• Title/Summary/Keyword: Blood loss

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The Comparative Study of on Pump CABG during Pulsatile $(T-PLS^{TM})$ and Nonpulsatile $(Bio-pump^{TM})$ Perfusion (관상동맥우회술 시 사용된 박동성펌프$(T-PLS^{TM})$와 비박동성펌프$(Bio-pump^{TM})$의 비교연구)

  • Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.354-358
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    • 2006
  • Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

Effect of Dietary Bacillus subtilis on Growth Performance, Immunological Cells Change, Fecal NH3-N Concentration and Carcass Meat Quality Characteristics in Finishing Pigs (비육돈 사료내 Bacillus subtilis의 첨가가 성장, 면역세포 변화, 분내 암모니아태질소 함량 및 도체 특성에 미치는 영향)

  • Cho, J.H.;Chen, Y.J.;Min, B.J.;Kim, H.J.;Shon, K.S.;Kwon, O.S.;Kim, J.D.;Kim, I.H.
    • Journal of Animal Science and Technology
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    • v.47 no.6
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    • pp.937-946
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    • 2005
  • This experiment was conducted to investigate the effects of dietary Bacillus subtilis on growth performance, nutrient digestibility, immunological cells change, fecal noxious gas and carcass meat quality characteristics in finishing pigs. The dietary treatments were 1) CON(basal diet), 2) BS0.1(basal diet+ 0.1% Bacillus subtilis) and 3)BS0.2(basal diet+0.2% Bacillus subtilis). Sixty crossbred(Landrace$\time$ Yorkshire$\time$Duroc) pigs(89.5$\pm$0.11kg average initial body weight) were used in a 42 days growth trial. The pigs were assigned to the treatments according to body weight and each treatment had 5 replicates of 4 pigs per pen in a randomized complete block design. Through the entire experimental period, average daily gain(ADG) and average daily feed intake(ADFI) were not significantly different among the treatments. Pigs fed BS0.1 diet significantly increased their gain/feed compared to pigs fed CON and BS0.2 diets(P<0.05). Also, dry matter(DM) and nitrogen(N) digestibilities were greater in the pigs fed BS0.1 diet than those fed CON diet(P<0.05). There were no significant differences in fecal NH3-N concentration among the treatments. In blood assay for immunological cells change investigations, red blood cells(RBC) counts increased in the pigs fed BS0.2 diet compared to pigs fed CON and BS0.1 diets. There were no significant differences in carcass pH, drip loss, marbling and firmness. However, sensual color and a*(redness) value of meat in the pigs fed BS0.2 diet were higher than in pigs fed CON diet(P<0.05). Therefore, this experiment suggested that Bacillus subtilis supplementation could improve nutrient digestibility, RBC counts and carcass meat color of pigs.

Quality Characteristics and Retarding Retrogradation of Sponge Cakes containing Red Yeast Rice(Monascus nuruk) Flour (홍국(Monascus nuruk) 분말을 첨가한 스폰지 케이크의 품질 특성 및 노화 억제 분석)

  • Song, Ka-Young;Kim, Jong-Hee;O, Hyeon Bin;Zhang, Yangyang;Kim, Young-Soon
    • Culinary science and hospitality research
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    • v.22 no.3
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    • pp.11-21
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    • 2016
  • This study investigated the quality characteristics and retarding retrogradation of sponge cakes made with red yeast rice (RYR) flour. RYR (Monascus nuruk) is known to help digestion, smooth blood flow, and have anti-cancer, anti-microbial, and inhibitory effects against biosynthesis of cholesterol and blood pressure. This studys aim' was to find the optimal proportion of RYR flour in sponge cake. RYR sponge cakes were prepared with various levels (0, 5, 10, 15 and 20%) replacement of wheat flour and were designated as the control (without RYR), RYR5, RYR10, RYR15 and RYR20 respectively. Specific gravity was the lowest in RYR15 at 0.57, and the baking loss rate was not significantly different among the samples (p<0.05). The dough yield was the highest in RYR15 at 96.61. The moisture contents was highest in order, control, RYR5, and RYR15 at 28.67%, 28.18%, and 26.82% respectively. The L-value of crust tended to increase according to the level of RYR, but the L-value of crumb decreased in accorddance with the the content of RYR. The a-value of crust also decreased according to the level of RYR, although the a-value of crumb increased in response to higher levels of RYR. The b-value tended to decrease with increases of RYR (p<0.05). RYR5 exhibited the highest pH at 8.63, compared with RYR15 (8.57). The hardness, which was measured after cooling for 1 hour, was the lowest in RYR15 at $163.33g/cm^2$ and the springiness was not different significantly (p<0.05). Cohesiveness was the highest in RYR10 at 133.06%. The chewiness was the highest in RYR10 at $391.63g{\cdot}cm$ and lowest in RYR15 ast $169.62g{\cdot}cm$. Avrami equation showed that RYR15 and RYR20 had the lowest Avrami exponent (n) at 0.0664 and 0.4983 respectively. Time constant (1/k) was the highest in RYR15 at 200.00. Sensory evaluation revealed that RYR15 was the highest in color (5.50), flavor (4.95), sweetness (4.90), chewiness (4.75), and overall acceptability (4.60).

Effects of a Combined Diet of Jerusalem Artichoke's Inulin, Lotus Leaf and Herb Extracts in Obesity-induced White Rat with Fat Diet (돼지감자의 이눌린, 연잎, 허브의 병합식이가 고지방식이로 유도된 비만흰쥐에 미치는 영향)

  • Lee, Eun-Hye;Lee, Ye-Jin;Choi, Ok-Byung;Kang, Sang-Mo
    • Applied Biological Chemistry
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    • v.50 no.4
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    • pp.295-303
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    • 2007
  • A preliminary diet experiment utilizing Jerusalem artichoke's inulin, lotus leaf powder, nettle powder and eucalyptus powder extract indicated that combining all four elements gave the most effective result. Therefore, a study was conducted to evaluate the effectiveness of combined diet for weight loss. In this study, Sprague-Dawley, male white rats about 200 g in weight was fed with high fat diet for 8 weeks in order to induce obesity followed by 4 week administration of combined diet to look into the effect of the diet. After a total of 12 weeks of feeding, factors relevant to weight, blood, and lipid metabolism by liver in the body were researched and histologic change was examined with optical microscope. In terms of weight change, both high fat diet group and regular diet group gained weight from high fat diet for 8 weeks compared to normal group. Then, for another 4 weeks, while normal group and high fat diet group kept gaining weight, combined diet group which was provided with high fat diet for 8 weeks, lost weight to the normal group level after 3 week administration of diet. However, after the 4th week of administration, the group weighted significantly less than the normal group and the efficiency of diet also significantly dropped. In the biochemical analysis of blood, total cholesterol, LDL-cholesterol, triglyceride, glucose, GOT, GPT, ${\gamma}-GTP$ and creatine showed significant increase in high fat diet group and there was no significant difference between diet group and normal group except for GPT, ${\gamma}-GTP$ and creatine. In the biochemical analysis of liver, there was significant increase in LDL-cholesterol, triglyceride of high fat diet group compared to normal group, while there was no significant difference in term of total cholesterol and HDL-cholesterol. Compared to normal group, diet group had higher HDL-cholesterol, while total cholesterol dropped significantly. There was no significant difference in terms of LDL-cholesterol and triglyceride. Besides, in high fat diet group, observation of histologic change in liver and change in ultrastructure showed volume increase of hepatic cell and severe fatty degeneration in hepatic cell around hepatic vein. However in diet group, like normal group, no pathological change was observed in terms of cytoplasm, nucleus and capillary in hepatocyte and the alignment of hepatocyte had regularity thanks to the administration of combined diet. Therefore, combined diet utilizing Jerusalem artichoke's inulin, lotus leaf powder, nettle powder and eucalyptus powder was proven to be an effective measure to prevent and improve obesity as a result of abnormal adipose deposition.

