• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.56-60
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• 2011

Purpose: The optimal dose of oximes for use in the treatment of organophosphorus pesticide poisoning has not been conclusively established. In this retrospective study, we assessed the effectiveness of the use of high-dose pralidoxime infusion in treating organophosphorus pesticide poisoning. Methods: From January 1998 to December 2009, 71 patients visited the hospital Emergency Department (ED) as a result of organophosphate pesticide intoxication. All of these patients received an initial bolus of 2 g of pralidoxime as the first step of treatment. Patients who then received continuous infusion of pralidoxime at a dose of 500 mg/hr were entered into study group 1 (low dose), and those treated by continuous infusion of pralidoxime at a dose of 1000 mg/hr were entered into study group 2 (high-dose). Plasma cholinesterase activities for each patient were evaluated at ED arrival and re-evaluated 24 hours after pralidoxime infusion. The effectiveness of the two treatment modalities was gauged by comparing the required duration of mechanical ventilation, time spent in the intensive care unit (ICU) and total time spent in the hospital. Results: The mean duration of mechanical ventilation was $9.98{\pm}6.47$ days for group 1 and $4.39{\pm}6.44$ days for group 2. The respective mean duration of time spent in ICU and the total number of days in the hospital were $16.38{\pm}18.84$ days and $21.87{\pm}20.16$ days for group 1, and $7.83{\pm}9.99$ days and $11.71{\pm}13.53$ days for group 2. Highdose pralidoxime treatment was associated with shorter required durations for mechanical ventilation, ICU and hospital stay. In addition, plasma cholinesterase reactivation rates were higher for those patients receiving high-dose pralidoxime treatment. Conclusion: The results suggest that high-dose pralidoxime treatment has greater efficacy for patients suffering from organophosphorus pesticide poisoning.

• Korean journal of applied entomology
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• v.40 no.2
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• pp.97-103
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• 2001

The rate of gerbera (Gerbera jamesonii Bolus.) leaf damaged by Liriomyza trifolii larvae was lower than that by adults. The adults began to be attracted to yellow sticky trap immediately after transplanting and increased gradually up to early August followed by low population density from middle to late August. In the second year, adults began to be attracted from late April after transplanting and increased abrubtly from middle May and the high density was maintained till early truly. The density decreased, however, from middle July, and then followed by the high density again early September and late October The seasonal fluctuations of larva and pupa were similar to that of adults and the peaks of pupa occurred one week later than that of larvae. Larva infected by parasitoid were observed 4 weeks after transplanting. Parasitism was 65% in average from early July to late August but decreased to 50% from early September. Number of trapped adults was the highest in the yellow sticky trap among the five different colour raps. Catches at 30~60 cm above soil surface were significantly greater than that at 90 cm.

• Korean Chemical Engineering Research
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• v.43 no.5
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• pp.609-615
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• 2005

$TiO_2$ particles, 30-300 nm in diameter, were prepared by thermal decomposition of titanium tetraisopropoxide (TTIP) using an aerosol microreactor, by which about $1{\mu}l$ of the liquid precursor is injected into an evaporator, 1 cc in volume, and vaporized precursor is then transported by nitrogen as a bolus to a tubular reactor 4 mm in diameter and 35 cm in length. Investigated were the effects of the reactor temperature and the concentration of TTIP vapor on the morphology, particle size distribution and crystalline structure of produced $TiO_2$ particles. With TTIP vapor concentration kept constant at 1 mol%, the reactor temperature was varied from 300 to 500 and $700^{\circ}C$. The primary particle size decreased with increasing the temperature, and the size distributions were mono-modal at 300 and $500^{\circ}C$, but bi-modal at $700^{\circ}C$. The TTIP vapor concentration was increased from 1 to 3.5 and 7 mol%, holding the reactor temperature at $700^{\circ}C$. The bi-modal distribution seen at the concentration of 1 mol% disappeared and the number of particles composing an agglomerate increased at the higher concentrations. These effects of the reactor temperature and the precursor concentration were discussed in comparison with experimental results reported earlier.

