• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.441-446
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• 2001

Flumazenil is a competitive antagonist of benzodiazepines. It is usually administered intravenously. However, if the intravenous route is not available then other routes of drug administration should be considered. This study was designed to evaluate the reversal effects of flumazenil after nasal administration. Twenty-five young, healthy adult volunteers participated in this clinical trial. The dosage of 0.08mg/kg midazolam was administered intravenously to induce deep sedation. Ten minutes after midazolam administration, 0.5mg of flumazenil was dropped nasally, over a period of one minute. Blood samples were taken to measure the concentration of midazolam and flumazenil at 0, 5, 10, and 20min after nasal administration of flumazenil, using High Performance Liquid Chromatography. The degree of sedation was evaluated with sedation score and bispectral index (BIS), Statistical analysis was performed by multivariate ANOVA and correlation analysis (P<0.05). Peak serum flumazenil concentration was reached in 10min. Sedation score decreased after midazolam administration and showed a significant increase after flumazenil administration. However, BIS decreased during the first 10min after midazolam administration and then no significant changes after flumazenil administration. There were two instances representing rapid and complete reversal of midazolam after intranasal administration of flumazenil. In conclusion, intranasal flumazenil administration may be effective in some patients when intravenous route is not available in condition of benzodiazepine overdose.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.206-215
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• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.29 no.5
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• pp.603-613
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• 1996

Hydrographic conditions (temperature, salinity, dissolved oxygen), nutrients, chlorophyll-a and suspended solid have been studied in the southwestern coastal area of Cheju Island from April 1993 to March 1994. Vertical profile of temperature, salinity and chemical properties (nutrients, chlorophyll-a) distribution in th southwestern sea of Cheju Island showed a upwelling feature. Although it was not clear in winter season, it seems to continued through out the year. In the surface water at the upwelling areas, the ranges of dissolved oxygen, nitrate, phosphate and silicate was $3.30\~8.43\;ml/l,\;0\~7.12{\mu}g/l,\;0.03\~1.75{\mu}g-at/l\;and\;2.75\~22.32\;{\mu}g-at/l$l, respectively. Nutrients was higher in the shore water than in the offshore water, because sufficient supply of nutrients from the bottom water by coastal upwelling. In November, especially high concentration silicate was observed at all the stations and depth in the study area. At all station of bottom water (down to the depth of 60 meter), concentration value of dissolved of gen was as high as 8 ml/l. Mean values of N/P was 8.0, lower than Redifield ratio of 16. The mean values of Si/P was observed to 46.3 in southwest of Cheju Island. Concentration of chlorophyll-a was in the range of $0.04\~2.36\;{\mu}g/l$. Concentration of chlorophyll-a in surface orator at all station was especially higher in spring than in other seasons. Mean concentration value of suspended solids was 3.14 mg/l $(0.75\~8.47\;mg/l)$. Ratio of the volatile suspended solids to the suspended solids was higher in the inshore water $(53\%)$ than in the offshore water $(46\%)$, and higher in the surface water than in the bottom water.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.868-873
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• 2008

Purpose : Immunotherapy is accepted as the only treatment of allergic disease that can modify the natural course of the disease and ameliorate symptoms. This study aimed to evaluate the safety and efficacy of ultra-rush therapy using Dermatophagoides extracts in children. Methods : Of children older than four years who had visited Bundang CHA Pediatric Allergy Clinic, those showing positive reactions only to Dermatophagoides in the skin prick test and to the nasal provocation test were included. In all, 11 and 12 patients respectively preferred conventional and ultra-rush immunotherapy. We elevated allergen concentrations diluted to 1,000:1 of the end strength by 2-3 times with 30-minute intervals and checked oxygen saturation, pulse rate, blood pressure, and systemic reactions every 15 minutes. Immunotherapy effectiveness was valued by changes in nasal provocation test scores before and after immunotherapy. Results : The average ages of patients in the conventional and ultra-rush immunotherapy groups were $8.3{\pm}2.3$ and $9.2{\pm}2.8years$, respectively. Systemic reactions were observed in six in the ultra-rush group (50%) without anaphylaxis and one (9%) in the conventional group. The average scores in the nasal provocation test before and after treatment in the conventional group were $8.2{\pm}1.5$ and $4.6{\pm}2.1$, respectively (P=0.043). In the ultra-rush immunotherapy group, the scores changed from $6.2{\pm}2.2$ to $3.7{\pm}2.5$ (P=0.017). Conclusion : Ultra-rush immunotherapy using Dermatophagoides in children is effective for treating allergic disease but can induce systemic effects rather than conventional immunotherapy.