Role of Catecholamines in Ventricular Fibrillation (Catecholamines에 관(關)하여 -제4편(第四編) : 심실전동발생(心室顫動發生)에 있어서의 catecholamines의 의의(意義)-)

  • Lee, Woo-Choo
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.15-35
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    • 1983
  • Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

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Role of MYH Polymorphisms in Sporadic Colorectal Cancer in China: A Case-control, Population-based Study

  • Yang, Liu;Huang, Xin-En;Xu, Lin;Zhou, Jian-Nong;Yu, Dong-Sheng;Zhou, Xin;Li, Dong-Zheng;Guan, Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6403-6409
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    • 2013
  • Purpose: Biallelic germline variants of the 8-hydroxyguanine (8-OG) repair gene MYH have been associated with colorectal neoplasms that display somatic $G:C{\rightarrow}T:A$ transversions. However, the effect of single germline variants has not been widely studied, prompting the present investigation of monoallelic MYH variants and susceptibility to sporadic colorectal cancer (CRC) in a Chinese population. Patients and Methods: Between January 2006 and December 2012, 400 cases of sporadic CRC and 600 age- and sex-matched normal blood donors were screened randomly for 7 potentially pathogenic germline MYH exons using genetic testing technology. Variants of heterozygosity at the MYH locus were assessed in both sporadic cancer patients and healthy controls. Univariate and multivariate analyses were performed to determine risk factors for cancer onset. Results: Five monoallelic single nucleotide polymorphisms (SNPs) were identified in the 7 exon regions of MYH, which were detected in 75 (18.75%) of 400 CRC patients as well as 42 (7%) of 600 normal controls. The region of exon 1 proved to be a linked polymorphic region for the first time, a triple linked variant including exon 1-316 $G{\rightarrow}A$, exon 1-292 $G{\rightarrow}A$ and intron 1+11 $C{\rightarrow}T$, being identified in 13 CRC patients and 2 normal blood donors. A variant of base replacement, intron 10-2 $A{\rightarrow}G$, was identified in the exon 10 region in 21 cases and 7 controls, while a similar type of variant in the exon 13 region, intron 13+12 $C{\rightarrow}T$, was identified in 8 cases and 6 controls. Not the only but a newly missense variant in the present study, p. V463E (Exon 14+74 $T{\rightarrow}A$), was identified in exon 14 in 6 patients and 1 normal control. In exon 16, nt. 1678-80 del GTT with loss of heterozygosity (LOH) was identified in 27 CRC cases and 26 controls. There was no Y165C in exon 7 or G382D in exon 14, the hot-spot variants which have been reported most frequently in Caucasian studies. After univariate analysis and multivariate analysis, the linked variant in exon 1 region (p=0.002), intron 10-2 $A{\rightarrow}G$ (p=0.004) and p. V463E (p=0.036) in the MYH gene were selected as 3 independent risk factors for CRC. Conclusions: According to these results, the linked variant in Exon 1 region, Intron 10-2 $A{\rightarrow}G$ of base replacement and p. V463E of missense variant, the 3 heterozygosity variants of MYH gene in a Chinese population, may relate to the susceptibility to sporadic CRC. Lack of the hot-spot variants of Caucasians in the present study may due to the ethnic difference in MYH gene.

Development of High-Functional Hyaluronic Acid/Salmon Extract Formulation Using Gamma-Ray (감마선을 이용한 고기능성 히알루론산/연어추출물 제형개발)

