• Asian-Australasian Journal of Animal Sciences
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• v.18 no.10
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• pp.1414-1420
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• 2005

The purpose of this research was to determine whether or not feeding induced hypovolemia (decreases in plasma volume) and decreases in plasma bicarbonate concentration caused by loss of $NaHCO_3$ from the blood, act to suppress feed intake and saliva secretion volumes during the initial stages of feeding in goats fed on dry forage. The animals were fed twice a day at 10:30 and at 16:00 for 2 h each time. Prior to the morning feeding, the collected saliva (3-5 kg) was infused into the rumen. During the morning 2 h feeding period (10:30 to 12:30), the animals were fed 2-3 kg of roughly crushed alfalfa hay cubes. At 16:00, the animals were fed again with 0.8 kg of alfalfa hay cubes, 200 g of commercial ground concentrate and 20 g of sodium bicarbonate. In order to compensate for water or $NaHCO_3$ lost through saliva during initial stages of feeding, a 3 h intravenous infusion (17-19 ml/min) of artificial mixed saliva (ASI) or mannitol solution (MI) was begun 1 h prior to the morning feeding and continued until the conclusion of the 2 h feeding period. The physiological state of the goats in the present experiment remained unchanged after parotid gland fistulation. Circulating plasma volume decreases caused by feeding (estimated by increases in plasma total protein concentration) were significantly suppressed by the ASI and MI treatments. During the first 1 h of the 2 h feeding period, plasma osmolality in the ASI treatment was the same as the NI (non-infusion control) treatment, while plasma osmolality in the MI treatment was significantly higher. In comparison to the NI treatment, cumulative feed intake levels for the duration of the 2 h feeding period in the ASI and MI treatments increased markedly by 56.6 and 88.3%, respectively. On the other hand, unilateral cumulative parotid saliva secretion volume following the termination of the 2 h feeding period in the ASI treatment was 50.7% higher than that in the NI treatment. MI treatment showed the same level as the NI treatment. The results of the present experiment proved that the humoral factors involved in the suppression of feeding and saliva secretion during the initial stages of feeding in goats fed on dry forage, are feeding induced hypovolemia and decrease in plasma $HCO_3^-$ concentration caused by loss of $NaHCO_3$ from the blood.

• The Korean Journal of Physiology
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• v.9 no.1
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• pp.45-56
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• 1975

Various factors influencing the lymph flow from thoracic duct were investigated in an attempt to evaluate their contributing degree and the mechanisms. Sixteen mongrel dogs weighing between 10 and 16 kg were anesthetized and polyethylene catheters were inserted into the thoracic duct and femoral veins. Arterial blood pressure, heart rate, central venous pressure, lymph pressure and lymph flow were measured under various conditions. Electrical stimulation of left sciatic nerve, stepwise increase of central venous pressure, manual application of rhythmical depressions onto abdomen, injection of hypertonic saline solution and histamine infusion were employed. Measurement of cental venous pressure was performed through the recording catheter inserted into abdominal inferior vena cava. Changes in central venous pressure were made by an air-ballooning catheter located higher than the tip of the recording catheter in the inferior vena cava. Lymph flow from thoracic duct was measured directly with a graduated centrifuge tube allowing the lymph to flow freely outward through the inserted cannula. The average side pressure of thoracic lymph was $1.1\;cmH_2O$ and lymph flow was 0.40 ml/min or 1.9 ml/kg-hr. Hemodynamic parameters including lymph flow were measure immediately before and after (or during) applying a condition. Stimulation of left sciatic nerve with a square wave (5/sec, 2 msec, 10V) caused the lymph flow to increase 1.4 times. The pattern of lymph flow from thoracic duct was not continuous throughout the respiratory cycle, but was continuous only during Inspiration. Slow and deep respiration appeared to increase the lymph flow than a rapid and shallow respiration. Relationship between central venous pressure and the lymph flow revealed a relatively direct proportionality; Regression equation was Lymph Flow (ml/kg-hr)=0.09 CVP$(cmH_2O)$+0.55, r=0.67. Manual depressions onto the abdomen in accordance with the respiratory cycle caused the lymph flow to increase most remarkably, e.g,. 5.5 times. The application of manual depressions showed a fluctuation of central venous pressure superimposed on the respiratory fluctuation. Hypertonic saline solution (2% NaCl) administered Intravenously by the amount of 10 m1/kg increased the lymph flow 4.6 times. The injection also increased arterial blood pressure, especially systolic Pressure, and the central venous pressure. Slow intravenous infusion of histamine with a rate of 14-32 ${\mu}g/min$ resulted in a remarkable increase in the lymph flow (4.7 times), in spite of much decrease in the blood pressure and a slight decrease in the central venous pressure.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.4
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• pp.213-219
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• 2014

Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth. Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was $1{\mu}g/ml$ (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was $0.6{\mu}g/ml$ and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared. Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total sedation time. However, total infused dose and the effect site target concentration of propofol was $163.8{\pm}74.5mg$ and $1.13{\pm}0.21{\mu}g/ml$ in group 1, and $104.3{\pm}46.5mg$ and $0.72{\pm}0.26{\mu}g/ml$ in the group 2 with $1.02{\pm}0.21ng/l$ of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation. Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.135-140
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• 2009

Background: The chronobiology of postoperative pain is an interesting topic. This study was performed to evaluate the effects of adenosine on inta-operative remifentanil requirements and on postoperative pain in patients undergoing tonsillectomies and how those effects change with changing time of day the surgery is performed. Methods: For this study, 120 patients were randomly allocated into four groups. Patients in groups B and D received adenosine at a dose of $50{\mu}g/kg/min$, and those in group A and C received an equal volume of saline from 10 minutes after the induction of anesthesia until the end of surgery. Group A (saline) and B (adenosine) patients entered the operating room after 08:30 and finished before 11:00, Group C (saline) and D (adenosine) patients entered the operating room after 13:30 and finished before 16:00. We evaluated the intraoperative time-weighted mean remifentanil dose, and postoperative pain scores at 1, 6, 12, and 24 hours, and the analgesic dose required during the following 24 hours. Results: Time-weighted mean remifentanil doses during the intraoperative period and the analgesic requirement during the following 24 hours in group D was significantly lower than in the other groups. The numeric rating scale for pain at 1, and 6 hours in group D was significantly lower (P < 0.01) than that of group A. There were no significant differences in side effects among groups. Conclusions: Use of intraoperative adenosine infusion provides perioperative analgesia. Postoperative pain is affected by the time of day the operation is performed.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.233-241
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• 1995

Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5238-5246
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• 2012

This study was done to identify the evaluation of CPSCS for neurocritical patients and provide effective nursing interventions for these patients. Data were collected from medical records of 203 neurocritical patients over 18 years of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009 and from October 2011 to December 2011. Collected data were analyzed through t-test, ANOVA test, Person's correlation analysis, trend analysis, stepwise multiple regression. The average CPSCS score was $112.09{\pm}18.91$ and there was a significant trendency for higher severity to lead to higher CPSCS's scores(survival: J-T:9.795, die: J-T:5.415, p=<.001). The scores of the respective areas follows measurement of vital sign($3.74{\pm}2.15$), monitoring($28.97{\pm}4.31$), activity daily living ($34.99{\pm}3.66$), feeding($.19{\pm}.98$), intravenous infusion ($18.20{\pm}8.27$), treatment/procedure ($16.93{\pm}4.90$), respiratory therapy($8.61{\pm}7.07$). By means of stepwise multiple regression analysis, the intravenous therapy & medication, respiratory therapy, activities of daily living, and monitoring area that contains the model showed a significant (F=2073.963, p<.001), and they explained 98.1% of CPSCS. These findings provide information that is relevant in designing interventions to enhance CPSCS among neurocritical patients in hospital.

• Korean Journal of Veterinary Research
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• v.43 no.3
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• pp.361-371
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• 2003

The vasorelaxant actions and blood pressure lowering of the ${\alpha}_2$-adrenoceptor agonists (${\alpha}_2$-AAs) clonidine and xylazine were investigated in rat isolated aortic rings and anesthesized rats. Both clonidine and xylazine produced a concentration-dependent inhibition of the sustained contraction induced by norepinephrine (NE), but not by KCl. NE-induced contractions were attenuated partly by nifedipine or verapamil, voltage dependent $Ca^{2+}$ channel blockers. These $Ca^{2+}$ channel blockers-resistant contractions were abolished by clonidine or xylazine. Inhibitory effects of a ${\alpha}_2$-AAs on contractions could be reversed by ryanodine, an intracellular $Ca^{2+}$, transport blocker, and tetrabutylammonium (TBA), a $Ca^{2+}$ activated $K^+$ channel blocker, but not by nifedipine, glibenclamide or removal of extracellular $Ca^{2+}$ and endothelium. Moreover, ${\alpha}_2$-AAs produced relaxation in NE-precontracted isolated intact aortic rings in a concentration-dependent manner, but not in KCl-precontracted rings. The relaxant effects of ${\alpha}_2$-AAs were inhibited by ryanodine and TBA, but not by nifedipine, glibenclamide, N (G)-nitro-L-arginine (L-NNA), N(omega)-nitro-L-arginine methyl ester (L-NAME), aminoguanidine (AG), 2-nitro-4-carboxyphenyl N,N-diphenylcarhurnte (NCDC), lithium sulfate, staurosporine or removal of extracellular $Ca^{2+}$ and endothelium. In vivo, infusion of xylazine elicited significant decrease in anerial blood pressure. This xylazinelowered blood pressure was completely inhibited by the intravenous injection of TBA, but not by the intravenous injection of glibenclamide, L-NNA, L-NAME, AG, nifedipine, lithium sulfate or saponin.. These findings showed that the receptor-mediated and ${\alpha}_2$-adrenoceptor A-stimulated endothelium-independent vasorelaxant effect may be explained by decreasing intracellular $Ca^{2+}$ release and activation of $Ca^{2+}$-activated $K^+$ channels, which may contribute to the hypotensive effects of ${\alpha}_2$-AAs in rats.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.467-476
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• 2013

