High Pressure Group Research Articles

Study of thioredoxin antioxidative system in lateral geniculate body of chronic intraocular hypertension rat

To investigate the dynamic changes and molecular mechanisms of thioredoxin system in lateral geniculate body of chronic intraocular hypertension rats. Glaucoma model was established by cauterizing rat's episclera veins. Right eye is the treatment group, while left eye is the sham operation group, vein of which is just isolated not be cauterized. There were 25 rats in high intraocular pressure group, and 4 rats in control group. The expression of Trx, Trx1, Trx2, Sesn2, Srxn1, Txnip was detected by Western blot and RT-PCR at different time points after intraocular pressure rose (1, 3, 7, 14, 28 d), and were grouped according to the time points. Paired t test was used in the data analysis within each time group and one-way ANOVA was used in the comparisons among different time groups. After 3 days of glaucoma induction, the gray-scale value of thioredoxin (0.83 ± 0.02) was statistically significant decreased (F = 4.871, P = 0.005), compared with the control group (1.02 ± 0.04). After 14 days, TRX1 related expression level reduced to 0.63 ± 0.04, while the control group level was 0.96 ± 0.03 (t = 13.647, P < 0.05). The related expression level of SESN2 was 0.53 ± 0.11, but the control group expression was 0.96 ± 0.03 (t = 13.812, P < 0.05). SRXN1 decreased to 0.71 ± 0.05 and 0.49 ± 0.03 after 7 days and 14 days respectively, while the expression of control group were 0.97 ± 0.02 and 0.96 ± 0.02 respectively. (Group 7 d, t = 9.451, P < 0.05; group 14 d, t = 13.611, P < 0.01).On the contrary, expression of TXINP was upregulated to 1.83 ± 0.04 and 2.37 ± 0.03 respectively, while the expression of control group were 1.00 ± 0.02 and, 0.95 ± 0.03 (Group 7 d, t = 7.924, P < 0.05;14 d t = 12.637, P < 0.01) respectively. Oxidative stress existed in lateral geniculate body of chronic intraocular hypertension rat model, and the down-regulated expression of Trx, Trx2 of the Trx system in lateral geniculate body was inhibited by multiple pathways when oxidative damage occurs. The inhibitor genes on up-stream increased while promoting genes diminished.

Vasopressin V2 receptor antagonist tolvaptan is effective in heart failure patients with reduced left ventricular systolic function and low blood pressure.

Diuresis is a major therapy for the reduction of congestive symptoms in acute decompensated heart failure (ADHF) patients. Carperitide has natriuretic and vasodilatory effects, and tolvaptan produces water excretion without electrolyte excretion. We previously reported the usefulness of tolvaptan compared to carperitide in ADHF patients with fluid volume retention. The purpose of this study was to examine whether the efficacy of tolvaptan was altered in ADHF patients with reduced left ventricular systolic function and in those with hypotension. A total of 109 hospitalized ADHF patients were randomly assigned to either a tolvaptan or a carperitide treatment group. Baseline clinical characteristics were not different between the two groups. We divided these patients based on the left ventricular ejection fraction (EF) by echocardiography, and blood pressure (BP) at the time of admission. Daily urine volume between the tolvaptan and carperitide groups in patients with preserved EF (≥ 50%) was not different, however, in those with reduced EF (< 50%), the urine volume was significantly higher in the tolvaptan group than in the carperitide group (day 2, 3, 4, P < 0.05 for all). Daily urine volume did not differ between these two groups in the high blood pressure group (BP ≥ 140 mmHg), but was significantly higher in the tolvaptan group than in the carperitide group (day 1, P = 0.021; day 3, P = 0.017) in the low blood pressure group (BP < 140 mmHg). The present study reveals that tolvaptan is more effective than carperitide, especially in ADHF patients with reduced left ventricular systolic function and without hypertension.

Suppression effects of negative pressure on the proliferation and metastasis in human pancreatic cancer cells.

