• Title/Summary/Keyword: Mean Effective Pressure

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Change of Pulmonary Artery Hemodynamics and Pulmonary Vascular Resistance in Experimental Pulmonary Embolism (실험적 급성 폐색전증에서 폐동맥혈역학 및 폐혈관저항의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho;Kim, Cheol-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.913-922
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    • 1995
  • Background: When we define the pressure of pulmonary vasculature in which a recruitment of blood flow occurs as $P_I$ and the proportion of change in pulmonary artery to that in cardiac output as IR and then we compare PI and IR with pulmonary vascular resistance, we would find some problems in pulmonary vascular resistance. In other words, it is the theory that, IR should be increased mainly in pulmonary embolism in which decreases the cross sectional area of pulmonary vasculature. But there are many contradictory reports resulted from various researches and the fact is known widely that any difference exists between PVR and PI, IR. For this reason, the purpose of this study is to observe how PI and IR change at the time of the outbreak and during treatment of the pulmonary embolism, and to find out the meaning of these new indicators and the difference from the pulmonary vascular resistance used generally when we subdivide the pulmonary vascular resistance into PI and IR. Method: After making AV fistula in experimental dog, we controlled cardiac output at the intervals of 15 minute in case of three kinds(all AV fistula are obstructed, only one of fistula is open and all of fistula is open), and after evoking massive pulmonary embolism with radioactive autologous blood clots, we measured the mean pulmonary artery pressure, and calculated PI and IR. We observed the pattern of change in PI and IR, without giving the control group any specific treatment and with injecting intravenously rtPA in the Group 1 and Group 2 at the dose of 1mg per kg, for 15 minutes fot the former and 3 hours for the latter. Result: 1) Pulmonary vascular resistance showed a change similar to that of pulmonary artery pressure and in all three group, PVR increased significantly, but group 1 and group 2 showed tendency that PVR keeps on decreasing after treatment, and the rate of decrease in group 1 is more rapid than group 2 significantly. 2) Both intersection(PI) and degree(IR) are proved statistically significant, in view of the straight line relationship between cardiac output and pulmonary artery pressure, calculated by minimal regression method. 3) PI changed similarly to pulmonary vascular resistance, while in the IR which is theoretically more similar to PVR, there was no significant difference or change after rtPA infusion. Conclusion: In the pulmonary embolism, Both change in IR which means real resistance of pulmonary vasculature and PI which was developed due to secondary vasoconstriction by pulmonary embolism are reflected same time.

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A Study of Intravenous Sedation in Dankook University Dental Hospital (단국대학교 치과대학 부속치과병원에서 시행된 정주진정에 대한 연구)

  • O, Jeong Eun;Kim, Jong-Su;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.1
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    • pp.1-7
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    • 2013
  • Background: Intravenous sedation is effective for dental patients who are anxious. Recently, target-controlled infusion (TCI) has begun to be used widely to administer and titrate propofol and remifentanil during sedation. To investigate the effect and safety of the pharmacologic agents used in anesthetic department, we performed a retrospective study. Methods: Retrospective study of a series of dental procedure under intravenous sedation performed in department of anesthesiology in Dental Hospital of Dankook University was carried out with propofol or propofol/remifentanil between January and August 2011 and January and April 2012. All patients received oxygen by nasal cannula. The average propofol and remifentanil target was 0.5 ${\mu}g/ml$ and 1.0 ng/ml, respectively using a TCI pump. The average peripheral oxygen saturation ($SpO_2$), heart rate, blood pressure, respiratory rate, nasal end-tidal $CO_2$ were recorded at 5-10 minute intervals. The age, gender, weight, procedure and sedation time, type of procedure were also recorded. Results: We included 22 cases of 19 adults (group A) and 6 cases of children (group B). In group A, 4 patients received propofol (group A-P), and 15 patients received propofol with remifentanil (group A-PR). In group B, 6 patients received propofol only. The mean age of group A was 41.1 years old and that of group B was 9.5 years old. No clinically significant complications were noted. There were no case of de-saturation <90%. The median respiratory rate was 13.1 (range 6 to 36) in group A and 19 (range 13 to 25) in group B. The median end tidal $CO_2$ was 36.7 mmHg(range 8 mmHg to 56 mmHg) in group A and 41.7 mmHg (range 30 mmHg to 53 mmHg) in group B. Conclusions: Based on our results, dental sedation using propofol/remifentanil in adult and propofol in children with TCI pump seems to appear as a safe and effective procedure while performing dental procedure.