  • Kweon, Dong-Keon;Shim, Jae-Goo;Ha, Man
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.9-16
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    • 2018
  • Hangover after drinking is different from person to person symptoms and degree, but usually thirst, fatigue, headache, general boredom, gastrointestinal disorder, vomiting, diarrhea, deficiency of vitamin appears. This hanging phenomenon is caused by the action of precursors such as ethyl acetate and acetaldehyde, which are the by products of fermentation contained in alcohol and alcohol accumulated in hepatocytes and body. In order to solve the hangover phenomenon, the same Origin as polysaccharide Polydeoxyribonucleotide, which is a nucleic acid-sugar-phosphate complex, which is a semen or testicular extract in salmon extract, and a water soluble salmon extract powder having the same structure and lower price than Polydeoxyribonucleotide And D-Glucuronic acid and N-Acetyl glucosamine. It has excellent biocompatibility, viscoelasticity and moisturizing power. It has effect on reduction of body water loss and skin moisture content in hangover phenomenon. It is antioxidant and skin moisturizing effect Hyaluronic acid was irradiated with gamma rays, and the composition was prepared by using the salmon extract powder and the main raw material. The ethanol degradation, the acetaldehyde reduction amount, the blood acetaldehyde concentration and the acetic acid concentration were measured to evaluate the alcoholysis effect, Skin moisture evaporation rate To examine the evaluation unit water content of the skin was improved determine whether the antioxidant and provide skin moisturizing effect. The addition of ethanol extracts of salmon extracts showed a decrease of 5 to 7 times compared with no addition, and a decrease of 3 to 5 times of acetaldehyde. In addition, the change of acetaldehyde concentration and acetic acid concentration in blood showed a rapid decrease compared to the no - added control group. In addition, when the raw material of hyaluronic acid was used, skin moisture content was high and skin moisture evaporation amount was decreased. Therefore, hyaluronic acid, which is a polysaccharide polymer, has excellent viscoelasticity and moisturizing ability, It is considered to provide antioxidant and skin moisturizing effect. Therefore, it can be said that the composition containing salmon extract powder and hyaluronic acid as a main ingredient is effective for the hangover phenomenon which occurs after drinking.

A Study of Acute Gastroenteritis in Neonates Transfered from Postpartum Care Centers (산후조리원에서 전원되어 입원한 신생아 급성 장염 환자들에 대한 임상적 고찰)

  • Kim, Jong Suh;Lee, Hae Sung;Choi, Jung Hwan;Shin, Yoon Jung;Koo, Mi Lim;Kim, Sung Sin;Kim, Heui Suck;Kim, Eun Ah;Yoon, Sin Won;Kwon, Jae Hoon;Yoon, Sin Won;Kim, Jong Hoon;Sin, Sun Heui;Koo, Sung Kyung;Yang, Sung;Yoo, Sin;Ahn, Young Min;Kim, Eun Mi;Lee, Dong Hwan
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.186-192
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    • 2003
  • Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.

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Effects of Dietary Coconut Fat Powder Supplementation on Performance and Milk Characteristics in Lactating Sow (포유모돈 사료에 코코넛 분말지방 첨가가 모돈의 생산성 및 모유성상에 미치는 효과)

  • Kim, H.J.;Cho, J.H.;Chen, Y.J.;Yoo, J.S.;Shin, S.O.;Huang, Y.;Kim, I.H.
    • Journal of Animal Science and Technology
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    • v.49 no.6
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    • pp.773-782
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    • 2007
  • A total of thirty sows(Landrace×Yorkshire) were used to determine the effects of plant protein source containing multienzyme on performance, nutrients digestibility and milk characteristics. A feeding trial was conducted for 21 days from parturition to weaning. Experimental diets were supplied for 1 week before the parturition day and throughout the experimental period. Dietary treatments included: 1) Control(CON; basal diet), 2) CGLT(included corn gluten) and 3) FSPM(included fermented soy protein containing multienzyme). Through the entire experimental period, backfat loss and return-to-estrus intervals were not affected by the treatments(P>0.05). Nitrogen digestibility was increased significantly(P<0.05) in FSPM treatment compared to CON treatment. Blood urea nitrogen(BUN) concentration was increased significantly (P<0.05) in FSPM treatment compared to CON treatment. At the initial  period, total protein content of milk was higher significantly(P<0.05) in FSPM treatment compared to CGLT treatment and at the final period, total fat content of milk was higher significantly(P<0.05) in FM treatment compared to CON treatment. Rectal temperature showed similar tendency of change among treatments. The final piglet body weight, weight gain and ADG were higher significantly in FSPM treatment compared to CON treatment. On diarrhea rate in piglet, just one piglet occurred in CGLT treatement. In conclusion, 2.5% dietary plant protein source containing multienzyme suppelmentation improved N digestibility, BUN concentration, fat and protein contents in milk and weight gain in piglet.

Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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