• Proceedings of the KSME Conference
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• 2003.11a
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• pp.747-752
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• 2003

Many clinical studies have suggested that the blood flow in ideal geometry is involved in the development of atherosclerosis. This study simulated blood flow in the abdominal artery with real geometry to investigate MWSS(mean wall shear stress), AWSS(amplitude of wall shear stress) and OSI(oscillator shear index). The calculation grid for the real geometry was constructed by extracting the surface of arterial wall from CT(Computed Tomography) or MRI(Magnetic Resonance Imaging) sheets called as DICOM (Digital Imaging and Communications in Medicines). The calculated MWSS, AWSS and OSI are much different from those of ideal geometry calculation. The MWSS increased while the AWSS decreased. Many shear forces are related to shapes of gradient. This paper will give clinical datum where the MWSS, AWSS and OSI are strong or weak. The hemodynamic analysis based on real geometry can provide surgeons with more reliable information about the effect of blood flow.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.485-489
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• 2010

Objective : To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms. Methods : A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed. Results : Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively. Conclusion : In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition.

• Journal of Korean Biological Nursing Science
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• v.17 no.2
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• pp.114-122
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• 2015

Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.

• The Korea Journal of Herbology
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• v.20 no.3
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• pp.75-81
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• 2005

Objectives : In brain disorders such as ischemic stroke, the final outcome depends largely on the duration and the degree of the ischemia as well as the susceptibility of various cell types in the affected brain region. In the present study, the effects of Nodus Nelumbinis Rhizomatis Extract(NNRe) were tested for the anti-oxidative action of rCBF. Methods : Regional cerebral blood flow(rCBF) were determined by LDF methods. LDF allows for real time, noninvasive, continuous recordings of local CBF. The LDF method has been widely used to trace hemodynamic changes in the superficial or the deep brain structures in experimental stroke research. Results : NNRe treatment showed no change on rCBF in methylene blue, ODQ and L-NNA pretreated rats. 120 minutes of MCAO and followed reperfusion, 0.1% concentration of NNR treatment improved the altered cerebral hemodynamics of cerebral ischemic by increasing rCBF. Conclusions : The ischemia/reperfusion induced oxidative stress may have contributed to cerebral damage in rats, and the present study provides clear evidences for the beneficial effect of NNR on ischemia/reperfusion induced brain injury.

• Journal of Veterinary Science
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• v.21 no.1
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• pp.6.1-6.12
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• 2020

Currently, the optimal resuscitation fluid remains debatable. Therefore, in the present study, we designed a trometamol-balanced solution (TBS) for use as a resuscitation fluid for hemorrhagic shock. Hemorrhagic shock was induced in 18 male Wistar-Kyoto rats, which were assigned to normal saline (NS), Ringer's solution (RS), and TBS groups. During the hemorrhagic state, their hemodynamic parameters were recorded using an Abbott i-STAT analyzer with the CG4+ cartridge (for pH, pressure of carbon dioxide, pressure of oxygen, total carbon dioxide, bicarbonate, base excess, oxygen saturation, and lactate), the CG6+ cartridge (for sodium, potassium, chloride, blood glucose, blood urea nitrogen, hematocrit, and hemoglobin), and enzyme-linked immunosorbent assay kits (calcium, magnesium, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, and albumin). Similar trends were found for the parameters of biochemistries, electrolytes, and blood gas, and they revealed no significant changes after blood withdrawal-induced hemorrhagic shock. However, the TBS group showed more effective ability to correct metabolic acidosis than the NS and RS groups. TBS was a feasible and safe resuscitation solution in this study and may be an alternative to NS and RS for resuscitation in hemorrhagic shock patients without liver damage.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.90-97
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• 2016

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

• Korean Journal of Clinical Pharmacy
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• v.16 no.2
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• pp.113-122
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• 2006

Purpose: A retrospective study was performed to assess the efficacy and tolerance of ${\beta}-blocker$ administration in patients with heart failure and diabetes. Method: Records of 164 patients who were treated for the heart failure condition more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of ${\beta}-blockers$ ($DM+{\beta}-blocker$ group: 14, DM w/o ${\beta}-blocker$: 19, No DM + ${\beta}-blocker$: 62, No DM + no ${\beta}-blocker$: 69). All patients had been receiving conventional therapy such as digoxin, ACE-I, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints (death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of ${\beta}-blocker$ treatment. To evaluate toxicity of ${\beta}-blocker$, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained. Result: There were less death and hospital admission in DM + ${\beta}-blocker$ group than in DM without ${\beta}-blocker$ group (p=0.014). Relative risk of hospital admission for $DM+{\beta}-blocker$ group over no DM group was 1.17. Long term ${\beta}-blocker$ administration was associated with an improvement of heart rate in patients with DM (P< 0.02) with no significant improvement of LVEF, SBP, DBP. in DM patient. In patient without DM, ${\beta}-blocker$ was associated with improvement in LVEF, HR and DBP (P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference. Conculsion: Treatment of heart failure patients with ${\beta}-blocker$ appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of ${\beta}-blocker$ treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.723-727
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• 1996