• KSBB Journal
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• v.23 no.1
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• pp.90-95
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• 2008

In this study, a combined process of sequential anaerobic-aerobic digestion (SAAD), fluidized-bed bioreactor (FBBR), and ultrafiltration (UF) for the treatment of small scale food waste leachate was developed and evaluated. The SAAD process was tested for performance and stability by subjecting leachate from food waste to a two-phase anaerobic digestion. The main process used FBBR composed of aerators for oxygen supply and fluidization, three 5 ton reaction chambers containing an aerobic mesophilic microorganism immobilized in PE (polyethylene), and a sedimentation chamber. The HRTs (hydraulic retention time) of the combined SAAD-FBBR-UF process were 30, 7, and 1 day, and the operation temperature was set to the optimal one for microbial growth. The pilot process maintained its performance even when the CODcr of input leachate fluctuated largely. During the operation, average CODcr, TKN, TP, and salt of the effluent were 1,207mg/L, 100mg/L, 50 mg/L, and 0.01 %, which corresponded to the removal efficiencies of 99.4%, 98.6%, 89.6%, and 98.5%, respectively. These results show that the developed process is able to manage high concentration leachate from food waste and remove CODcr, TKN, TP, and salt effectively.

• 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.

• Journal of Korean Society on Water Environment
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• v.31 no.6
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• pp.599-609
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• 2015

In order to investigate why OSA (oxic-settling-anaerobic) process produces less sludge than CAS (conventional activated sludge) process, sequential cultivation through 1^st aerobic-anaerobic-2^nd aerobic conditions, were carried out. Then, the intracellular concentrations of adenosine triphosphate (ATP), nicotinamide adenine dinucleotide (NAD and NADH), and nicotinamide adenine dinucleotide phosphate (NADP and NADPH) were monitored for these three stages. Results showed that the concentrations of these energy substances rapidly decreased through time in both aerobic and anaerobic conditions but the anaerobic culture contained the lower energy level than aerobic culture. The 2^nd aerobic culture that experienced anaerobic condition showed lower concentration of these energy substances than those of the 1^st aerobic culture. Meanwhile, the anaerobic culture corresponding to the sludge holding stage of OSA was subjected to different soluble chemical oxygen demand (SCOD) levels, detention time, and temperature to evaluate the effects of these variations on the energy level difference between the 1^st and 2^nd aerobic stages. The lower the SCOD concentration, the longer detention time; and the higher temperature in the anaerobic stage tended to further reduce the intracellular level of the 2^nd aerobic culture. On the average, the intracellular energy level of the anaerobic and 2^nd aerobic stage were 57.73% and 39.12% of the 1st aerobic culture, respectively. These indicated that the insertion of an anaerobic stage between two aerobic stages could lower the intracellular energy levels, hence the lower the sludge in OSA than CAS process. Moreover, manipulation of the operating conditions of the intervening anaerobic stage can change intracellular energy levels thereby controlling sludge production.