• Journal of the Korean Dietetic Association
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• v.7 no.3
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• pp.217-226
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• 2001

It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.30-35
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• 2002

Objective: To determine the effectiveness and toxicity of chemoradiation therapy in nasopharyngeal carcinoma by comparing with radiation therapy alone. Materials and Methods: Between October 1989 and July 2000, One hundred eleven patients with newly diagnosed and histologically proven nasopharyngeal carcinoma treated in Department of Radiation Oncology, Asan Medical Center were retrospectively reviewed. Forty-five patients were treated with radiation therapy alone (Group I) and 66 patients were treated with radiation therapy and concurrent cisplatin (Group II). Cisplatin was administered once a week, on the first day of each successive week of treatment, starting on day 1 of radiation therapy and given as a intravenous bolus at a dose of $20mg/m^2$ of body-surface area. Radiation therapy was given in doses of 1.8Gy, once a day, 5 days per week with 4MV or 6 MV photons. Initial field was received a total of 60Gy and a primary tumor and enlarged lymph nodes were boosted with an high dose intracavitory brachytherapy and 3D conformal therapy. Results: The complete response rate was 86.7% in Group I, and was 90.9% in Group II. The 5 year overall survival rate for Group I was 60% and for Group II was 45% (p=0.2520). The 5 year disease free survival rate was 52% versus 45%, respectively (p=0.7507). The median follow up was 44 months versus 34 months, respectively. Conclusion: Analysis of the III patients showed no significant difference in disease free survival and overall survival in two treatment group. This retrospective analysis did not demonstrate benefit with concurrent chemoradiation using cisplatin at a dose of $20mg/m^2$ of body-surface area in treatment result than radiation alone.

• Asian-Australasian Journal of Animal Sciences
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• v.25 no.4
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• pp.502-514
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• 2012

When ruminants consume dry forage, they also drink large volumes of water. The objective of this study was to clarify which factor produced when feed boluses enter the rumen is mainly responsible for the marked increase in water intake in the second hour of the 2 h feeding period in large-type goats fed on dry forage for 2 h twice daily. Six large-type male esophageal- and ruminal-fistulated goats (crossbred Japanese Saanen/Nubian, aged 2 to 6 years, weighing $85.1{\pm}4.89kg$) were used in two experiments. In experiment 1, the water deprivation (WD) control and the water availability (WA) treatment were conducted to compare changes in water intake during and after dry forage feeding. In experiment 2, a normal feeding conditions (NFC) control and a feed bolus removal (FBR) treatment were carried out to investigate whether decrease in circulating plasma volume or increase in plasma osmolality is mainly responsible for the marked increase in water intake in the second hour of the 2 h feeding period. The results of experiment 1 showed that in the WA treatment, small amounts of water were consumed during the first hour of feeding while the majority of water intake was observed during the second hour of the 2 h feeding period. Therefore, the amounts of water consumed in the second hour of the 2 h feeding period accounted for 82.8% of the total water intake. The results of experiment 2 indicated that in comparison with the NFC control, decrease in plasma volume in the FBR treatment, which was indicated by increase in hematocrit and plasma total protein concentrations, was higher (p<0.05) in the second hour of the 2 h feeding period. However, plasma osmolality in the FBR treatment was lower (p<0.05) than compared to the NFC control from 30 min after the start of feeding. Therefore, thirst level in the FBR treatment was 82.7% less (p<0.01) compared with that in the NFC control upon conclusion of the 30 min drinking period. The results of the study indicate that the increased plasma osmolality in the second hour of the 2 h feeding period is the main physiological stimulating factor of water intake during and after dry forage feeding in large-type goats.

• Biomedical Science Letters
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• v.3 no.2
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• pp.83-88
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• 1997

In septic patients, disseminated intravascula. coagulation (DIC) occurs frequently and is a pathologic condition associated with a variety of critical illness. DIC may complicate the already complex clinical situations and contribute to the high mortality. Nevertheless, its pathogenic mechanisms are not completely elucidated. Present study was prospectively designed to understand the pathogenetic mechanisms involved in the development of DIC. 15 rats were subjected to study and according to the aim, they were divided into three groups： group I, control (not treated-endotoxin, n=5)； group II (12 hours after endotoxin injection, n=5)； group III (24 hours after endotoxin injection, n=5). Experimental DIC was induced in rats by a bolus injection of endotoxin (1mg/kg, E. coli serotype 055:B5). Blood was collected by direct puncture of the heart. Platelet count, fibrinogen and plasminogen concentration, antithrombin III, D-dimer and complement components (C3 and C4) were measured in all subjects. In group II and III, there were apparent signs of DIC, including thrombocytopenia, decreased fibrinogen (but increase in group III), reduced C3 and antithrombin III, and elevated D-dimer. These data indicated that endotoxin might induce the activation of several pathways such as coagulation, fibrinolytic and complement cascade, causing DIC and subsequent multiple organ failures. Ultimately, the increased knowledge of the various pathogenetic mechanisms of coagulation activation and fibrinolysis in endotoxin-induced DIC may have prophylactic or therapeutic implications.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1121-1126
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• 2013

