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Usefulness of Tunneled Trans-saphenous IVC Catheters for Long Term Venous Access in Pediatric Patients (소아환자에서 대복재정맥을 통한 하대정맥도관법의 유용성)

  • Kim, Seung-Hwan;Kim, Seong-Min;Oh, Jung-Tak;Han, Seok-Joo;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.167-174
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    • 2006
  • Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

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Histopathological and Histochemical Studies on the Effect of Garlic and Garlic oil to the Rats (마늘 및 마늘 정유투여(精油投與)가 백서(白鼠)(Rat)의 간장(肝臟) 및 신장(腎臟)에 미치는 영향(影響)에 관(關)하여)

  • Ro, Ihl-Hyeob;Lee, Sook-Yun
    • Journal of Nutrition and Health
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    • v.1 no.3_4
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    • pp.201-205
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    • 1968
  • The authors has observed the histopathologically and histochemically on the effect of the garlic and garlic oil to the liver and kidney of rats. In order to confirm the histochemical changes of the metabolism of polysaccarides, the periodic acid Schiff reaction was applied. The 30 albino adult male rats weighing about 150 grames from the National Institute of Health were housed individualy and devide into 3 experimental groups: Group C: stock diet group Group B: stock diet-garlic group Group A: stock diet-garlic oil group Group C was fed with stock diet only through out this experimental period, Group B was fed with stock diet supplemented with garlic homogenator to be 1%, and Group A was fed with stock diet supplemented with the garlic oil to 0.05%. The garlic oil used in this experiments was extracted by author. And all rats was fed during 10 weeks. The histopathological and histochemical results were shown in each figure. According to the all results, the following concIusions were drawn. 1) In the garlic oil administrated groups, congestion of the sinusoid was subsided and the liberation of the Kupffer's cells were observed. 2) In garlic administrated groups, fatty metamorphosis in hepatic cells, and slight liberation of Kupffer's cells in sinusoidal walls were observed. Connective tissue proliferation and collagen bundle were observed. 3) The connective tissue and blood vessel wall in portal area Were reacted intensely with PAS stain. The hepatic cells Were reacted intensely with PAS stain in control group and moderately or slightly in garlic and garlic oil administrated group. 4) There were no significant differences in collecting and Henle's loops in each groups, but narrowing of lumen of the distal tubules were observed in garlic oil administrated group. 5) The basement membrane of the tubules and the connective tissues of the vessel wall in Kideny were reacted intensely with PAS stain in each groups. In control and garlic administrated groups. the brush border of the proximal tubules were reacted intensely with PAS stain, but epithelium of the Heine's loop, proximal, distal and collecting tubules were reacted moderately. In garlic oil administrated-group, there were tendency of decreasing of PAS stain in each tubules.

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EVALUATION OF MICROLEAKAGE WITH RETROGRADE FILLING MATERIALS IN BLOOD CONTAMINATION USING FLUID TRANSPORT MODEL (Fluid transport model을 이용한 치근단 역충전 재료의 혈액오염시 미세누출평가)

  • Ahn, Hyo-Soon;Jang, In-Ho;Lee, Se-Joon;Lee, Kwang-Won
    • Restorative Dentistry and Endodontics
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    • v.27 no.1
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    • pp.24-33
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    • 2002
  • Leakage studies have been performed frequently, since a fluid-tight seal provided by various dental fill-ing materials has been considered clinically important. The leakage of the various root-end filling materials has been widely investigated mostly dye penetration method. These dye studies cannot offer any information about the quality of the seal of a test material over a long period of time The purpose of this study was to evaluate the microleakage of root end cavities in blood contamination filed amalgam, intermediate restorative material(IRM), light cured glass ionomer cement(GI) and mineral trioxide aggregate(MTA) by means of a modified fluid transport model. Fifty standard human root sections, each 5mm high and with a central pulp lumen of 3mm in diameter, were and filled with our commonly used or potential root end fill ing materials after they were contaminated with blood. At 24h. 72h, 1, 2, 4, 8, and 12 weeks after filling, leakage along these filling materials was determined under a low pressure of 10KPa(0.1atm) using a fluid transport model. The results were as follows : 1 MTA group showed a tendency of decreasing percent of gross leakage (20m1/day) in process of time, whereas the other materials showed a tendency of increasing in the process time. 2. At the all time interval, GI group leaked significantly less than amalgam group and IRM group (p<0.05). 3. At the 4 weeks, the percentage of gross leakage in MTA group decreased to 0% thereafter, the low per-centage of gross leakage was maintained in MTA group until the end of the experiment, whereas the percentage in IRM group increased to 100% 4. At the 12 weeks, percentage of gross leakage was significantly low in MTA group(0%), comparison with GI group(40%), amalgam group(90%) and IRM group(100%), but there was no significant difference between latter two materials.

