• Title/Summary/Keyword: 정맥형

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Influence of Intracerebroventricular Domperidone on Rabbit Renal Function (가토 신장기능에 미치는 뇌실내 Domperidone의 영향)

  • Kim, Young-Soo
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.135-145
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    • 1988
  • Dopamine when given icv induces antidiuresis along with transient natriuretic tendency, and it has been suggested that both subtypes of central dopamine receptors may influence renal function differentially. This study was undertaken to delineate the role of central $D_2$ receptors employing domperidone (DOM), a selective $D_2$ antagonist. DOM icv elicited antidiuresis and antinatriuresis in doses ranging from 15 to $135{\mu}g/kg$. GFR and RPF as well as sodium excretion decreased. Systemic blood pressure increased slightly. Intravenous DOM did not elicit significant changes in sodium excretion. Denervation of the kidney abolished the hemodynamic change induced by icv DOM, but sodium excretion decreased on both innervated and denervated kidneys. No diuretic tendency was uncovered by the denervation. Dopamine, $150{\mu}g/kg$ icv, produced antidiuresis along with decreases in hemodynamics. These effects were not affected by DOM-pretreatment, and no natriuretic tendency was unveiled. Bromocriptine, a $D_2$ receptor agonist, $200{\mu}g/kg$ icv, elicited marked diuresis and natriuresis, which were completely abolished by DOM-pretreatment. Apomorphine, another prototype of $D_2$ agonist, $150{\mu}g/kg$ icv, produced diuresis and natrituresis with increases in renal hemdoynamics, followed by decreases in all parameters. DOM-pretreatment did not affect the renal hemodynamic effects, wherease the increases in urine flow and sodium excretion were markedly reduced by DOM, Present study suggests that central $200{\mu}g/kg$ receptors mediate natriuretic and diuretic influence to the kidney, possibly through mediation of natriuretic humoral factor, and provide further evidence supporting the hypothesis that central $200{\mu}g/kg$ receptors mediate antidiuretic influence via nerve pathway, whereas natriuresis are brought about through mediation of central $200{\mu}g/kg$ receptors.

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Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

Significance of Cerebral Venography in Surgery of Petroclival Meningiomas (추체사대 수막종의 수술과 관련하여 뇌 정맥조영상의 의미)

  • Hwang, Sung-Kyun;Gwak, Ho-Shin;Paek, Sun Ha;Oh, Chang-Wan;Lee, Sang Hyung;Kim, Dong Gyu;Kim, Hyun Jib;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1200-1209
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    • 2001
  • Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

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Pharmacokinetics of oxytetracycline in rabbits after intravenous and intramuscular administrations (토끼에서 oxytetracycline의 정맥 및 근육 투여시의 약물동태학)

  • Kim, Eun-jung;Yun, Hyo-in;Park, Seung-chun;Oh, Tae-kwang;Cho, Chun-hyung
    • Korean Journal of Veterinary Research
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    • v.34 no.2
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    • pp.259-266
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    • 1994
  • The study was carried out to determine the pharmacokinetic parameters after intravenous(iv) and intramuscular(im) administration (10mg/kr) in healthy rabbits. The results obtained through the experiments were summarized as follows: 1. Bioassay (Bacillus cereus 11778) was evaluated very useful for the determination of oxytetracycline(OTC) in the rabbit serum and tissues, with the detection limit of $0.125{\mu}g/ml$. 2. The pharmacokinetic profiles of OTC (10mg/kg, iv) in rabbits were best described with a two compartment open model $(C=29.5e^{-4,3t}{\pm}3.6^{-0.2t})$, whereas that of OTC (10mg/kg, im) showed a one compartment curve fitting. 3. Following iv administration, a rapid distribution phase was predominant [$t_{\frac{1}{2}}({\alpha}):1.43{\pm}0.98hr$ (♂), $0.5{\pm}0.1hr$(♀)], and then more slow elimination phase ensued [$t_{\frac{1}{2}}({\beta}):4.52{\pm}0.76hr$(♂), $7.32{\pm}2.52hr$(♀)]. Other computer generated pharmacokinetic values were as follows:C1 [$67.76{\pm}18.59ml/kg/h$(♂), $76.03{\pm}22.98ml/kg/h$ (♀)] Vd [$257.74{\pm}180.47ml/kg$ (♂), $92.33{\pm}23.62$ (♀)] AUC [$25.6{\pm}4.44mgh/L$ (♂), $39.6{\pm}12.13mgh/l$ (♀)]. There were no statistical significance between both sexes for all the parameters at the confidence level of 95%. 4. After im administaration, the absorption from the injection sites was very rapid [ Ka:$0.18{\pm}0.03h^{-1}$ (♂), $0.24{\pm}0.02h^{-1}$ (♀)] followed by a monoexponential elimination fashion. The time to peak blood level (Tmax) were calculated $1.64{\pm}0.15hr$ and $1.34{\pm}0.24hr$, in the male and female, respectively. The peak levels (Cmax) at the corresponding time were $1.69{\pm}0.23{\mu}g/ml$ (♂) and $2.08{\pm}0.16{\mu}g/ml$ (♀), with no statistical differences (p>0.05).

