• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.353-360
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• 2019

Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO₂) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO₂ monitoring did not present with sufficient benefits over the risk and cost.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1020-1029
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• 1988

The authors evaluated 153 patients who had undergone cardiac valve replacement between October 1979 and July 1988. The results are as follows: l. Out of 153 patients, there were 56 males and 97 females ranging from 15 to 62 years of age with a mean of 37 years. 2. Isolated mitral valve replacement took place in 82 patients, aortic valve replacement[AVR] in 16, double valve replacement[DVR] in 34, AVR combined with open mitral commissurotomy in 19, and tricuspid valve replacement[TVR] was done in 2 patients. 3. 153 patients had 187 prosthetic valves replaced with Ionescu-Shiley valves[16], Carpentier-Edwards[36], Bjork-Shiley[19], St. Jude Medical[108], and Duromedics[8]. 4. Our of 98 patients with atrial fibrillation[ 64% of a total 153 patients ] during the preoperative period, 22 patients recovered NSR[ 22/98, NSR recovery rate 22.4%] after valvular surgery and remaining 76 patients revealed persisting atrial fibrillation[76/153, 49.7% ]. 5. Preoperative episodes of systemic arterial embolization were attained in 9 patients[9/153, 6% ], and left atrial thrombi were confirmed in 22 patients intraoperatively[ 22/153, 14% ]. Of these, only one patient, however, demonstrated the correspondence of preoperative embolization and intraoperative existence of LA thrombi. 6. With mechanical prostheses, anticoagulant therapy was begun 48 hours after operation with sodium warfarin[2.5-5.0mg/day], maintaining the prothrombin time between 16 and 18 seconds or 30 to 50% of control values and continued for life. With tissue prostheses, sodium warfarin was continued for 3 to 6 months and converted into buffered ASA[ 325 mg/day ] for one year. 7. The mean follow-up for the survivors was 30.1 months, with a range from 3 months to 9 years. All suspected or confirmed thromboembolic episodes counted as events and occurred in 4 patients[ 1.04%/patient-year] with mechanical valve replacement. No persistent paralysis or death was noted. Late complications have not yet occurred in the patients with isolated MVR and AVR. 8. There were remarkable structural failures of tissue valves in 3 patients[ 1.9%/patient-year ], while no instance of failure of a mechanical valve. 9. There were 10 operative early deaths[10/153, 6.5%] and 5 late deaths[5/153, 3.3%]. Consequently, overall mortality was 9.8%[ 15/153] during follow-up period. 10. We currently favor using the St. Jude Medical valve in all patients requiring valve replacement except in those who can not take warfarin anticoagulation.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6673-6679
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• 2015

Background: Male breast cancer is a rare neoplasm, and its treatments are based on those of female breast cancer. This study aimed to analyze 20 years of male breast cancer clinical characteristics and treatment results from the Middle Black Sea Region of Turkey. Materials and Methods: A retrospective analysis of 16 male breast cancer patients treated in our tertiary hospital between 1994 and 2014 was performed. Epidemiologic data, tumor characteristics, and treatments were recorded and compared with 466 female breast cancer ((premenopausal; n = 230) + (postmenopausal n = 236)) patients. The 5-year disease-free and overall survival rates were calculated. Results: Male breast cancer constituted 0.1% of all malignant neoplasms in both sexes, 0.2% of all malignant neoplasms in males, and 0.7% of all breast cancers. The mean patient age in this study was $59.8{\pm}9.5$ (39-74) years. The mean time between first symptom and diagnosis was $32.4{\pm}5.3$ (3-60) months. Histology revealed infiltrative ductal carcinoma in 81.3% of patients. The most common detected molecular subtype was luminal A, in 12 (75%) patients. Estrogen receptor rate (93.8%) in male breast cancer patients was significantly higher than that in female breast cancer (70.8% in all females, p = 0.003; 68.2% in postmenopausal females, p = 0.002) patients. Most of the tumors (56.3%) were grade 2. Tumor stage was T4 in 50% of males. The majority (56.3%) of the patients were stage III at diagnosis. Surgery, chemotherapy, radiotherapy and endocrine-therapy were applied to 62.5%, 62.5%, 81.2% and 73.3%, respectively. Loco-regional failure did not occur in any of the cases. All recurrences were metastastic. The 5-year disease-free and overall survival rates in male breast cancer patients were 58% and 68%, respectively. