• Title/Summary/Keyword: Fluid injection

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Detection of TNF-alpha in Serum as the Effect of Corticosteroid to the Myocardial Protection in Cardiopulmonary Bypass (체외순환시 스테로이드의 심근보호효과에 관한 혈청내 TNF-alpha 측정의 의의)

  • 최영호;김욱진;김태식;조원민;김학제
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.502-508
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    • 1998
  • Proinflammatory cytokines such as tumor necrosis factor-$\alpha$(TNF-$\alpha$) have been implicated in myocardial and organ dysfunction associated with postperfusion syndrome. We tested the hypothesis that cytokine productions are depressed by preoperative cortiosteroid injection for cardiopulmonary bypass(CPB) and the postoperative courses will be better than without steriod pretreated cases. Cardiac surgery was performed in randomized blind fashion for 20 patients from June 1996 to September 1996. In the steroid group(n=10), corticosteroid(dexamethasone 1 mg/kg) was injected 1 hour before anesthetic induction, but in the control group(n=10), nothing was injected. Each of groups were sampled 11 times as scheduled for TNF-$\alpha$ bioassays. We have checked EKG, cardiac enzymes(CPK, LDH with isoenzyme), WBC count preoperative day, one day and three days after operation. Viatal signs were continuously monitored for three postoperaive days. In the postoperative period three patients in the control group had elevated body temperature and four patients had hypotension that required considerable intravenous fluid administration. But steroid injected patients showed normal body temperture and acceptable blood pressures without supportive treatment. CPK enzymes rose in control group higher than steroid group at postoperative 1st and 3rd day(CPK; 1122$\pm$465 vs 567$\pm$271, 864$\pm$42 vs 325$\pm$87), and CPK-MB enzymes rose in control group higher than steroid group at postoperative 1st day(106.4$\pm$115.1 vs 29.5$\pm$22.4)(P=0.02). Arterial tumor necrosis factor-$\alpha$ rose during cardiopulmonary bypass, peaking at 5 minutes before the end of aortic cross clamping(ACC-5min) in steroid group(11.9$\pm$4.7 pg/ml), and 5 minutes before the end of cardiopulmonary bypass(CPB-5min) in control group(22.3$\pm$6.8 pg/ml). The steroid pretreated patients had a shorter period of time in respirator suport time, ICU stay day, hospital admission day. We conclude that corticosteroid suppress cytokine production during and after cardiopulmonary bypass, and may improve the postoperative course through inhibition of reperfusion injury such as myocardial stunning and hemodynamic instability.

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Study on Image Quality Assessment in Whole Body Bone Scan (전신 뼈검사에서의 영상 평가 연구)

  • Kwon, Oh Jun;Hur, Jae;Lee, Han Wool;Kim, Joo Yeon;Park, Min Soo;Roo, Dong Ook;Kang, Chun Goo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.30-36
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    • 2015
  • Purpose Whole body bone scan, which makes up a largest percentage of nuclear medicine tests, has high sensitivity and resolution about bone lesion like osteomyelitis, fracture and the early detection of primary cancer. However, any standard for valuation has not yet been created except minimum factor. Therefore, in this study, we will analysis the method which show a quantitative evaluation index in whole body bone scan. Materials and Methods This study is conducted among 30 call patients, who visited the hospital from April to September 2014 with no special point of view about bone lesion, using GE INFINIA equipment. Enumerated data is measured mainly with patient's whole body count and lumbar vertabrae, and the things which include CNR (Contrast to Noise ratio), SNR (Signal to Noise ratio) are calculated according to the mean value signal and standard deviation of each lumbar vertabrae. In addition, the numerical value with the abdominal thickness is compared to each value by the change of scan speed and tissue equivalent material throughout the phantom examination, and compared with 1hours deleyed value. Completely, on the scale of ten, 2 reading doctors and 5 skilled radiologists with 5-years experience analysis the correlation between visual analysis with blind test and quantitative calculation. Results The whole body count and interest region count of patients have no significant correlation with visual analysis value throughout the blind test(P<0.05). There is definite correlation among CNR and SNR. In phantom examination, Value of the change was caused by the thickness of the abdomen and the scan speed. And The poor value of the image in the subject as a delay test patient could be confirmed that the increase tendency. Conclusion Now, a standard for valuation has not been created in whole body bone scan except minimum factor. In this study, we can verify the significant correlation with blind test using CNR and SNR and also assure that the scan speed is a important factor to influence the imagine quality from the value. It is possible to be some limit depending on the physiology function and fluid intake of patient even if we progress the evaluation in same condition include same injection amount, same scan speed and so on. However, that we prove the significant evaluation index by presenting quantitative calculation objectively could be considered academic value.

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Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2015 (설비공학회 분야의 최근 연구 동향 : 2015년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.28 no.6
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    • pp.256-268
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    • 2016
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2015. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering were carried out in the areas of flow, heat and mass transfer, cooling and heating, and air-conditioning, the renewable energy system and the flow inside building rooms. Research issues dealing with air-conditioning machines and fire and exhausting smoke were reduced. CFD seems to be spreading to more research areas. (2) Research works on heat transfer area were carried out in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the economic analysis of GHG emission, micro channel heat exchanger, effect of rib angle on thermal performance, the airside performance of fin-and-tube heat exchangers, theoretical analysis of a rotary heat exchanger, heat exchanger in a cryogenic environment, the performance of a cross-flow-type, indirect evaporative cooler made of paper/plastic film. In the area of pool boiling and condensing, the bubble jet loop heat pipe was studied. In the area of industrial heat exchangers, researches were performed on fin-tube heat exchanger, KSTAR PFC and vacuum vessel at baking phase, the performance of small-sized dehumidification rotor, design of gas-injection port of an asymmetric scroll compressor, effect of slot discharge-angle change on exhaust efficiency of range hood system with air curtain. (3) In the field of refrigeration, various studies were carried in the categories of refrigeration cycle, alternative refrigeration/energy system, system control. In the refrigeration cycle category, a cold-climate heat pump system, $CO_2$ cascade systems, ejector cycles and a PCM-based continuous heating system were investigated. In the alternative refrigeration/energy system category, a polymer adsorption heat pump, an alcohol absorption heat pump and a desiccant-based hybrid refrigeration system were investigated. In the system control category, turbo-refrigerator capacity controls and an absorption chiller fault diagnostics were investigated. (4) In building mechanical system research fields, eighteen studies were reported for achieving effective design of the mechanical systems, and also for maximizing the energy efficiency of buildings. The topics of the studies included energy performance, HVAC system, ventilation, and renewable energies, piping in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment was mostly focused on indoor environment and building energy. The main researches of indoor environment were related to the user and location awareness technology applied dimming lighting control system, the lighting performance evaluation for light-shelves, the improvement evaluation of air quality through analysis of ventilation efficiency and the evaluation of airtightness of sliding and LS window systems. The subjects of building energy were worked on the energy saving estimation of existing buildings, the developing model to predict heating energy usage in domestic city area and the performance evaluation of cooling applied with economizer control. The studies were also performed related to the experimental measurement of weight variation and thermal conductivity in polyurethane foam, the development of flame spread prevention system for sandwich panels, the utilization of heat from waste-incineration facility in large-scale horticultural facilities.

Young Rabbit Model for Pathophysiologic Study of Acute Lung Injury in Early Childhood (유아기 급성폐손상 병태생리 연구를 위한 어린 토끼 실험모델)

  • 권영민;최석철;박종원;김양원;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.545-558
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    • 2003
  • Adult respiratory distress syndrome (ARDS) is of particular interest because of its severity of the associated lung injury and its high mortality. However, the pathophysiologies of ARDS in infant and childhood groups are still not well clarified inspite of many previous investigations. To investigate the time course of pathophysiology of ARDS in infant and childhood groups, this study was designed with experimental endotoxin-induced ARDS model using young rabbits (8 week-old). Material and Method: Rabbits were divided into the control group (n=8) and the endotoxin-treated group (n=32). The endotoxin group was subdivided into 4 groups by the sampling times as 3, 6, 12 and 24 hr-groups (G- $E_{3,6,12,24,}$ each n=8). The experimental ARDS was made by a bolus injection of endotoxin (Escherichia coli serotype 055 : B5, 0.50 mg/kg) via rabbit ear vein. For evaluation of the hematologic and inflammatory markers, and superoxide dismutase (SOD) concentrations, the blood samples were taken from the heart. The bronchoalveolar lavage fluid (BALF) were obtained for analysis of the leukocytes and protein concentration. With biopsy of the lung, histopathologic changes of the lung were also evaluated. Result: In the endotoxin groups, significant leukopenia (owing to pancytopenia) occurred in 3 and 6-hr groups, which was followed by significant leukocytosis (owing to neutrophilia) in the 12 and 24-hr groups (p<0.05). Serum levels of tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and interleukin-1 $\beta$ (IL-1 $\beta$) in the endotoxin groups were higher than those of control group (p<0.05). Serum levels of superoxide dismutase (SOD) of G- $E_{3}$ and G- $E_{6}$ were higher than those of control group, whereas those of G- $E_{12}$ were lower than those of control groups (p<0.05). Total leukocyte counts and protein con-centrations in BALF were significantly elevated in the endotoxin groups compared to the control group (p < 0.05). The hemorrhagic pattern of BALF showed occurred in the endotoxin groups. The endotoxin groups (in G- $E_{6}$) had severe infiltration of inflammatory cells (lymphocyte and monocyte) in the pulmonary interstitium and parenchyma, migrations of neutrophil and eosinophil into alveolar spaces and interstitial widening, which are the evidences of acute lung injury. In the endotoxin groups, there were significant positive correlations between the BALF findings and the immunologic markers (TNF-$\alpha$, IL-1$\beta$, SOD) (p<0.05). Conclusion: Severe acute lung injury occurred in all the endotoxin-treated rabbits. The pathophysiologic findings were so progressive until 6-hr by time dependant pattern, and then recovered slowly, Variable hematologic, immuno-logic, and pathologic factors were well correlated in the development and progression of endoxin-induced lung injury. The pathophysiologic responses were sensitive and rapid in young rabbit Young rabbit seemed to be a useful experimental animal model for infant and childhood groups.roups.