• Design & Manufacturing
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• v.14 no.2
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• pp.34-41
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• 2020

Typical characteristics of medical device parts are that they can not be reused and there are many disposable products. Therefore, there is a need for an injection molding machine having excellent repeatability of molding conditions and a precision injection mold for mass production. Recently, the performance of an injection machine has made a remarkable evolution compared to the past. However, defects such as short-shot, flash, weld line, gas burning, warpage, and deformation, which are typical defects, still do not disappear at all. This is due to the lack of gas ventilation from the product cavities, even if the gas is smoothly vented from the sprue and runner of the mold. For this reason, the internal pressure of the cavity rises and is directly connected to the quality defects. In this study, an active gas vent system was designed to prevent defects due to trapped gas in the cavity. Since it can be easily adjustable in response to the molding conditions and the mold temperature changes, it is expected to improve productivity due to the reduction of the defective ratio.

• Journal of Digital Convergence
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• v.12 no.12
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• pp.507-512
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• 2014

Because it is impossible to form a culture. To correctly read the code unless the consumer is considering skater that can be shared in the emotion of the characters and the consumer culture that supply. May be possible to force the active dissemination of education shall ceramic crafts culture. We need the ceramics craft culture in this sense also once again confirmed the importance of education and redevelopment. The workshop enabled to the Ceramic Study presented based on the importance of education in workshop operations Activation is required in order to plan the education and above all a culture of catheter positioned in the area of contemporary craft. Such as teaching methods and ways to activate.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.493-499
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• 2019

Thiamine (vitamin $B_1$) is a water-soluble vitamin that is not endogenously synthesized in humans. It is absorbed by the small intestine, where it is activated. Its active form acts as a coenzyme in many energy pathways. We report a rare case of thiamine deficiency in a 3.5-year old boy with short bowel syndrome secondary to extensive bowel resection due to necrotizing enterocolitis during his neonatal age. The patient was parenteral nutrition-dependent since birth and had suffered from recurrent central catheter-related bloodstream infections. He developed confusion with disorientation and unsteady gait as well as profound strabismus due to bilateral paresis of the abductor muscle. Based on these and a very low thiamine level he was diagnosed and treated for Wernicke encephalopathy due to incomplete thiamine acquisition despite adequate administration. He fully recovered after thiamine administration. After 1999 eight more cases have been reported in the PubMed mostly of iatrogenic origin.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.284-287
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• 2021

We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1204-1214
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• 2006

Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.391-397
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• 1992

Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.137-141
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• 2006

Background: It has been known that melatonin is involved in the modulation of nociceptive transmission. However, the effect of melatonin administered spinally has not been examined. Therefore, we examined the effect of melatonin on the formalin-induced or thermal-induced nociception at the spinal level. Methods: Intrathecal catheter was inserted into the subarachnoid space of male Sprague-Dawley rats. Pain was assessed by formalin test (induced by injection of $50{\mu}l$ of a 5% formalin solution to the hindpaw) or Hot-Box test (induced by radiant heat application to the hindpaw). The effect of intrathecal melatonin was examined on flinching behavior in the formalin test or withdrawal response in Hot-Box test. Results: Intrathecal melatonin produced a limited, but dose-dependent reduction of the flinching response during phase 1 and 2 in the formalin test. In addition, melatonin delivered at evening also decreased the flinching response in both phases of the formalin test. Melatonin restrictively increased the withdrawal latency in Hot-Box test. Conclusions: These results suggest that melatonin is active against the formalin- and thermal-induced nocicpetion at the spinal level, but the effect is limited.

• Journal of Gastric Cancer
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• v.19 no.1
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• pp.72-82
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• 2019

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.285-294
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• 2023

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion: Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors.

• The Korean Journal of Pharmacology
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• v.18 no.1
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• pp.43-54
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• 1982

Bile formation is a complex process comprised of three separate physiologic mechanism operating at two anatomical sites. At present time, it was known that at least two processes are responsible for total canalicular secretion at the bile canaliculus. One of the processes is bile salt-dependent secretion (BSDS) hypothesis that the active transport of bile salts from plasma to bile provided a primary stimulus for bile formation: the osmotic effect of actively transported bile acid was responsible for the movement of water and ions into bile. The other process is bile salt-independent secretion (ESIS), which is unrelated to bile salt secretion at the canaliculus and which may involve the active transport of sodium. The third process for bile formation involves the biliary ductal epithelium. Secretin-stimulated bile characteristically contained bicarbonate in high concentration. Therefor, it was suggested that secretin stimulated water and bicarbonate secretion from the biliary ductules. One the other hand, it was found that a large amounts of cAMP was present in canine bile but no apparent relationship between bile salt secretion and cAMP content in dog bile. However, bile flow studies in human have demonstrated that secretin and glucagon increase bile cAMP secretion as does secretin in baboons. Secretin increases baboon bile duct mucosal cAMP levels in addition to bile CAMP levels suggesting that in that species secretin-stimulated bile flow may be cAMP mediated. It has been postulated that glucagon and theophylline which increase the bile salt-independent secretion in dogs might act through an increased in liver cAMP content. In a few studies, the possible role of cAMP on bile formation has teen tested by administration of an exogenous derivative of cAMP, dibutyryl cAMP. In the rat, DB cAMP did not modify bile flow, but injection of DB cAMP in the dog promoted an increase in the bile salt-independent secretion. Because of these contradictory results, this study was carried out to examine the relationship between cyclic nucleotides and bile flow due to various bile salts as well as secretin or theophylline. Experiments were performed in rabbits with anesthesia produced by the injection of seconal(30 mg/kg). Rabbits had the cystic duct ligated and the proximal end of the divided common duct cannulated with an appropriately sized polyethylene catheter. A similar catheter was placed into the inferior vena cava for administration of drugs. Bile was collected for determination of cyclic nucleotides and total cholate in 15 min. intervals for a few hours. The results are summerized as followings. 1) Administrations of taurocholic acid or chenodeoxycholic acid increased significantly the concentrations of cAMP and cGMP in bile of rabbits. 2) Concentration of cAMP in bile during the continuous infusion of ursodeoxycholic acid, was remarkedly increased in accordance with the increase of bile flow, while on the contrary concentration of cGMP in bile was decreased significantly. 3) Dehydrocholic acid and deoxycholic acid significantly increased bile flow, total cholate output and cyclic nucleotides in bile. 4) Only cAMP concentration in bile was significantly increased from control value by secretin, while theophylline increased cAMP as well as cGMP in rabbit bile. 5) In addition, the administration of secretin to taurocholic acid-stimulated bile flow increased cAMP while theophylline produced the increases of cAMP and cGMP in bile. 6) The administration of insulin to taurocholic acid-stimulated bile flow decreased cAMP concentration, while on the contrary cGMP was remarkedly increased in rabbit bile.