• Title/Summary/Keyword: stabilization of pressure

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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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Relationship of Hemodynamic Changes during Off-Pump Coronary Bypass Grafting and Their Effects on Postoperative Outcome (심폐바이패스 없이 시행하는 관상동맥 우회수술 중의 혈역학적 변수들의 변화양상 및 수술 후 결과에 미치는 영향)

  • 허재학;장지민;김욱성;장우익;이윤석;정철현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.576-582
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    • 2003
  • During the Off-Pump Coronary Arterial Bypass surgery (OPCAB), the manipulation of the heart can depress cardiac contractility and cause hemodynamic instability. In this study, hemodynamic parameters were measured during operation and the laboratory and clinical data were investigated to evaluate their effects on postoperative outcome. Material and Method: From March 2001 to August 2002, 50 consecutive patients who underwent OPCAB were included in this study. During the same period, total number of CABG was 71 The blood pressure, pulmonary artery pressure, mixed venous oxygen saturation, and cardiac index were measured before manipulation, after application of stabilizer, and at the end of anastomosis. Postoperatively, we measured the cardiac enzymes such as CK-MB, troponin 1 and checked the amount of inotropes required, chest tube drainage, the amount of transfusion, duration of ventilator support, and duration of ICU stay. Result: The number of mean distal anastomoses was 2.8$\pm$0.9 per patient. On elevation and stabilization of the heart, systolic blood pressure was depressed and pulmonary artery pressure was elevated significantly, but during each anastomosis no significant changes were detected. The peak level of cardiac markers was 29.2$\pm$46.7 for CK-MB, 0.69$\pm$0.86 for troponin 1 on postoperative day f. Among the intraoperative hemodynamic parameters, the ischemic change of EKG and bolus injection of inotropes significantly affected the posteroperative cardiac enzymes. But, no difference other than the level of cardiac enzymes between the two groups with or without the ischemic change of EKG and bolus injection of inotropes was noticed. Conclusion: The significant hemodynamic changes occurred when the heart was elevated and stabilized, however during anastomoses there were no significant changes. Serum cardiac enzymes rose significantly in the group that showed the ischemic charge of EKG or needed the bolus injection of inotropes for maintaining hemodynamic stability intraoperatively, but it did not affect the postoperative outcome. In conclusion, the ischemic change of EKG and the need for bolus injection of intropes during operation may be very indicative for probable ischemia.

A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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Change of Ichthyofauna and Fish Communities after Complete Removal of Large Mouth Bass, Micropterus salmoides (Perciformes; Centrachidae) in Farm Reservoir, Korea (농업용저수지에서 생태계교란 생물 배스 Micropterus salmoides 완전제거 후 어류상의 변화 및 군집 분석)

  • Jae Goo Kim;Yun Jeong Cho;Cheol Woo Park;Jong Wook Kim;Su Hwan Kim
    • Korean Journal of Ichthyology
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    • v.35 no.4
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    • pp.270-277
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    • 2023
  • Since its introduction in 1973, the bass, Micropterus salmoides, has spread to dams and rivers in Korea, adversely affecting native fish communities. In this study, after complete removal of bass from Bukchosan Reservoir, an farm reservoir that has lost its function, an attempt was made to indirectly confirm the adverse effects of bass on fish by comparing fish communities in reservoirs of a similar size where bass inhabit. The study was conducted three times a year from 2019 to 2022. As a result of the study, in Bukchosan Reservoir, where the species composition of fish was judged to be simplified due to the habitat of bass, only four species such as Carassius auratus and Rhinogobius brunneus that could be used as a food source for bass appeared before the removal of bass, but after the removal of bass. The appearance and increase of the population of the introduced small freshwater fish (Oryzias sinensis, Rhinogobius giurinus) were confirmed. When comparing Gangjeong Reservoir, Susim Reservoir, which are other reservoirs inhabited by bass investigated in this study, and Bukchosan Reservoir, this result is judged to show a trend of stabilization and recovery of fish species after removal of bass in small reservoirs with high predation pressure of bass.

Study on Application of Skin Care Cosmetic and Stabilization of Idebenone by Forming Niosome Vesicle Technology

