• Title/Summary/Keyword: 정맥 접근

Search Result 49, Processing Time 0.024 seconds

Careful Approach for Ureteronephrectomy in a Dog with Hydronephrosis causing Dense Adhesion (치밀한 유착조직을 형성한 수신증을 가진 개에서 신요관절제술을 위한 세심한 접근)

  • Kim, Young-Ki;Uhm, Mi-Young;Lee, Scott-S.;Wang, Ji-Hwan;Park, Kee-Tae;Jin, Yeung-Bae;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
    • /
    • v.26 no.4
    • /
    • pp.353-358
    • /
    • 2009
  • Unilateral ureteronephrectomy was performed in a dog presented with unilateral hydroureter and hydronephrosis. On laparotomy, severe adhesion of the dorsomedial border of the affected kidney to the abdominal aorta longitudinally and caudal pole of the kidney firmly to the ipsilateral ovary were observed. Since it was not possible to ligate the renal artery and vein separately due to severe adhesion tissue, two mass ligations were applied in the medial border of kidney, and the adhesion tissue was transected distal to each ligature. Then, blunt and sharp dissections were performed to isolate dorsomedial border of the kidney from the abdominal aorta, but they brought out unexpected hemorrhage caused by incision of renal artery and it has been suspected that two mass ligations could not include renal artery, which was adhered to dorsomedial border of the kidney. The hemorrhage was controlled by double ligations and electrocautery. In this case report, we recommend that if isolation of renal vessels is impossible due to strict adhesion of kidney to adjacent tissue, the mass ligation could be chosen to isolate and exteriorize the kidney and placed carefully not only at medial border of the kidney, where the renal vessels come into the kidney anatomically but also additional border of the kidney where adhesion tissues are formed.

Repair of Acute Aortic Arch Dissection with Hypothermic Circulatory Arrest and Retrograde Cerebral Perfusion (저체온순환정지와 역행성 뇌관류에 의한 대동맥궁을 침범한 급성 대동맥 박리증의 수술결과)

  • 이삼윤
    • Journal of Chest Surgery
    • /
    • v.37 no.1
    • /
    • pp.43-49
    • /
    • 2004
  • Background: Acute thoracic aortic dissections involving the aortic arch differ in diagnosis, surgical procedures, and operative results compared to those that do not involve the aortic arch. In general cerebral perfusion under deep hypothermic circulatory arrest (HCA) is performed during the repair of the aortic arch dissection. Here, we report our surgical results of the aortic arch dissection repair using retrograde cerebral perfusion (RCP) and its safety. Material and Method: Between January 1996 and June 2002, 22 consecutive patients with aortic arch dissection underwent aortic arch repair. In 20 of them RCP was performed under HCA. RCP was done through superior vena cava in 19 patients and by systemic retrograde venous perfusion in 1, in whom it was difficult to reach the SVC. When the patient's rectal temperature reached 16 to 18$^{\circ}C$, systemic circulation was arrested, and the amount of RCP amount was 481.1 $\pm$292.9 $m\ell$/min with perfusion pressure of 20∼30 mmHg. Result: There were two in-hospital deaths (4.5%) and one late death (9.1%). Mean circulatory arrest time (RCP time) was 54.0$\pm$ 13.4 minutes (range, 7 to 145 minutes). RCP time has no correlation with the appearance of consciousness, recovery of orientation, or ventilator weaning time (p=0.35, 0.86, and 0.92, respectively). Ventilator weaning was faster in patients with earlier recovery of consciousness and orientation (r=0.850, r=926; p=0.000, respectively). RCP of more than 70 minutes did not affect the appearance of consciousness, recovery of orientation, ventilator weaning time, exercise time, or hospital stay (p=0.42, 0.57, 0.60, 0.83, and 0.51, respectively). Conclusion: Retrograde cerebral perfusion time under hypothermic circulatory arrest during repair of aortic arch dissection may not affect recovery of orientation, ventilator weaning time, neurologic complications, and postoperative recovery.

