• Title/Summary/Keyword: 산소압

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Can Peritoneal Dialysis Remove Endothelin-1 after Cardiopulmonary Bypass for Repair of Congenital Heart Disease? (체외순환을 이용한 선천성 심장수술 후에 시행한 복막투석이 내피의존성 혈관 활성 물질인 Endothelin-1을 제거할 수 있는가?)

  • Chang, Yun-Hee;Ban, Ji-Eun;Lee, Hyoung-Doo;Lee, Sun-Hee;Rhym, Byuong-Yong;Sung, Si-Chan
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.247-255
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    • 2007
  • Background: Lung injury that follows bypass has been well described. It is manifested as reduced oxygenation and lung compliance and, most importantly, increased pulmonary vascular resistance reactivity; this is a known cause of morbidity and mortality after repair of congenital heart disease. Injury to the pulmonary vascular endothelium, and its associated alterations of endothelin-1, is considered to be a major factor of bypass-induced lung injury. Removing endothelin-1 after bypass may attenuate this response. This study measured the concentration of serum and peritoneal effluent endothelin-1 after performing bypass to determine if endothelin-1 can be removed via peritoneal dialysis. Material and Method: From March 2005 to March 2006, 18 patients were enrolled in this study Peritoneal catheters were placed at the end of surgery. Serum samples were obtained before and after bypass, and peritoneal effluents were obtained after bypass. Endothelin-1 was measured by enzyme linked immunosorbent assay (ELISA). Result: In the patients with a severe increase of the pulmonary artery pressure or flow, the mean preoperative plasma endothelin-1 concentration was significantly higher than that in the patients who were without an increase of their pulmonary artery pressure or flow (4.2 vs 1.8 pg/mL, respectively, p<0.001). The mean concentration of plasma endothelin-1 increased from a preoperative value of $3.61{\pm}2.17\;to\;5.33{\pm}3.72 pg/ml$ immediately after bypass. After peritoneal dialysis, the mean plasma endothelin-1 concentration started to decrease. Its concentration at 18 hours after bypass was significantly lower than the value obtained immediately after bypass (p=0.036). Conclusion: Our data showed that the plasma endothelin-1 concentration became persistently decreased after starting peritoneal dialysis, and this suggests that peritoneal dialysis can remove the circulating plasma endothelin-1.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Comparison of the Low Potassium Dextran Solution and ET-Kyoto Solution in Rabbit Lung (토끼 폐장 분리관류 모형을 이용한 LPD 폐보존액과 ET-Kyoto 폐보존액의 비교)

  • Lim, Cheong;Kim, Kyung-Hwan;Kim, Young-Tae;Sung, Sook-Whan;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1159-1166
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    • 1997
  • For Improvement of lung preservation, many tripes of preservation solution were developed and tested. The aim of this study was to compare the effect of the most frequently used extracellular type pieservation solution (Low Potassium Dextran, LPD) with a newly developed trehalose containing extracellular type preservation solution(ET-Kyoto, ETK) on postischemic lung function. Twelve New-Zealand white rabbit lungs were harvested and studied on an isolated, blood-perfused model of lung function after 4 hours of cold ischemia at $10^{\circ}C$ In group I (n=6), lungs were preserved with 100 mL/kg of LPD solution; in group II(n=6), lungs were preserved with 100 mL/kg of ETK solution. A few minutes before flushing with preservation solutions, 20$\mu\textrm{g}$ of PGEI were injected into main pulmonary artery. Functions of the preserved lung were compared with PO2, PA pressure, t acheal air pressure, and drylwet ratio. The pulmonary efferent blood oxygen tension at the end of the 60-minute reperfusion period was higher in group II compacted with group I(486.5 $\pm$ 80.3 mmHg versus $432.5\pm82.9$ mmHg at FiO2 1.0, p-value = NS). The mean pulmonary arterial pressure was similar in both $groups.(33.7\pm2.2$ mmHg versus $35.5\pm2.0$ mmHg, p-value : NS). The peak inspiratory airway pressure was significantly lower in group 11(8.010.6 mmHg versus 11.8 $\pm$ 1.4 mmHg, p-value=0.02) The water content of the lung was lower in group II $(70.2\pm6.9%$ versus 78.5 $\pm6.1%),$ but not significant. These data demonstrate that a newly-developed trehalose-containing ET-Kyoto solution yield equal or slightly superior lung function after reperfusion compared with LPD solution.

