• Korean Journal of Radiology
• /
• v.21 no.11
• /
• pp.1230-1238
• /
• 2020

Objective: We aimed to assess the effects of remote ischemic pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy (CIN) after an intravenous (IV) or intra-arterial injection of contrast medium (CM) in patient and control groups. Materials and Methods: This prospective, randomized, single-blinded, controlled trial included 26 patients who were hospitalized for the evaluation of the feasibility of transcatheter aortic valve implantation and underwent investigations including contrast-enhanced computed tomography (CT), with Mehran risk scores greater than or equal to six. All the patients underwent four cycles of five minute-blood pressure cuff inflation followed by five minutes of total deflation. In the RIPC group (n = 13), the cuff was inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in the control group (n = 13), it was inflated to 10 mm Hg below the patient's SBP. The primary endpoint was the occurrence of CIN. Additionally, variation in the serum levels of cystatin C was assessed. Results: One case of CIN was observed in the control group, whereas no cases were detected in the RIPC group (p = 0.48, analysis of 25 patients). Mean creatinine values at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 88 ± 32 μmol/L, 91 ± 28 μmol/L and 82 ± 29 μmol/L, respectively (p = 0.73) in the RIPC group, whereas in the control group, they were 100 ± 36 μmol/L, 110 ± 36 μmol/L, and 105 ± 34 μmol/L, respectively (p = 0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18] mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p = 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13 [1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in the control group. Conclusion: The risk of CIN after an IV injection of CM is very low in patients with Mehran risk score greater than or equal to six and even in the patients who are unable to receive preventive hyperhydration. Hence, the Mehran risk score may not be an appropriate method for the estimation of the risk of CIN after IV CM injection.

• Transactions of the Korean Society of Mechanical Engineers B
• /
• v.36 no.2
• /
• pp.145-151
• /
• 2012

Evaluation of the heart work is starting to emerge as a new diagnostic tool for arterial diseases. The aim of this study is to develop a mathematical model for the estimation of heart work utilizing the pulse waves between two points of a vessel. In order to calculate heart work, medical data such as blood pressure waveforms (which are measured using a cuff) are utilized. The heart work is calculated by employing the modified Windkessel model together with the viscosity models of Casson or Herschel-Bulkely (H-B). The results indicate that the compliance values at the proximal and distal locations differ for the Casson and H-B models.

• Biomolecules & Therapeutics
• /
• v.8 no.1
• /
• pp.93-98
• /
• 2000

This study has been carried out to investigate general pharmacological action of bamboo salt (jukyom) in terms of effects on central nervous system and cardiovascular system in experimental animals. After bamboo salt, crude salt or reagent-grade NaCl were orally administered into male ICR mice with dose of 2.0 g/kg, general behavioural syndromes such as body weight and locomotor activity, spontaneous motor activity, pento-barbital-induced sleeping time, muscle incoordination, electroshock-induced convulsion, body temperature and writhing response caused by 0.6% acetic acid solution were observed. Bamboo salt had no influences in these indices for examinition of effect on central nervous system. Additionally, conscious male Sprague Dawley rats fastened overnight won ere treated with bamboo salt, crude salt or reagent-grade NaCl (2.0 g/kg, p.o.) to examine the effect of these salts cardiovascular system. Systolic, median and diastolic food pressure and heart rate were dertemined using tail cuff indirect method. Treatment with Hydralazine (50 mg/kg, p.o) as a positive control produced the decreases in systolic, median and diastolic blood treasure and an increase in heart rate. whereas no changes were observed in bamboo salt, crude salt and reagent-grade NaCl treated groups. These results strongly suggest that bamboo salt may have no effects on general pharmacology of central nervous systems and cardio-vascular systems.

• Journal of Korean Critical Care Nursing
• /
• v.3 no.1
• /
• pp.53-65
• /
• 2010

Purpose: The purpose of this study was to identify the intensity and types of discomfort caused by an endotracheal tube in patients during ventilator therapy after cardiac surgery, and to analyze the differences in the intensity and types of discomfort by sociodemographic and clinical characteristics and characteristics related to endotracheal tubes. Methods: The intensity of discomfort was measured using an 11-point numeric rating scale and the types of discomfort were measured using a 4-point numeric rating scale. Sociodemographic and clinical characteristics and characteristics related to endotracheal tube were collected by observation and the electronic medical chart using a structured questionnaire. Results: The mean intensity of discomfort in patients due to endotracheal tubes was 6,91 points, 84% of patients reported discomfort over 5 points, The most severe discomfort was pain during endotracheal suctioning, and dry mouth and breathing difficulties were also found to induce discomfort. Patients who had more severe surgical site pain, longer duration of intubation and higher cuff pressure demonstrated more severe discomfort due to the endotracheal tube. Conclusion: These results can be used as basic data for developing nursing intervention to relieve the discomfort caused by endotracheal tubes in patients during ventilator therapy.

• Journal of Korean Critical Care Nursing
• /
• v.2 no.2
• /
• pp.42-55
• /
• 2009

Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

• Korean Journal of Bronchoesophagology
• /
• v.8 no.1
• /
• pp.61-65
• /
• 2002

Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

• Journal of Korean Critical Care Nursing
• /
• v.10 no.2
• /
• pp.14-23
• /
• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.

• Journal of Chest Surgery
• /
• v.30 no.6
• /
• pp.636-640
• /
• 1997

The common cause of tracheoesophageal fistula(T-I fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-I fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed ope ative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.31 no.3
• /
• pp.194-201
• /
• 2021

Objectives: The purpose of this study was to identify the distribution of diagnostic disease among applicants for shoulder musculoskeletal disease. Methods: In 2020, 47 diagnostic disease applicants were investigated for sociodemographic, health, work, job, and diagnostic disease characteristics. The data were corrected through on-site visits and analyzed using descriptive statistics with SPSS WIN23.0. Results: Most of the applicants were male and elderly. They had high blood pressure(38.3%) and diabetes (21.3%), and the drinking rate and smoking rate were also high. The most common type of employment was daily workers, and it was confirmed that the working condition was poor due to excessive working hours and short rest times. Most of the applicants for shoulder diagnostic diseases were in the construction industry, and the most common diagnostic disease was a rotator cuff tear. Conclusions: It is necessary to develop a musculoskeletal disease prevention program suitable for construction workers to reduce their work-related disease. When establishing a program, business type, task, and diagnostic disease must be considered.

• Physical Therapy Korea
• /
• v.24 no.4
• /
• pp.77-83
• /
• 2017

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. Although the side-lying wiper exercise (SWE) is the most effective shoulder external rotation exercise to maximize infraspinatus activity, the effect of adduction force on the infraspinatus and posterior deltoid has not been demonstrated. Objects: This study was conducted to investigate whether horizontal adduction force increases infraspinatus activity and decreases posterior deltoid activity. Methods: Twenty-eight healthy subjects (male: 21, female: 7; $age=23.5{\pm}1.8years$; $height=170.1{\pm}7.4cm$; $weight=69.4{\pm}9.6kg$) were recruited. Subjects were asked to perform the SWE under two conditions: (1) general SWE and (2) SWE with adduction force using pressure biofeedback. Surface electromyography (EMG) signals of the infraspinatus and posterior deltoid were recorded during SWE. Paired t-tests were used to compare the EMG activity of the infraspinatus and posterior deltoid between the two conditions. Results: Posterior deltoid muscle activity was significantly decreased following SWE with adduction force ($7.53{\pm}4.52%$) relative to general SWE ($11.68{\pm}8.42%$) (p<.05). However, there was no significant difference in the infraspinatus muscle activity between the SWE with adduction force ($28.33{\pm}12.16%$) and the general SWE ($26.54{\pm}13.69%$) (p>.05). Conclusion: Horizontal adduction force while performing SWE is effective at decreasing posterior deltoid activity.