The outcome of percutaneous stent implantation in congenital heart disease: experience of a single institute

  • Kim, Moon Sun;Yoon, Ja Kyoung;Kim, Seong Ho;Bang, Ji Seok;Jang, So Ick;Lee, Sang Yoon;Choi, Eun Young;Park, Su Jin;Kwon, Hye Won
    • Clinical and Experimental Pediatrics
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    • v.61 no.6
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    • pp.187-193
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    • 2018
  • Purpose: The efficacy of percutaneous stent implantation for congenital heart disease (CHD) in Korea, where stent availability is limited, has not been determined. This study evaluated the acute and midterm results of stent implantation in different CHD subgroups. Methods: Stents were implanted in 75 patients with 81 lesions: (1) pulmonary artery stenosis (PAS) group, 56 lesions in 51 patients; (2) coarctation of the aorta (CoA) group, 5 lesions in 5 patients; (3) Fontan group, 13 lesions in 12 patients; (4) ductal stent group, 3 lesions in 3 patients; and (5) other CHD group, 4 lesions in 4 patients. Mean follow-up duration was 2.1 years (0.1-4 years). Medical records were reviewed retrospectively. Results: The minimum lumen diameter (MLD) in PAS and CoA increased from $5.0{\pm}1.9mm$ and $8.4{\pm}1.6mm$ to $10.1{\pm}3.6mm$ and $12.3{\pm}2.5mm$, respectively (P<0.01). In the PAS group, pressure gradient decreased from $25.7{\pm}15.6mmHg$ to $10.4{\pm}10.1mmHg$, and right ventricular to aortic pressure ratio from $0.56{\pm}0.21$ to $0.46{\pm}0.19$. In the CoA group, the pressure gradient decreased from $50{\pm}33mmHg$ to $17{\pm}8mmHg$. In the ductal stent group, the MLD of the ductus increased from 2.3 mm to 4.3 mm and arterial oxygen saturation from 40%-70% to 90%. No deaths were associated with stent implantation. Stent migration occurred in 3 patients, but repositioning was successful in all. Stent redilation was performed successfully in 26 cases after $29{\pm}12months$. Conclusion: Percutaneous stent implantation was safe and effective, with acceptable short and mid-term outcomes in Korean CHD patients.

Effects of Supplemental Lactobacillus on Broiler Performance (유산균의 급여가 육계의 성장능력에 미치는 영향)

  • 박수영;김상호;유동조;이상진;류경선
    • Korean Journal of Poultry Science
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    • v.28 no.1
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    • pp.27-40
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    • 2001
  • This study was conducted to investigate the effects of feeding various Lactobacillus on performance, nutrients digestibility, intestinal microflora, and fecal noxious gas of broiler chicks. One thousand eighty one dat old male broiler chicks were fed into Lactobacillus crispatus avibrd 1(LCB), Lactobacillus reuteri avibro 2(LRB), Lactobacillus crispatus avihen 1(LCH), and Lactobacillus vaginalis avehen 2(LVH) at the level of $10^{4}$ and 10(sup)7cfu/g diet. There were four replicates with thirty chicks per pen. Diets contained ME 3,100, 3,100kcal/kg, and CP 22.0, 20.0% for starting and finishing period, respectively. Weight gain of checks fed Lactobacillus spp. tended to increase from the first week and was higher from 50 to 100g in Lactobacillus treatments than control. Feed intake and feed conversion were not statistically different of all treatments. Dry Matter(DM) digestibility of Lactobacillus treatments was tended to improve compared to that of control, but was not significantly different. Protein and Ca digestibility were also tended to improve in Lactobacillus treatments relative that of control. Lactobacillus treatments showed improved tendency in crude ash and fat compared to those of control, whereas phosphorus digestibility was not consistency. Nutrients digestibilities of bird fed LCH were superior to those of other treatments. It showed significantly higher in Ca and P digestibility than control(P〈0.05). Total Lactobacillus spp. of birds fed various lactobacillus was significantly higher in ileum for five weeks(P〈0.05), but was not different at cecum. Yeast was thought to be not completely attached to intestinal lumen for one week. However, total number of yeast was significantly increased in cecum and ileum from three weeks old chicks(P〈0.05). The number of anaerobes exhibited to tendency the increase in Lantobacillus treatments from one week old of age at both ileum and cecum. Moisture contents of birds fed Lactobacillus spp. was shown from 27 to 30% at five weeks old, whereas it was 38.2% in control. It decreased approximately 25% in Lactobacillus treatments relative to that of control and showed significance between them(P〈0.05). Fecal $NH_{3}$ gas emission was significantly decreased in Lactobacillus treatments and maintained $\frac{1}{3}$to $\frac{1}{2}$ of control(P〈0.05). LCH and LVH treatments were most effective to decrease fecal $NH_{3}$ gas and especiallt impreved ti significantly at the level of the level of 10(sup)7cfu/g diets covpared to that of $10^{4}$ cfu/g diets and control(P〈0.05). In conclusion, feeding Lactobacillus spp. increase performance and nutrients digestibilities of broiler chicks and improve environments of house. Proper supplemental level of Lactobacillus spp. is considered more than $10^{4}$ cfu/g diet.

