• Title/Summary/Keyword: Bolus

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The Dose Distribution of Arc therapy for High Energy Electron (고에너지 전자선 진자조사에 의한 선량분포)

  • Chu, S.S.;Kim, G.E.;Suh, C.O.;Park, C.Y.
    • Radiation Oncology Journal
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    • v.1 no.1
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    • pp.29-36
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    • 1983
  • The treatment of tumors along curved surfaces with stationary electron beams using cone collimation may lead to non-uniform dose distributions due to a varying air gap between the cone surface and patient. For large tumors, more than one port may have to be used in irradiation of the chest wall, often leading to regions of high or low dose at the junction of the adjacent ports. Electron-beam arc therapy may elimination many of these fixed port problems. When treating breast tumors with electrons, the energy of the internal mammary port is usually higher than that of the chest wall port. Bolus is used to increase the skin dose or limit the range of the electrons. We invertiaged the effect of various arc beam parameters in the isodose distributions, and combined into a single arc port for adjacent fixed ports of different electron beam eneries. The higher fixed port energy would be used as the arc beam energy while the beam penetration in the lower energy region would be controlled by a proper thickness of bolus. We obtained the results of following: 1. It is more uniform dose distribution of electron to use rotation than stationary irradiation. 2. Increasing isocenter depth on arc irradiation, increased depth of maximum dose, reduction in surface dose and an increasing penetration of the linear portion of the curve. 3. The deeper penetration of the depth dose curve and higher X-ray background for the smaller field sized. 4. If the isocenter depth increase, the field effect is small. 5. The decreasing arc beam penetration with decreasing isocenter depth and the isocenter depth effect appears at a greater depth as the energy increases. 6. The addition of bolus produces a shift in the penetration that is the same for all depths leaving the shape of the curves unchanged. 7. Lead strips 5 mm thick were placed at both ends of the arc to produce a rapid dose drop-off.

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Efficacy of Epidural Droperidol in Reducing Nausea and Vomiting Associated with Postoperative Epidural Morphine (술후 경막외 Morphine으로 인한 오심 및 구토에 대한 경막외 Droperidol의 효과)

  • Park, Jin-Woo;Lee, Dong-Kun;Choe, Young-Kyun;Kim, Young-Jea;Shin, Chee-Mahn;Pak, Myoung;Park, Ju-Yuel
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.380-384
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    • 1996
  • Background: To determine the effectiveness of continuous epidural infusion of droperidol, combined with epidural morphine, in reducing nausea or vomiting associated with epidural morphine and minimizing the side effects of droperidol, 48 patients undergoing elective thoracic surgery were randomly assigned to one of two study groups. Methods: Patients received continuous infusion of epidural morphine(6.0 mg/day) following a bolus loading dose of 3.0 mg(Group A), or epidural mixture of morphine(6.0 mg/day) plus droperidol(5.0 mg/day) following a bolus loading dose(morphine 3.0mg, droperidol 1.5 mg)(Group B). For the first 48 postoperative hours, the incidence of nausea or vomiting, the need for antiemetic therapy, level of sedation, and adverse effects associated with droperidol were evaluated. Results: The incidence of nausea or vomiting and the number of patients who required antiemetic therapy were significantly less in Group B than in Group A(P<0.05). There were no significant differences between groups with regard to the adverse effects associated with droperidol such as mental depression, respiratory depression and abnormal movements(P=NS). Conclusion: We conclude that simultaneous titration of morphine and droperidol via epidural continuous infusion following epidural bolus injection of the mixture reduces nausea or vomiting associated with epidural morphine while it prevents the side effects of droperidol.

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Significance of the AFP Level and HBsAg in Differentiation of Hepatic Masses (간종괴의 감별진단에 있어서 AFP수치와 HBsAg의 의의)

  • Kim, Jae-Woon;Park, Won-Kyu;Cho, Jae-Ho;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.302-307
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    • 1996
  • Hepatic masses show different enhancing patterns in IV bolus computed tomography: Hepatocellular carcinoma shows high-attenuation in the early enhancing phase and low-attenuation in the late enhancing phase, hemangioma shows peripheral dot-like high-attenuation in the early enhancing phase and central high-attenuation in the late enhancing phase, and metastatic cancer and cholangiocelluar carcinoma show peripheral high-attenuation rim in the early enhancing phase and central portion gradulally high-attenuation in the late enhancing phase. but sometimes enhancing patterns of the hepatic masses are confuse. To evaluate the significance of the AFP level and HBsAg in differentiation of the hepatic masses, we retrospectively analyzed AFP level and HBsAg in 228 pathologically or radiologically confirmed hepatocellular carcinomas, and 137 pathologically nonhepatocellular cacinomas. The results were as follows : In hepatocellular carcinoma, AFP level above 20ng/ml was 77.8% and HBsAg positve was 72.6%. In nonhepatocellular carcinoma, AFP level above 20ng/ml was 3.7% and HBsAg positve was 16.1%. We concluded that AFP level and HBsAg are helpful to distinguish hepatocellular carcinoma from nonhepatocellular carcinoma, when IV bolus computed tomogram finding is uncertain.

