• Title/Summary/Keyword: hemodynamic change

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The Usefulness of the Ivy Sign on Fluid-Attenuated Intensity Recovery Images in Improved Brain Hemodynamic Changes after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Adult Patients with Moyamoya Disease

  • Lee, Jung Keun;Yoon, Byul Hee;Chung, Seung Young;Park, Moon Sun;Kim, Seong Min;Lee, Do Sung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.302-308
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    • 2013
  • Objective : MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. Methods : We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. Results : Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. Conclusion : After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.

NUMERICAL ANALYSIS FOR THE EFFECT OF BLOOD FLOW RATE AND BIFURCATION ANGLE ON THE LOCATION OF ANTERIOR CIRCULATION ANEURYSM AND THE CHANGE OF BLOOD FLOW CHARACTERISTICS AFTER ANEURYSM FORMATION (전방순환동맥류 발생 위치에 대한 혈류량 및 분지각의 영향 및 동맥류 발생 전후의 유동 변화에 관한 수치해석 연구)

  • Kim, S.Y.;Ro, K.C.;Ryou, H.S.
    • Journal of computational fluids engineering
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    • v.16 no.4
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    • pp.64-71
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    • 2011
  • Cerebral aneurysm mostly occurs at a bifurcation of the circle of Willis. When the cerebral aneurysm is ruptured, a disease like subarachnoid hemorrhage and stroke is caused and this can be even deadly for patients. Generally it is known that causes of the intracranial aneurysm are a congenital deformity of the artery and pressure or shear stress from the blood flow. A blood flow pattern and the geometry of the blood vessel are important factors for the aneurysm formation. Research for several hemodynamic indices has been performed and these indices can be used for the prediction of aneurysm initiation and rupture. Therefore, the numerical analysis was performed for hemodynamic characteristics of the blood flow through the cerebral artery applying the various bifurcation angle and flow rate ratio. We analyze the flow characteristics using indices from the results of the numerical simulation. In addition, to investigate the flow pattern in the aneurysm according to the bifurcation angle and the flow rate ratio, we performed the numerical simulation on the supposition that the aneurysm occurs.

Early Postoperative Hemodynamic Changes in Patients of Congenital Complex Heart Disease using Blood Cardioplegic Solution (Blood cardioplegic solution을 사용한 선천성 복잡 심기형 환자의 술 후 조기 혈류학 변화에 관한 연구)

  • Kim, Yeong-Tae;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1192-1202
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    • 1992
  • Postoperative cardiac outputs and other hernoaynamic values were serially measured in fifteen patients of cyanotic congenital heart disease, after use of blood cardioplegic solution. Cardiac indices showed no change untill eight postoparative hours, then it began to decline to reach as low as 3.22$\pm$0.7L/min/m2 at 12 hours. After then gradual increse occ-ured to recover upto immediate postoperative value at 20 hours. Sharp decrese of heart rate and increse of systemic vascular resistance during 8~16 hours and steady increase of stroke indices during the whole study periods were observed. These observations suggested that the myocardium recovered gradually after open heart surgery, and that the decrease of cardiac indices during 8~16 hours could be a result of decrease of heart rates and increase of afterload. The changes of cardiac indices correlated with the changes of heart rate, postoperative time and mixed venous oxygen saturation [p<0.05]. No other hemodynamic values found to be in statistically significant correlation with the changes of cardiac indices. Left ventricular dysfunction seemed to occur more frequently during 8~12 hours, but it was not statistically significant. [p=0.73] In conclusion, great care must be taken during 2~3 days after the operation of cyanotic congenital heart disease, not to fall into a low cardiac output state, by maintaing adequate heart rates and reducing afterload especially when the systemic vascular resistance increases.

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NUMERICAL ANALYSIS FOR THE EFFECT OF BLOOD FLOW RATE AND BIFURCATION ANGLE ON THE LOCATION OF ANTERIOR CIRCULATION ANEURYSM AND THE CHANGE OF BLOOD FLOW CHARACTERISTICS AFTER ANEURYSM FORMATION (전방순환동맥류 발생 위치에 대한 혈류량 및 분지각의 영향 및 동맥류 발생 전후의 유동 변화에 관한 수치해석 연구)