Background: Palliative chemotherapy with cisplatin/5-fluorouracil (5FU) is the commonest regimen employed for metastatic and recurrent head and neck squamous cell carcinoma (SCCHN) and nasopharyngeal carcinoma (NPC). However, this regimen is cumbersome requiring 5 days of admission to hospital. Carboplatin/5FU may be an alternative regimen without compromising survival and response rates. This study aimed to compare the efficacy and toxicity of carboplatin/5FU regimen with the cisplatin/5FU regimen. Materials and Methods: This retrospective study looked at patients who had palliative chemotherapy with either cisplatin/5FU or carboplatin/5FU for metastatic and recurrent SCCHN and NPC. It included patients who were treated at UKMMC from $1^{st}$ January 2004 to $31^{st}$ December 2009 with either palliative IV cispaltin 75 $mg/m^2$ D1 only plus IV 5FU 750 $mg/m^2$ D1-5 infusion or IV Carboplatin AUC 5 D1 only plus IV 5FU 500 $mg/m^2$ D1-2 infusion plus IV 5FU 500 $mg/m^2$ D1-2 bolus. The specific objectives were to determine the efficacy of palliative chemotherapy in terms of overall response rate (ORR), median progression free survival (PFS) and median overall survival (OS) and to evaluate the toxicities of both regimens. Results: A total of 41 patients were eligible for this study. There were 17 in the cisplatin/5FU arm and 24 in the carboplatin/5FU arm. The ORR was 17.7 % for cisplatin/5FU arm and 37.5 % for carboplatin/5FU arm (p-value=0.304). The median PFS was 7 months for cisplatin/5FU and 9 months for carboplatin/5FU (p-value=1.015). The median OS was 10 months for cisplatin/5FU arm and 12 months for carboplatin/5FU arm (p-value=0.110). There were 6 treatment-related deaths (6/41=14.6%), four in the carboplatin/5FU arm (4/24=16.7%) and 2 in the cisplatin/5FU arm (2/17=11.8%). Grade 3 and 4 hematologic toxicity was also more common with carboplatin/5FU group, this difference being predominantly due to grade 3-4 granulocytopenia (41.6% vs. 0), grade 3-4 anemia (37.5% vs. 0) and grade 3-4 thrombocytopenia (16.6% vs. 0). Conclusions: Carboplatin/5FU is not inferior to cisplatin/5FU with regard to its efficacy. However, there was a high rate of treatment-related deaths with both regimens. A better alternative needs to be considered.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.304-314
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• 2001

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

• Journal of Nutrition and Health
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• v.28 no.4
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• pp.345-354
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• 1995

Blenderized diets are not recommended because of difficulties in providing a constant content of nutrients, phoblems with viscosity and osmolarity, time needed for preparation, and increased risk of contamination. To determine the possibility of substituting commercial formulas for blenderized diets, 27 unconscious patients were randomized into two different groups : blenderized diet group(n=11) and commercial formula group(n=16). Blenderized diets were composed of food sources such as rice, milk, egg, juices and others, and its energy percentage of protein, fat, and carbohydrate was 15%, 30%, and 55%, respetively. Commercial enteral formulas provided 1 kcal/ml and the energy percentage of protein, fat and carbohydrate was 25%, 20% and 55% in greenbia(G) and 20%, 20%, and 60% in Greenbia-DM(GD), repectively. In commercial formula group, five patients with diarrhea, constipation, and high blood glucose level received GD, and the other eleven patients received G. All patients received their lipuid diet for 4 weeks through 16 French rubber nasogastric tube by bolus feeding 6 times daily. The patients in commercial formula group had a similar mean daily calorie intake to the patient in blenderized diet group, 32-34kcal/kg/d and 30-35kcal/kg/d, respectively. Patients given commercial formula gained an averge of 1.7kg in weight but those given blenderized diet lost an average of 2.6kg. There was a trend toward an increase in percent ideal body weight in commercial formula group(94$\pm$5 vs 99$\pm$6%). However, blenderized diet group showed a trend toward a decrease in percent ideal body weight(106$\pm$5 vs $101\pm$6%). The initial levels of total lymphocyte counts, serum albumin and tranferrin were below the normal rante, The mean daily protein intake was significanlty higher for commercial formula group(2.0-2.1g/kg/d) than for blenderized diet group(1.1-1.3g/kg/d). Patient fed cormmercial formula for 4 weeks showed a trend toward an increase in serum albumin(8.1%) and a significant increase in serum transferrin(32.1%) without increasing the levels of blood glucose. GOT, GPT, blood urea nitrogen and serum creatinine. In the blenderized diet group, however, no significant improvement were obseved in the concentration of serum albumin and transferin, compared to initial value. There was a trend toward a decrese in the level of hemoglobin and hematocrit in blenderized deit group but no significnat change in commercial formulas goups. All patients tolerated both diets well and no significant complications were encountered. The results indicate that the commercial enteral formulas tested in this study can be an effective substitution for blenderized diet in unconscious tube-fed patients.