  • Kim, In-Young
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.2
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    • pp.592-599
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    • 2019
  • This study is to stabilize insoluble and unstable active ingredient which is Idebenone (INCI name: hydroxydecyl ubiquinone) in a multi-lamellar vesicle (MLV) and to stabilize it in the skin care cosmetics. Idebenone is good effective raw material in the treatment of Alzheimer's disease in the medical field and a powerful antioxidant in dermatology. It is well known as a substance that inhibits the formation of melanin and cleans the skin pigment. However, it did not dissolve in any solvent and it was difficult to apply in cosmetic applications. Niosome vesicle was able to develop a nano-particle by making a multi-layer of idebenone encapsulated with a nonionic surfactant, hydrogenated lecithin and glycine soja (soybean) sterols and passing it through a high pressure microfluidizer. Idebenone niosome vesicle (INV) has been developed to have the ability to dissolve transparently in water and to promote transdermal penetration. The appearance of the INV was a yellowish liquid having specific odor, and the particle size distribution of INV was about 10~80 nm. The pH was 5~8 (mean=6.8). This capsulation with idebenone was stored in a $45^{\circ}C$ incubator for 3 months and its stability was observed and quantitatively measured by HPLC. As a result, the stability of the sample encapsulated in the niosome vesicle (97.5%) was about 66.3% higher than that of the non-capsule sample of 32.5%. Idebenone 1% INV was used for the efficacy test and clinical trial evaluation as follows. The anti-oxidative activity of INV was 38.2%, which was superior to that of 12.8% tocopherol (control). The melanin-reducing effect of B16 melanoma cells was better than INV (17.4%) and Albutin (control) (9.6%). Pro-collagen synthesis rate was 128.2% for INV and 89.3% for tocopherol (control). The skin moisturizing effect was 15.5% better than the placebo sample. The elasticity effect was 9.7% better than the placebo sample. As an application field, INV containing 1% of idebenone is expected to be able to develop various functional cosmetic formulations such as skin toner, ampoule essence, cream, eye cream and sunblock cream. In addition, it is expected that this encapsulated material will be widely applicable to emulsifying agents for skin use in the pharmaceutical industry as well as the cosmetics industry.

Development of Chitosan Coated Solid Lipid Nano-particles Containing 7-Dehydrocholesterol (7-디하이드로콜레스테롤을 함유한 키토산 코팅 처리 Solid Lipid Nano-particle의 개발에 관한 연구)

  • Lee Geun-Soo;Kim Tae-Hoon;Lee Chun-Il;Pyo Hyeong-Bae;Choe Tae-Boo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.31 no.2 s.51
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    • pp.141-146
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    • 2005
  • Unstable cosmetic active ingredients could rapidly break down in chemical and photochemical process. Therefore, it has become a very important issue to encapsulate active ingredient for the stabilization. 7-Dehydrocholesterol (7-DHC), a precursor of vitamin $D_3$, has been shown to increase levels of protein and mRNA for heat shock protein in normal human epidermal keratinocytes. However, topical dermal application of 7-DHC is restricted due to its poor solubility and chemical unstability. In this study, 7-DHC was incorporated into nano-emulsion (NE), solid lipid nano-particle (SLN), and chitosan coated solid lipid nano-particle (CASLN), respectively. In order to prepare NE and SLN dispersion, high-pressure homogenization at temperature above the melting point of lipid was used Hydrogenated lecithin and polysorbate 60 were used as stabilizer for NE and SLN. CASLN was prepared by high speed homogenizing after adding chitosan solution to the SLN dispersion and showed positively charged particle properties. Decomposition rate of 7-DHC in NE, SLN and CASLN was studied as a function of time at different temperature. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) studies were performed to characterize state of lipid modification. It appeared that CASLN is the most effective to stabilize 7-DHC and may be used for a useful topical dermal delivery system.

Studies in Biomechanical Properties on Brain-spinal Cord Response Mechanism by Human Posture Control Ability (자세조절능력에 따른 뇌-척수 신경 반응기전의 역학적 해석)

  • Yoo, Kyoung-Seok
    • 한국체육학회지인문사회과학편
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    • v.58 no.6
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    • pp.449-459
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    • 2019
  • The purpose of this study is to identify how postural mechanics affects postural control on balance and stability by using frequency analysis technique from the kinematic data acquired during the one leg standing posture. For this purpose, the experimental group consisted of two groups, the normal group (n=6) and the national Gymnastics group (n=6). Displacement data of CoP were analyzed by frequency analysis of rambling (RM) and trembling (TR) by FFT signal processing. As a results, there was a significant difference in evaluating the stabilization index between the two groups with the eyes open and closed one leg stnading (p <.05). The cause of the difference was found to be the output of the maximum amplitude of RM (f1) and TR (f2) (p <.05). In particular, in the low frequency RM of 8-9 Hz, which is a natural frequency of signal wave involved in postural feedback feedback, the main frequency appeared to be performs the exercise mechanism of stable brain posture control. And in the high frequency TM of 120-135 Hz, it is considered that the adaptation of the reflective muscle response is minimized to minimize posture shaking. In conclusion, this study provides evidence for the intrinsic main frequencies according to the postural control ability which affects the CNS in one leg standing.

The role of porous graphite plate for high quality SiC crystal growth by PVT method (고품질 4H-SiC 단결정 성장을 위한 다공성 흑연 판의 역할)

  • Lee, Hee-Jun;Lee, Hee-Tae;Shin, Hee-Won;Park, Mi-Seon;Jang, Yeon-Suk;Lee, Won-Jae;Yeo, Im-Gyu;Eun, Tai-Hee;Kim, Jang-Yul;Chun, Myoung-Chul;Lee, Si-Hyun;Kim, Jung-Gon
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.25 no.2
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    • pp.51-55
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    • 2015
  • The present research is focused on the effect of porous graphite what is influenced on the 4H-SiC crystal growth by PVT method. We expect that it produces more C-rich and a change of temperature gradient for polytype stability of 4H-SiC crystal as adding the porous graphite in the growth cell. The SiC seeds and high purity SiC source materials were placed on opposite side in a sealed graphite crucible which was surrounded by graphite insulator. The growth temperature was around $2100{\sim}2300^{\circ}C$ and the growth pressure was 10~30 Torr of an argon pressure with 5~15 % nitrogen. 2 inch $4^{\circ}$ off-axis 4H-SiC with C-face (000-1) was used as a seed material. The porous graphite plate was inserted on SiC powder source to produce a more C-rich for polytype stability of 4H-SiC crystal and uniform radial temperature gradient. While in case of the conventional crucible, various polytypes such as 6H-, 15R-SiC were observed on SiC wafers, only 4H-SiC polytype was observed on SiC wafers prepared in porous graphite inserted crucible. The defect level such as MP and EP density of SiC crystal grown in the conventional crucible was observed to be higher than that of porous graphite inserted crucible. The better crystal quality of SiC grown using porous graphite plate was also confirmed by rocking curve measurement and Raman spectra analysis.

Tracheal gas insufflation (TGI) in patients with increased deadspace fraction: the effect and its determining factors (사강호흡율이 증가된 환자에서 기관내 가스주입법(Tracheal Gas Imsufflation)이 가스교환에 미치는 효과와 그 결정인자)

  • Lim, Chae Man;Jung, Bok Hyun;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Park, Pyung Hwan;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.136-145
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    • 1997
  • Background : Tracheal Gas Insufflation (TGI) is one of the newer ancillary measures in mechanical ventilation employed to enhance carbon dioxide elimination. TGI exerts its effect through reduction of deadspace ventilation, but the factors determining its effect are not well studied yet. Method : The subjects were seven mechanically-ventilated patients ($58.8{\pm}10.6$ yrs) who showed increased physiologic deadspace greater than 60%. After 30 nun of stabilization with 100% oxygen on pressure control ventilation, continuous flow TGI was administered via the insufflation lumen of Hi-Lo Jet Tracheal Tube (Mallincrodt, USA) for 15 min at 3 L/min and 5 L/min each. Results : $PaCO_2$ was decreased ($51.4{\pm}17.6$ at baseline, $49.1{\pm}18.9$ at TGJ 3 L/min $45.0{\pm}14.9$ mm Hg at TGI 5 L/min, p=0.050), and pH was increased ($7.37{\pm}0.12$, $7.38{\pm}0.13$, $7.39{\pm}0.12$, respectively, p=0.037) while mixed expired $CO_2$ ($P_ECO_2$) was not changed significantly from baseline (p=0.336) by TGI. Physiologic deadspace(Vdphy) was decreased ($73.0{\pm}7.9$% at baseline, $69.8{\pm}10.0$% at TGI 3 L/min, and $67.1{\pm}10.1$% at TGI 5 L/min, p=0.015). $AaDO_2$(p=0.147), Vt(p=0.2140), Pmean(p=0.7788) and mean arterial pressure(p=0.4169) were not changed. The correlation between % maximal decrease of Vdphy were r=0.790 with the ratio of baseline Vdana/Vdphy(p=0.035) and r=-0.754 with baseline Vdalv(p=0.050). Conclusion: TGI was effective in reducing $PaCO_2$ and deadspace, and the deadspace-reducing effect was best correlated with baseline anatomic/physiologic deadspace ratio.

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The Effect of the Histidine-Tryptophan-Ketoglutarate (HTK) Solution on Myocardial Protection in Isolated Rat Heart (흰쥐의 적출심장에서 HTK 용액의 심근보호 효과)

  • 송원영;장봉현;김규태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.632-643
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    • 2004
  • Background: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high. concentration of histidine biological buffer which confer a buffering capacity superior to that of blood.. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is. exceeding 120 minutes at two different temperature (10 to 12$^{\circ}C$, 22 to 24$^{\circ}C$) using the Langendorff apparatus, Material and Method: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm $H_2O$. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10∼12$^{\circ}C$) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22∼24$^{\circ}C$) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. Result: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02$\pm$0.29, 1.52$\pm$0.26, 1.56$\pm$0.45, 2.22$\pm$0.44 respectively. Conclusion: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22∼ 24$^{\circ}C$). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.