• Tuberculosis and Respiratory Diseases
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• v.61 no.1
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• pp.26-33
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• 2006

Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.

• The Korean Journal of Physiology
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• v.27 no.1
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• pp.67-77
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• 1993

Acute and chronic effects of ethanol (EOH) administration on the cardiovascular and hormonal responses to repeated hemorrhage were investigated in conscious normotensive Wistar rats and spontaneously hypertensive rats (SHR). The chronic EOH treated group received 5% EOH (vol/vol) ad libitum in the drinking water far the first week,10% for the last 2 weeks, and 20% for the last 5 weeks from the age of 6 weeks. The EOH free group received tap water. Chronic EOH and EOH free groups were randomly subdivided into acute EOH infusion and control groups. Under ether anesthesia, catheters were inserted into the femoral vein and both femoral arteries. After rats regained consciousness and their blood pressure was stabilized, responses to quick hemorrhage (5 ml/kg BW) were tested. In the acute EOH infusion group, hemorrhage was induced 20 min after EOH infusion (1.0 g/kg BW), Baroreceptor reflex sensitivity was assessed by the ratio of changes in hen.1 rate and mean arterial pressure (${\Delta}HR/{\Delta}MAP$) immediately after the hemorrhage. Chronic EOH administration elevated MAP in Wistar rats. During acute EOH infusion, MAP do- creased and HR increased in all groups. In comparison to EOH free control rats, acute or chronic EOH treated rats showed a greater reduction in MAP and a smaller elevation in heart rate in response to a hemorrhage. The degree of MAP reduction was significantly greater in SHR than in Wistar rats. Both the acute and chronic EOH administration attenuated the baroreceptor reflex and retarded MAP recovery, again the trend being much more prominent in SHR. The increase in plasma vasopressin and lenin concentrations after hemorrhage were intensified by the chronic EOH administration. SHR showed a greater vasopressin response but a smaller lenin response than Wistar rats. These results indicate that the EOH treated rats, particularly SHB, are prone to shock by a hemorrhage, which may be partly attributed to an impaired baroreceptor reflex function.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.181-185
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• 2001

Background: Bradycardia frequently occurs in intravenous anesthesia with propofol. Additionally, the thoracic sympathetic nerves influence the heart so that the heart rate (HR) and blood pressure are expected to decrease due to this procedure. Therefore, we measured changes in HR, mean arterial pressure (MAP) and both thumb temperatures before and after thoracic sympathicotomy under total intravenous anesthesia with propofol. Methods: The subjects included 21 outpatients of ASA class I who received thoracoscopic thoracic sympathicotomy under total intravenous anesthesia. Anesthesia was induced with propofol (2 mg/kg) and vecuronium (0.1 mg/kg) and maintained with propofol-fentanyl-oxygen (100%). The surgical procedure was performed at the T3 level in the order of left sympathicotomy (LST) and right sympathicotomy (RST). Measurements of HR, MAP and both thumb temperatures were taken before induction of anesthesia, before and after LST and RST, and 1 hour after the completion of anesthesia. Additionally, the time to the beginning of a rise in temperature in both thumbs after sympathicotomy was recorded. Results: HR did not show any significant difference before or after sympathicotomy, however it decreased at 1 hour after the completion of anesthesia. MAP decreased after LST and decreased further after RST. Left thumb temperature began to increase at $45.8{\pm}10.7$ seconds after LST. Right thumb temperature initially decreased after LST and increased from $45.2{\pm}11.8$ seconds after RST. Subsequently, both increased temperatures were maintained at 1 hour after the completion of anesthesia. Conclusions: Although HR and MAP decreased, there were no severe hemodynamic changes. An increase in the thumb temperature was confirmed within 1 minute after sympathicotomy on the same side.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.1-14
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• 2004

Objectives : This research was performed to investigate the effect of acupuncture at the $KI_2\;KI_{10}\;HT_8\;HT_3$, on Aquaporin-2(AQP2) expression related with the renal functions in rats. Methods : Acupuncture was performed during 100-seconds, 6-times, at 150-seconds intervals under anesthesia in rats. We observed rats' mean arterial pressure(MAP), heart rate(HR), renal sympathetic nerve activity(RSNA) during acupuncture and AQP2 expression by western blot method and atrial natriuretic peptide(ANP), renin, norepinephrine of plasma after decapitation. Results : The AQP2 expression was significantly increased in $HT_8$ group, but decreased in $KI_{10}$ group. Average MAP during 6-times acupuncture was significantly increased in $HT_8$ group. Average HR was significantly increased in $HT_8$ group, Average RSNA was increased in $KI_{10}$ group, but that was marginally increased in $KI_{10}$ group. Plasma renin concentration was increased in $KI_2,\;HT_3$, groups. Plasma ANP show a tendency to decrease in $KI_10\;HT_3$ groups, increased in $KI_2,\;HT_3$ but not significant. Plasma norepinephrine concentration was significantly decreased in $KI_{10},\;HT_3$ groups. Conclusions : These results suggested that acupuncture at $HT_8$ activate renal function to reuptake, but $KI_{10}$ show a decline on effect of AQP2 expression, blood pressure, nerve activity and renin.

• Neonatal Medicine
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• v.18 no.1
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• pp.124-129
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• 2011

Purpose: To evaluate the effect of oral sildenafil therapy in neonates with persistent pulmonary hypertension of the newborn (PPHN) Methods: We conducted a retrospective review of 32 neonates ${\geq}$35 weeks' gestation and fraction of inspired oxygen ($FiO_2$) 1.0 with PPHN. The first dose (0.5 mg/kg) of oral sildenafil was started and 1 mg/kg was given every 6 hour thereafter. Mean airway pressure (MAP), $FiO_2$, oxygenation index (OI), mean arterial blood pressure (MBP) were documented before and 6, 12, 24, and 48 hours after sildenafil. For adverse effects, gastrointestinal symptoms, brain ultrasound, funduscopy and auditory brainstem response results were evaluated. Results: The underlying diseases of PPHN (n=32) were meconium aspiration syndrome (n=9), respiratory distress syndrome (n=8), pneumonia (n=3), and idiopathic (n=12). Thirty-one neonates survived; 3 neonates were transferred for inhaled nitric oxide (iNO) and all of them survived. In 28 infants, $FiO_2$ and OI improved significantly by 6 hours and MAP improved significantly by 48 hours after initiation of sildenafil. There were no clinically significant adverse effects of sildenafil. Conclusion: Sildenafil may be an effective and safe agent for near-term and term neonates with PPHN, providing significant improvement in oxygenation, and thus may be especially useful in the treatment of PPHN in hospitals without iNO.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.1
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• pp.371-375
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• 2019

The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) in hemodynamically unstable pancreatic trauma is unclear. We report here a case of traumatic pancreatic bleeding controlled with REBOA and angioembolization of the splenic artery before surgery. A 65-year old man experienced blunt trauma upon falling from a height of 20 m. Computed tomography (CT) revealed distal pancreatic trauma (grade III) and contrast extravasation around the splenic artery. Shortly after CT, his systolic blood pressure was 60 mmHg and REBOA was performed for hemodynamic stability. His systolic pressure increased to 130 mmHg after balloon inflation and angioembolization of the splenic artery was performed. On angiography, no further arterial bleeding was identified and the balloon was removed. Subsequently, the patient underwent emergent laparotomy with distal pancreatectomy. There was no active bleeding during surgery and distal main pancreatic duct injury was identified. After surgery, the patient recovered without complication. In this case, hemodynamically unstable hemorrhagic pancreatic trauma was treated effectively and safely with distal pancreatectomy after REBOA with angioembolization.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.661-668
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• 2005

Background: We have hypothesized that, if a low resistant gravity-flow membrane oxygenator is used, then the twin blood sacs of TPLS can be located at downstream of the membrane oxyenator, which may double the pulse rate at a given pump rate and increase the pump output. The purpose of this study was to determine the optimal configuration for the ECLS circuits by using the concept of pulse energy and pump output. Material and Method: Animals were randomly assigned to 2 groups in a total cardiopulmonary bypass model. In the serial group, a conventional membrane oxygenator was located between the twin blood sacs. In the parallel group, the twin blood sacs were placed downstream of the gravity-flow membrane oxygenator. Energy equivalent pressure (EEP) and pump output were collected at pump-setting rates of 30, 40, and 50 BPM. Result: At the given pump-setting rate, the pulse rate was doubled in the parallel group. Percent changes of mean arterial pressure to EEP were $13.0\pm1.7,\; 12.0\pm1.9\;and\;7.6\pm0.9\%$ in the parallel group, and $22.5\pm2.4,\; 23.2\pm1.9,\;and\;21.8\pm1.4\%$ in the serial group at 30, 40, and 50 BPM of pump-setting rates. Pump output was higher in the parallel circuit at 40 and 50 BPM of pump-setting rates $(3.1\pm0.2,\;3.7\pm0.2L/min\;vs.\;2.2\pm0.1\;and\;2.5\pm0.1L/min,\;respectively,\;p=0.01)$. Conclusion: Either parallel or serial circuit configuration of the ECLS generates effective pulsatility. As for the pump out, the parallel circuit configuration provides higher flow than the serial circuit configuration.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.210-222
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• 2000

Background: Endothelin(ET) is the most potent vasoconstrictor and bronchoconstrictor. The plasma ET-1 level is elevated in patients with acute pulmonary thromboembolism(APTE). This finding suggest that ET-1 may be an important mediator in the cardiopulmonary derangement of APTE. But whether ET-1 is a pathogenic mediator or a simple marker of APTE is not known. The role of ET-1 in the pathogenesis of cardiopulmonary dysfunction in APTE(delete) was investigated through an evaluation of the effects of $ET_A$-receptor antagonist on APTE. The increase in local levels of preproET-1 mRNA and ET-1 peptide in the embolized lung was also demonstrated. Methods: In a canine autologous blood clot pulmonary embolism model, $ET_A$-receptor antagonist(10 mg/kg intravenously, n=6) was administered one hour after the onset of the embolism. Hemodynamic measurements, blood gas tensions and plasma levels of ET-1 immunoreactivity in this treatment group were compared with those in the control group(n=5). After the experiment., preproET-1 mRNA expression(using Northern blot analysis) and the distribution of ET-1(by immunohistochemical analysis) in the lung tissues were examined. Results: The increases in pulmonary arterial pressure and pulmonary vascular resistance of the treatment group were less than those of the control group. Decrease in cardiac output was also less in the treatment group. Complications such as systemic arterial hypotension and hypoxemia did not occur with the administration of $ET_A$-receptor antagonist The plasma level of ET-1 like(ED: what does 'like' mean?) immunoreactivity was increased after embolization in both groups but was significantly higher in the treatment group. The preproET-1 mRNA and ET-1 peptide expressions were increased in the embolized lung. Conclusion: ET-1 synthesis increases with embolization in the lung and may plays play an important role in the pathophysiology of cardiopulmonary derangement of APTE. Furthermore, $ET_A$-receptor antagonist attenuates cardiopulmonary alterations seen in APTE, suggesting a potential benefit of this therapy.

• Tuberculosis and Respiratory Diseases
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• v.40 no.1
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• pp.16-22
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• 1993

Background: The Microbicidal and cytotoxic activities of neutrophils are to a large extent dependent on a burst of oxidative metabolism which generates superoxide anion, hydrogen peroxide, and other reactive products of oxygen. The respiratory burst of PMN is initiated by intracellular calcium mobilization that follows immune or particular stimulation and is very sensitive to modulation by c-AMP or adenosine. Despite its antagonism against adenosine, earlier study has demonstrated potent theophylline inhibition of the PMN respiratory burst at variable ranges of blood concentrations of theophylline in the healthy normal volunteers and in the septic animals pretreated or early post-treated with aminophylline (AMPH) or pentoxifylline. However it is unclear whether theophylline inhibits the superoxide generation or not in the established human sepsis caused by acute pneumonia, as taking into consideration of the fact that full activation of neutrophils have occurred within minutes after the septic insult in the animal experiments. Methods: We measured the $O_2$ generation of peripheral arterial neutrophils obtained from 11 human septic subjects caused by acute pneumonia before and 1 hour after completion of continuous AMPH infusion. Patients were identified and studied within 48 hour of admission. All subjects were administered an intravenous loading and maintenance dose of AMPH. The generation of $O_2$ was measured at a discrete time point (60 min) by the reduction of ferricytochrome c.PMA (10 ${\mu}g/ml$) was used as a stimulating agent. PMNs were isolated at a concentration of $2{\times}10^6$ cells/ml. The arterial oxygen tension, blood pressure and heart rates were also checked to evaluate the systemic effects of AMPH in the acute pneumonia. Results: The mean serum concentration of AMPH at 60 minutes was $8.8{\pm}0.6{\mu}g/ml$. Sixty minutes after AMPH infusion the generatition of $O_2$ was decreased from $0.076{\pm}0.034$ to $0.013{\pm}0.004$(OD) (p<0.05) and from $0.177{\pm}0.044$ to $0.095{\pm}0.042$(OD) (p<0.01) in the resting and stimulated PMNs respectively. $PaO_2$ was not changed after AMPH infusion. Conclusion: AMPH may compromise host defense by significant inhibition of neutrophil release of superoxide anion and it had no effect on improving $PaO_2$ in the acute pneumonia.

• Journal of Nutrition and Health
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• v.55 no.6
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• pp.642-655
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• 2022

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m² ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilate-sadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance, moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion: This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.