• Journal of Trauma and Injury
• /
• v.21 no.2
• /
• pp.108-114
• /
• 2008

Purpose: Using a propensity analysis, a recent study reported that blood transfusion might not be an independent predictor of mortality in critically ill patients, which contradicted the results of earlier studies. This study aims to reveal whether or not blood transfusion is an independent predictor of mortality in trauma patients. Methods: A total of three hundred fifty consecutive trauma patients who were admitted to our emergency center from January 2004 to October 2005 and who underwent an arterial blood gas analysis and a venous blood analysis were included in this study. Their medical records were collected prospectively and retrospectively. Using a multivariate logistic analysis, data on the total population and on the propensity-score -matched population were retrospectively analyzed for association with mortality. Results: Of the three hundred fifty patients, one hundred twenty-nine (36.9%) received a blood transfusion. These patients were older (mean age: 48 vs. 44 years; p=0.019) and had a higher mortality rate (27.9% vs. 7.7%; p<0.001). In the total population, the multivariate analysis revealed that the Glasgow coma scale score, the systolic blood pressure, bicarbonate, the need for respiratory support, past medical history of heart disease, the amount of blood transfusion for 24 hours, and hemoglobin were associated with mortality. In thirty-seven pairs of patients matched with a propensity score, potassium, new injury severity score, amount of blood transfusion for 24 hours, and pulse rate were associated with mortality in the multivariate analysis. Therefore, blood transfusion was a significant independent predictor of mortality in trauma patients. Conclusion: Blood transfusion was revealed to be a significant independent predictor of mortality in the total population of trauma patients and in the propensity-score-matched population.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.26 no.1
• /
• pp.19-25
• /
• 2012

This study was designed to investigate the effects of a new herbal medicine named CWS-A on the changes in regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP) in normal rats, and further to determine the mechanism of action. Also, this study was designed to investigate the effects of CWS-A on the changes in rCBF in cerebral ischemic rats and the safety examination of CWS-A in rats regared to body weight change, renal and liver function test, CBC, $LD_{50}$ and histological observation in rats. The rCBF was significantly and stably increased and MABP was significantly decreased by CWS-A during the period of cerebral reperfusion in normal rats. However, there were no here were no significant changes of rCBF in ischemic rats. In additional, there were no significant changes on the safety examination. In conclusion, these results suggest that medication of CWS-A is effective for the improve the cerebral blood flow and CWS-A can be prescribed as vertigo(眩暈) symptoms treatment.

• Biomolecules & Therapeutics
• /
• v.3 no.4
• /
• pp.316-321
• /
• 1995

All the pharmacological studies of LB17522 described here were carried out with high doses (fifteen to sixty times of the therapeutic dose) to determine an indication of potential side effects in clinical use in terms of the acute clinical signs, cardiovascular and central nervous system. LB10522 does not produce any observable clinical signs except for the symptoms such as moist eye, skin rash, slight salivation, vomitting, and slightly reduced activity. The effects of LB10522 on the hemodynamics and cardiac function of anesthetized beagle dogs are as follows; heart rates and mean arterial blood pressure had a tendency to increase mildly, which is a normal finding in anesthetized dogs. All the animals except for one showed relatively stable respiratory rates throughout the observation period. Each animal treated with LB10522 showed slight increase in the left cardiac work and left ventricular stroke work which are mainly related to corresponding increases in cardiac output. Femoral blood flow were shown to be increased in some animals treated with LB10522. The epileptogenic activities of various cephalosporins were assessed by a direct intracerebral injection of appropriate concentration of test articles. The CD$_{50}$ values (nmol) obtained from the analysis of the dose-response data are as follows; 78.2, 175.3, 156.3, and 53.5 for cefazolin, cephaloridine, ceftazidime, and LB 10522, respectively. LB10522 seems to be equipotent with cefazolin or to be three times more potent than cephaloridine and ceftazidime in causing adverse CNS stimulation. Taken into consideration all the information obtained, LB10522 is not supposed to induce much changes in the functions examined in these studies in man at therapeutic doses.s.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.25 no.3
• /
• pp.220-230
• /
• 2018