An adequate exposure is important in thoracoscopic procedures. The insufflation of $CO_2$has been demonstrated to aid in compressing lung parenchyma, and act as a retractor when combined with changes in patient's position. However, a recent study demonstrated that $CO_2$insufflation during thoracoscopy in the pig has adverse hemodynamic consequences. We prospectively studied 12 patients undergoing thoracoscopy to evaluate the effect of $CO_2$insufflation in the clinical setting. The mean arterial pressure, heart rate, central venous pressure, arterial oxygen saturation, and end-tidal $CO_2$pressure were monitored. Measurements were determined at baseline, at the initiation of one-lung ventilation, and at intrapleural pressure of 5, 10, 15 mmHg and following results were obtained. 1) The insufflation of 5 to 15 mmHg of $CO_2$had no significant effect on the mean arterial pressure, heart rate, arterial oxygen saturation. 2) The end-tidal $CO_2$pressure rose from 31.00$\pm$1.67 mmHg to 38.49$\pm$1.82 mmHg at an intrapleural pressure of 15 mmHg(p<0.05). 3) The central venous pressure rose from 7.75$\pm$0.76 mmHg to 12.83$\pm$1.64 mmHg and 16.16$\pm$l.97mmHg at an intrapleural pressure of 10 and 15 mmHg(p<0.05). 4) The low pressure (<10 mmHg) insufflation is a safe adjunct to the conduct of thoracoscopic surgical procedures.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.332-338
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• 2020

Background: Attaining an adequate effective orifice area (EOA) is definitive goal in aortic valve replacement (AVR). The simple interrupted suture (SIS) technique could be a solution to achieve this goal, but limited data are available in the literature. This study aimed to compare hemodynamic differences between the SIS and non-everting mattress suture (NMS) techniques. Methods: From our database, 215 patients who underwent AVR for severe aortic stenosis were extracted to form the overall cohort. From March 2015 to November 2016, the SIS technique was used in 79 patients, while the NMS technique was used in 136 patients. Hemodynamic outcomes were evaluated, as detected by transthoracic echocardiography and computed tomography. Results: There were no significant differences in baseline characteristics between the 2 groups. On immediate postoperative echocardiography, the SIS group showed a significantly wider EOA (1.6±0.4 vs. 1.4±0.5 ㎠, p=0.007) and a lower mean pressure gradient (PG) (13.3±5.4 vs. 17.0±6.0 mm Hg, p<0.001) than the NMS group. On follow-up echocardiography, the SIS group continued to have a wider EOA (1.6±0.4 vs. 1.4±0.3 ㎠, p<0.001) and a lower mean PG (11.0±5.1 vs. 14.1±5.5 mm Hg, p<0.001). There was no significant difference in paravalvular leakage. Conclusion: The SIS technique for AVR was associated with a wider EOA and a lower mean PG. The SIS technique could be a reasonable option for AVR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.78-82
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• 2001

Background : The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. Methods : Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. Results: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is $48.63{\pm}21.12ml$ and second day is $23.92{\pm}19.53ml$ and third day is $7.82{\pm}5.32ml$ and group II of first day $60.45{\pm}22.65ml$ and second day is $22.14{\pm}13.21ml$ and third day is $7.32{\pm}6.25ml$. III group of first day $58.16{\pm}10.13ml$ and second day is $21.27{\pm}11.72ml$ and third day is $7.13{\pm}4.90ml$. 5. Infusion of group I is mean PRC $1.08{\pm}0.91$ pint, FFP $1.03{\pm}0.75$ pint, crystalloid $2562.23{\pm}1345.53ml$ and group II is mean PRC $1.05{\pm}0.89$ pint, FFP $1.71{\pm}0.78$, crystalloid $2650.47{\pm}1096.36ml$ and group III is mean PRC $1.79{\pm}1.45$ pint, crystalloid $3295.43{\pm}1472.432ml$.