  • Kim, S.Y.;Ro, K.C.;Ryou, H.S.
    • 한국전산유체공학회:학술대회논문집
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    • 2011.05a
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    • pp.161-168
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    • 2011
  • Cerebral aneurysm mostly occurs at a bifurcation of the circle of Willis. When the cerebral aneurysm is ruptured a disease like subarachnoid hemorrhage and stroke is caused and this can be even deadly for patients. Generally it is known that causes of the intracranial aneurysm are a congenital deformity of the artery and pressure or shear stress from the blood flow. A blood flow pattern and the geometry of the blood vessel are important factors for the aneurysm formation. Research for several hemodynamic indices has been performed and these indices can be used for the prediction of aneurysm initiation and rupture. Therefore, the numerical analysis was performed for hemodynamic characteristics of the blood flow through the cerebral artery applying the various bifurcation angle and flow rate ratio. We analyze the flow characteristics using indices from the results of the numerical simulation. In addition, to investigate the flow pattern in the aneurysm according to the bifurcation angle and the flow rate ratio, we performed the numerical simulation on the supposition that the aneurysm occurs.

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The Frequency Effect in the Somatosensory Cortex Response to Vibrotactile Stimulator in fMRI (기능적 자기공명영상에서 진동자의 자극 주파수가 감각피질의 반응에 미치는 영향)

  • Lee Hyunsook
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.128-133
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    • 2004
  • The fMRI response of the somatosensory cortex was investigated with vibrotactile stimulation. Three different frequencies of 8, 15, or 25 Hz were applied in order to mainly focus on the hemodynamic response of Meissner corpuscles sensitive to frequencies of 5-40 Hz. A closed-system, pneumatically-driven, rubber diaphragm was fabricated that overcame many of the limitations of existing vibrotactile devices and produced robust sensory cortex activation in an fMRI experiment. Increasing frequency vs. activation area was analyzed in terms of signal percent change and number of pixels. Our preliminary results indicated that the distribution of the signal percentage change widened and more activated pixels were obtained with higher frequencies.

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Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions (고비중 Bupivacaine 척추마취 후 체위에 따른 마취수준과 부작용의 비교)

  • Moon, Ji Young;Kim, Bo Hwan
    • 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.

Effects of Sanjointang on Hemodynamic Functions of Isolated Rat Heart Induced by Sleep Deprivation (산조인탕이 수면박탈 흰쥐 심장의 혈역학적 기능에 미치는 영향)

  • Shin, Yu-Jeong;Kim, Deog-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.3
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    • pp.106-120
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    • 2010
  • Objectives: Sanjointang has been clinically used much for treating sleeplessness. However, the effects of Sanjointang in artificial sleep deprivation situations are not known. The purpose of this study is to evaluate the heart rate, left ventricular systolic pressure, left ventricular diastolic pressure, +dp/dt maximum, -dp/dt maximum, and -dp/dt / +dp/dt ratio which are related to the hemodynamic functions of the heart by using sleep-deprived Sparague-Dawley rats, in order to clarify the impact of Sanjointang on hemodynamic functions of the heart of sleep deprived rats. Methods: Eighteen hearts were removed from the male Sparague-Dawley rats weighting about 180g were perfused by the Langendorff technique with modified 37 Krebs-Henseleit's buffer solution at a constant perfusion pressure (60mmHg). They were randomly assigned to one of the following three groups, 1) Normal group (those which did not have sleep deprivation and received normal saline administration), 2) Control group (sleep deprived and normal saline administered), 3) Sample group (sleep deprived and Sanjointang was administered). Control and sample groups rats were deprived 96 hours of sleep by using the modified multiple platform technique. Heart rate, left ventricular systolic pressure, left ventricular diastolic pressure, +dp/dt maximum, -dp/dt maximum, -dp/dt / +dp/dt ratio were evaluated at baseline after the administration of either normal saline or Sanjointang. Results: The heart rate and -dp/dt / +dp/dt ratio was significantly decreased in rats with 96 hours of sleep deprived significantly decreased. The change in the heart rate after administering Sanjointang did not show any significant difference. The left ventricular systolic pressure of the removed heart significantly decreased due to Sanjointang administration, while the left ventricular diastolic pressure significantly increased (p<0.05). The +dp/dt maximum and -dp/dt maximum both significantly decreased in the removed heart after administering Sanjointang. (p<0.05). There was no significant difference observed in the -dp/dt / +dp/dt ratio after administering Sanjointang. Conclusions: According to the results above, sleep deprivation significantly decreases heart rate and -dp/dt / +dp/dt ratio. This is considered as a result of exhaustion due to accumulation of fatigue. Meanwhile, Sanjointang reduced left ventricular systolic pressure and raised left ventricular diastolic pressure, and relieved the contractility and relaxation of the myocardium. Consequently, this reduces the burden of the heart and creates a relatively stabilized heart condition similar to a sleeping condition.