The aim was to explore the effect of negative pressure on the proliferation and metastasis of human pancreatic cancer SW1990 cells. Three groups were conducted in the work: normal control group (NC group, 0 mm Hg), low negative pressure group (LN group, -300 mm Hg), and high negative pressure group (HN group, -600 mm Hg). Cell morphological assay was conducted using an inverted Nikon TE2000-S microscope. Cell viability was assayed using cell counting kit-8 solution. Cell apoptosis was evaluated with flow cytometry. Cell migration was investigated using transwell assay. Compared to LN and HN groups, SW1990 cells in NC group grew quite well, showing a higher density. The NC group represented the highest cell viability. The HN group represented the lowest cell viability, which was lower than that of the LN group (P < 0.01). The apoptosis rate in NC group, LN group and HN group was 1.91% ± 0.13%, 2.31% ± 0.06% and 15.22% ± 0.81%, respectively (P < 0.05). The average number of migration cells in NC group was 53.60 ± 4.14 (× 200), which was decreased to 18.93 ± 3.67 and 11.07 ± 3.01 in LN group and HN group, respectively (P < 0.01). The negative pressure shows suppression effects on the proliferation and metastasis of human pancreatic cancer SW1990 cells. It is indicated that negative pressure may be involved in the development of human pancreatic cancer by influencing cell biological characteristics.

The differences of horizontal optic disc diameter and cup/disc ratio in eyes with different kinds of retinal vein occlusion

Objective To observe the differences of horizontal optic disc diameter and cup/disc (C/D) ratio in eyes with different kinds of retinal vein occlusion (RVO).Methods A total of 392 eyes from 385 RVO patients diagnosed by fundus fluorescein angiography (FFA) were included in this study.The patients included 192 males and 193 females.The average age was (58.30±11.51) years.The disease duration was from 7 days to 1 month.The eyes were divided into RVO group (356 eyes),RVO combining diabetes mellitus (DM) group (20 eyes) and RVO combining high blood pressure (HP) group (16 eyes).One hundred normal eyes examined by FFA in the same testing period were selected as the control group.Among the 356 eyes in the RVO group,there were 201 eyes with branch RVO (BRVO),100 eyes with central RVO (CRVO),17 eyes with hemi CRVO (H-CRVO),and 38 eyes with macular BRVO (M-BRVO).Among the 101 non-ischemic RVO eyes,there were 17 eyes with BRVO,53 eyes with CRVO,6 eyes with H-CRVO,and 25 eyes with M-BRVO.Among the 255 ischemic RVO eyes,there were 184 eyes with BRVO,47 eyes with CRVO,11 eyes with H-CRVO and 13 eyes with M-BRVO.The diameter of optic cup and disk,and the C/D ratio was measured on fundus infrared radiation (IR) IR30°image by Heidelberg confocal laser fundus imaging system.Results There was no significant difference of horizontal optic disc diameter among 4 groups (F=1.17,P＞0.05).The difference of C/D ratio was significant among 4 groups (F=82.24,P＜0.05).The differences of horizontal optic disc diameter and C/D ratio in different kinds of RVO in normal group and RVO group were significant (F=4.49,61.396; P＜0.05).The horizontal optic disc diameter of eyes with CRVO was a little smaller than normal eyes (P＜0.05).There was no difference of horizontal optic disc diameter between the eyes with BRVO,M-BRVO,H-CRVO and normal eyes (P＞0.05).The difference of C/D ratio was significant between the eyes with BRVO,CRVO,M-BRVO,H-CRVO and normal eyes (P＜0.05).The differences of horizontal optic disc diameter and C/D ratio were significant between RVO group (in different kinds of RVO eyes) and control group (F=3.94,33.16; P＜0.05).Compared the horizontal optic disc diameters of RVO eyes with the same subtype,the difference was significant between non-ischemic H-CRVO and ischemic H-CRVO (P＜0.05),while the differences were not significant between other non-ischemic RVO and ischemic CRVO (BRVO:P=0.35,CRVO:P =0.86,M-BRVO:P=0.22).The difference of C/D ratio between non-ischemic RVO and ischemic CRVO was not significant (BRVO:P=0.35,CRVO:P=0.48,H-CRVO:P=1.00,M-BRVO:P=1.00).Conclusions The C/D ratio increased with varying degrees in RVO eyes.There is no obvious change in horizontal optic disc diameters except for CRVO eyes. Key words: Retinal vein occlusion/etiology; Optic disk

