• 제목/요약/키워드: Infusion Method

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Fontan 수술을 받은 정신지체 소아에서 인상채득을 위해 시행한 깊은 진정 (Deep Sedation for Palate Alginate Impression Procedure in a Post-Fontan Procedure Patient with Mental Retardation)

  • 이정만;서광석;김현정;신순영;신터전
    • 대한치과마취과학회지
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    • 제12권1호
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    • pp.45-50
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    • 2012
  • The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

In Vivo Neuroprotective Effect of Histidine-Tryptophan-Ketoglutarate Solution in an Ischemia/Reperfusion Spinal Cord Injury Animal Model

  • Kang, Shin Kwang;Kang, Min-Woong;Rhee, Youn Ju;Kim, Cuk-Seong;Jeon, Byeong Hwa;Han, Sung Joon;Cho, Hyun Jin;Na, Myung Hoon;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • 제49권4호
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    • pp.232-241
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    • 2016
  • Background: Paraplegia is a devastating complication following operations on the thoracoabdominal aorta. We investigated whether histidine-tryptophan-ketoglutarate (HTK) solution could reduce the extent of ischemia/reperfusion (IR) spinal cord injuries in a rat model using a direct delivery method. Methods: Twenty-four Sprague-Dawley male rats were randomly divided into four groups. The sham group (n=6) underwent a sham operation, the IR group (n=6) underwent only an aortic occlusion, the saline infusion group (saline group, n=6) underwent an aortic occlusion and direct infusion of cold saline into the occluded aortic segment, and the HTK infusion group (HTK group, n=6) underwent an aortic occlusion and direct infusion of cold HTK solution into the occluded aortic segment. An IR spinal cord injury was induced by transabdominal clamping of the aorta distally to the left renal artery and proximally to the aortic bifurcation for 60 minutes. A neurological evaluation of locomotor function was performed using the modified Tarlov score after 48 hours of reperfusion. The spinal cord was harvested for histopathological and immunohistochemical examinations. Results: The spinal cord IR model using direct drug delivery in rats was highly reproducible. The Tarlov score was 4.0 in the sham group, $1.17{\pm}0.75$ in the IR group, $1.33{\pm}1.03$ in the saline group, and $2.67{\pm}0.81$ in the HTK group (p=0.04). The histopathological analysis of the HTK group showed reduced neuronal cell death. Conclusion: Direct infusion of cold HTK solution into the occluded aortic segment may reduce the extent of spinal cord injuries in an IR model in rats.

수술후 통증관리를 위한 Buprenorphine의 지속적 경막외 투여효과 (Effects of Continuous Epidural Infusion of Buprenorphine for Postoperative Pain Management)

  • 윤희동;박영철;임혜자
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.151-158
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    • 1996
  • Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid $\mu$-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can possibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and side effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg morphine (M group), 0.15 mg buprenorphine (0.15B group), 0.3 mg buprenorphine (0.3B group) combined with 0.25% bupivacaine 10ml, and subsequent continuous infusion doses were 6 mg morphine plus 0.125% bupivacine 100 ml (M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml (0.15B, 0.3B, group) during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group (P<0.05). Conclusion: The above results suggest that continuous epidural infusion of buprenorphine combined with low-dose bupivacaine is an advisable method of postoperative analgesia.

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VaRI 공정 유동해석 간소화 방법에 대한 연구 (A Study on Simplifying Flow Analysis of VaRI Process)