A Study on Urinary Incontinence of Elderly Women in a Community (노인여성의 요실금 실태)

  • Park, Ok-Hee;Kwon, In-Soo;Kang, Young-Sil
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.536-546
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    • 2001
  • The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.

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The Spectral Characteristics of Climatological Variables over the Asian Dust Source Regions and its Association with Particle Concentrations in Busan (황사 발원지 기후자료의 시계열 특성과 부산지역 먼지 농도의 연관성 분석)

  • Son, Hye-Young;Kim, Cheol-Hee
    • Journal of the Korean earth science society
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    • v.30 no.6
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    • pp.734-743
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    • 2009
  • In order to examine how climatological condition can influence on urban scale particulate air pollutants, single and cross spectrum analysis have been performed to daily mean concentrations of particulate matters ($PM_{10}$) in Busan together with the climatological variables over the Asian dust source regions. Single power spectrum analysis of $PM_{10}$ concentrations in Busan shows that, aside from the typical and well-known periodicities, 3-4 year of peak periodicity of power spectrum density was identified. In cross spectrum analysis, this 3-4 year periodicity is found to have a strong positive correlation with the wind speed and pressure, and negative with the temperature and relative humidity, which is rather consistent with both characteristics of air mass during the Asian dust event whose periodicities have been recorded inter-annually over the Korean urban cities. Over the Asian dust source regions, $PM_{10}$ vs. precipitation shows no significant periodicity from the time series of precipitation data, but the periodicity of EDI (Effective Drought Index) shows some interannual variabilities ranging from 2 to 4 years over the various source regions, suggesting that, rather than precipitation itself, the EDI could be more closely associated with the occurrence frequency of Asian dust and interannual variability of urban particle concentrations in Korean cities.

Dissolved Methane Measurements in Seawater and Sediment Porewater Using Membrane Inlet Mass Spectrometer (MIMS) System (Membrane Inlet Mass Spectrometer (MIMS) 시스템을 이용한 해수 및 퇴적물 공극수내 용존 메탄의 측정)

  • An, Soon-Mo;Kwon, Ji-Nam;Lim, Jea-Hyun;Park, Yun-Jung;Kang, Dong-Jin
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.3
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    • pp.244-250
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    • 2007
  • Membrane inlet mass spectrometer (MIMS) has been used to accurately quantify dissolved gases in liquid samples. In this study, the MIMS system was applied to measure dissolved methane in seawater and sediment porewater. To evaluate the accuracy of the measurement, liquid samples saturated with different methane partial pressure were prepared and the methane concentrations were quantified with the MIMS system. The measured values correspond well with the expected values calculated from solubility constants. The standard error of the measurements were $0.13{\sim}0.9%$ of the mean values. The distribution of dissolved methane concentration in seawater of the South Sea of Korea revealed that the physical parameters primarily control the methane concentration in sea water. The MIMS system was effective to resolve the small dissolved methane difference among water masses. The probe type inlet in MIMS system was proven to be effective to measure porewater methane concentration.