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Development of Differential Diagnosis and Treatment Method of Reproductive Disorders Using Ultrasonography in Cows II. Differential Diagnosis of Subestrous Dairy Cows (초음파검사에 의한 소의 번식장애 감별진단 및 치료법 개발 II. 무발정우의 감별진단)

  • 강병규;최한선;강현구;오기석;서동호;손창호;서국현
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.307-318
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    • 1998
  • Accuracy of rectal palpation and ultrasonography for differential diagnosis of subestrous dairy trows were investigatedl using the result of pIRsma progesterone assay. The ovaries were examined 2 times of 10 days interval in 520 posearom and postinsemination subestroHs dairy cows, using rectal palpation and B-mode transrectal ultrasonography. The results of rectal palpation, ultrasonographic examination and measurement of plasma progesterone profiles in 520 subestrous dairy cows were silent brat or error of estrus detection 303 (58.3%), persistent corpus luteum 59 (11.3%), follicular cyst 37 (7.1%), luteal cyst 16 (3.1%), inactive ovary 9 (1.7%), granulosa tumor 1 (0.2%), hydmsalphinx 1 (0.2%), endomehris 81 (15.6%), pyometra 12 (2.3%) and mummified fetus 1 (0.2%), respectively. Accuncy of rectal palpation and ultrasonography for diagiosing ovarian disordeir based on plasma progesterone profiles were silent heat or error of estrus detection 80.5% and 96.7%$\boxUl$ persistent corpus luteum 57.6% and 94.9%, follicular cyst 62.5% and 91.9%1 luteal cyst 62.5% and 87.5%, maclive ovary 55.6% and 88.9% and granulosa cell tumor 100% and 100%, respectively. Acnuucy of rectal palpation for diagnosing uterine disorders based on ultrasonography was pyometra 75.0%1 endometritis 51.9% and mummified fetus 100%, respectively. Cbaracteristic ultrasonographic appearances of ovaries in subestrous dairy cows were as follows; Silent heat or error of estrus detection: anechoic follicle or hypoechoic corpus luteum than ovarian stroma was alternately present on Day 0 (first examination) and Day 10. Follicular cyst: uniformly nonechogenic ovarian structure $\geq $ 25 mm in diameter with a wall < 3 mm was present in ipsilateral on Day 0 and Day 10. Luteal cyst: luteal cyst was similar to follicular cysts but thickness of cystic wall was $\geq $ 3 mm. Inactive ovary : structures within ovaries was not present on Day 0 Bnd Day 10. Characteristic uthssonograpsc appearances of uterus in subestrous dairy cows were as follows; Endometritis: characterized by uterine lumen containing fluid in which 'snowy'echogenic particles art suspended. Pyometra: ultrasonographic appearance of pyometra was diffuse echogenic particles distributed in fluid within the distended uterus, and a thickened uterine wall. These results indicated that ultrasonography was practical far diagnosing reproductive disorders. To diagnosing ovarian disorders, ultrasonography should be carried out 2 times of 10 days interval and rndometritis should be differentiated with uterus of luteal phase in normal cycling cows.