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Patient Controlled Analgesia of Alfentanil after a Total Abdominal Hysterectomy: A Comparison of the Intravenous and Epidural Route (전자궁 적출술 후 자가통증조절장치를 이용하여 정맥과 경막외로 투여된 Alfentanil의 진통효과 비교)

  • Choi, Soo Kyeong;Yoon, Seok Hwa;Lee, Jun Hwa;Hwang, Jae Ha;Jung, Woo Suk;Kim, Yoon Hee;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.169-173
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    • 2007
  • Background: Although the use of intravenous patient controlled analgesia (IVPCA) has been compared to the use of patient conrolled epidural analgesia (PCEA), there is no optimal administration route of alfentanil for the treatment of postoperative pain. This randomized double-blind study compared the efficacy of the use of IVPCA and PCEA for postoperative pain and the side effects after a total abdominal hysterectomy (TAH). Methods: Sixty patients undergoing a TAH were randomly assigned to receive either IVPCA (Group I) or PCEA (Group E) for the infusion of alfentanil for postoperative pain control. In both groups, a loading dose of $750{\mu}g$ alfentanil was administered. All patients received the same continuous infusion rate (0.3 mg/h), bolus dose (0.15 mg), and lockout time (15 min). The incidence of side effects, the VAS (visual analog scale) of pain, blood pressure, and heart rate were checked for 20 hours after the loading dose injection. Results: The VAS of pain was not significantly different between the two groups of patients. The onset of the analgesic effect was significantly more rapid in the Group I patients than in the Group E patients. There was no difference in side effects for either group. Conclusions: When considering multiple factors such as the onset of analgesia, technical difficulties or infection after the procedure, IVPCA using alfentanil is more useful than PCEA for postoperative pain control after a TAH.

Bilateral Popliteal Artery Entrapment Syndrome (양측성 슬와동맥 포착증후군)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.136-139
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    • 2007
  • Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