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Enhanced Bioslurping System for Remediation of Petroleum Contaminated Soils (Enhanced Bioslurping system을 이용한 유류오염 토양의 복원)

  • Kim Dae-Eun;Seo Seung-Won;Kim Min-Kyoung;Kong Sung-Ho
    • Journal of Soil and Groundwater Environment
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    • v.10 no.2
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    • pp.35-43
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    • 2005
  • Bioslurping combines the three remedial approaches of bioventing, vacuum-enhanced free-product recovery, and soil vapor extraction. Bioslurping is less effective in tight (low-permeability) soils. The greatest limitation to air permeability is excessive soil moisture. Optimum soil moisture is very soil-specific. Too much moisture can reduce air permeability of the soil and decrease its oxygen transfer capability. Too little moisture will inhibit microbial activity. So Modified Fenton reaction as chemical treatment which can overcome the weakness of Bioslurping was experimented for simultaneous treatment. Although the diesel removal efficiency of SVE process increased in proportion to applied vacuum pressure, SVE process was difficulty to remediation quickly semi- or non-volatile compounds absorbed soil strongly. And SVE process had variation of efficiency with distance from the extraction well and depth a air flow form of hemisphere centering around the well. Below 0.1 % hydrogen peroxide shows the potential of using hydrogen peroxide as oxygen source but the co-oxidation of chemical and biological treatment was impossible because of the low efficiency of Modified Fenton reaction at 0.1 % (wt) hydrogen peroxide. NTA was more efficiency than EDTA as chelating agent and diesel removal efficiency of Modified Fenton reaction increased in proportion to hydrogen peroxide concentration. Hexadecane as typical aliphatic compound was removed less than Toluene as aromatic compound because of its structural stability in Modified Fenton reaction. What minimum 10% hydrogen peroxide concentration has good remediation efficiency of diesel contaminated groundwater may show the potential use of Modified Fenton reaction after bioslurping treatment.

Development and validation of an analytical method for nematicide imicyafos determination in agricultural products by HPLC-UVD (HPLC-UVD를 이용한 살선충제 imicyafos의 시험법 개발 및 검증)

  • Do, Jung-Ah;Park, Hyejin;Kwon, Ji-Eun;Choi, Won-Jo;Lee, Hyun-Sook;Chang, Moon-Ik;Hong, Jin-Hwan;Oh, Jae-Ho
    • Analytical Science and Technology
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    • v.27 no.5
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    • pp.234-242
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    • 2014
  • Imicyafos which is a nematicide for controlling root-knot nematodes has been registered in the Republic of Korea in 2012, and the maximum residue limits of imicyafos are set to watermelon and korean melon as each 0.05 mg/kg. Extremely reliable and sensitive analytical method is required for ensuring food safety on imicyafos residues in agricultural commodities. Imicyafos residues in samples were extracted with acetone, partitioned with hexane and dichloromethane, and then purified with florisil. The purified samples were analyzed by HPLC-UVD and confirmed with LC-MS. Linear range was between 0.1~5 mg/kg with the correlation coefficient ($r^2$) 0.99997. Average recoveries of imicyafos ranged from 77.0 to 115.4% at the spiked levels of 0.02 and 0.05 mg/kg with the relative standard deviations of 2.2~9.6%. Limit of detection and quantification were 0.005 and 0.02 mg/kg, respectively. An inter-laboratory study was conducted to validate the determination method in depth, and the results were satisfactory. All of the validation results revealed that the developed analytical method in this study is relevant for imicyafos determination in agricultural commodities and will be used as an official analytical method.

Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Clinical Study of Pulmonary Thromboembolism (폐혈전색전증의 임상적 연구)

  • Bak, Sang-Myeon;Lee, Sang-Hwa;Lee, Sin-Hyung;Sin, Cheol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.106-116
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    • 2001
  • Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.

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Spectral Response of $TiO_{2}$/Se : Te Heterojunction for Color Sensor (컬러센서를 위한 $TiO_{2}$/Se : Te 이종접합의 스펙트럼 응답)

  • Woo, Jung-Ok;Park, Wug-Dong;Kim, Ki-Wan;Lee, Wu-Il
    • Journal of Sensor Science and Technology
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    • v.2 no.1
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    • pp.101-108
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    • 1993
  • $TiO_{2}$/Se : Te heterojunction for color sensor has been fabricated by RF reactive sputtering and thermal evaporation methods onto glass substrate. The optimum deposition condition of $TiO_{2}$ films was such that RF power was 120 W, substrate temperature was $100^{\circ}C$, oxygen concentration was 50%, working pressure was 50 mTorr for the $TiO_{2}$ film thickness of $1000{\AA}$. In this case, the optical transmittance of $TiO_{2}$ film at 550 nm-wavelength was 85%, resistivity was $2{\times}10^9{\Omega}{\cdot}cm$, refractive index was 2.3, and optical bandgap was 3.58 eV. The composition ratio of 0 to Ti by AES analysis was 1.7. When $TiO_{2}$ films were annealed at $400^{\circ}C$ for 30 min. in $O_{2}$ ambient, the optical transmittance of $TiO_{2}$ films at the wavelength range of $300{\sim}580$ nm was improved from 0 to 25%. When Se : Te films were annealed at $190^{\circ}C$ for 1 min., photosensitivity under illumination of 1000 lux was 0.75. The optical bandgap of Se : Te films was 1.7 eV. The structures of Se : Te films were the hexagonal with (100) and (110) orientation. The spectral response of a-Se was improved by the addition of Te, especially in the long wavelength region. The $TiO_{2}$/Se : Te heterojunction showed wide spectral response, and more improved one than that of a-Si film in the blue light region.

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Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province (가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태)

  • Ahn, Jong-Joon;Lee, Ki-Man;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.624-632
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    • 2000
  • Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

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