• Journal of Chest Surgery
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• 제37권1호
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• pp.1-10
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• 2004

배경: 기존에 사용되고 있는 인공심폐기는 비박동성 펌프로 회로 내부에 형성되는 압력이 낮고 혈구 손상이 적어서 표준 인공 심폐기로 선호되고 있다. 그러나 많은 실험적 연구들을 보면 박동성 관류가 혈역학, 대사, 장기의 기능, 미세 순환에 대하여 비박동성 관류보다 유익함을 알 수 있다. 그러나 박동성 인공심폐기는 높은 회로 내부 압력과 혈구손상이 해결되어야 할 문제점으로 개발이 어려웠다. 이 연구의 목적은 국내에서 제작된 이중 박동성 인공심폐기의 안전성 및 유효성을 알아보는 것이다. 대상 및 방법: 6마리의 송아지를 대상으로 이중 박동성 인공 심폐기 실험을 하였으며, 완전체외순환을 시켰다. 체외순환은 상,하 대정맥과 대동맥 사이를 우회하였으며, 막형 산화기를 사용하여 혈액을 산화시켰다. 산화기는 좌우측 펌프 중간에 위치시켰다. 순환 시간은 4시간이었다. 동맥혈가스분석, 혈액검사, 혈장 유리 혈색소를 측정하였으며, 맥압과 회로 내부압력을 관찰하였다. 측정은 인공 심폐기 구동 전과 순환 1, 2, 3, 4시간째에 측정하였다. 결과: 동맥혈 가스분석상 pH, 이산화 탄소분압은 모두 정상 범위였으며, 동맥혈 산소 분압은 100 mmHg 이상의 충분한 산화를 보였다. 혈장 유리혈색소는 완전 체외순환하여 4시간이 경과하면서 15.87 $\pm$5.63 mg/㎗로 점차 증가소견을 보였으나 20 mg/㎗ 이내였다. 혈액검사소견상 뚜렷한 이상소견은 없었다. 순환전 수축기 혈압은 97.5$\pm$5.7 mmHg이었으며 시간 경과하여도 100 mmHg 이상의 혈압을 유지하였다. 확장기 혈압은 72.2$\pm$7.7 mmHg이었으며 시간 경과하여도 잘 유지되었다. 평균 혈압은 순환 전 83$\pm$9.2 mmHg이었으며, 시간 경과 시 증가된 소견을 보였다. 펌프의 유량은 3.3 L/min이상을 유지할 수 있었다. 완전체외순환 동안의 혈압의 변화를 보면 순환 전 심장과 유사한 동맥혈압을 보였다. 결론: 이중 박동 구조를 이용한 박동성 인공심폐기는 효과적인 박동성 혈류를 제공하면서 혈구 세포손상도 적었으며, 혈액학적 및 혈역학적인 면에서도 우수한 결과를 보였다. 따라서 모든 심장수술의 인공심폐기로 사용되어질 경우 말초장기에 생리적이고 안정적인 혈류를 공급할 수 있을 것으로 기대된다.

• 한국임상수의학회지
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• 제33권4호
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• pp.237-242
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• 2016

A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.

• 한국임상수의학회지
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• 제24권2호
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• pp.208-213
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• 2007