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Effects of Rhizoma Coptidis Herbal Acupuncture applied to HapGok $(LI_4)$ on TNBS-induced Colitis in rats (흰쥐의 합곡부위(合谷部位)에 황련약침(黃連藥鍼)이 TNBS로 유발된 대장염(大腸炎)에 미치는 영향(影響))

  • Do, Jin-Woo;An, Sung-Hun;Koo, Sung-Tae;Baek, Tae-Bong;Kim, Kyung-Sik;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.21 no.2
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    • pp.95-110
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    • 2004
  • Objectives : Ulcerative colitis and Crohn's diseases are chronic inflammatory disease of the gastrointestinal tract identified mainly for diarrhea, stomachache, hemafecia. The source and pathologic mechanism about ulcerative colitis and Crohn's disease are still unknown but stress, infection, a genetic factor, environmental factors etc. may be the cause of chronic inflammatory disease of the gastrointestinal tract recently. Methods : Because ulcerative colitis and Crohn's disease is recognized as Ha-ri(下痢) or Jang-Byok(腸?) in Oriental Medicine, Rhizoma Coptidis Herbal acupunctures were injected in hapgok $(LI_4)$ which is used to treat intestinal disease in clinic. All animals were subjected to the injection of saline $(300\;{\mu}l,\;500\;{\mu}l)$ for a study control and TNBS $(300\;{\mu}l,\;500\;{\mu}l)$ into the lumen of the colon, 8cm proximal to the anus through the intestine. Rhizoma Coptidis Herbal (20 mg/ml, 0.4 ml) acupuncture solution was injected to the $LI_4$ (both hands) at the secondary injection time of TNBS in rats. And body weight, RBC count, WBC count, total protein, Paw edema rate, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels were observed to study the effects of Rhizoma Coptidis Herbal acupuncture in hapgok $(LI_4)$. Results : In results, Rhizoma Coptidis Herbal acupuncture in hapgok $(LI_4)$ on TNBS-induced colitis reduced the rate of weight loss but had no effect on RBC and WBC count. And it reduced total protein concentration, paw edema, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels. Conclusion : Data suggest that injection of Rhizoma Coptidis herbal acupuncture solution into hapgok has significant therapeutic effect on the colitis.

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Chemical Properties and Fiber Dimension of Eucalyptus pellita from The 2nd Generation of Progeny Tests in Pelaihari, South Borneo, Indonesia

  • Lukmandaru, Ganis;Zumaini, Umi Farah;Soeprijadi, Djoko;Nugroho, Widyanto Dwi;Susanto, Mudji
    • Journal of the Korean Wood Science and Technology
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    • v.44 no.4
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    • pp.571-588
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    • 2016
  • Eucalyptus pellita F. Muell is one of pulp woods that is being developed through breeding plantation programs in Indonesia. The research aimed at exploring the chemical and morphological characteristics of fiber, and to determine the rank of plus trees from 4 provenances based on the suitability for pulps. The materials included the plus trees of E. pellita (9 years) from the 2nd generation of progeny tests in Pelaihari, South Borneo. Wood properties under investigation included the chemical properties and morphological fiber characteristics (fiber dimensions and its derived properties). In the present study, data were analyzed using descriptive statistic, Analytic Hierarchy Process (AHP) and Pearson's correlation. Results showed that the chemical properties of E. pellita, i.e. the contents of ethanol-toluene extractives, hot water soluble extractives, holocellulose, alphacelullose, and lignin were $3.08{\pm}1.00%$, $1.41{\pm}0.38%$, $75.26{\pm}2.58%$, $49.02{\pm}2.88%$, and $29.49{\pm}1.86%$, respectively. The average values of wood fiber morphology were $1.02{\pm}0.08$ mm (fiber length), $13.25{\pm}1.64{\mu}m$ (fiber diameter), of $6.94{\pm}1.70{\mu}m$ (lumen diameter), $3.15{\pm}0.52{\mu}m$ (fiber wall thickness), $0.97{\pm}0.30$ (Runkel ratio), $0.57{\pm}0.10$ (Luce's shape factor), $78.21{\pm}10.34$ (slenderness ratio) and $130.91{\pm}33.77{\times}10^3{\mu}m^3$ (solids factor). The AHP scoring rank indicated that the best individuals were 28.4.3.28 (Kiriwo Utara), 12.1.5.28 (North Kiriwo), 19.11.5.45 (Serisa Village), 3.8.4.9 (South Kiriwo), and 6.6.3.15 (South Kiriwo). Pearson correlation analysis showed significant correlations between the levels of fiber length with alpha-cellulose content (r = 0.39) as well as the fiber length with ethanol-toluene extractive contents (r = -0.41).

