• 제목/요약/키워드: Cardiovascular stability

검색결과 65건 처리시간 0.024초

제왕절개환자에 있어서 Succinylcholine-Atracurium의 임상적 고찰 (A Clinical Study of Succinylcholine-Atracurium for Cesarian Section)

  • 박대팔
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.49-51
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    • 1986
  • 제왕절개술 환자 10인에게 Succinylcholine Chloride 및 atracurium을 준 결과 다음과 같은 결론을 얻었다. 1. Succinyline chloride 1mg/kg와 atracurium 0.4mg/kg를 주어 충분한 근육이완을 유지하였다. 2. 혈압과 맥박은 atracurium주사 후 의의있는 변화는 없었다. 3. 태아의 Apgar score는 1분과 5부때 8~10점으로 모두 양호한 상태였다.

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Successful Damage Control Resuscitation with Resuscitative Endovascular Balloon Occlusion of the Aorta in a Pediatric Patient

  • Heo, Yoonjung;Chang, Sung Wook;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.170-174
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

고령 경비원의 직무스트레스와 관련요인 (Occupational Stress and Related Factors among Aged Security Guards)

  • 최은숙;신동수
    • 한국직업건강간호학회지
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    • 제18권1호
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    • pp.106-115
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    • 2009
  • Purpose: Occupational stress is a determinant risk factor for cardiovascular disease and work disability. This study aims to describe occupational stress and identify its related factors among aged security guards. Methods: A random sample of 76 aged security guards were interviewed by three research assistants. The criteria of the subjects were as follows : 50 or older male with 40 or more working hours a week working with colleagues ranged from 3 to 50. The data were collected in September, 2007 and analyzed by multiple regression using SAS Version 9.1. Results: The mean score of occupational stress among aged security guards was 47.2. The mean scores of its sub-scales were 31.3(physical environment), 33.8(occupational demand), 80.8occupational control), 44.6(interpersonal conflict), 51.3 (occupational insecurity), 53.6(occupational system), 57.5(lack of reward), and 30.3(work environment). The scores of occupational control, interpersonal conflict, and occupational insecurity were higher than the scores of Korean average occupational stress sub-scales. Significant variables affecting occupational stress and its sub-scales were work place, work type, and employment type. Conclusion: In order to reduce occupational stress among security guards, sufficient occupational control and interpersonal conflict control, appropriate reward, and employment stability should be considered. Also long working hours and work shift should be improved.

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소아 X선 촬영에서 청각과 시각의 환경변화에 따른 유용성 평가 (Evaluation of Usefulness according to Environmental Change of Auditory and Visual in Pediatric X-ray)

  • 백성욱;송종남;김정훈;한재복
    • 한국방사선학회논문지
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    • 제11권7호
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    • pp.605-610
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    • 2017
  • 성인과 달리 소아의 경우 인지능력과 의사전달이 정확하지 않아 X선 검사에 있어 심리적 불안감으로 인한 움직임은 재검사를 증가시키는 요인 중 하나이다. X선 검사라는 거부감을 최소화하고 의료 서비스의 만족도를 향상하기 위한 방법으로 검사실의 환경을 개선하여 심리적 안정에 도움을 주어 검사과정에서 발생하는 불필요한 재검사를 비롯한 피폭선량 절감에 긍정적인 방안을 알아보고자 하였다. 실험대상으로는 2017년 5월부터 2017년 8월까지 본원 일반촬영실에서 만 6개월 이상~만 36개월 미만의 총 186명의 소아를 대상으로 청각과 시각적 환경변화를 모두 적용시키지 않는 평소 검사실을 A 군, 시각적 환경변화는 제외시키고 청각적 환경변화만 적용한 검사실을 B 군, 청각적 환경변화는 제외시키고 시각적 환경변화만 적용한 검사실을 C 군, 청각과 시각적 환경변화를 모두 적용한 검사실을 D 군으로 설정하여 연구를 진행하였다. A 군에서는 재검사 건수가 10건, B 군 7건, C 군 5건, D 군 2건의 결과를 도출할 수 있었다. 특히 A 군과 D 군에서 통계학적 유의수준 p<0.053으로 유의 하다는 결과를 얻을 수 있었다. 결론적으로 청각과 시각적 환경변화가 소아 심리적 안정에 많은 영향을 미쳤으며, 재검사 건수도 감소하여 의료서비스의 질적 향상 보였다.

다한증수술후 발한분포 및 상하지의 온도변화와 혈류량변화 (The Changes of Sweating Area, Temperature and Blood Flow in the Upper and Lower Extremity after Hyperhidrosis Operations)

  • 김용환;장윤희;문석환;조건현;왕영필;김세화;곽문섭;김학희;장혜숙
    • Journal of Chest Surgery
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    • 제32권5호
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    • pp.456-460
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    • 1999
  • 배경: 다한증에 대한 흉부교감신경절제술은 흉강경기구 및 수술술기 발달로 효과적인 치료방법으로 인식되고 있으나 보상성 다한증으로 그 만족도가 떨어지고 있다. 따라서 저자들은 수술결과 및 보상성 다한증을 분석하고자 하였으며 수술전후 손과 발의 온도 차이 그리고 상지와 하지의 혈류량을 측정하였다. 대상 및 방법: 1995년 12월부터 1998년 7월까지 강남성모병원에서 총 47명의 다한증환자를 흉강경하에 교감신경절제술을 시행하였다. 수술전후로 손가락 및 발가락에서 온도변화를 측정하였고, 혈류량 측정은 도플러 초음파검사로 손가락동맥, 요골동맥, 그리고 족배동맥에서 측정하였다. 결과: 수술사망은 없었으며, 기흉 7건, 재발 3건, 안검하수 1건등의 합병증이 있었다. 보상성 다한증은 수술한 환자의 95%에서 있었으며 이중 5명이 수술을 후회하였다. 족부 다한증은 흉부교감신경절제술후 46%에서 향상되었고, 수술전후 온도변화는 우측 손에서 1$^{\circ}C$, 좌측 손에서 1.9$^{\circ}C$였고 통계적으로 의미있게 증가하였다. 그러나 족부 다한증에서는 의미있는 온도차이가 없었다. 혈류량은 손에서 의미있게 증가하였으나 발에서는 차이가 없었다. 결론: 다한증의 흉부 교감신경절제술은 안전하고 효과적인 치료이지만 그 만족도는 보상성 다한증에 의해 감소하고 있으므로 수술전에 보상성 다한증에 대하여 충분히 설명하는 것이 중요하다. 족부 다한증은 생리적 변화에 의한 것이라기 보다는 정신적 안정에 의한 것으로 보인다.

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인공심장판막의 개발과 동물실험 -인공심장판막의 2차 동물실험- (The Second Animal Tests of Artificial Heart Valves)

  • 김형묵
    • Journal of Chest Surgery
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    • 제23권4호
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    • pp.617-621
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    • 1990
  • A heart supplies blood of about 15, 000 liters to each human organ in a day. A normal function of heart valves is necessary to accomplish these enormous work of heart. The disease of heart valve develops to a narrowness of a closure, resulting in an abnormal circulation of blood. In an attempt to eliminate the affliction of heart valves, the operative method to replace with artificial heart valves has developed and saved numerous patients over past 30 years. This replacement operation has been performed since early 1960`s in Korea, but all the artificial heart valves used are imported from abroad with very high costs until recent years. New artificial heart valves have been developed in Korea Advanced Institute of Science and Technology since early 1980`s. The first developed valve was designed with a free-floating pyrolytic carbon disk that is suspended in a titanium cage. The design of the valve was tested in vitro, and in animals in 1987. The results from this study was that the eccentrically placed struts creates a major and minor orifice when the disc opens and stagnation of flow in the area of the minor orifice has led to valve thrombosis. In this work, the design of the valve was changed from a single - leaflet valve to double - leaflet one in order to resolve the problems observed in the first - year tests. Morphological and hemodynamic studies were made for the newly designed valves through the in vitro and in vivo tests. The design and partial materials of the artificial heart valve was improved comparing with first - year`s model. The disc in the valve was modified from single - leaflet to bi - leaflet, and the material of the cage was changed from titanium metal to silicon - alloyed pyrolytic carbon. A test was made for the valve in order to examine its mechanical performance and stability. Morphological and hemodynamic studies were made for the valve that had been implanted in tricuspid position of mongrel dogs. All the test animals were observed just before the deaths. A new artificial heart valve was designed and fabricated in order to resolve the problems observed in the old model. The new valve was verified to have good stability and high resistance to wear through the performance tests. The hemodynamic properties of the valve after implantation were also estimated to be good in animal tests. Therefore, the results suggest that the newly designed valve in this work has a good quality in view of the biocompatibility. However, valve thrombosis on valve leaflets and annulus were found. This morphological findings were in accordance with results of surface polishing status studies, indicating that a technique of fine polishing of the surface is necessary to develop a valve with higher quality and performance.

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Characterization of Homocysteine ${\gamma}$-Lyase from Submerged and Solid Cultures of Aspergillus fumigatus ASH (JX006238)

