completion, are in the range of 10 and 40 m throughout the construction stage, indicating relatively good hydraulic connection between the near surface and bedrock groundwater systems. On the other hand, two Hydraulic Rock Domains(C, D) adjacent to the FZ-1, the groundwater levels in the upper and lower zones are shown a great difference in the maximum of 120 m and the high water levels in the upper groundwater system were not varied during the construction stage. This might be resulted from the very low hydraulic conductivity$(7.2X10^{-10}m/sec)$ in the zone, six times lower than that of Domain C, D. Groundwater recharge rates obtained from the numerical modeling are 2% of the annual mean precipitation(1,356mm/year) for 20 years.

Seasonal Variations of Evapotranspiration Observed in a Mixed forest in the Seolmacheon Catchment (설마천 유역의 혼효림에서 관측된 증발산의 계절변화)

  • Kwon, Hyo-Jung;Lee, Jung-Hoon;Lee, Yeon-Kil;Lee, Jin-Won;Jung, Sung-Won;Kim, Joon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.11 no.1
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    • pp.39-47
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    • 2009
  • The importance of securing water resources and their efficient management has attracted more attention recently due to water deficit. In water budget analysis, however, evapotranspiration(${\lambda}E$) has been approximated as the residual in the water balance equation or estimated from empirical equations and assumptions. To minimize the uncertainties in these estimates, it is necessary to directly measure ${\lambda}E$. In this study, using the eddy covariance technique, we have measured ${\lambda}E$ in a mixed forest in the Seolmacheon catchment in Korea from September 2007 to December 2008. During the growing season(May-July), ${\lambda}E$ in this mixed forest averaged about $2.2\;mm\;d^{-1}$, whereas it was on average $0.5\;mm\;d^{-1}$ during the non-growing season in winter. The annual total ${\lambda}E$ in 2008 was $581\;mm\;y^{-1}$, which is about 1/3 of the annual precipitation of 1997 mm. Despite the differences in the amount and frequency of precipitation, the accumulated ${\lambda}E$ during the overlapping period(i.e., September to December) for 2007 and 2008 was both ${\sim}110$ mm, showing virtually no difference. The omega factor, which is a measure of decoupling between forest and the atmosphere, was on average 0.5, indicating that the contributions of equilibrium ${\lambda}E$ and imposed ${\lambda}E$ to the total ${\lambda}E$ were about the same. The results suggest that ${\lambda}E$ in this mixed forest was controlled by various factors such as net radiation, vapor pressure deficit, and canopy conductance. In this study, based on the direct measurements of ${\lambda}E$, we have quantified the relative contribution of ${\lambda}E$ in the water balance of a mixed forest in the Seolmacheon catchment. In combination with runoff data, the information on ${\lambda}E$ would greatly enhance the reliability of water budget analysis in this catchment.