Difference in Patient's Work of Breathing Between Pressure-Controlled Ventilation with Decelerating Flow and Volume-Controlled Ventilation with Constant Flow during Assisted Ventilation (보조환기양식으로서 감속형유량의 압력-조절환기와 일정형유량의 용적-조절환기에서 환자의 호흡일의 차이)

  • Kim, Ho-Cheol;Park, Sang-Jun;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.803-810
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    • 1999
  • Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

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Conversion of Total Atrio-pulmonary Connection to Total Cavo-pulmonary Connection - Review of Indications and Hemodynamic Characteristics - (심방-폐동맥 문합술 후 총 체정맥-폐동맥 문합술로의 전환 - 수술 적응증 및 혈역학적 특징의 검토 -)

  • Seo, Jung Ho;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.199-207
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    • 2002
  • Purpose : Since the successful application of total atrio-pulmonary connection(TAPC) to patients with various types of physiologic single ventricles in 1971, post-operative survival rates have reached more than 90%. However some patients have been shown to present with late complications such as right atrial thrombosis, atrial fibrillation and protein losing enteropathy eventually leading to re-operation to control the long-term complications. The aim of this study is to review the results of total cavo-pulmonary connection(TCPC) in cases with late complications after TAPC. Methods : Between Jan. 1995 and Dec. 2000, 6 patients(5 males and 1 female) underwent cardiac catheterization $11{\pm}3$ months after conversion of previous TAPC to TCPC. We compared the hemodynamic and morphologic parameters before and after TCPC and also assessed the clinical outcomes. The indications for TAPC were tricuspid atresia in 4 cases and complex double-outlet right ventricle with single ventricle physiology in 2 cases. Results : There was no peri-operative mortality and all patients were clinically and hemodynamically improved at a mean follow-up of 11 months(range : 4 to 13). However, protein losing enteropathy recurred in 2 patients; this was were successfully treated with subcutaneous administration of heparin. Right atrial pressure before TCPC was $18.0{\pm}3.6mmHg$, but baffle pressure, corresponding to right atrial pressure decreased to $14.8{\pm}3.6mmHg$ after TCPC. The size of the pulmonary arteries did not regress after TCPC. Conclusion : The conversion of TAPC to TCPC improves clinical and hemodynamic status by decreasing the right atrial pressure and by providing a laminar cavo-pulmonary flow which enhances the effective pulmonary circulation in the so-called Fontan circulation.

Relationship between Body Fat Distribution and Metabolic Risk Factors in Adolescents (청소년에서의 체지방 분포와 대사위험 인자들의 연관성)

  • Kim, Dal Hyun;Seong, Tae Jung;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.326-334
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    • 2003
  • Purpose : The objectives of this study were to estimate the prevalence of obesity in adolescents; to study the association between obesity, blood pressure, and dyslipidemia; and to evaluate the superiority of waist circumference to waist/hip ratio(WHR) in central obesity. Methods : We selected 1382 adolescents(M : F=690 : 692) aged from 11 to 18 years(mean age; boys 15.0, girls 15.4) in Incheon. We measured weight, height, waist, waist/hip ratio, and blood pressure, with blood sampling to evaluate the dyslipidemia. Results : The prevalence of obesity was 6.7% in boys and 6.9% in girls by body mass index(BMI). The prevalence of systolic hypertension was 15.7% in normal group, 32.4% in the overweight group, and 35.4% in the obese group by BMI. The prevalence of diastolic hypertension was 4.9% in the normal group, 6.9% in the overweight group, and 14.6% the in obese group. In boys and girls, BMI, waist circumference, and WHR were positively correlated with systolic and diastolic blood pressure. respectively. In boys, triglyceride was positively correlated with waist circumference(r=0.34, P<0.05). In boys and girls, BMI was highly correlated with obesity index(r=0.98, each), with waist circumference(r=0.89, r=0.82, respectively), and with body fat(r=0.85, r=0.89) respectively. Conclusion : These data suggest the importance of the screening of blood pressure in obese adolescents, with prevention and intervention of obesity since it may be the most cost-effective way of reducing the complications related with obesity.

Effects of a low glycemic load diet on body weight loss in overweight or obese young adults (식단의 당부하량에 따른 20대 성인의 체중 감량 효과 연구)

  • Park, Mi Hyeon;Nam, Kisun;Chung, Sang-Jin
    • Journal of Nutrition and Health
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    • v.53 no.5
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    • pp.464-475
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    • 2020
  • Purpose: This study compared the effects of a high glycemic load (high GL) diet and low glycemic load (low GL) diet on the body weight, body fat, blood pressure, and blood lipid indicators. Methods: Twenty-one young adults aged between 21 and 28 years who were overweighted or obese (body mass index [BMI] between 23 and 33.5 kg/㎡) before the study and after calorie reduction diets with either low GL or high GL for 2 weeks each were examined. The study was a randomized crossover design with a 2-week washout period between the 2 types of diet. The order of the low GL and high GL diet periods was randomized. The body weight, body fat, blood pressure, levels of blood lipids, fasting glucose, insulin, homeostatic model assessment (HOMA) insulin, C-peptide, and HOMA C-peptide were measured at the baseline, as well as 2, 4, and 6 weeks after starting the experiment. Results: When subjects were on the low GL diet, they lost more weight than those eating the high GL diet (mean ± SD, -2.77 ± 1.09 vs. -1.56 ± 0.78 kg; p < 0.001); there were greater decreases in body fat mass (-1.62 ± 1.19 vs. -0.88 ± 0.91 kg; p = 0.024) and BMI (-0.95 ± 0.32 vs. -0.56 ± 1.08 kg/㎡; p < 0.001). On the other hand, there were no significant differences in changes in biochemical parameters, such as blood lipids and fasting glucose levels, and blood pressure. The body weight, body fat mass, BMI, percent body fat, blood pressure, cholesterol (total, low-density lipoprotein, and high-density lipoprotein), fasting glucose, C-peptide, HOMA-insulin resistance-C-peptide levels were decreased significantly at 6 weeks. Conclusion: The low GL diet may be more effective in losing body weight, body fat mass, and BMI than the high GL diet for 2 weeks in healthy young overweight or obese adults.

Prediction of Continuous Positive Airway Pressure Level for Treatment of Obstructive Sleep Apnea (폐쇄성 무호흡의 치료시 지속적 기도 양압치의 예측)

  • Lee, Kwan Ho;Chung, Jin Hong;Lee, Hyun Woo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.755-762
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    • 1996
  • Background : Continuous positive airway pressure(CPAP) is doubtlessly using as a medical treatment of choice for patients with obstructive sleep apnea (OSA) syndrome. CPAP is effective in OSA patients as a physical "pneumatic pressure splint" mechanism. We have done this study for two purposes, first to seek for the factors to determine the optimal CPAP titer, second to predict the minimal CPAP titer using the determined factors. Methods: We studied a 72 OSA patients who were treated with CPAP. All of them were studied by using a two nights polysomnographic rests in hospital. We compared the patients requiring CPAP over $10cmH_2O$ with those who required CPAP under 5cm $H_2O$ to determine the factors affecting the minimal CPAP titer. Results : The high CPAP group is characterized by a significantly higher body mass index(BMI), apnea index(AI) and apnea and hyponea index(AHI) and significantly lower lowest $SaO_2$. Regression analysis using the optimal four variables resulted in the following prediction equation for CPAP titer. CPAPtiter=8.382 + 0.064 ${\times}$ BMI + 0.077 ${\times}$ AI - 0.004 ${\times}$ AHI - 0.077 ${\times}$ lowest $SaO_2$ When this regression equation was applied to the 72 patients, the mean CPAP titer as predicted by the above equation was $7.80{\pm}2.96$ mmHg. Compared this value with actually determined CPAPtiter, $7.93{\pm}4.00$mmHg, there was no significant difference between the two values. Conclusion: Obesity, apnea severity and lowest Sa02 were strongly correlated with CPAP titer. Linear regression equation for CPAP titer using these indices predicted very closely the actually measured values in the sleep laboratory.

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