Objective : This study aimed to evaluate the hypotheses that administration routes [intra-arterial (IA) vs. intravenous (IV)] affect the early stage migration of transplanted human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in acute brain infarction. Methods : Male Sprague-Dawley rats (n=40) were subjected to photothrombotic infarction. Three days after photothrombotic infarction, rats were randomly allocated to one of four experimental groups [IA group : n=12, IV group : n=12, superparamagnetic iron oxide (SPIO) group : n=8, control group : n=8]. All groups were subdivided into 1, 6, 24, and 48 hours groups according to time point of sacrifice. Magnetic resonance imaging (MRI) consisting of T2 weighted image (T2WI), $T2^*$ weighted image ($T2^*WI$), susceptibility weighted image (SWI), and diffusion weighted image of rat brain were obtained prior to and at 1, 6, 24, and 48 hours post-implantation. After final MRI, rats were sacrificed and grafted cells were analyzed in brain and lung specimen using Prussian blue and immunohistochemical staining. Results : Grafted cells appeared as dark signal intensity regions at the peri-lesional zone. In IA group, dark signals in peri-lesional zone were more prominent compared with IV group. SWI showed largest dark signal followed by $T2^*WI$ and T2WI in both IA and IV groups. On Prussian blue staining, IA administration showed substantially increased migration and a large number of transplanted hBM-MSCs in the target brain than IV administration. The Prussian blue-positive cells were not detected in SPIO and control groups. Conclusion : In a rat photothrombotic model of ischemic stroke, selective IA administration of human mesenchymal stem cells is more effective than IV administration. MRI and histological analyses revealed the time course of cell migration, and the numbers and distribution of hBM-MSCs delivered into the brain.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.2
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• pp.207-224
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• 1998

The purposes of this study were to identify nurse's recognition and performance and to represent the factors of hindrance in the IV therapy management. The subjects were 420 nurses who worked at five general hospitals in Pusan. Tha data were collected using a questionnaire and the period of data collection was from January 1 to January 31, 1998. The instrument for this study was made by author oneself on the basis of guidelines Simmons et al', CDC' Stanley' and Kurdi' guideline, Cllinical Nurse's Association' that consist of 68 items for 5 fields ; pre-injection, just before-injection, needle-injection, during injection, post-injection field. Cron-bach Alpha coefficient of recognition and performance in the IV therapy management was .93 and .87. The datas were analized by a SPSS program using frequency, percent, paired t-test, t-test and oneway ANOVA. The results obtained were as follows : 1. The mean score of recognition in IV therapy management was significantly higher than that of performance(t=5.86, P<.001). 2. The items of lower than mean score of each fields in performance were the identification of drugs, hands washing, patient teaching about medication, disinfectional methods of the injection site and the rubber stopper in bottle, the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, use of tape and armboard, changing the IV tubing, labeling the dressing over the injection site, observation and recordings of patient's condition after medication and confirmation of the needle length at the needle removal. 3. The factors of hindrance in IV therapy were 'having no time', 'insufficiency of goods', 'unknowing of methods', 'no disadvantage', and 'factors of doctor's doing'. The most important factor was 'have no time', especially item of hands washing. The other factors of hindrance showed high frequency in the following items ; 'insufficiency of goods' in the use of disposable gloves, mask and eye goggles at the chemotherapy preparation, 'unknowing of methods' in the certification of drugs compatibility, 'no disadvantage' in the labeling the dressing over the injection site, and 'factors of doctor's doing' in the changing the subclavian catheter dressing and checking the glucose level during the TPN infusion. In conclusion, there is necessity of educational program which can improve the nurse's knowledge of drugs, disinfection methods, comfort of patient and recordings in IV therapy management and alternative plan which are political and financial aids such as setting up the sink, giving of paper towels and necessary goods in the IV therapy for reducing the factors of hindrance for IV therapy management.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.169-176
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• 2010

Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.