A prospective randomized trial of postoperative pain following different insufflation pressures during gynecologic laparoscopy

ObjectiveTo determine the effects of different intra-abdominal pressure values on visceral pain following gynecologic laparoscopic surgery in the Trendelenburg position. Study designThis randomized, controlled prospective trial was conducted at a tertiary education hospital and included 150 patients who underwent gynecologic laparoscopy with different abdominal insufflation pressures. There were 54 patients in the 8mmHg low pressure group (LPG), 45 in the 12mmHg standard pressure group (SPG), and 51 in the 15mmHg high pressure group (HPG). We assessed mean age, body mass index (BMI), duration of surgery, analgesic consumption, length of hospital stay, amount of CO2 expended and volume of hemorrhage. Visceral pain and referred visceral pain were assessed 6, 12, and 24h postoperatively using a visual analog scale (VAS). ResultsThere was no significant difference in age, BMI, analgesic consumption or length of hospital stay among groups. The mean operative time and total CO2 expended during surgery were higher in the LPG compared with the SPG and HPG. The mean intensity of postoperative pain assessed by the VAS score at 6 and 12h was less in the LPG than in the SPG and HPG and was reduced significantly at 12h. VAS scores at 24h in the LPG and SPG were lower than in the HPG. ConclusionPain is reduced by low insufflation pressure compared with standard and high insufflation pressure following gynecologic laparoscopic surgery in the Trendelenburg position. However, low insufflation pressure may result in longer operation times and increased hemorrhage.

High pressure does not counterbalance the advantages of open techniques over closed techniques during heated intraperitoneal chemotherapy with oxaliplatin

Heated intraperitoneal chemotherapy (HIPEC) treats residual microscopic disease after cytoreductive surgery. In experimental models, the open HIPEC technique has shown a higher and more homogenous concentration of platinum in the peritoneum than achieved using the closed technique. A 25-cm H2O pressure enhances the penetration of oxaliplatin. Because pressure is easier to set up with the closed technique, high pressure may counterbalance the drawbacks of this technique versus open HIPEC, and a higher pressure may induce a higher penetration. Because higher concentration does not mean deeper penetration, a study of tissues beneath the peritoneum is required. Finally, achieving a deeper penetration (and a higher concentration) raises the question of the passage of drugs through the surgical glove and the surgeon's safety. Four groups of pigs underwent HIPEC with oxaliplatin (150 mg/L) for 30 minutes in open isobaric pressure and pressure at 25 cm H2O, and closed pressure at 25 and 40 cm H2O. Systemic absorption and peritoneal mapping of the concentration of platinum were analyzed, as well as in the retroperitoneal tissue and the surgical gloves. Blood concentrations were higher in open groups. In the parietal surfaces, the concentrations were not different between the isobaric and the closed groups (47.08, 56.39, and 48.57 mg/kg, respectively), but were higher in the open high-pressure group (85.93 mg/kg). In the visceral surfaces, they were lower in the closed groups (3.2 and 3.05 mg/kg) than in the open groups (7.03 and 9.56 mg/kg). Platinum concentrations were similar in the deep retroperitoneal tissue when compared between isobaric and high-pressure procedures. No platin was detected in the internal aspect of the gloves. The use of high pressure during HIPEC does not counterbalance the drawbacks of closed techniques. The tissue concentration of oxaliplatin achieved with the open techniques is higher, even if high pressure is applied during a closed technique. Open 25 cm H2O HIPEC achieved the highest tissue penetration of oxaliplatin, but did not enhance the depth of oxaliplatin penetration. High pressure did not enhance the risk of HIPEC.

Classification and Morphological Structure of Scale in the Process of Alumina Production High Pressure Digestion

The chemical composition, phase component and morphology characteristics of scale were researched by chemical analysis, XRD, SEM and TEM. The results show that the scale can be divided into iron minerals, silicon minerals, Ca-Ti-Mg minerals and aluminum hydroxide. Alumogoethite and micro-fine sodium-silicon slag fill in the gaps between the neat and bulky hematite crystals. Microgranular hydrated garnet and olivine fill in the gaps between the goethite crystals with a dense layered structure, accompanied by a small amount of galena and apatite precipitation particles. Perovskite and magnesium hydroxide have five periodic sedimentary cycles, forming an alternating sedimentary layer structure. Aluminum hydroxide forms thick scale and presents two kinds of typical structures, spherulitic and laminated. The research provides the theoretical basis for preventing and controlling scale in high-pressure digester group.

Pain sensitivity subgroups in individuals with spine pain: potential relevance to short-term clinical outcome.

Cluster analysis can be used to identify individuals similar in profile based on response to multiple pain sensitivity measures. There are limited investigations into how empirically derived pain sensitivity subgroups influence clinical outcomes for individuals with spine pain. The purposes of this study were: (1) to investigate empirically derived subgroups based on pressure and thermal pain sensitivity in individuals with spine pain and (2) to examine subgroup influence on 2-week clinical pain intensity and disability outcomes. A secondary analysis of data from 2 randomized trials was conducted. Baseline and 2-week outcome data from 157 participants with low back pain (n=110) and neck pain (n=47) were examined. Participants completed demographic, psychological, and clinical information and were assessed using pain sensitivity protocols, including pressure (suprathreshold pressure pain) and thermal pain sensitivity (thermal heat threshold and tolerance, suprathreshold heat pain, temporal summation). A hierarchical agglomerative cluster analysis was used to create subgroups based on pain sensitivity responses. Differences in data for baseline variables, clinical pain intensity, and disability were examined. Three pain sensitivity cluster groups were derived: low pain sensitivity, high thermal static sensitivity, and high pressure and thermal dynamic sensitivity. There were differences in the proportion of individuals meeting a 30% change in pain intensity, where fewer individuals within the high pressure and thermal dynamic sensitivity group (adjusted odds ratio=0.3; 95% confidence interval=0.1, 0.8) achieved successful outcomes. Only 2-week outcomes are reported. Distinct pain sensitivity cluster groups for individuals with spine pain were identified, with the high pressure and thermal dynamic sensitivity group showing worse clinical outcome for pain intensity. Future studies should aim to confirm these findings.

Nutritional characteristics of chronic fatigue syndrome in Korean college students (628.16)

This study was conducted to investigate the relationship nutritional characteristics and chronic fatigue in college students in Korea. Total subjects were 130 students which numbers of male and female were sixty respectively. The measurement for chronic fatigue was Korean version of Fatigue Assessment Instrument (FAI). And blood pressure and body fat contents etc. were analyzed. In the case that the average BMI was 21, the group with high systolic pressure showed lower FAI scores than the group with low systolic pressure. The same pattern was showed in diastolic pressure and % body fat except blood glucose level. Moreover the sleep tended to be longer in the high systolic pressure group even though there was no significant difference. Between the group that BMI was under 18.9 and the group BMI was over 24, the former group showed higher FAI scores than the latter. The results might suggest that some increase of blood pressure and body fat could alleviate the chronic fatigue syndrome in adults.Grant Funding Source: Kyungnam University

Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing direct percutaneous coronary intervention

Background Balloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI. Methods There were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine, â-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed. Results The results showed that CK-MB, HAMD, SAS were significantly different (P &lt;0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7±7.6) U/L vs. (76.7±11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P &lt;0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%, P &lt;0.05). Conclusion In stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.

Effects of different pressure levels of CO2 pneumoperitoneum on liver regeneration after liver resection in a rat model