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The Postoperative Pain Control for the Benign Prostatic Hypertrophy: Continuous Epidural Pain Block versus Intravenous Patient-Controlled Analgesia (양성 전립선 비대증 환자의 술후 통증치료)

  • Park, Sun-Gyoo;Kim, Jin-Yun;Rah, Eun-Gil
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.268-272
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    • 1998
  • Background: Postoperative bleeding is a common complication in transurethral resection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two Methods for post-operative analgesia. Methods: We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group (I, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusion rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl $50\sim100{\mu}g$ followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP. Results: Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group. Conclusions: Postoperative continuous epidural pain block and IV-PCA are both effective Methods of postoperative pain control with lower incidence of side effects.

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Comparison of Epidural Droperidol and Metoclopramide for Prevention of Postoperative Nausea and Vomiting Associated with Epidural Morphine (술후 경막외 Morphine으로 인한 오심 및 구토에 대한 경막외 Droperidol과 Metoclopramide의 효과 비교)

  • Park, Jin-Woo;Lee, Sang-Hwa;Jung, Soon-Ho;Choe, Young-Kyun;Shin, Chee-Mahn;Park, Ju-Yuel;Kim, Young-Jae
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.86-90
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    • 1998
  • Background: There are no controlled studies assessing the effect of metoclopramide and droperidol administered epidurally for the prevention of nausea and vomiting associated with epidural morphine. This study was undertaken to compare the effectiveness of continuous epidural metoclopramide and droperidol in reducing nausea and vomiting associated with epidural morphine. Methods: Ninty patients undergoing elective gynecologic surgery were randomly assigned to one of three study groups; Group A(n=30) patients received continuous infusion of epidural morphine(6.0 mg/day) following a bolus loading dose of 3.0 mg; Group B(n=30), epidural mixture of morphine and droperidol(5.0 mg/day) following a bolus loading dose(morphine 3.0 mg, droperidol 1.5 mg); Group C, (n=30), epidural mixture of morphine and metoclopramide(20 mg/day) following a bolus loading dose(morphine 3.0 mg, metoclopramide 10 mg). For the 24 postoperative hours, the incidence of nausea and vomiting, degree of pain, level of sedation and other adverse effects were evaluated. Results: Incidence of nausea and vomiting, and number of patients who required antiemetic therapy were significantly less in Group B and C than in Group A(P<0.05). Patients in Group A and C were less sedated than those in Group B. Conclusions: We conclude metoclopramide is more effective than droperidol for postoperative nausea and vomiting due to its lower of sedative effect.

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Nefopam Reduces Dysesthesia after Percutaneous Endoscopic Lumbar Discectomy

  • Ok, Young Min;Cheon, Ji Hyun;Choi, Eun Ji;Chang, Eun Jung;Lee, Ho Myung;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.40-47
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    • 2016
  • Background: Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD). The recently discovered dual analgesic mechanisms of action, similar to those of antidepressants and anticonvulsants, enable nefopam (NFP) to treat neuropathic pain. This study was performed to determine whether NFP might reduce the neuropathic pain component of postoperative pain. Methods: Eighty patients, who underwent PELD due to herniated nucleus pulposus (HNP) at L4-L5, were randomly divided into two equal groups, one receiving NFP (with a mixture of morphine and ketorolac) and the other normal saline (NS) with the same mixture. The number of bolus infusions and the infused volume for 3 days were compared in both groups. The adverse reactions (ADRs) in both groups were recorded and compared. The neuropathic pain symptom inventory (NPSI) score was compared in both groups on postoperative days 1, 3, 7, 30, 60, and 90. Results: The mean attempted number of bolus infusions, and effective infused bolus volume for 3 days was lower in the NFP group for 3 days. The most commonly reported ADRs were nausea, dizziness, and somnolence, in order of frequency in the NFP group. The median NPSI score, and all 5 median sub-scores in the NFP group, were significantly lower than that of the NS group until postoperative day 30. Conclusions: NFP significantly reduced the neuropathic pain component, including paresthesia/dysesthesia until 1 month after PELD. The common ADRs were nausea, dizziness, somnolence, and ataxia.

Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy (부분 혀 절제술로 인해 연하 장애가 있는 환자에서 상악 구개 증대 총의치 제작 증례)

  • Kim, Hyung-Seok;Park, Ji-Young;Yim, Sun-Young;Heo, Yu-Ri;Son, Mee-Kyoung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.239-245
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    • 2018
  • If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

Measurement of the Rate of Protein Synthesis in Chickens by HPLC/MS

  • Seo, S.S.;Coon, C.
    • Korean Journal of Poultry Science
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    • v.31 no.3
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    • pp.137-143
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    • 2004
  • The fractional synthesis rates(FSR) were measured with 2l-wk and 3l-wk-old broiler breeder pullets and hens to investigate the effect of sexual maturity on FSR. The FSR were obtained from chicken tissues and blood samples using High-Performance Liquid Chromatography/Mass Spectrometry(HPLC/MS). A L-l-13C, 15N -leucine saline solution was infused by bolus injection as a tracer into broiler breeder pullets in the experiment. A rapid HPLC/MS method was developed to measure the isotopic enrichments of leucine in plasma, tissue samples, and eggs. The enrichments of stable isotope leucine incorporated into protein and the enrichments of the stable isotope free leucine were measured in liver, breast muscle and blood samples. Two sets of experiments were conducted. In experiment one, 2l-wk-old, sexually immature broiler breeder pullets were divided into groups of three and blood samples were collected at 20 or 30 min intervals until 1.5 h from initial injection. The pullets were sacrificed in groups of three at varying time intervals for 7 h after injection. The liver, breast muscle and blood samples were removed for analysis. The FSR were estimated to be 8.7l%/day for liver, 4.06%/day for breast muscle, and 5.08%/day for blood samples in 30 minutes after injection from the enrichment ratios. In experiment two, sexually matured 3l-wk-old broiler breeder hens were assorted into groups of three and blood samples were obtained at 20 or 30 min intervals for 2 h. The FSR for blood samples were determined. The broiler breeder hens were sacrificed in groups of three at various time intervals until 7 h after injection and liver, breast muscle and blood samples were removed for analysis. The FSR were calculated to be 5.96%/day for liver. Eggs were collected from five chickens daily for 10 days after large bolus injection. The average of total enrichments of stable isotope in egg albumin was increased by 0.064% at 4 days after injection and was back to normal in 7 days.

Comparison of sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam, xylazine-ketamine, and propofol in beagle dogs (비글견에서 tiletamine-zolazepam, xylazine-ketamine 및 propofol의 간헐적 일시 정맥주사에 의한 진정효과의 비교)

  • Lee, Soo-Han;Bae, Chun-Sik;Lee, Byeong-han;Chung, Byung-Hyun
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.263-271
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    • 2005
  • To compare the sedative effects using intermittent intravenous bolus injection with tiletamine-zolazepam (n = 5, TZ group), xylazine-ketamine (n = 5, XK group) and propofol (n = 5, PI group), we investigated the changes of hemodynamic (heart rate, arterial pressure), $SpO_2$, rectal temperature, respiratory rate and pain score during 60 minute sedation and 40 minute recovery period in beagle dogs. The value of rectal temperature was significantly higher in PI groups (p<0.05) during recovery period. The value of heart rate was significantly lower in XK group (p<0.05) during sedation. The changes of respiratory rate were similar tendency in all groups. The change of $SpO_2$ was stable during sedation and value was significantly higher in PI group (p<0.05) during recovery period. The value of systolic arterial pressure (SAP) was significantly lower in XK group (p<0.05) than PI group during sedation and recovery period. Low analgesic effect occurred in PI group. We concluded that intravenous anesthesia by intermittent bolus injection with propofol is useful in stabilizing rectal temperature, $SpO_2$ and hemodynamic during sedation and provide fast recovery, but have low analgesic effect.

Evaluation of Efficacy of the Patient-controlled Analgesia for Implant Surgery under General Anesthesia (전신마취 하 임플란트 시술을 받은 환자에서 자가통증조절법 치료의 효용성 평가)

  • Shin, Teo-Jeon;Seo, Kwang-Suk;Park, Yun-Ki;Lee, Jung-Hoo;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.2
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    • pp.98-103
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    • 2009
  • Background: Despite increasing popularity of dental implants, there is limited information on the pain experience associated with the surgical implant placement under general anesthesia. The aim of this study was to assess the characteristics of patient-reported pain and efficacy of patient controlled analgesia after implant surgery under general anesthesia. Methods: Total 39 patients who underwent implant surgery under general aensthesia were enrolled. In PCA group (n=30), patients received patient controlled analgesia (fentanyl 700 mg and ketorolac 150 mg) set to basal rate 1 ml/h, bolus 1 ml, and lockout interval 10 min. In control group (n=9), patients received ketorolac 30 mg intravenously when they feel painful. We evaluated pain intensity using VAS score at the end and after 12 hr of the operation and recorded the number of bolus injection as a surrogate of rescue therapy. We compared the VAS data, the frequency of complication between two groups. Results: The self reported pain was highest at 1 hous after surgery in both groups. However, the intensity was not severe (PCA group = 5.7, control group = 5.6), and decreased gradually thereafter. Total demand bolus number was less than 6 in nearly 65% patients. And there was no significant difference in the frequency of complications such as nausea, vomiting and dizziness between both groups. Conclusions: The Pain following the surgical placement of dental implants was generally mild and gradually decreased with time. There was no difference in complications between control group and PCA group.

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