• Title/Summary/Keyword: L2 Trigger

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Retrograde Autologous Priming: Is It Really Effective in Reducing Red Blood Cell Transfusions during Extracorporeal Circulation? (역행성 자가혈액 충전법: 체외순환 중 동종적혈구 수혈량을 줄일 수 있는가?)

  • Lim, Cheong;Son, Kuk-Hui;Park, Kay-Hyun;Jheon, Sang-Hoon;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.473-479
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    • 2009
  • Background: Retrograde autologous priming (RAP) is known to be useful in decreasing the need of transfusions in cardiac surgery because it prevents excessive hemodilution due to the crystalloid priming of cardiopulmonary bypass circuit. However, there are also negative side effects in terms of blood conservation. We analyzed the intraoperative blood-conserving effect of RAP and also investigated the efficacy of autotransfusion and ultrafiltration as a supplemental method for RAP. Material and Method: From January 2005 to December 2007, 117 patients who underwent isolated coronary artery bypass operations using cardiopulmonary bypass (CPB) were enrolled. Mean age was 63.9$\pm$9.1 years (range 36$\sim$83 years) and 34 patients were female. There were 62 patients in the RAP group and 55 patients in he control group. Intraoperative autotransfusion was performed via the arterial line. RAP was done just before initiating CPB using retrograde drainage of the crystalloid priming solution. Both conventional (CUF) and modified (MUF) ultrafiltrations were done during and after CPB, respectively. The transfusion threshold was less than 20% in hematocrit. Result: Autotransfusions were done in 79 patients (67.5%) and the average amount was 142.5$\pm$65.4 mL (range 30$\sim$320 mL). Homologous red blood cell (RBC) transfusion was done in 47 patients (40.2%) and mean amount of transfused RBC was 404.3$\pm$222.6 mL. Risk factors for transfusions were body surface area (OR 0.01, 95% CI 0.00 $\sim$ 0.63, p=0.030) and cardiopulmonary bypass time (OR 1.04, 95% CI 1.01 $\sim$ 1.08, p=0.019). RAP was not effective in terms of the rate of transfusion (34.5% vs 45.2%, p=0.24). However, the amount of transfused RBC was significantly decreased (526.3$\pm$242.3ml vs 321.4$\pm$166.3 mL, p=0.001). Autotransfusion and ultrafiltration revealed additive and cumulative effects decreasing transfusion amount (one; 600.0$\pm$231.0 mL, two; 533.3$\pm$264.6 mL, three; 346.7$\pm$176.7 mL, four; 300.0$\pm$146.1 mL, p=0.002). Conclusion: Even though RAP did not appear to be effective in terms of the number of patients receiving intraoperative RBC transfusions, it could conserve blood in terms of the amount transfused and with the additive effects of autotransfusion and ultrafiltration. If we want to maximize the blood conserving effect of RAP, more aggressive control will be necessary - such as high threshold of transfusion trigger or strict regulation of crystalloid infusion, and so forth.

A Fast Handover Mecllanism in Mobile IPv6 Networks for Reliable Multicasting Services (이동 IPv6 망에서 신뢰성 있는 멀티캐스트 서비스를 지원하는 빠른 핸드오버 메커니즘)

  • Shin Seok-Jae;Yoo Sang-Jo
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.30 no.9A
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    • pp.838-849
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    • 2005
  • Fast handover protocol provides seamless handover in mobile Ipv6 networks by reducing handover latency. This paper proposes FMIP-M mechanism to apply this advantage of fast handover protocol to multicast service. The FMIP-M is a fast handover mechanism that supports a reliable multicast service in mobile Ipv6 networks. When hosts move other networks, they may have seine data missing and out-of-synch problems of multicast data. The proposed mechanism provides reliable multicast transmission by compensating data losses from the previous AR. Also it provides an additional function that is able to change multicasting service types dynamically in accordance with network status related with multicasting. So that it is able to make multicast paths very close to the optimum and more efficient multicast service is possible. The performance of the proposed mechanism is evaluated by a time analysis and simulations in various conditions.

Performance Enhancement of Handover in mSCTP using Pre-acquisition RA in WLAN (WLAN에서 RA 선수신을 이용한 mSCTP 핸드오버 성능 향상)

  • Choi, Soon-Won;Kim, Kwang-Ryoul;Min, Sung-Gi
    • Journal of KIISE:Information Networking
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    • v.33 no.2
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    • pp.156-164
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    • 2006
  • The SCTP (Stream Control Transmission Protocol) implementation with the DAR (Dynamic Address Reconfiguration) extension is called the mSCTP (Mobile SCTP) that is proposed recently for mobility support in transport layer. The mSCTP does not satisfy short handover latency for real-time applications and it has no specific handover decision mechanisms. In this paper, we propose fast handover schemes for mobile nodes that are moving into different subnet using pre-acquisition RA (Router Advertisement) and L3 trigger for improving handover performance. Furthermore, we introduce three specific methods which are RA cache, FMIPv6 (Fast Handovers for Mobile IPv6) and dual interface and how proposed scheme can be interoperated with handover process respectively. Finally, we show two experimental results which are the mSCTP and the mSCTP using FMIPv6 on Linux platforms. Experimental results show that handover performance is improved with reducing the time of receiving RA which takes most of total handover latency.