Security Enhancement to an Biometric Authentication Protocol for WSN Environment (WSN 환경에서 Biometric 정보를 이용한 안전한 사용자 인증 스킴의 설계)

  • Lee, Youngsook
    • Convergence Security Journal
    • /
    • v.16 no.6_2
    • /
    • pp.83-88
    • /
    • 2016
  • Over recent years there has been considerable growth in interest in the use of biometric systems for personal authentication. Biometrics is a field of technology which has been and is being used in the identification of individuals based on some physical attribute. By using biometrics, authentication is directly linked to the person, rather than their token or password. Biometric authentication is a type of system that relies on the unique biological characteristics of individuals to verify identity for secure access to electronic systems. In 2013, Althobati et al. proposed an efficient remote user authentication protocol using biometric information. However, we uncovered Althobati et al.'s protocol does not guarantee its main security goal of mutual authentication. We showed this by mounting threat of data integrity and bypassing the gateway node attack on Althobati et al.'s protocol. In this paper, we propose an improved scheme to overcome these security weaknesses by storing secret data in device. In addition, our proposed scheme should provide not only security, but also efficiency since sensors in WSN(Wireless Sensor Networks) operate with resource constraints such as limited power, computation, and storage space.

Relationship between Bispectral Index, Sedation Score and Plasma Concentration, during Midazolam Sedation (Midazolam을 이용한 진정법 시 Bispectral Index, 진정점수, 그리고 midazolam의 혈중 농도 사이의 관계)

  • Park, Eun-Jin;Park, Chang-Joo;Yum, Kwang-Won;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
    • /
    • v.1 no.1 s.1
    • /
    • pp.21-25
    • /
    • 2001
  • 연구배경: 임상적으로 진정법을 시행할 경우 뇌의 상태에 대한 접근은 매우 중요하다. 환자의 뇌에 대한 마취제의 영향을 측정하기 위해 개발된 Bispectral Index (BIS)는 환자의 진정을 방해하지 않고 객관적인 진정정도를 평가할 수 있다. 그러나 이는 항상 진정 깊이의 임상적인 척도와는 일치하지 않는다. 이번 연구에서는 진정법 시행시 환자의 진정 정도를 측정하기 위한 BIS의 유용성을 검증하기 위하여 BIS, 진정점수, 그리고 midazolam의 혈중 농도와의 관계를 연구하였다. 방법: 25명의 건강한 성인 지원자들을 대상으로 무의식을 유도하기 위하여 midazolam 0.08 mg/kg을 정맥으로 주입하였으며 환자의 의식 상태를 진정 회복 시까지 관하였다. BIS와 진정점수는 진정 전과, midazolam 투여 후 10, 20, 30분 간격으로 측정하였다. Midazolam의 혈중 농도는 주입 후 10분 경과 후에 정맥혈 채취 후 HPLC를 이용하여 측정하였다. BIS는 BISTM monitor (Aspect Medical Systems, USA)으로 측정하였으며 또한 진정 정도는 진정 점수로도 평가하였다. 결과: BIS 수치는 진정점수와 유의한 상관관계를 보였다(r = 0.676, p < 0.05). 혈중 midazolam 농도가 감소함에 따라 혈중 농도는 진정점수와 유의한 상관관계를 보였다(r = -0.656). Midazolam 투여 후 10분에서 BIS 수치와 midazolam의 혈중 농도는 유의한 상관관계를 보이지 않았지만(r =0.467) 진정 후 수치는 진정 전 수치와 명확히 구분되었다. 결론: BIS는 환자의 수면상태의 효과적인 척도로 알려져 있으며 진정점수와도 높은 상관관계를 보였다. 그러나 항상 진정 깊이를 나타내는 임상적인 척도와는 일치하지 않았다. 그러므로 진정법 시행동안 BIS 만을 사용하는 것은 더욱 많은 주의가 필요하며 매 주어진 시간마다 다양한 진정 점수 측정방법으로 환자의 의식을 감시하는 것이 추천된다.

  • PDF

T Wave Detection Algorithm based on Target Area Extraction through QRS Cancellation and Moving Average (QRS구간 제거와 이동평균을 통한 대상 영역 추출 기반의 T파 검출 알고리즘)

  • Cho, Ik-sung;Kwon, Hyeog-soong
    • Journal of the Korea Institute of Information and Communication Engineering
    • /
    • v.21 no.2
    • /
    • pp.450-460
    • /
    • 2017
  • T wave is cardiac parameters that represent ventricular repolarization, it is very important to diagnose arrhythmia. Several methods for detecting T wave have been proposed, such as frequency analysis and non-linear approach. However, detection accuracy is at the lower level. This is because of the overlap of the P wave and T wave depending on the heart condition. We propose T wave detection algorithm based on target area extraction through QRS cancellation and moving average. For this purpose, we detected Q, R, S wave from noise-free ECG(electrocardiogram) signal through the preprocessing method. And then we extracted P, T target area by applying decision rule for four PAC(premature atrial contraction) pattern another arrhythmia through moving average and detected T wave using RT interval and threshold of RR interval. The performance of T wave detection is evaluated by using 48 record of MIT-BIH arrhythmia database. The achieved scores indicate the average detection rate of 95.32%.