Nonlinearity in the Somatosensory Cortex Response to Vibrotactile Stimulator in fMRI (기능성 자기공명영상에서 진동자극에 대한 감각피질의 비선형성)

  • Lee, Hyun-Sook
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.159-166
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    • 2006
  • The nonlinearity of hemodynamic response in the somatosensory cortex was investigated with vibrotactile stimulation. The stimuli consisted of a train of 25 Hz, each tasting five different duration periods, 2 s, 4 s, 8 s 12 s, or 16 s with 20 sec periods of no vibration in a pseudo-random order. In order to understand the linearity on the change of stimulus duration for somatosensory cortex, two different tests- checking the linearity of system and finding the impulse response function from gamma-variate function were applied to analyze the hemodynamic response functions. They have produced nearly same results. The BOLD response in the somatosensory cortex Is nonlinear for stimuli of less than 8 seconds, but nearly linear for stimuli greater than 8 seconds. The amplitude, area, TTP, and FWHM as functions of the stimulus duration were calculated and showed a significant downward trend with Increasing stimulus duration for the amplitude and the area. It supports the ranges of nonlinearity are less than 8 seconds.

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Effects of Pyengpaetang Extracts on the Acute Pulmonary Edema induced by Oleic acid in dogs (평폐탕(平肺湯)이 Oleic acid로 유발(誘發)된 가견(家犬)의 급성폐수종(急性肺水腫)에 미치는 영향(影響))

  • Chung, Jae-Woo;Han, Sang-Whan;Choe, Sun-Ho
    • The Journal of Internal Korean Medicine
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    • v.11 no.2
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    • pp.1-15
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    • 1990
  • Certain oriental medication have been shown to be effective in decreasing pulmonary vascular resistance and increasing cardiac output in primary pulmonary artery pressure secondary to pulmonary edema. So oleic acid was administered in 14 dogs in order to induce acute lung injury. And we studied the hemodynamics and blood gas changes of Pyengpaetang(50mg, 100mg) with continuous postive pressure was ventilation in pulmonary edema. The pulmonary edema group, arterial oxygenation was improved after 5 and $10cmH_2O$ PEEP(positive end expiratory pressure), but cardiovascular system was depressed. Blood pressure and cardiac output were decreased, and CVP, MP AP, PCWP were increased. In Pyengpaetang(50mg) group, mean aortic pressure was decreased and PCWP(pulmonary capillary wedge pressure) was decreased remarkably, while there was a significant increase in cardiac output. And there was improvement in $PaO_2$ and $PaCO_2$ without hemodynamic changes after applying 5cm $H_2O$ PEEP, but arterial blood gases$(PaO_2,\;PaCO_2)$ were improved, while cardiovascular effects were depressed after cm $H_2O$ PEEP. In Pyengpaetang(100mg) treated group, there was no significant hemodynamic change. But mean pulmonary arterial pressure was significantly increased, and cardiac output was decreased significantly after applying the more degree of PEEP. And blood gases were not changed significantly after applying the more degree of PEEP. The above results suggest that the effects of Pyengpaetang(50mg) group is superior to those of Pyengpaetang(100mg) group on the effects of hemodynamics and gas exchanges in acute lung injury in dogs. So we can conclude that lower degree PEEP 5cm $H_2O$ is more beneficial in Pyengpaetang(50mg) treated group.

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Comparison of sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam, xylazine-ketamine, and propofol in beagle dogs (비글견에서 tiletamine-zolazepam, xylazine-ketamine 및 propofol의 간헐적 일시 정맥주사에 의한 진정효과의 비교)

  • Lee, Soo-Han;Bae, Chun-Sik;Lee, Byeong-han;Chung, Byung-Hyun
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.263-271
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    • 2005
  • To compare the sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam (n = 5, TZ group), xylazine-ketamine (n = 5, XK group) and propofol (n = 5, PI group), we investigated the changes of hemodynamic (heart rate, arterial pressure), $SpO_2$, rectal temperature, respiratory rate and pain score during 60 minute sedation and 40 minute recovery period in beagle dogs. The value of rectal temperature was significantly higher in PI groups (p<0.05) during recovery period. The value of heart rate was significantly lower in XK group (p<0.05) during sedation. The changes of respiratory rate were similar tendency in all groups. The change of $SpO_2$ was stable during sedation and value was significantly higher in PI group (p<0.05) during recovery period. The value of systolic arterial pressure (SAP) was significantly lower in XK group (p<0.05) than PI group during sedation and recovery period. Low analgesic effect occurred in PI group. We concluded that intravenous anesthesia by intermittent bolus injection with propofol is useful in stabilizing rectal temperature, $SpO_2$ and hemodynamic during sedation and provide fast recovery, but have low analgesic effect.