호흡곤란과 후지마비 및 발등부위의 괴사를 나타낸 수컷 진돗개가 전북대학교 동물의료센터에 내원하였다. 초기 검사에서 심장 사상충 감염이 확인되었다. 흉부방사선 외측상에서 폐동맥의 확장과 후엽의 간질패턴, 그리고 복배상에서 주 폐동맥의 뚜렷한 확장등이 관찰되어 심장사상충증을 뒷받침하였고, 복부 외측상 및 복배상에서 복부세부음영 소실이 관찰되어 복수를 의심하였다. 초음파상에서 복수와 불규칙한 간변연 그리고 신장양극의 피질에서 쐐기모양의 국소적 고에코상을 관찰하였으며 복부대동맥에서 분지하여 주행하는 바깥장골동맥의 3상형 동맥파형이 분지부 근위에서 관찰되었으나 이 후 대퇴동맥의 파형은 확인되지 않았다. 혈액화학검사에서 백혈구증다증, 빈혈, 혈색소 뇨, 고빌리루빈혈증, 저 알부민혈증, 전해질불균형, 그리고 간장 및 신장효소치의 상승등이 관찰되어 광범위한 장기의 손상이 의심되었다. 특히 글루코스는 정상적인 전지와 마비를 보이는 후지에서 비교한 결과 후지의 글루코스 수치가 현저하게 낮았다. 전산화단층촬영술 후 3차원으로 재구성한 영상을 이용하여 후지 마비의 원인으로 여겨지는 후지 동맥의 혈전색전증과 폐동맥혈전색전증 및 신장경색 등을 확인하였다. 예후불량으로 판단되었으며 실험적 중재적 방사선술을 시도하였으나 마취에서 깨어나지 못했다. 3차원 재구성 CT 영상은 색전증의 빠르고 정확한 진단에 유용하며 효과적인 치료 계획을 수립하는데도 큰 도움이 된다고 판단된다.

• 대한중풍순환신경학회지
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• 제6권1호
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• pp.25-32
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• 2005

Background and purpose: Arterial stiffness is an important, independent determinant of cardiovascular risk. Pulse wave velocity (PWV) has been used as a valuable index of arterial stiffness and as a surrogate marker for atherosclerosis. The Framingham risk score was developed using categorized risk factors to predict the 10 year absolute risk of developing coronary heart disease (CHD). This algorithm is established using recommended guidelines for blood pressure, total cholesterol, and high density lipoprotein cholesterol in addition to age, smoking history and history of diabetes. Tongxinluo(TXL) has been shown to have anti hyperlipidemic activity and anti atherogenic effects. To determine its efficacy and safety, we examined whether TXL improves PWV, ABI, Framingham score, blood pressure, and lipid profile in high risk group of cardiovascular diseases. Subjects and methods: 49 subjects with the high risk of cardiovascular diseases were recruited. Subjects were administered TXL with the dose of 1110mg three times a day for 8 weeks. baPWV, ABI, Framingham risk score, Blood pressure and serum lipid profile were assessed at baseline and after 4 and 8weeks. Results: Total cholesterol, LDL cholesterol, triglyceride, total lipid and phospolipid significantly decreased after 4 weeks of medication. Total cholesterol, total lipid and phospolipid significantly decreased after 8 weeks of medication. There were no significant changes in Framingham risk scores, ABI, PWV and blood pressure. On safety assessment, there were no adverse effects, hepatic or renal toxicity. Conclusion: We suggest that TXL is a safe and useful herbal medicine for hyperlipidemia and as for anti-atherognic effects, further research would be necessary.

• 대한간호학회지
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• 제30권4호
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• pp.995-1005
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• 2000

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.56-65
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• 2019

본 연구는 12주간 여성노인이 체중을 이용한 복합운동(저항운동 30분, 유산소운동(30)) 참여가 그들의 신체구성(체중, 체지방률, 제지방, 신체질량지수, 근육량)과 심혈관요인(상완-발목 맥파속도, 동맥협착도)에 미치는 영향을 연구하였다. 연구의 목적을 달성하기 위해 연구에 참여한 대상자는 총 32명으로 운동그릅 16명, 통제그룹 16명으로 무선할당하였다. 운동집단은 주3회 60분씩 복합운동을 실시 하였으며, 통제그룹은 같은 기간 동안 평소와 동일한 환경에서 생활하였다. 본 연구의 통계분석은 동질성을 확보하기 위해서 모든 사전 변인들에 t-검증을 실시하였고 동질성이 확보되서 분산분석방법을 사용하였으며 유의수준은 0.05로 하였다. 연구결과 복합운동에 참여한 운동그룹과 통제그룹간에 신체구성에 대한 것은 통계적으로 유의한 차이를 보이지 않았다. 하지만 심혈관계 요인 중 복합운동 그룹의 상완-발목맥파속도 오른쪽(baPWV-Right(p=.001)), 상완-발목맥파속도 왼쪽(baPWV-Left(p=.001))은 통계적으로 유의한 감소를 나타냈고, 통제그룹은 통계적으로 유의한 차이를 보이지 않았다. 이상의 결과를 살펴보면 65세이상 여성노인이 12주간 체중을 이용한 복합운동에 참여하면 맥파속도(baPWV-Right)가 감소하고 심혈관 질환을 예방하여 노인들의 삶의 질을 높일 수 있을 것이다.