Growth Ingibiton Effect of E. coli O157:H7 and Salmonella typhimurium by Lactic Fermented Milk Products Administrated Orally in Rabbit (토끼에서 유산 발효유제품 급여에 의한 Escherichia coli O157:H7 및 Salmonella typhimurium의 증균억제효과)

  • 신광순;김용환;손원근;석주명;김상현
    • Journal of Food Hygiene and Safety
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    • v.12 no.3
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    • pp.188-194
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    • 1997
  • The growth inhibition effect of Orally administrated yogurt ACE and Metchnikoffupon E. coli O157:H7 and S. typhimurium inoculated into gastric lumen of rabbits was in vestigated. The rabbits challenged with each 1 $m\ell$ of suspension containing 108 CFU/$m\ell$ of the pathogens were divided into 4 groups by the interval of yogurt administration: A group; preadministrated 7 days before inoculation of the pathogens and fed daily; B group; administrated daily after inocjlation of the pathogens, C group; administrated every 3 days after inoculation of the pathogens; Control group, not fed after inoculation of the pathogens. Each 3 $m\ell$ of yogurt containing 109 CFU/$m\ell$ was orally administrated into rabbits. All yogurt administrated groups (A, B, c) chowed growth ingibition effect on E. coli O157:H7 in one day after inoculation of the pathogen by the level of 0.8~1.0 log CFU/g, compared with the result differences between the control group and the yogurt administrated groups. In the control group after 5 days of inoculation, the number of colonized pathogens was 105~106 CFU/g, whereas 103~104 CFU/g was detected in the yogurt administrated groups. After 10 days of inoculation, the viable pathogen number per gram (g) of the rabbit feces was 103 CFU/g in the control group, whereas the number below 101 CFU/g was detected in the group A, and 102 CFU/g in the control group, B and C. The growth inhibition effect of yogurt administration on E. coli O157:H7 was highly increased in the order of A, B, and C group. The same effect on S. typhimurium was observed at the level of 2 log CFU/g in the Metchnikoff yogurt administrated groups, compared with the control group result in one day after inoculation of the pathogen. In 7 days after inoculation of the pathogen, the viable number was increasingly decreased, and finally after 15 days no viable cell of S. typhimurium was discharged into the fecal samples in the group A, and the mean level of 10* CFU/g was detected in the group B, but there was no growth inhibition effect in the group C. The growth inhibition effect on S. typhimurium was observed at the same level of viable cell number between the yogurt ACE administrated groups and the control group in 5 days after inoculation. But, after 10 days of inoclation the viable cell number was started to decrease, and the viable cell of S. typhimurium was not discharged from rabbit intestinal contents after 15 days of inoculation in the yogurt ACE administrated groups. In such a case that yogurt was administrated in order to prevent the pathogens, pre-administration on a daily basis one week before inoculation of the pathogens exerted considerable effect in growth inhibition. In comparison with two kinds of yogurt tested in this study, the growth inhibition effect on two kinds of pathogens was observed more highly in the Metchnikoff administated group than the ACE administrated group.

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Conceptual Source Design and Dosimetric Feasibility Study for Intravascular Treatment: A Proposal for Intensity Modulated Brachytherapy (혈관내 방사선치료를 위한 이론적 선원 설계 및 선량적 관점에서의 적합성 연구: 출력변조를 이용한 근접치료에 대한 제안)

  • Kim Siyong;Han Eunyoung;Palta Jatinder R.;Ha Sung W.
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.158-166
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    • 2003
  • Purpose: To propose a conceptual design of a novel source for intensity modulated brachytherapy. Materials and Methods: The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a $^{90}Sr/Y$ Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quater of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. Results: The preliminary hypothetical simulation and optimization results demonstrated the 87$\%$ difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7$\%$ by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. Conclusion: The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter.