• 중환자간호학회지
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• 제9권1호
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• pp.40-50
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• 2016

Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

• Journal of Oral Medicine and Pain
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• 제42권4호
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• pp.89-101
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• 2017

Purpose: The purpose of this study is to investigate the prevalence of temporomandibular disorders (TMDs) in children and adolescents, their characteristic contributing factors, the characteristic features of symptoms and symptoms, and the response to treatment. Methods: We studied the researches, that were the results of the searches for words such as temporomandibular disorder, TMD, children, adolescents, and juvenile through PubMed and DBpia. Results: According to a study conducted in Busan, the ratio of adolescents increased from 18.3% to 21% in 2008 compared to 2000, and the proportion of boys increased from 38.58% to 45.38%. One of the characteristic contributing factors for adolescents is the macrotrauma such as jaw trauma, vehicle accidents, sports, physical abuse, forceful intubation, and third molar extraction. The second is a microtrauma from parafunctional habit such as bruxism, clenching, hyperextension, wind instrument, and fingernail biting that can cause joint overload, cartilage breakdown, synovial fluid alterations, and other changes within the joint. The diagnosis of TMDs in juvenile adolescents is not significantly different from that of adults. Medical history, clinical examination and radiological examinations are required. Conclusions: In the temporomandibular joint history and assessment, all comprehensive dental history examination is required, including head and neck pain, mandibular dysfunction, previous orofacial trauma, history of present illness with an account of current symptoms. For the treatment and management of temporomandibular arthritis in juvenile adolescents, understanding the characteristics of TMDs in juvenile adolescents and thoroughly analyzing appropriate diagnosis and possible contributing factors through comprehensive history taking & examination, conservative treatment, including fast and active cautions education, will be essential.

• 한국산업융합학회 논문집
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• 제24권6_2호
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• pp.801-808
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• 2021

In this paper, a numerical analysis was conducted on the effect of the flow control valve of a oscillation water column(OWC) type wave power generator turbine. The OWC wave power turbine operates with compressed air in the air chamber according to the change of wave height. When the wave height changes rapidly, a flow control valve is required due to overload of the turbine and reduced efficiency. Therefore, in this paper, a flow control valve with an opening angle of 60 degrees was installed in the front of the turbine, and the pressure drop, torque, and overall performance were calculated according to the change of turbine RPM and flow rate of turbine inlet. In conclusion, the flow control valve with an opening angle of 60 degrees affects when the turbine rotates at low rotation and the inlet flow rate is large. But it does not have a significant effect on overall turbine performance and it is necessary to find the optimal angle in the future works.

• Journal of Chest Surgery
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• 제37권8호
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• pp.660-664
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• 2004

배경: 냉혈심정지액은 저온에서 적혈구응집현상을 방지하고 미세순환을 좋게 하기 위해 심정지액을 4 : 1로 희석하여 사용하도록 권장되었는데 간헐적전방온혈심정액(IAWBC)에서는 심정지액을 냉각하지 않기 때문에 희석할 필요가 없이 고농도 포타슘을 바로 사용할 수 있게 되었다. 본 연구는 IAWBC에서 희석되지 않은 고농도 포타슘 사용의 안전성과 유용성을 알아보고자 한다. 대상 및 방법: 관상동맥우회로 조성수술을 받은 환자 중 IAWBC를 이용한 환자 30명을 대상으로 하였다. 1 : 4로 희석된 온혈심정지액을 사용한 군을 dilutedplegia군으로 하고 희석되지 않은 포타슘을 사용한 군을 microplegia군으로 하였다. dilutedplegia군의 심정지액은 1 : 4 delivery kit를 이용하여 상행대동맥뿌리에 주입되었고 microplegia군에서는 희석되지 않은 포타슘을 infusion pump를 이용하여 산소포화 된 혈액에 직접 연결하여 대동맥뿌리에 주입하였다. 걸과: microplegia군이 16명, 대조군인 dilutedplegia군이 14명으로 나이, 성별, 좌심실 구획률, 이식혈관 수, 대동맥차단시간, 수술 후 심근효소치에서는 두 군에서 차이가 없었다(p＞0.05). 모든 환자에서 수술 후 심근경색과 수술사망은 없었다. dilutedplegia군에서 사용된 crystalloid심정지액의 양은 1346$\pm$597 mL (평균$\pm$표준편차)이었고 microplegia군에서는 28$\pm$9mL이었다. 체외순환 중 적혈구 구획률은 microplegia군에서 24$\pm$3%로 dilutedplegia군의 21$\pm$4%에 비해 약간 높았으나 통계학적 의의는 없었다. 체외순환 중에 수혈을 받은 환자는 microplegia군에서 4명인데 비해 dilutedplegia군에서는 11명으로 높았다(p＜0.05). 수술 중 환자의 소변량과 혈액여과한 양에서 microplegia군이 959$\pm$410 mL와 1481$\pm$784 mL로 dilutedplegia군의 1250$\pm$810mL와 1689$\pm$548 mL에 비해 통계학적으로 의의 있게 적었다(p<0.05). 결론: 관상동맥우회로 조성수술에서 전방온혈심정지액을 사용할 때 희석되지 많은 고농도 포타슘은 fliud overload와 수혈을 피하고 delivery kit를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.183-190
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• 1997