• 동의생리병리학회지
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• 제27권4호
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• pp.465-470
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• 2013

The purpose of this study is to observe clinically the effects of red onion prescription on type 2 diabetes. The subject of this study were middle-aged people. We measured clinically physiological index, body composition, radial arterial pulse wave before taking medicine and after taking medicine for 4 month (the prescription of red onion). The study results were as follows. In physiological Index, diastolic blood pressure(mmHg)(p<0.001), Fasting blood glucose(mg/dL)(p=0.001), and HbA1c(%)(p<0.001) were decreased significantly after taking medicine. In body Composition, waist-hip ratio(p=0.031), body fat percentage(p=0.006), fat mass(kg)(p=0.005), and muscle mass(kg)(p=0.001) were decreased significantly after taking medicine. Blood Circulation Index, ECO(L/min)(p=0.038) and ECI($L/min/m^2$)(p=0.007) were increased significantly after taking medicine, ECR($dyne^*sec^*cm^{-5}$)(p=0.002), and ECRI($dyne^*sec/cm$)(p=0.001) were decreased significantly after taking medicine for 4 month. The prescription of red onion was showed significant change in physiological index, character of body composition, blood circulation index. Based on this result, it is considered that red onion prescription has the positive effects on type 2 diabetes and blood circulation clinically. In the future, diversified studies on the effects of red onion prescription are needed.

• 성인간호학회지
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• 제12권1호
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• pp.122-133
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• 2000

The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

• The Korean Journal of Physiology and Pharmacology
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• 제18권5호
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• pp.411-418
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• 2014

Vascular remodelling is an adaptive mechanism, which counteracts pressure changes in blood circulation. Nicotine content in cigarette increases the risk of hypertension. The exact relationship between nicotine and vascular remodelling still remain unknown. Current study was aimed to determine the effect of clinically relevant dosage of nicotine (equivalent to light smoker) on aortic reactivity, oxidative stress markers and histomorphological changes. Twelve age-matched male Sprague-Dawley rats were randomly divided into two groups, i.e.: normal saline as control or 0.6 mg/kg nicotine for 28 days (i.p., n=6 per group). On day-29, the rats were sacrificed and the thoracic aorta was dissected immediately for further studies. Mean arterial pressure (MAP) and pulse pressure (PP) of nicotine-treated vs. control were significantly increased (p<0.05). Nicotine-treated group showed significant (p<0.05) increase tunica media thickness, and decrease in lumen diameter, suggesting vascular remodelling which lead to prior hypertension state. The phenylephrine (PE)-induced contractile response in nicotine group was significantly higher than control group ($ED_{50}=1.44{\times}10^5M$ vs. $4.9{\times}10^6M$) (p<0.05~0.001). However, nicotine-treated rat showed significantly lower endothelium-dependent relaxation response to acetylcholine (ACh) than in control group ($ED_{50}=6.17{\times}10^7M$ vs. $2.82{\times}10^7M$) (p<0.05), indicating loss of primary vascular function. Malondialdehyde (MDA), a lipid peroxidation marker was significantly higher in nicotine group. Superoxide dismutase (SOD) enzymatic activity and glutathione (GSH) were all reduced in nicotine group (p<0.05) vs. control, suggesting nicotine induces oxidative imbalance. In short, chronic nicotine administration impaired aortic reactivity, probably via redox imbalance and vascular remodelling mechanism.

• Clinical and Experimental Pediatrics
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• 제56권12호
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• pp.526-533
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• 2013

Purpose: Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. Methods: In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). Results: We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. Conclusion: In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.