A recent study demonstrated that high pressure of carbon dioxide (CO2) pneumoperitoneum before liver resection impairs postoperative liver regeneration. This study was aimed to investigate effects of varying insufflation pressures of CO2 pneumoperitoneum on liver regeneration using a rat model. 180 male Wistar rats were randomly divided into three groups: control group (without preoperative pneumoperitoneum), low-pressure group (with preoperative pneumoperitoneum at 5 mmHg), and high-pressure group (with preoperative pneumoperitoneum at 10 mmHg). After pneumoperitoneum, all rats were subjected to 70% partial hepatic resection and then euthanized at 0 min, 12 h, and on postoperative days (PODs) 1, 2, 4, and 7. Following outcome parameters were used: liver regeneration (liver regeneration rate, mitotic count, Ki-67 labeling index), hepatocellular damage (serum aminotransferases), oxidative stress [serum malondialdehyde (MDA)], interleukin-6 (IL-6), and hepatocyte growth factor (HGF) expression in the liver tissue. No significant differences were observed for all parameters between control and low-pressure groups. The liver regeneration rate and mitotic count were significantly decreased in the high-pressure group than in control and low-pressure groups on PODs 2 and 4. Postoperative hepatocellular damage was significantly greater in the high-pressure group on PODs 1, 2, 4, and 7 compared with control and/or low-pressure groups. Serum MDA levels were significantly higher in the high-pressure group on PODs 1 and 2, and serum IL-6 levels were significantly higher in the high-pressure group at 12 h and on POD 1, compared with control and/or low-pressure groups. The HGF tissue expression was significantly lower in the high-pressure group at 12 h and on PODs 1 and 4, compared with that in control and/or low-pressure groups. High-pressure pneumoperitoneum before 70% liver resection impairs postoperative liver regeneration, but low-pressure pneumoperitoneum has no adverse effects. This study suggests that following laparoscopic liver resection using appropriate pneumoperitoneum pressure, no impairment of liver regeneration occurs.

Impact of different pneumoperitioneal pressure on pathomorphism and function of intestines following laparoscopic radical gastrectomy

To investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG). Forty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared. There were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05). Laparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.

Changes of the electroencephalographic background in preterm infants before and after instillation of pulmonary surfactant in different ways

Objective To monitor the electroencephalographic background activities of preterm infants before and after using pulmonary surfactant(PS), so as to investigate an appropriate way to endotracheally instill PS through the changes of electroencephalographic background activities. Methods Thirty-five preterm infants who were hospita-lized in Neonatal Intensive Care Unit of Guangzhou Women and Children's Medical Center from Jun.2011 to Apr.2013 and treated with PS were involved.They were divided into the normal pressure group and the high pressure group, based on the peak inspiratory pressure when PS instilled.The electroencephalographic background activities of the preterm infants before using PS and 15 min, 30 min, 60 min and 120 min after using PS were monitored continuously by using cerebral function monitor.The changes of 2 groups were compared.Oxygen saturation and heart rate were recorded at the same time. Results 1.In normal pressure group, lower amplitude decreased and the duration of interburst interval(IBI) increased 15 min after instillation of PS compared with before using PS(t=-6.012, 5.202, all P 0.05). There were significant differences between the 2 groups(t=-4.832, 4.029, all P 0.05). Between the 2 groups, there were significant differences in lower amplitude(t=-2.828, P 0.05). Lower amplitude and IBI of the normal pressure group returned to the level before using PS at 60 min and 120 min after using PS(lower amplitude: t=0.557, 1.849, all P 0.05). Moreover, in the high pressure group, lower amplitude even increased at 60 min and 120 min after using PS(t=2.153, 3.112, all P<0.05).2.After using PS, desaturation happened in 8 preterm infants of the normal pressure group and 2 preterm infants of the high pressure group.There was significant difference between the 2 groups(P=0.025).3.Bradycardia accompanied with desaturation happened in 2 preterm infants of the normal pressure group, but none in the high pressure group. Conclusions Instillation of PS may cause embolism and obstruct the airway, which may induce hypoxia, and then lead to the depression of the elec-troencephalographic background.Therefore, when instilling PS, giving high pressure can shorten or avoid the hypoxia episode, and make PS reach alveoli as soon as possible to play a role in lung compliance. Key words: Pulmonary surfactant; Amplitude-integrated electroencephalogram; Background activity; Preterm infant

Comparison of Visual Field Progression Between Relatively Low and High Intraocular Pressure Groups in Normal Tension Glaucoma Patients