A Study on the Reversible SCR Servo Amplifier (정역전이 가능한 SCR 서보증폭기에 관한 연구)

  • Ahn, B. W.;Park, S. K.
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.31 no.2
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    • pp.190-198
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    • 1995
  • Many industrial servo amplifiers employ power transister as output device. Thyristor converters are not adopted to drive servo motor, although thyristor is superior to power TR in power rating, noise immunity, price, and size. The reason is, thyristor has no ability of self turn - off. Here in this paper line commutation, in which thyristor is turned off naturally since cathode voltage is higher than anode as time goes by, is employed to turn on thyristor with a delicate sequence. We developed thyristor servo amplifier which does not cause any damage on thyristor because it is designed to prevent triggering the two SCRs in the same arm simultaneously. And it was made clearly how to trigger SCR without any power line shorting and also harmonic analysis is carried out with the aid of FFT analyzer and proved that it can be used even severe reactive load. The designed circuit operated as a good DC amplifier in conventinal servomotor and the results can be use as a position control system application.

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Treatment of Canine Cervical and Lumbar Disc Disease by Injection-Acupuncture (개 경부 및 요부 디스크의 수침치료)

  • Kim Duck-Hwan;Liu Jian-Zhu;Lee Young-Won;Song Kun-Ho;Kang Sang-Kyu;Choi Ho-Jung;Seo Kang-Moon;Choi Seok-Hwa;Nam Tchi-Chou;Rogers Phil A.M.
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.65-68
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    • 2006
  • Two cases of canine intervertebral disc disease (IVDD) were treated twice a week with injection-acupuncture (injection-AP) using 0.1 ml/acupoint. In case 1, a paralysed dog with cervical intervertebral disc disease (C3-C4), was submitted to injection-AP with dexamethasone (1 mg/ml) at session 1-2 and thiamine (25 mg/ml) at session 3-5. Injected acupoints included GV-16, GB-20, BL-10, LU-7, LI-4 and SI-6. The acupoints GV-6, GV-20 and SP-6 were added at session 2-5. Trigger point (TP) therapy with 0.2 ml of 2% lidocaine was used in session 3-5 at TP in the infraspinatus and triceps muscles. Treatment was stopped when paralysis disappeared after 5 injection-AP treatments; there were no recurrent symptoms in the follow-up period of 5 months. In case 2, an ataxic dog with lumbar IVDD (L1-L2), was submitted to injection-AP with dexamethasone at session 1 and 2 and thiamine at session 3-4. Injected acupoints included GV-6 as the main point, ST-36, GB-30, ST-40, GB-34, ST-41 and BL-40. TP therapy with 0.2 ml of 2% lidocaine was used at TP in the ileocostorum lumborum and quadriceps muscles. Treatment was stopped when ataxia disappeared after 4 treatments; there were no recurrent symptoms In the fallow-up period of 5 months. Injection-AP using dexamethasone and thiamine, combined with TP therapy using lidocaine, effectively alleviate the symptoms of canine cervical and lumbar IVDD.

β-elemene Induces Caspase-dependent Apoptosis in Human Glioma Cells in vitro through the Upregulation of Bax and Fas/FasL and Downregulation of Bcl-2