Tocolytics 임신부의 조기진통시 치료제로 많이 사용되는 약제지만 드물게는 폐부종을 일으켜 치명적일 수 있다. Tocolytics가 폐부종을 일으키는 기전은 용적증가, 교질삼투압의 감소, 심근 손상, 모세혈관 내막의 손상등에 의해 발생한다고 설명되고 있으나 아직 불확실한 상태이며 폐부종 발생의 양대 기전인 정수압적 폐부종과 투과성 폐부종의 양상이 모두 관여하는 것으로 알려져 있다. 또한 임산부가 다산부이거나 다태아 임신인 경우, 임신중 수액공급을 많이 받은 경우, 심장 질환이 동반된 경우, 감염이 동반된 경우, 동시에 steroid나 MgSO4로 치료 받은 경우등이 tocolytics 사용시 폐부종이 쉽게 발생될 수 있는 선행요인으로 작용함이 알려져왔다. 저자들은 조기진통이 있어 tocolytics인 ritodrine 치료후 정상분만하였으나 분만후 급속히 진행하는 폐부종이 발생한 30세 여자 환자를 경험하였기에 문헌고찰과 함께 보고하는 바 이다.

• 대한한의학회지
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• 제23권4호
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• pp.161-168
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• 2002

Objectives: Hwangryunhaedok-tang (Huang-lian-jie-du-tang, HRHDT, 黃連解毒湯) is a traditional Korean herbal medicine that is formulated with Coptidis Rhizoma, Phellodendri Cortex, Scutellariae Radix and Gardeniae Fructus. HRHDT is cold (寒) and bitter (苦) in nature and has general properties of clearing heat and detoxifying (淸熱解毒), strengthening the stomach and settling the liver (健胃平肝), and reducing inflammation, fever and swelling. This formula can prevent and treat artherosclerosis, hyperplasia of the endothelium, cerebral fluid circulation, cerebral vascular deterioration through aging, impairment of neurotransmitters, or disruption of the functioning of the cerebral cortex following infection or trauma. The purpose of the study reported here was to determine the neuroprotective effect of HRHDT on global ischemia induced by 4-vessel occlusion in Wistar rats. Methods: HRHDT extract was lyophilized after extraction with 85% methanol and 100% water. Rats were induced to 10 minutes of forebrain ischemia by 4-vessel occlusion (4-VO) and reperfused again. HRHDT was administered with a dose of 100 mg/kg, and 500 mg/kg of 85% methanol extracts and 100 mg/kg of 100% water extracts, respectively, at 0 min and 90 min after 4-VO. Rats were killed at 7 days after ischemia and the number of CA1 pyramidal neurons was counted in hippocampal sections stained with cresyl violet. Results: Body temperature of animals showed no significant difference between saline-treated groups and HRHDT extracts-treated groups until 5 hours of reperfusion. This result indicated that neuroprotective effects of HRHDT extracts were not due to hypothermic effects. The administration of HRHDT showed a significant neuroprotective effect on hippocampal CA1 neurons at 7 days after ischemia compared to the saline-treated group (P<0.001). HRHDT methanol extracts of 100 mg/kg, 500 mg/kg and HRHDT water extracts of 100 mg/kg showed 88.5%, 98.3% and 95.1 % neuroprotection, respectively. Conclusions: The results of this study demonstrate that administration of HRHDT is highly effective in reducing neuronal damage in response to transient global cerebral ischemia. HRHDT may involve many mechanisms that might account for its high degree of efficacy. A number of factors including free radicals, glutamate, calcium overload, NO, and various cytokines have been proposed to have an important role in causing neuronal death after short periods of global ischemia. Further studies are needed to know the neuroprotective mechanisms of HRHDT.