  • 김영민;이정완;김정수;안세훈;오영석;이진우;김위대;엄문광
    • Composites Research
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    • 제34권4호
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    • pp.233-240
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    • 2021
  • VaRI(Vacuum assisted Resin Infusion) 공정은 공정비용이 저렴하며, 크기가 큰 복합재 제작에 적합한 OoA(Out of Autoclave) 공정이다. VaRI 공정에서는 원할한 수지 주입을 위해 섬유 상단에 유로망을 적층한다. 수지는 이 유로망을 따라 섬유의 면 방향으로 빠르게 공급되고, 공급된 수지는 다시 섬유의 두께방향으로 함침된다. 면방향의 유동과 두께방향의 유동이 동시에 일어나기 때문에 수지의 유동을 예측하기 힘들며, 수지 주입과정을 예측하기 위해 3D 수치해석 프로그램이 사용되고 있다. 하지만, 3D로 해석하기 위해서 섬유와 유로망의 두께방향에 많은 Element가 필요하고, 이로 인해 제품의 크기가 클수록 해석시간이 오래 걸린다. 따라서 본 연구에서는 3D 유동해석을 2D 해석으로 간소화하여 유동해석에 소요되는 시간을 줄이는 방법을 제시하였다. 3D 유동해석과 간소화된 2D 유동해석을 동일조건에서 비교하여 효용성을 검증하였고, 충진시간 오차율은 약 7%, 유동해석시간 감소율은 약 95%로 나타났다. 또한 3D 해석에서 섬유 상, 중, 하단 간의 유동 전진 거리의 차이가 일정하다는 것을 활용하여 간소화된 2D 유동해석에서도 상, 중, 하단의 유동 전진 거리를 예측할 수 있었다.

이중 콘덕턴스법에 의한 실기체방출률 측정 (Measurement of Real Outgassing Rate using Double Conductance Method)

  • 인상렬
    • 한국진공학회지
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    • 제5권3호
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    • pp.175-180
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    • 1996
  • Double conductance method is proposed as an effectvie way to measure real outgassing rates of materials regardless of their adsorbing power. The real outgassing rate and the sticking coefficient of the CFC (carbon fiber composite) which is used widely as the material for armor plates infusion experiment devices were obtained by adopting this method. At $40^{\circ}C$ the real ougassing rate was $Pa, m^3/s.m^2$(in $N_2$ equivalent), which was higher than 5 times the measured one, and the sticking coefficient was about 0.018($H_2O\; and \;H_2$ were the main residual gases).

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원격 수액모니터링 시스템의 주입량의 정확도에 영향을 주는 융합인자의 비교 분석 (Comparative analysis of fusion factors affecting the accuracy of injection amount of remote fluid monitoring system)

  • 김선칠
    • 한국융합학회논문지
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    • 제13권3호
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    • pp.125-131
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    • 2022
  • 최근에는 COVID-19 인해 의료기관에서 원격으로 관리되는 환자케어 시스템의 보급이 증가되고 있다. 특히 수액 모니터링인 경우 환자의 안전과 간호사의 업무를 줄일 수 있는 시스템으로 병원에서 도입을 고려하고 있다. 현재 개발되어 있는 제품은 무게를 측정하는 로드셀 방식과 적외선 센싱으로 수액 방울을 검출하는 방식의 두 가지 제품이 있다. 각 제품은 동작원리, 센서의 종류, 크기, 사용법, 가격등의 차이가 있지만, 의료기관에서는 획득되는 데이터의 정확도에 관심이 높다. 본 연구에서는 센서 방식이 다른 두 가지 시제품을 제작하여 수액모니터링 장치의 핵심인 정확도를 실험하기 위해 시간당 총 수액량을 측정하였다. 또 외부의 움직임이 있을 경우 수액 측정값의 변화를 실험하여 측정방식에 따른 정확도를 평가하였다. 실험 결과 두 장치의 측정값 오차는 5% 미만의 차이가 있었고, 로드셀 방식은 저용량 측정값에서 적외선 방식은 고용량 측정값에서 차이를 보였다. 본 연구결과 수액모니터링장치의 센서방식에 따른 정확도 차이는 거의 없었고, 향후 의료기관에서 사용할 경우 정확도의 문제는 없을 것으로 사료된다.