To determine the risk factors of visual field (VF) progression in relatively low and high intraocular pressure (IOP) groups in normal tension glaucoma (NTG) patients and to compare progression rate of VF defects between the 2 groups. Forty-nine eyes of 49 NTG patients with untreated IOP of ≤15 mm Hg (group A) and 49 eyes of 49 NTG patients matched by age and baseline VF mean deviation (MD) who had untreated IOP of >15 mm Hg (group B) were included in this retrospective chart review study. All patients were followed >5 years. Risk factors for VF progression were evaluated using Cox proportional hazards models in each group, separately. Changes in VF indexes were compared between the 2 groups. Mean IOP and IOP fluctuation were significantly greater in group B than in group A (P<0.001 and P=0.016), whereas other factors did not differ between the groups. In multivariable analysis, VF progression was significantly associated with disc hemorrhage in group A (HR, 6.19; P=0.017) and mean IOP in group B (HR, 1.77; P=0.029). There was no significant difference between the groups in incidence of progression and in changes of MD, pattern SD, and VF index (P=0.942, 0.874, and 0.887, respectively). Although progression rate was similar, the risk factors for VF progression were different in the 2 groups. These findings may suggest that IOP-dependent and IOP-independent factors affect VF progression differently in the 2 groups.

Postoperative pharyngolaryngeal adverse events with laryngeal mask airway (LMA Supreme) in laparoscopic surgical procedures with cuff pressure limiting 25 cmH₂O: prospective, blind, and randomised study.

To reduce the incidence of postoperative pharyngolaryngeal adverse events, laryngeal mask airway (LMA) manufacturers recommend maximum cuff pressures not exceeding 60 cmH2O. We performed a prospective randomised study, comparing efficacy and adverse events among patients undergoing laparoscopic surgical procedures who were allocated randomly into low (limiting 25 cmH2O, L group) and high (at 60 cmH2O, H group) LMA cuff pressure groups with LMA Supreme. Postoperative pharyngolaryngeal adverse events were evaluated at discharge from postanaesthetic care unit (PACU) (postoperative day 1, POD 1) and 24 hours after discharge from PACU (postoperative day 2, POD 2). All patients were well tolerated with LMA without ventilation failure. Before pneumoperitoneum, cuff volume and pressure and oropharyngeal leak pressure (OLP) showed significant differences. Postoperative sore throat at POD 2 (3 versus 12 patients) and postoperative dysphagia at POD 1 and POD 2 (0 versus 4 patients at POD 1; 0 versus 4 patients at POD 2) were significantly lower in L group, compared with H group. In conclusion, LMA with cuff pressure limiting 25 cmH2O allowed both efficacy of airway management and lower incidence of postoperative adverse events in laparoscopic surgical procedures. This clinical trial is registered with KCT0000334.

A higher salt intake leads to a lower rate of adequate blood pressure control.

The relationship between salt intake and adequate blood pressure control is not well investigated in Korea populations, especially in patients with cardiovascular disease. This cross-sectional study enrolled 19,083 subjects who participated in the Korea National Health and Nutrition Examination Survey conducted from 2009-2011. The amount of salt intake was estimated using the Tanaka equations based on spot urine samples. Comparing patients with and without cardiovascular disease, systolic blood pressure (129.1±18.1 mmHg vs. 120.0±18.1 mmHg, P<0.001) and the amount of urinary sodium excretion (149.4±37.5 mM/day vs. 144.1±36.2 mM/day, P<0.001) were higher in patients with cardiovascular diseases. Among patients with cardiovascular disease, the high blood pressure group showed an increased amount of urinary sodium excretion compared to the normal blood pressure group (155.5±38.2 vs. 146.6±36.9 mM/day, P<0.001). The odds ratio (OR) of high blood pressure was higher (OR, 1.825; 95% CI, 1.187-2.807; P-for-trend 0.003, highest quartile of urinary sodium excretion vs. lowest quartile) in patients with cardiovascular disease. A higher amount of urinary sodium excretion was associated with a lower rate of adequate blood pressure control in Korean population, especially with cardiovascular disease.