• Toxicological Research
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• 제23권3호
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• pp.279-287
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• 2007

Copper (Cu) is an essential trace element indispensable for brain development and function; either excess or deficiency in Cu can cause brain malfunction. While it is known that Cu and Fe homeostasis are strictly regulated in the brain, the question as to how systemic Fe status may influence brain Cu distribution was poorly understood. This study was designed to test the hypothesis that dietary Fe condition affects Cu transport into the brain, leading to an altered brain distribution of Cu. Rats were divided into 3 groups; an Fe-deficient (Fe-D) group which received an Fe-D diet ($3{\sim}5 mg$ Fe/kg), a control group that was fed with normal diet (35mg Fe/kg), and an Fe-overload group whose diet contained an Fe-O diet (20g carbonyl Fe/kg). Following a 4-week treatment, the concentration of Cu/Fe in serum, CSF (cerebrospinal fluid) and brain were determined by AAS, and the uptake rates of Cu into choroids plexus (CP), CSF, brain capillary and parenchyma were determined by an in situ brain perfusion, followed by capillary depletion. In Fe-D and Fe-O, serum Fe level decreased by 91% (p<0.01) and increased by 131% (p<0.01), respectively, in comparison to controls. Fe concentrations in all brain regions tested (frontal cortex, striatum, hippocampus, mid brain, and cerebellum) were lower than those of controls in Fe-D rats (p<0.05), but not changed in Fe-O rats. In Fe-D animals, serum and CSF Cu were not affected, while brain Cu levels in all tested regions (frontal cortex, striatum, hippocampus, mid brain, and cerebellum) were significantly increased (p<0.05). Likewise, the unidirectional transport rate constants $(K_{in})$ of Cu in CP, CSF, brain capillary and parenchyma were significantly increased (p<0.05) in the Fe-D rats. In contrast, with Fe-O, serum, CSF and brain Cu concentrations were significantly decreased as compared to controls (p<0.05). Cu transport was no significant change of Cu transport of serum in Fe-O rats. The mRNA levels of five Cu-related transporters were not affected by Fe status except DMT1 in the CP, which was increased in Fe-D and decreased in Fe-O. Our data suggest that Cu transport into brain and ensuing brain Cu levels are regulated by systemic Fe status. Fe deficiency appears to augment Cu transport by brain barriers, leading to an accumulation of Cu in brain parenchyma.

• Journal of Chest Surgery
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• 제35권9호
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• pp.653-658
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• 2002

개흉술 후 생기는 급성 호흡 부전 증후군은 아직까지 그 원인과 경과가 자세히 알러져 있지 않다. 이에 저자들은 개흉술 후 생기는 급성 호흡 부전 증후군이 발생한 환자들을 대상으로 원인 및 유병률, 경과, 치료 성적 등을 알아보고자 하였다. 대상 및 방법: 1996년 1월부터 2001년 8월까지 흉강경 수술을 포함한 총 개흉술 4018례중 급성 호흡 부전 증후군이 발생한 32명의 환자들을 대상으로 후향적 분석을 하였다. 결과 : 총 4018례 중 32례에서 급성 호흡 부전 증후군이 발생하여 전체 발생 빈도는 0.8%였다. 전폐 절제술이 245례 시행되었으며 이중 13례(5.3%)에서 급성 호흡 부전 증후군이 발생하였고, 폐엽 절제술이 710례 중에서 9례 (1.3%), 식도 절제술이 226례 중에서 10례(4.4%) 발생하였다. 32명의 환자 중 31명(96.9%)이 악성 종양으로 수술한 환자였고, 1명은 아스페르길루스종으로 수술한 환자이다. 발병원인을 알 수 없는 경우가 21례(65.6%)로 대부분을 차지했으며, 최초 발병일은 평균 수술 후 7.4$\pm$7.0일이었다. 최초 병변 발생 부위는 우하엽부분이 10례(31.2%), 좌하엽 부분이 9례(28.1%)였고 양하엽 부분이 12례(37.5%)로 31례(96.9%)가 하엽 부분에서 병변이 시작 되었다. 수술 후 4일 이전에 발생한 급성 호흡부전 증후군 환자군에서 그 이후에 발생한 환자군보다 통계적으로 유의하게 수분 과다 투여가 관찰되었다. (p＜0.05). 총 32례 중 21례가 사망하여 사망률은 65.6%였으며 복와위와 질소가스 환기등 적극적인 치료를 시작한 1998년 7월 이전과 이후의 사망률은 각각 100%, 47.6%로 통계적으로 유의한 사망률의 감소를 보였다(p＜0.05) 절론 : 개흉술 후 발생하는 급성 호흡 부전 증후군은 악성 질환으로 폐엽 절제술, 전폐 절제술, 식도 절제술과 더불어 광범위한 임파절 절제술이 동반되는 경우에 그 빈도가 높았다. 수술 직후 발생한 급성 호흡 부전 증후군의 경우 수술 중 수분의 과다 투여가 관찰되었으며 복와위, 질소 가스 환기 등 적극적인 치료로 사망률을 낮출 수 있었다.