  • El-Sayed, Ashraf S.;Khalaf, Salwa A.;Aziz, Hani A.
    • Journal of Microbiology and Biotechnology
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    • 제23권4호
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    • pp.499-510
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    • 2013
  • Among 25 isolates, Aspergillus fumigatus ASH (JX006238) was identified as a potent producer of homocysteine ${\gamma}$-lyase. The nutritional requirements to maximize the enzyme yield were optimized under submerged (SF) and solid-state fermentation (SSF) conditions, resulting in a 5.2- and 2.3-fold increase, respectively, after the last purification step. The enzyme exhibited a single homogenous band of 50 kDa on SDS-PAGE, along with an optimum pH of 7.8 and pH stability range of 6.5 to 7.8. It also showed a pI of 5.0, as detected by pH precipitation with no glycosyl residues. The highest enzyme activity was obtained at $37-40^{\circ}C$, with a $T_m$ value of $70.1^{\circ}C$. The enzyme showed clear catalytic and thermal stability below $40^{\circ}C$, with $T_{1/2}$ values of 18.1, 9.9, 5.9, 3.3, and 1.9 h at $30^{\circ}C$, $35^{\circ}C$, $40^{\circ}C$, $50^{\circ}C$, and $60^{\circ}C$, respectively. Additionally, the enzyme $K_r$ values were 0.002, 0.054, 0.097, 0.184, and 0.341 $S^{-1}$ at $30^{\circ}C$, $35^{\circ}C$, $40^{\circ}C$, $50^{\circ}C$, and $60^{\circ}C$, respectively. The enzyme displayed a strong affinity to homocysteine, followed by methionine and cysteine when compared with non-S amino acids, confirming its potency against homocysteinuria-related diseases, and as an anti-cardiovascular agent and a specific biosensor for homocysteinuria. The enzyme showed its maximum affinity for homocysteine ($K_m$ 2.46 mM, $K_{cat}\;1.39{\times}10^{-3}\;s^{-1}$), methionine ($K_m$ 4.1 mM, $K_{cat}\;0.97{\times}10^{-3}\;s^{-1}$), and cysteine ($K_m$ 4.9 m M, $K_{cat}\;0.77{\times}10^{-3}\;s^{-1}$). The enzyme was also strongly inhibited by hydroxylamine and DDT, confirming its pyridoxal 5'-phosphate (PLP) identity, yet not inhibited by EDTA. In vivo, using Swiss Albino mice, the enzyme showed no detectable negative effects on platelet aggregation, the RBC number, aspartate aminotransferase, alanine aminotransferase, or creatinine titer when compared with negative controls.

슬링(Sling) 시스템을 이용한 경부 안정화 운동 (Cervical stabilization exercise using the Sling system)

  • 권재확;조미주;박민철;김선엽
    • 대한정형도수물리치료학회지
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    • 제8권2호
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    • pp.57-71
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    • 2002
  • Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

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Fatty Acid Modulation of Atherosclerosis by Peroxisome Proliferator- Activated Receptors

  • Erickson, Kent L.;Hubbard, Neil E.;Meinecke, Lynette M.
    • Preventive Nutrition and Food Science
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    • 제7권4호
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    • pp.454-460
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    • 2002
  • While atherosclerosis is a major killer, there is now concern that mortality from the disease will increase due to the rising incidence of type II diabetes. Because diet can potentially influence both diseases, it is important to elucidate the role of diet in the progression of atherosclerosis. In addition, the mechanisms involved in dietary-related alterations of the disease need to be defined to guide public health recommendations to reduce athero-sclerosis incidence and limiting unwanted side effects. Since diet is thought to play a role in atherosclerosis even without added complications due to type II diabetes, reducing the incidence of that metabolic disease will not be enough. While evidence is increasing that high intake of carbohydrate can lead to type II diabetes and atherosclerosis, the preponderance of existing evidence indicates that intake of specific fats as a major dietary causal factor. It has recently been hypothesized that a dietary fat link to atherosclerosis may depend partly on the activity of a transcriptional regulator, the peroxisome proliferator activated receptors (PPAR). Thusfar, PPAR $\alpha$, $\beta$/$\delta$ and ${\gamma}$, have been shown to play a major role in metabolism, inflammation, and cancer. Furthermore, PPAR may regulate specific processes associated with atherosclerosis such as triglyceride and low density lipoprotein (LDL) metabolism; the reverse cholesterol transport pathway; lipid accumulation within plaques; the local inflammatory response and plaque stability. Synthetic ligands for PPAR have been developed; however, natural ligands include specific fatty acids and their metabolites. Though the role of PPAR in atherosclerosis has been reported with respect to synthetic ligands, additional studies need to be done with established and possible natural ligands. In this review, we will focus on the relation of dietary fat to PPAR alteration of atherosclerosis.

Dexmedetomidine과 Pethidine을 이용한 정맥내 진정하에 시행된 악교정수술 후 금속나사제거 (Plate and Screw Removal after Orthognathic Surgery, under Intravenous Sedation with Dexmedetomidine and Pethidine)

  • 강희제;김종렬;김시엽;최태성;장광욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권4호
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    • pp.260-266
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    • 2012
  • Purpose: The purpose of this study is to identify the changes of a physiologic nature and the sedative parameters associated with dexmedetomidine and pethidine, in patients undergoing plate and screw removal surgery, after orthognathic surgery. Methods: Twenty-three patients were sedated with dexmedetomidine and pethidine during plate and screw removal, after orthognathic surgery. An initial loading dose of dexmedetomidine ($1.0{\mu}g/kg$ infused over 10 minutes) was followed by a maintenance dose ($1.0{\mu}g/kg/hr$). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, and heart rate were monitored. Perioperative amnesia and anxiety were recorded. Results: Significant changes were found in the blood pressure and heart rate (Freidman test, P<0.05), but not in oxygen saturation (Freidman test, P>0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased. Conclusion: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.