• Title/Summary/Keyword: Discharge change

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Pressor Action of Physostigmine in the Rabbit (토끼에 있어서의 Physostigmine의 혈압상승작용)

  • Kim, Je-Bong
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.101-111
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    • 1990
  • The effect of physostigmine (PS), which has been shown to act on the muscarinic receptors in the brains of the rat, dog and cat, on the arterial blood pressure (BP) was investigated in urethane-anesthetized rabbits. Intravenous (iv) PS, $25{\sim}300\;{\mu}g/kg$, caused little change in BP. However, after treatment of rabbits with either of chlorisondamine (CS), hexamethonium, intracerebroventricular (icv) clonidine, icv xylazine and icy reserpine iv PS produced a pressor response. Spinalization of the rabbit also caused iv PS to increase BP. The pressor effect of iv PS in CS-treated rabbits was markedly reduced after prazosin or pirenzepine. Iv PS inhibited the pressor response to McN-A-343 in CS-treated and in spinal rabbits; alternately during the infusion of McN-A-343 iv PS failed to produce the pressor response. The pressor response to DMPP was not affected by iv PS. Icv PS, $12{\sim}200\;{\mu}g/kg$, produced a pressor response which was accentuated after CS-treatment. This pressor effect was inhibited, though not complete, by prazosin or by pirenzepine. A simultaneous treatment of rabbits with both $[Sar^{1},\;Ala^{8}]-angiotensin$ II, an angiotensin II antagonist, and prazosin or pirenzepine almost completely abolished the pressor effect of icv PS, whereas the angiotensin II antagonist did not enhance the inhibitory effect of pirenzepine and prazosin on the pressor response to iv PS . Icv pirenzepine blocked the pressor response to icv PS without affecting that to iv PS. The present results show that the pressor response to iv PS in CS-treated and in spinal rabbits arises from stimulation of the muscarinic receptors in the sympathetic ganglia, whereas the pressor response by icv PS via activation of the muscarinic receptors in the brain which causes an enhancement in the outflow of sympathetic discharge and angiotensin. The results also suggest that iv PS is unable to produce a pressor response in the rabbit unless the sensitivity of the gangionic muscarinic receptors is altered by ganglionic nicotinic blockade, by the decrease of central sympathetic outflow on the sympathetic ganglia or by spinalization.

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Numerical Hydrodynamic Modeling Incorporating the Flow through Permeable Sea-Wall (투수성 호안의 해수유통을 고려한 유동 수치모델링)

  • Bang, Ki-Young;Park, Sung Jin;Kim, Sun Ou;Cho, Chang Woo;Kim, Tae In;Song, Yong Sik;Woo, Seung-Buhm
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.25 no.2
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    • pp.63-75
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    • 2013
  • The Inner Port Phase 2 area of the Pyeongtaek-Dangjin Port is enclosed by a total of three permeable sea-walls, and the disposal site to the east of the Inner Port Phase 2 is also enclosed by two permeable sea-walls. The maximum tidal range measured in the Inner Port Phase 2 and in the disposal site in May 2010 is 4.70 and 2.32 m, respectively. It reaches up to 54 and 27%, respectively of 8.74 m measured simultaneously in the exterior. Regression formulas between the difference of hydraulic head and the rate of interior water volume change, are induced. A three-dimensional numerical hydrodynamic model for the Asan Bay is constructed incorporating a module to compute water discharge through the permeable sea-walls at each computation time step by employing the formulas. Hydrodynamics for the period from 13th to 27th May, 2010 is simulated by driving forces of real-time reconstructed tide with major five constituents($M_2$, $S_2$, $K_1$, $O_1$ and $N_2$) and freshwater discharges from Asan, Sapkyo, Namyang and Seokmoon Sea dikes. The skill scores of modeled mean high waters, mean sea levels and mean low waters are excellent to be 96 to 100% in the interior of permeable sea-walls. Compared with the results of simulation to obstruct the flow through the permeable sea-walls, the maximum current speed increases by 0.05 to 0.10 m/s along the main channel and by 0.1 to 0.2 m/s locally in the exterior of the Outer Sea-wall of Inner Port. The maximum bottom shear stress is also intensified by 0.1 to 0.4 $N/m^2$ in the main channel and by more than 0.4 $N/m^2$ locally around the arched Outer Sea-wall. The module developed to compute the flow through impermeable seawalls can be practically applied to simulate and predict the advection and dispersion of materials, the erosion or deposion of sediments, and the local scouring around coastal structures where large-scale permeable sea-walls are maintained.

Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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Understanding Chemical Characteristics of Seepage Water and Groundwater in a Coastal LPG Storage Cavern using Factor and Cluster Analyses (인자 및 군집분석을 통한 해안 LPG공동 유출수 및 지하수 수질특성의 이해)

  • Jo, Yun-Ju;Lee, Jin-Yong
    • Economic and Environmental Geology
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    • v.42 no.6
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    • pp.599-608
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    • 2009
  • This study was conducted to examine chemical characteristics and correlations among seepage water, subsurface waters and inland groundwater in and around a coastal underground LPG cavern using factor and cluster analyses. The study area is located in western coast of Incheon metropolitan city and is about 8 km off the coast. The LPG cavern storing propane and butane was built beneath artificially reclaimed island. Mean bathymetry is 8.5 m and maximum sea level change is 10 m. Water sampling was conducted in May and August, 2006 from 22 sampling points. Correlation analysis showed strong correlations among $Fe^{2+}$ and $Mn^{2+}$ (r=0.83~0.99), and Na and Cl (r=0.70~0.97), which indicated reductive dissolution of iron and manganese bearing minerals and seawater ingression effect, respectively. According to factor analysis, Factors 1 (May) and I (August) showed high loadings for parameters representing seawater ingression into the cavern and effect of submarine groundwater discharge, respectively while Factors 2 and IV showed high loadings for those representing oxidation condition (DO and ORP). Factors 4 and II have large positive loadings for $Fe^{2+}$ and $Mn^{2+}$. The increase of $Fe^{2+}$ and $Mn^{2+}$ was related to decomposition of organic matter and subsequent their dissolution under reduced condition. Cluster analysis showed the resulting 6 groups for May and 5 groups for August, which mainly included groups of inland groundwater, cavern seepage water, sea water and subsurface water in the LPG storage cavern. Subsurface water (Group 2 and Group III) around the underground storage cavern showed high EC and major ions contents, which represents the seawater effect. Cavern seepage water (Group 5 and Group II) showed a reduced condition (low DO and negative ORP) and higher levels of $Fe^{2+}$ and $Mn^{2+}$.

Evaluation of the Water Quality Changes in Agricultural Reservoir Covered with Floating Photovoltaic Solar-Tracking Systems (수상 회전식 태양광 발전시설 설치에 따른 농업용 저수지의 수질변화 평가)

  • Lee, Inju;Joo, Jin Chul;Lee, Chang Sin;Kim, Ga Yeong;Woo, Do Young;Kim, Jae Hak
    • Journal of Korean Society of Environmental Engineers
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    • v.39 no.5
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    • pp.255-264
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    • 2017
  • To evaluate the water quality changes in agricultural reservoir covered with floating photovoltaic solar-tracking systems, the water quality variations with time and depth were monitored on both six sites for light blocking zones and four sites for light penetration zones after the installation of floating photovoltaic solar-tracking systems in Geumgwang reservoir at Anseong-si, Kyeonggi province. For one year with 16 monitoring events, water quality parameters [i.e., water temperature, pH, dissolved oxygen (DO), chlorophyll-a (Chl-a), and blue-green algae (BGA)] were monitored at depths of 0.3 m, 1 m, 3 m, and 5 m, while chemical oxygen demand (COD), total nitrogen (TN), and total phosphorus (TP) were monitored at depths of 0.3 m. Statistically, the difference in all water quality parameters was not significantly different (p > 0.05) at the level of significance of 0.05. Based on these results, the water quality data from light blocking zones (site 1~6) and light penetration zones (site 7~10) were clustered, and were compared with time and depth. As a result, the difference in water temperature, pH, DO, COD, TN, TP, Chl-a, and BGA between light blocking zones and light penetration zones was not significant (p > 0.05) with different time and depth. For Chl-a and BGA, some data from light blocking zones greater than light penetration zones were temporary observed due to the severe drought, low water storage rate, and over growth of periphyton. However, this temporal phenomenon did not impact the water quality. Considering the small water surface area (${\leq}0.5%$) covered by floating photovoltaic solar-tracking systems, the mixing effect of whole Geumgwang reservoir caused by Ekman current and continuous discharge were more dominant than the effect of reduced solar irradiance. Further study is warranted to monitor the changes in water quality and aquatic ecosystems with greater water surface area covered by floating photovoltaic solar-tracking systems for a long time.

Structural Safety Assessment of a Sunken Ship Considering Hull Corrosion and Damaged Members - Focus on the Sunken Ship 'No. 7 HaeSung' - (선체 부식 및 손상 부재를 고려한 침몰선박의 구조 안전성 평가에 관한 연구 - 제7 해성호를 중심으로 -)

  • Lee, Seung Hyun;Kim, Won Don;Suh, Jae-Joon
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.19 no.4
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    • pp.332-340
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    • 2016
  • Sunken ships cause damage to the environment due to the dispersal of fuel oil and harmful cargo goods in the hull. Since the sunken ship is mostly flooded by the seabed, it tends to be in a relatively stable condition. However, the heavy body, together with the load of remaining goods in the cargo hold, the constant contact with the seabed, and ocean currents and tidal waves, can affect dispersal of residual fuel oils out of the sunken ship. Corrosion of the sunken ship starts upon sinking, decreasing the thickness of the hull structure and sub-materials. Therefore, it is necessary to assess the structural stability against the potential breakdown of the sunken ship. Whilst evaluating the danger of the sunken ship, this result should be reflected in 'the possible discharge'. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship. The structural stability assessment to estimate the collapsibility of the hull was structure targeted at the sunken ship 'No. 7 HaeSung', which was classified as the prime example for the intensive management of sunken ships. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship and to propose a method to conduct a structural safety assessment that estimates the collapsibility of the hull by targeting the sunken ship 'No. 7 HaeSung',which was classified as the prime example for the intensive management of sunken ships. The collapsibility of the hull structure was estimated Based on the damage size of the hull structure, and the corrosion rate of the hull structure and sub-materials due to the seawater after sinking. It was confirmed that there was a low possibility of the total destruction of the hull structure at the current time. However, there is a high possibility in the potential failure of the hull structure due to increased rate of corrosion thereafter. Therefore, we believe continuous study on influence of corrosion and marine environment change to sunken ship's structural safety is necessary.

Sleep Quality and Sleep Patterns of Patients Treated by the Hemopoietic Stem Cell Transplantation (조혈모세포 이식환자의 입원 후 수면의 질과 수면양상의 변화)

  • Choi, So-Eun;Park, Hae-Ryung;Park, Ho-Ran
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.37-44
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    • 2005
  • Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

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Analysis of Fluidization in a Fluidized Bed External Heat Exchanger using Barracuda Simulation (바라쿠다 시뮬레이션을 이용한 유동층 외부 열교환기의 유동해석)

  • Lee, Jongmin;Kim, Dongwon;Park, Kyoungil;Lee, Gyuhwa
    • Korean Chemical Engineering Research
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    • v.58 no.4
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    • pp.642-650
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    • 2020
  • In general, the circulation path of the fluidized particles in a CFB (Circulating Fluidized Bed) boiler is such that the particles entrained from a combustor are collected by a cyclone and recirculated to the combustor via a sealpot which is one of non-mechanical valves. However, when a fluidized bed heat exchanger (FBHE) is installed to additionally absorb heat from the fluidized particles, some particles in the sealpot pass through the FBHE and then flow into the combustor. At this time, in the FBHE operated in the bubbling fluidization regime, if the heat flow is not evenly distributed by poor mixing of the hot particles (800~950 ℃) flowing in from the sealpot, the heat exchanger tubes would be locally heated and then damaged, and the agglomeration of particles could also occur by formation of hot spot. This may affect the stable operation of the circulating fluidized bed. In this study, the unevenness of heat flow arising from structural problems of the FBHE of the domestic D-CFB boiler was found through the operating data analysis and the CPFD (Computational Particle Fluid Dynamics) simulation using Barracuda VR. Actually, the temperature of the heat exchanger tubes in the FBHE showed the closest correlation with the change in particle temperature of the sealpot. It was also found that the non-uniformity of the heat flow was caused by channeling of hot particles flowing in from the sealpot. However, it was difficult to eliminate the non-uniformity even though the fluidizing velocity of the FBHE was increased enough to fluidize hot particles vigorously. When the premixing zone for hot particles flowing in from the sealpot is installed and when the structure is changed through the symmetrization of the FBHE discharge line for particles reflowing into the combustor, the particle mixing and the uniformity of heat flow were found to be increased considerably. Therefore, it could be suggested that the structural modification of the FBHE, related to premixing and symmetric flow of hot particles, is an alternative to reduce the non-uniformity of the heat flow and to minimize the poor particle mixing.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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