• Korean Journal of Ecology and Environment
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• v.33 no.2 s.90
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• pp.109-118
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• 2000

The dynamics of inorganic nutrients and phytoplankton population were examined at eight stations of Shihwa Reservoir, which situated near the cities newly constructed and the industrial complex of West-sea in Korea, from January to December 1999. Among environmental factors, average concentration of $NH_4$, SRP and SRSi were $522.7\;{\mu}g\;N/l$, $9.8\;{\mu}g\;N/l$ and $0.26\;{\mu}g\;Si/l$, respectively. Water quality was extremely deteriorated by a great amount of pollutants load into inner reservoir after the event of rainfall. Nutrients concentration was suddenly decreased toward the lower part. While $NO_3$ concentration did not much varied among stations, but it was relatively high in winter season. Chlorophyll-a concentration was high at the upper part of the reservoir, with average of $37.2\;{\mu}/l$, and closely related to the fluctuation of $NH_4$, SRP and SRSi concentrations. The phytoplankton development in the water column was dominated by diatom (autumn), prasinoid (winter) and dinoflagellate (summer). Dominant phytoplankton were composed to Skeletonema costatum of diatom, Prorocentrum minimum of dinoflagellate, Chroomonas spp. of cryptomonad, Eutreptiella gymnastica of euglenoid and Pyramimonas spp. of prasinoid. The large bloom of phytoplankton at the upper zone of the Shihwa Reservoir after inflow of a seawater were consistently observed. In consequence, water quality management of the inlet stream was assessed to be very important and urgent.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.593-598
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• 1996

The large number of past investigation on extended myocardial protection clearly indicates that cold potassium cardioplegia and topical cooling have limited capabilities. Accordingly, more recent experimen- tal approaches have focused on the modalities of reperfusion and their implication on postischemic myo- cardial recovery. Oxygen may play a crucial role in the development of ischemic and reperfusion injury. Reactive oxygen radicals may be produced during ischemia or reperfusion after incomplete reduction of molecular oxygen or from other pathway and then induce fatal injury of the heart. The important obser- vation of oxygen-induced myocardial damage during reperfusion has led to the concept of applying oxy- gen free radical scavengers. So, this study is on dietary vitamin C supplementation as antioxidant in rats to determine whether or not they have a higher tolerance against cardiac ischemia-reperf'usion injury under Langendorff system. Male or female Sprague-Dawley rats (190-33Og) were randomly separated into two groups. Group A was not treated(n=10). Group B received vitamin C supplement (n=10). Experiment was performed 24 hours after vitamin C 200mg fed orally as injectable ascorbic acid. There were significant differences in contractile parameters between control and vitamin C-treated group. The RLVP (r te of post/preischemic left ventricular pressure) and Rdp/dt (rate of post/preischemic dp/dt) were significant statistically between two groups (p<0.05). But, RHR (rate of post/preischemic heart rate), time to first beat and sta'utilization were not significant. In conclusion, pretreatment with the antioxidant, ascorbic acid, was found to preserve left ventricular contractile function. But the precise mechanism of action of ascorbic acid has not as yet been determined, so further study will be required.

• Neonatal Medicine
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• v.16 no.2
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• pp.146-153
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• 2009

Purpose: The aim of this study is to investigate the current use of dexamethasone rescue therapy (DRT) for bronchopulmonary dysplasia (BPD). Methods: This is a retrospective study of 251 BPD patients managed in the neonatal intensive care units at Seoul National University Childrens Hospital and Seoul National University Bundang Hospital between March 2004 and August 2008. The demographic data and clinical characteristics of the mothers and infants were analyzed. The infants were compared based on DRT responsiveness. The DRT complications were investigated. Results: Ninety-three patients (37.1%) were classified with severe BPD, DRT was only given to patients with severe BPD. Dexamethasone was administered to 24 patients (9.6%) whose respiratory status had precluded extubation, which indicated that conventional BPD management had failed. Fourteen patients (58.3%) who received DRT were responsive. DRT non-responders required more oxygenation and more complicated with pulmonary arterial hypertension (PAH). Responder had shorter length's of hospitalization and lower mortality rates. High dose dexamethasone was no more effective in weaning neonates from the ventilatior than low dose dexamethasone. Sepsis was the most common complication of DRT. Conclusion: DRT is a valuable treatment for severe BPD ahead of PAH development. DRT should not be performed in BPD patients with PAH due to the possibility of complications.