第51回ヨーロッパ高圧研究グループ会議&lt;br/&gt; (EHPRG51-London, UK) 参加報告

第51回ヨーロッパ高圧研究グループ会議&lt;br/&gt; (EHPRG51-London, UK) 参加報告

Usefulness of High Suction Pressure for Sufficient Tissue Collection During Endobronchial Ultrasound Guided Transbronchial Needle Aspiration

IntroductionThe optimal suction pressure during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) remains to be determined. The aim of this study was to compare suction pressures for performance in collecting sufficient tissue specimens from mediastinal and hilar lymph nodes during EBUS-TBNA.MethodsRetrospective analysis of consecutive patients with mediastinal and hilar lymphadenopathy who underwent EBUS-TBNA over a 3-year period. Results from patients who underwent EBUS-TBNA using a dedicated 20-mL VacLoc (Merit Medical Systems, Inc, South Jordan, UT) syringe (conventional method, group C) were compared with results from patients in whom a disposable 30-mL syringe (high pressure group, group H) was used. The yield for sufficient histologic specimen retrieval and amount of tissue obtained were compared between the 2 groups.ResultsOf 178 patients who underwent EBUS-TBNA, 131 had lung cancer confirmed by EBUS-TBNA: 35 in group C and 96 in group H. There were 7 patients in group C and 6 in group H who received final diagnoses by cytology alone. There were 28 in group C and 90 in group H who were diagnosed by both cytology and histology. There was a statistically significant difference between the groups in terms of the rate of sufficient sampling for histological specimens (p = 0.04). The H group revealed a tissue area approximately twice that of the C group (p = 0.003). There were no major procedure-related complications in either group.ConclusionHigher suction pressures with larger syringe volumes during EBUS-TBNA may be useful for safely collecting sufficient tissue specimens.

Analysis of age effect to determine optimal nasal pressure in Korean patients with obstructive sleep apnea

Introduction Determining of the optimal CPAP pressure is the key procedure of applying adequate CPAP for patients with Obstructive Sleep Apnea (OSA). There are some studies for predictors of optimal CPAP pressure, most of them emphasized the apnea hypopnea index, importance of anthropometric factors, especially body mass index, neck circumference. As The purpose of this study is to analysis of aging factors affecting CPAP pressure as well as polysomnographic data in Korean patients with OSA Materials and methods We retrospectively reviewed the records of 169 Korean patients with OSA who had undergone CPAP titration at the Sleep Clinic of Kyung Hee university hospital at Gangdong. The patients were examined by otolaryngologist for grading the anatomy of nasopharyngeal, oropharyngeal, retropharyngeal area before diagnostic polysomnography. Anthropometric data was consisted of Friedman palate position, modified Friedman palate position, Tonsil hypertrophy grade, nasopharyngeal endoscopy, retropharyngeal grade, uvular size and body mass index (BMI). We divided them subgroups according to age ; below 40 (group 1, n = 38, male 37, female 1), 41 ∼ 60 (group 2, n = 98, male 91, female 7), above 60 years old (group 3, n = 32, male 29, female 3). Results The mean optimal CPAP pressure in 169 patients was 8.40 ± 2.73 cmH2O and the apnea hypopnea index (AHI), respiratory distress index (RDI), arousal index (AI) and BMI were correlated with optimal CPAP level. There were no difference optimal CPAP pressure and modified Friedman palate position, tonsil hypertrophy grade, nasopharyngeal endoscopy, uvular size between groups. But, the retropharyngeal grade was correlated with optimal CPAP pressure in young age group. Patient with low optimal pressure group had tendency of longer uvula and Patient with high optimal pressure group had more narrow retropharyngeal area than in patient with low optimal pressure. Conclusion Our study shows that anatomic problem of retropharyngeal area influence to high optimal pressure only in young OSA patient. Previous studies for affecting factor of optimal CPAP pressure focused anthropometric factors. Our study suggests that functional problem as well as retropharyngeal anatomy may affect to determine optimal CPAP pressure in old OSA patient.

GW24-e2459 Ambulatory blood pressure monitoring in prediction the hypertension patients with coronary heart disease

Objectives148 cases combined dynamic blood pressure index analysis, this paper discusses the ambulatory blood pressure monitoring in essential hypertension with coronary heart disease in prediction function.MethodsAccording to the criteria, consecutive...