장기혈액투석환자의 투석중 혈압하강과 Coil내 혈액손실 방지를 위한 기초조사 (A Study on the long-term Hemodialysis patient중s hypotension and preventation from Blood loss in coil during the Hemodialysis)

  • 박순옥
    • 대한간호학회지
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    • 제11권2호
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    • pp.83-104
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    • 1981
  • Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance(P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

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Development of New Strategies for Enzyme Replacement Therapy for Lysosomal Storage Disorders

  • Ko, Ah-Ra
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제2권1호
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    • pp.17-18
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    • 2016
  • Enzyme replacement therapy (ERT) is a well-established means of treating lysosomal storage disease (LSD). However, classical IV infusion based ERT method produces less than ideal results, especially, CNS defects and quality of life in patients. To improve these main problems of parental IV formulation for LSDs, we investigate modified ERT method and evaluated the efficacy in animal model.

Optimal Sampling Times of Once Daily Gentamicin in Korean Patients with Urinary Tract Infections

  • Park, Hyo-Jung;Sohn, Kie-Ho;Choi, Kyung-Eob;Shin, Sang-Yup;Jung, Sook-In;Oh, Won-Sup;Peck, Kyong-Ran;Song, Jae-Hoon;Lee, Suk-Hyang
    • Biomolecules & Therapeutics
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    • 제11권3호
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    • pp.178-182
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    • 2003
  • The clinical use of once daily aminoglycoside (ODA) dosing has been increased because of the potential therapeutic advantages of this dosing regimen. To evaluate the optimal sampling times of ODA dosing method in a clinical setting, the study was prospectively conducted in a total of 28 patients with UTI. All of the patients were intravenously administered gentamicin at a dose of 7 mg/kg over 60 minutes and randomly divided into two groups. Blood was collected at 0, 2, and 6 hours in Group A and at 1, 2, and 6 hours in Group B after the end of 1-hour infusion. The pharmacokinetic parameters (Ke, Vd and Cmax) obtained using the 0, 6 hour levels and 2, 6 hour levels in Group A were statistically different while those of 1, 6 hour levels and 2, 6 hour levels in Group B were similar. This finding indicated that the distributional phase of ODA is completed within 1 hour following the end of the I-hour infusion. If we are allowed to collect only two blood samples in ODA considering patients comfort and the analytical cost of drug, the first one should be drawn after 1 hour following the end of infusion to obtain adequate pharmacokinetic information.

제왕절개술후 통증치료시 지속적 경막외 국소마취제와 Tramadol의 병용투여의 효과 (Continuous Epidural Infusion of Bupivacaine with Tramadol for Post-Cesarean Analgesia)

  • 강포순;조재군
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.54-59
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    • 1998
  • Background: Tramadol administered epidurally is known to have one-thirtieth the potency of morphine for treatment of pain following abdominal surgery. We designed a prospective, randomized, controlled study to evaluate the analgesic efficacy and safety of combined epidural infusion of bupivacaine and tramadol with 2-day infusor as ompared to bupivacaine and morphine combined epidural infusion. Methods: Sixty healthy women scheduled for Cesarean delivery were assigned randomly in double- blind fashion: Group 1 (n=20) were given a mixture of morphine 10 mg(1 ml), 0.5% bupivacaine 40 ml and normal saline(NS) 40 ml; Group 2(n=20) a mixture of tramadol 300 mg(6 ml), 0.5% bupivacaine 40 ml and NS 54 ml; Group 3(n=20) or a mixture of tramadol 500 mg(10 ml), 0.5% bupivacaine 50 ml and NS 50 ml, of continuous dose via epidural route following 1% lidocaine 6 ml as bolus dose for 48 hours postoperatively. We evaluated the analgesic efficacy and side effects of these three groups using visual analogue pain scale (VAPS) and verbal rating scale (VRS). Results: VAPS of group 1 and 3 were lower than group 2, and VAPS of group 1 was lower than group 3(12, 24, 36, 48 hours). VRS of group 1 and 3 were lower than group 2 (12, 24, 36 hours). There were incidences of pruritus was 16 patients in group 1. Conclusions: Tramadol does possess the analgesia effect of morphine, but has the added analgesia following increment. Further research to determine the most effective administration method and reguired dosage of tramadol is further needed.

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