Purpose: This study was a cross-sectional study comparing differences in self-management knowledge, self-management, physiologic indexes, and symptoms experience for two methods of dialysis. Methods: Participants were 90 patients on hemodialysis and 91 on peritoneal dialysis at A hospital. Results: There was no significant difference between the two groups for knowledge of self-management. A comparison of the categories in the evaluation of self-management showed that patients in the peritoneal dialysis group took better care of their dialysis access route (F=17.61, p<.001) and dialysis schedule (F=4.30, p=.040). The physiologic indexes between the two dialysis groups showed that hemoglobin levels were higher in the hemodialysis group (F=5.28, p=.023). The product of serum calcium and phosphate was higher in the peritoneal dialysis group (F=11.42, p=.001). Serum sodium level was also higher in the peritoneal dialysis group (t=5.36, p<.001) while serum albumin level (t=-3.36, p=.001) and mean arterial blood pressure (t=-2.50, p=.013) were higher in hemodialysis patients. There were no significant differences in the proportion of uncomfortable experiences between the two groups. Conclusion: Medical personnel should consider differences in self-management knowledge/self-management, physiologic indexes, and symptoms experience for hemodialysis and peritoneal dialysis populations, and should provide adequate education accordingly and promote behavioral change to improve physiologic indexes and reduce symptoms.

• Journal of Clinical Otolaryngology Head and Neck Surgery
• /
• v.29 no.2
• /
• pp.190-197
• /
• 2018

Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

• Biomedical Science Letters
• /
• v.27 no.1
• /
• pp.19-27
• /
• 2021

This study was undertaken to clarify the effects of omega-3 fatty acid on endotoxin-induced acute lung injury. Rabbits were randomly assigned to one of four groups. Each group received intravenous infusion of saline only, saline and Escherichia coli endotoxin, omegaven infuison (0.5 mL/kg/hr) and endotoxin, lipoven (0.5 mL/kg/hr) and endotoxin respectively. Infusion of saline was started 0.5 hr before the infusion of saline or endotoxin, and omegaven and lipoven were started 2 hours after endotoxin infusion for 4 hours. The lungs of rabbits were ventilated with 40% oxygen. Mean blood pressure, heart rate, arterial oxygen tension (PaO2), and peripheral blood leukocyte were recorded. The wet/dry (W/D) weight ratio of lung and lung injury score were measured, and analysis of bronchoalveolar lavage fluid (BALF) was done. Endotoxin decreased PaO2, and peripheral blood leukocyte and platelet count. And it increased W/D ratio of lung, lung injury score and leukocyte count, percentage of PMN cells, concentration of IL-8 in BALF. Omegaven attenuated all these changes except for peripheral blood leukocyte counts. Omegaven attenuated endotoxin-induced acute lung injury in rabbits mainly by inhibiting neutrophil and IL-8 responses, which may play a central role in endotoxin-related lung injury.

• Journal of Veterinary Science
• /
• v.23 no.4
• /
• pp.53.1-53.9
• /
• 2022

Background: Problems associated with using inhalational anaesthesia are numerous in veterinary anaesthesia practice. Decreasing the amount of used inhalational anaesthetic agents and minimising of cardiorespiratory disorders are the standard goals of anaesthetists. Objective: This experimental study was carried out to investigate the sparing effect of intravenous tramadol, lidocaine, dexmedetomidine and their combinations on the minimum alveolar concentration (MAC) of sevoflurane in healthy Beagle dogs. Methods: This study was conducted on six beagle dogs. Sevoflurane MAC was determined by the tail clamp method on five separate occasions. The dogs received no treatment (control; CONT), tramadol (TRM: 1.5 mg kg^-1 intravenously followed by 1.3 mg kg^-1 h^-1), lidocaine (LID: 2 mg kg^-1 intravenously followed by 3 mg kg^-1 h^-1), dexmedetomidine (DEX: 2 ㎍ kg^-1 intravenously followed by 2 ㎍ kg^-1 h^-1), and their combination (COMB), respectively. Cardiorespiratory variables were recorded every five minutes and immediately before the application of a noxious stimulus. Results: The COMB treatment had the greatest sevoflurane MAC-sparing effect (67.4 ± 13.9%) compared with the other treatments (5.1 ± 25.3, 12.7 ± 14.3, and 40.3 ± 15.1% for TRM, LID, and DEX treatment, respectively). The cardiopulmonary variables remained within the clinically acceptable range following COMB treatment, although the mean arterial pressure was higher and accompanied by bradycardia. Conclusions: Tramadol-lidocaine-dexmedetomidine co-infusion produced a remarkable sevoflurane MAC-sparing effect in clinically healthy beagle dogs and could result in the alleviation of cardiorespiratory depression caused by sevoflurane. Cardiorespiratory variables should be monitored carefully to avoid undesirable side effects induced by dexmedetomidine.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.151-157
• /
• 2022

Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3-238 months) and 7.5 kg (IQR, 5.8-49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39-195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6-112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

• Journal of Veterinary Science
• /
• v.21 no.1
• /
• pp.8.1-8.11
• /
• 2020

This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

• Journal of Chest Surgery
• /
• v.35 no.1
• /
• pp.20-26
• /
• 2002

Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.