• Title/Summary/Keyword: Lee Jae Won

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The Respiratory and Hemodynamic Effects of Prone Position According to the Level of PEEP in a Dog Acute Lung Injury Model (잡종견 급성폐손상 모델에서 Prone position 시행시 PEEP 수준에 따른 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Chin, Jae-Yong;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.140-152
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    • 1998
  • Background: Prone position improves oxygenation in patients with ARDS probably by reducing shunt Reduction of shunt in prone position is thought to be effected by lowering of the critical opening pressure (COP) of the dorsal lung because the pleural pressure becomes less positive in prone position compared to supine position. It can then be assumed that prone position would bring about greater improvement in oxygenation when PEEP applied in supine position is just beneath COP than when PEEP is above COP. Hemodynamically, prone position is expected to attenuate the lifting of cardiac fossa induced by PEEP. Based on these backgrounds, we investigated whether the effect of prone position on oxygenation differs in magnitude according to the level of PEEP applied in supine position, and whether impaired cardiac output in supine position by PEEP can be restored in prone position. Methods: In seven mongrel dogs, $PaO_2/F_1O_2$(P/F) was measured in supine position and at prone position 30 min. Cardiac output (CO), stroke volume (SV), pulse rate (PR), and pulmonary artery occlusion pressure (PAOP) were measured in supine position, at prone position 5 min, and at prone position 30 min. After ARDS was established with warmed saline lavage(P/F ratio $134{\pm}72$ mm Hg), inflection point was measured by constant flow method($6.6{\pm}1.4cm$ $H_2O$), and the above variables were measured in supine and prone positions under the application of Low PEEP($5.0{\pm}1.2cm$ $H_2O$), and Optimal PEEP($9.0{\pm}1.2cm$ $H_2O$)(2 cm $H_2O$ below and above the inflection point, respectively) consecutively. Results : P/F ratio in supine position was $195{\pm}112$ mm Hg at Low PEEP and $466{\pm}63$ mm Hg at Optimal PEEP(p=0.003). Net increase of P/F ratio at prone position 30 min, however, was far greater at Low PEEP($205{\pm}90$ mm Hg) than at Optimal PEEP($33{\pm}33$ mm Hg)(p=0.009). Compared to CO in supine position at Optimal PEEP($2.4{\pm}0.5$ L/min), CO in prone improved to $3.4{\pm}0.6$ L/min at prone position 5 min (p=0.0180) and $3.6{\pm}0.7$ L/min at prone position 30 min (p=0.0180). Improvement in CO was attributable to the increase in SV: $14{\pm}2$ ml in supine position, $20{\pm}2$ ml at prone position 5 min (p=0.0180), and $21{\pm}2$ ml at prone position 30 min (p=0.0180), but not to change in PR or PAOP. When the dogs were turned to supine position again, MAP ($92{\pm}23$ mm Hg, p=0.009), CO ($2.4{\pm}0.5$ L/min, p=0.0277) and SV ($14{\pm}1$ ml, p=0.0277) were all decreased compared to prone position 30 min. Conclusion: Prone position in a dog with saline-lavaged acute lung injury appeared to augment the effect of relatively low PEEP on oxygenation, and also attenuate the adverse hemodynamic effect of relatively high PEEP. These findings suggest that a PEEP lower than Optimal PEEP can be adopted in prone position to achieve the goal of alveolar recruitment in ARDS avoiding the hemodynamic complications of a higher PEEP at the same time.

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Comparison of the Physicochemical Properties of Meat and Viscera of Dried Abalone (Haliotis discus hannai) Prepared using Different Drying Methods (건조방법에 따른 건조 전복 (Haliotis discus hannai)의 이화학적 특성 비교)

  • Park, Jeong-Wook;Lee, Young-Jae;Park, In-Bae;Shin, Gung-Won;Jo, Yeong-Cheol;Koh, So-Mi;Kang, Seong-Gook;Kim, Jeong-Mok;Kim, Hae-Seop
    • Food Science and Preservation
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    • v.16 no.5
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    • pp.686-698
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    • 2009
  • We sought basic data for product development and storage improvement of abalone. We explored drying methodologies, such as shade drying, cold air drying, and vacuum freeze drying. We also examined various physicochemical features of both meat and viscera. Raw abalone meat had $78.88{\pm}1.01%$ moisture, $9.24{\pm}0.27%$ crude protein, and $10.05{\pm}0.81%$ carbohydrate (all w/w). The moisture level of dried abalone meat was highest after cold air drying, at $18.38{\pm}0.91%$, and lowest after vacuum freeze drying, at $1.05{\pm}0.05%$. The total amino acid content of raw abalone meat was $17,124.05{\pm}493.18\;mg%$, and fell after shade-drying to $12,969.92{\pm}583.65\;mg%$, and to $13,328.78{\pm}653.11\;mg%$ after cold air drying. The total free amino acid content of raw abalone meat was $4,261.99{\pm}106.55\;mg%$, and rose after shade-drying to $6,336.50{\pm}285.15\;mg%$, to $5,072.04{\pm}248.53\;mg%$ after cold air drying, and to $4,638.85{\pm}218.03\;mg%$ after vacuum freeze drying. The fatty acid proportions in raw abalone meat were $47.00{\pm}0.99%$ saturated, $22.18{\pm}1.05%$ monounsaturated, and $30.82{\pm}1.45%$ polyunsaturated. In the viscera, however, the proportions were $36.72{\pm}0.74%$ saturated, $25.44{\pm}1.12%$ monounsaturated, and $37.84{\pm}1.67%$ polyunsaturated. The contents of chondroitin sulfate in raw abalone were $11.95{\pm}0.35%$ in meat and $7.71{\pm}0.19%$ in viscera (both w/w). After shade-drying, the chondroitin sulfate content was $16.57{\pm}0.90%$ in meat and $9.24{\pm}0.50%$ in viscera. The figures after cold air drying were $16.17{\pm}0.79%$ and $12.44{\pm}0.61%$, and those after vacuum freeze drying $25.17{\pm}1.16%$ and $15.22{\pm}0.70%$ (thus including the highest meat content). The level of collagen in raw abalone was $69.80{\pm}3.07\;mg/g$ in meat and $40.62{\pm}1.79\;mg/g$ in viscera. Meat and viscera dried in the shade had $144.05{\pm}7.78\;mg/g$ and $44.16{\pm}2.39\;mg/g$ collagen, respectively, whereas the figures after cold air drying were $133.29{\pm}6.53\;mg/g$ and $69.20{\pm}3.39\;mg/g$, and after vacuum freeze drying $137.51{\pm}6.33\;mg/g$ and $60.61{\pm}2.79\;mg/g$. Volatile basic nitrogen values of raw abalone showed a higher content in viscera, at $19.01{\pm}0.84\;mg%$, compared to meat ($10.10{\pm}0.44\;mg%$). The value for shade-dried abalone meat was $136.77{\pm}7.37\;mg%$ and that of viscera $197.97{\pm}10.69\;mg%$. After cold air drying the meat and visceral values were $27.32{\pm}1.34\;mg%$ and $71.37{\pm}3.50\;mg%$, respectively.