임진강대 석류석의 성장과 다변형작용의 시간적-공간적 관계

  • 김윤섭;조문섭;안진호
    • Proceedings of the Mineralogical Society of Korea Conference
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    • 2003.05a
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    • pp.51-51
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    • 2003
  • 임진강대의 변성이질암은 전형적인 바로비안형 변성분대를 보이며, 남쪽으로 갈수록 변성도가 증가하여 석류석$\longrightarrow$십자석$\longrightarrow$남정석 대를 정의한다. 우리는 반상변정의 성장과 여러번에 걸친 광역변형작용의 연관성을 밝히기 위해 광물의 반응관계와 성장순서 그리고 미구조(microstructure)를 -특히 석류석에 대해서- 연구하였다. 임진강대는 크게 세 번에 걸쳐 변형작용을 받은 것으로 해석된다: (1) 지각 두께의 증가에 수반된 압축변형작용 (D$_{n-1}$), (2) 주 엽리(Sn)를 만든 변형작용(Dn), 그리고 (3) 연성전단작용에 수반된 신장변형작용(D$_{n+1}$ ). 석류석대의 석류석 반상변정에서는 약간 휘어진 포유물 궤적(inclusion trail)이 주 엽리면에 대해 연속적이며, 이는 Dn과 동시기에 반상변정이 생성되었음을 지시한다. 이러한 석류석은 녹니석과 백운모로 구성된 주 엽리를 치환하면서 자라기 때문에, 녹니석+백운모+석영=석류석+흑운모+$H_2O$의 반응에 의해 만들어진 것으로 해석된다. 석류석 자형변정(idioblast)이 주 엽리를 자르면서 성장하기도 하는데, 이는 Dn 이후에도 석류석이 후구조(post-tectonic) 광물로 성장했음을 지시한다. 또한, 이러한 석류석은 흑운모를 치환하기 때문에, 동구조(syn-tectonic) 석류석의 생성반응에서와는 달리 흑운모가 반응물임을 알 수 있다. 한편, 십자석대의 석류석은 포유물 궤적에 의해 정의되는 S$_{n-1}$면이 주 엽리면과 사각을 이루며 단속적이기 때문에, D$_{n-1}$과 Dn 사이에 자란 것으로 해석된다. 이와는 대조적으로 십자석은 주 엽리를 치환하면서 자라고 있어서 Dn과 동시기 혹은 Dn 이후에 자랐을 것으로 해석된다..의 환경문제를 발생하지 않으며, 공정액에 첨가제를 투입하지 않으므로 순환형 친환경공정으로 각광받을 수 있다. 본 연구에서는 고온, 고농도의 NaOH 수용액의 처리에 적합한 막소재와 발생될 수 있는 제반 문제점 등을 파악하였고, 장기간의 실험을 거쳐 최적 투과 압력(Trans membrane pressue), 세정 조건 및 주기, 막재질에 있어서 보강하여야 할 Point, 최적 운전 조건들을 토출해 내었고, 향후 실제 Plant에 적용할 계획이다.는 양적으로 다른 두 가지의 유사한 마그마가 수반된 것으로 추정된다. 것으로 추정된다.를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.를 보였다.4주까지에서는 비교적 폐포는 정상적 구조를 유지하면서 부분적으로 소폐동맥 중막의 비후와 간질에 호산구 침윤의 소견이 특징적으로 관찰되었다. 결론: 분리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된다.전 도부타민 심초음파는 관상동맥우회로술 후

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Comparison of virulence by Acanthamoeba strains in a murine model of acquired immunodeficiency syndrome (면역결핍 마우스를 이용한 Acnnthamoeba 분리주별 병원성 평가)

  • Gong, Hyeon-Hui;Lee, Seong-Tae;Jeong, Dong-Il
    • Parasites, Hosts and Diseases
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    • v.36 no.1
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    • pp.23-32
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    • 1998
  • The pathogenic potential of Acnnthamoebc strains was evaluated by experimental infection of murine AIDS (MAIDS) model. C57BL/6 mice were induced to immunocompromized state by intraperitoneal injection of LP-BM5 MuLV and revealed the typical splenomegalty and Iymphatic enlargement of axillar and inguinal regios on necropsy 4 weeks after viral infection. Although there was no significant difference in the mortality rate of MAIDS mouse according to the culture temperature, it was very different in the mortality rate from strain to strain of Accnthnmoebc. A. henIHi OC-3A strain isolated from the brain of a GAE patient showed !he highest mortality rate and A. culbertsoni A-1 strain from tissue culture was the second. KA/S3 and KA/S2 strains isolated from soil revealed very low virulence. The mice infected by intranasal inoculation of Acanthnmoebc showed relatively chronic course than intravenous inoculation. The gross findings of lungs and brains from infected mice were variable among mice. On the microscopic observations, the lungs showed much more severe inflammation and necrosis than the brains microscopically. This MAIDS model would be useful to study the opportunistic protozoan infections of AIDS patients. In the light of these results. the pathogenic potential and the virulence of Acnnthamoebo may be determined genetically.

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Retrograde Analysis of Complications of Jejunal Free Flap after Total Pharyngo-Laryngo-Cervical Esophagectomy in Advanced Hypopharyngeal Cancer Treatment (하인두암에서 후두인두 및 경부 식도 전 적출술 후 유리 공장 이식술의 합병증에 대한 후향적 분석)

  • Min, Hyun-Jin;Hyun, Dong-Woo;Kim, Young-Ho;Choi, Eun-Chang;Kim, Kwang-Moon;Kim, Se-Heon
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.43-46
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    • 2008
  • Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia

  • Ahn, Bin;Song, Seungha;Han, Mi Seon;Oh, Baek Lok;Choi, Jae Hong;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.27 no.3
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    • pp.198-204
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    • 2020
  • Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.