  • Li, Chen-Long;Chang, Liang;Guo, Lin;Zhao, Dan;Liu, Hui-Bin;Wang, Qiu-Shi;Zhang, Ping;Du, Wen-Zhong;Liu, Xing;Zhang, Hai-Tao;Liu, Yang;Zhang, Yao;Xie, Jing-Hong;Ming, Jian-Guang;Cui, Yu-Qiong;Sun, Ying;Zhang, Zhi-Ren;Jiang, Chuan-Lu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10407-10412
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    • 2015
  • Background: ${\beta}$-elemene, extracted from herb medicine Curcuma wenyujin has potent anti-tumor effects in various cancer cell lines. However, the activity of ${\beta}$-elemene against glioma cells remains unclear. In the present study, we assessed effects of ${\beta}$-elemene on human glioma cells and explored the underlying mechanism. Materials and Methods: Human glioma U87 cells were used. Cell proliferation was determined with MTT assay and colony formation assay to detect the effect of ${\beta}$-elemene at different doses and times. Fluorescence microscopy was used to observe cell apoptosis with Hoechst 33258 staining and change of glioma apoptosis and cell cycling were analyzed by flow cytometry. Real-time quantitative PCR and Western-blotting assay were performed to investigated the influence of ${\beta}$-elemene on expression levels of Fas/FasL, caspase-3, Bcl-2 and Bax. The experiment was divided into two groups: the blank control group and ${\beta}$-elemne treatment group. Results: With increase in the concentration of ${\beta}$-elemene, cytotoxic effects were enhanced in the glioma cell line and the concentration of inhibited cell viability ($IC_{50}$) was $48.5{\mu}g/mL$ for 24h. ${\beta}$-elemene could induce cell cycle arrest in the G0/G1 phase. With Hoechst 33258 staining, apoptotic nuclear morphological changes were observed. Activation of caspase-3,-8 and -9 was increased and the pro-apoptotic factors Fas/FasL and Bax were upregulated, while the anti-apoptotic Bcl-2 was downregulated after treatment with ${\beta}$-elemene at both mRNA and protein levels. Furthermore, proliferation and colony formation by U87 cells were inhibited by ${\beta}$-elemene in a time and does-dependent manner. Conclusions: Our results indicate that ${\beta}$-elemene inhibits growth and induces apoptosis of human glioma cells in vitro. The induction of apoptosis appears to be related with the upregulation of Fas/FasL and Bax, activation of caspase-3,-8 and -9 and downregulation of Bcl-2, which then trigger major apoptotic cascades.

Effects of Glutamine Deprivation and Serum Starvation on the Growth of Human Umbilical Vein Endothelial Cells (재대정맥 내피세포의 증식에 미치는 글루타민 및 혈청 결핍의 영향)

  • Jeong, Jin-Woo;Lee, Hye Hyeon;Park, Cheol;Kim, Wun-Jae;Choi, Yung Hyun
    • Journal of Life Science
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    • v.23 no.7
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    • pp.926-932
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    • 2013
  • Glutamine and serum are essential for cell survival and proliferation in vitro, yet the signaling pathways that sense glutamine and serum levels in endothelial cells remain uninvestigated. In this study, we examined the effects of glutamine deprivation and serum starvation on the fate of endothelial cells using a human umbilical vein endothelial cell (HUVEC) model. Our data indicated that glutamine deprivation and serum starvation trigger a progressive reduction in cell viability through apoptosis induction in HUVECs as determined by DAPI staining and flow cytometry analysis. Although the apoptotic effects were more predominant in the glutamine deprivation condition, both apoptotic actions were associated with an increase in the Bax/Bcl-2 (or Bcl-xL) ratio, down-regulation of the inhibitor of apoptosis protein (IAP) family proteins, activation of caspase activities, and concomitant degradation of poly (ADP-ribose) polymerases. Moreover, down-regulation of the expression of Bid or up-regulation of truncated Bid (tBid) were observed in cells grown under the same conditions, indicating that glutamine deprivation and serum starvation induce the apoptosis of HUVECs through a signaling cascade involving death-receptor-mediated extrinsic pathways, as well as mitochondria-mediated intrinsic caspase pathways. However, apoptosis was not induced in cells grown in glutamine- and serum-free media when compared with cells exposed to glutamine deprivation or serum starvation alone. Taken together, our data indicate that glutamine deprivation and serum starvation suppress cell viability without apoptosis induction in HUVECs.

Estimation of Internal Motion for Quantitative Improvement of Lung Tumor in Small Animal (소동물 폐종양의 정량적 개선을 위한 내부 움직임 평가)

  • Yu, Jung-Woo;Woo, Sang-Keun;Lee, Yong-Jin;Kim, Kyeong-Min;Kim, Jin-Su;Lee, Kyo-Chul;Park, Sang-Jun;Yu, Ran-Ji;Kang, Joo-Hyun;Ji, Young-Hoon;Chung, Yong-Hyun;Kim, Byung-Il;Lim, Sang-Moo
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.140-147
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    • 2011
  • The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was $1.59{\times}2.50mm$. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$ (자기공명분석기를 이용한 통증관리)

  • Park, Wook;Jin, Hee-Cheol;Cho, Myun-Hyun;Yoon, Suk-Jun;Lee, Jin-Seung;Lee, Jeong-Seok;Choi, Surk-Hwan;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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The Effect of External PEEP on Work of Breathing in Patients with Auto-PEEP (Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과)

  • Chin, Jae-Yong;Lim, Chae-Man;Koh, Youn-Suck;Park, Pyung-Whan;Choi, Jong-Moo;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.201-209
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    • 1996
  • Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

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