Design of Face Recognition System for Authentication of Internet Banking User (인터넷 뱅킹의 사용자 인증을 위한 얼굴인식 시스템의 설계)

  • 배경율
    • Journal of Intelligence and Information Systems
    • /
    • v.9 no.3
    • /
    • pp.193-205
    • /
    • 2003
  • In this paper, we suggest user authentication and authorization system for internet banking by face recognition. The system is one of Biometrics technology to verify and authorize personnel identification and is more unobtrusive than the other technologies, because they use physiological characteristics such as fingerprint, hand geometry, iris to their system that people have to touch it. Also, the face recognition system requires only a few devices such as a camera and keypad, so it is easy to apply it to the real world. The face recognition algorithms open to the public are separated by their analysis method differ from what characteristic of the human face use. There are PCA (principal Component Analysis), ICA (Independent Component Analysis), FDA (Fisher Discriminant Analysis). Among these, physiological data of encrypted form is translated utilizing PCA which is the most fundamental algorithm that analyze face feature, and we suggests design method of user authentication system that can do send-receive fast and exactly.

  • PDF

A Study of Authentication Design for Youth (청소년을 위한 인증시스템의 설계에 관한 연구)

  • Hong, Ki-Cheon;Kim, Eun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.8 no.4
    • /
    • pp.952-960
    • /
    • 2007
  • Most Websites perform login process for authentication. But simple features like ID and Password have no trust because most people worry about appropriation. So the youth can easily access illegal media sites using other's ID and Password. Therefore this paper examine features be adaptable to authentication system, and propose a design of authentication system using multiple features. A proposed authentication system has two categories, such as low-level and high-level method. Low-level method consists of grant of authentication number through mobile phone from server and certificate from authority. High-level method combines ID/Password and features of fingerprint, character, voice, face recognition systems. For this, this paper surveys six recognition systems such as fingerprint, face, iris, character, vein, voice recognition system. Among these, fingerprint, character, voice, face recognition systems can be easily implemented in personal computer with low cost accessories. Usage of multiple features can improve reliability of authentication.

  • PDF

Limitation of Prediction on Intravenous Immunoglobulin Responsiveness in Kawasaki Disease (가와사끼병에서 정맥용 면역글로불린 치료 반응 예측의 한계)

  • Kim, Seong-Koo;Han, Ji-Yoon;Rhim, Jung Woo;Oh, Jin Hee;Han, Ji-Whan;Lee, Kyung Yil;Kang, Jin-Han;Lee, Joon-Sung
    • Pediatric Infection and Vaccine
    • /
    • v.17 no.2
    • /
    • pp.169-176
    • /
    • 2010
  • Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
    • /
    • v.24 no.2
    • /
    • pp.206-215
    • /
    • 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.

  • PDF

Effects of Dental Hygienist's Musculoskeletal Pain Resolution and Self-Efficacy on Musculoskeletal Disorders (치과위생사의 근골격계 통증 해결 방법과 자기효능감이 근골격계 질환에 미치는 영향)

  • Moon, Ae-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.2
    • /
    • pp.329-338
    • /
    • 2018
  • This study was conducted to examine musculoskeletal disorder and analyze the effects of musculoskeletal pain control and self-efficacy on musculoskeletal disorders in dental hygienists. Material and Methods; 483 dental hygienists residing in Gwangju were collected by the convenience sampling method and the self-administered questionnaire survey was conducted. Frequency analysis, crosstab analysis, t-test, and multiple logistic regression analysis were used for analysis. Results: the prevalence of musculoskeletal pain among subjects was 83.9% for the prior year, with 29.8% of patients being afflicted by musculoskeletal disorders. The factors influencing musculoskeletal disorders were musculoskeletal pain resolution. For pain resolution, the odds ratio of musculoskeletal disorders of the group who answered treatment in a hospital, an Oriental medicine clinic, or a pharmacy was 0.22 (95% confidence interval, 0.14-0.34) compared with the group who answered sick leave or task change, suggesting a negative relationship. These findings indicate that people with musculoskeletal disorders were not treated in the hospital, Oriental medicine clinic, or pharmacy. Therefore, it is necessary to improve medical management (oriental medicine, intravenous injection or medication, heat therapy or cryotherapy, steroid treatment, counseling, endovascular treatment using spinal cord stimulation, physical therapy, stretching, rehabilitation, and manual therapy) and job environment and to make a good approach to the prevention of musculoskeletal disorders to control dental hygienists' musculoskeletal pain.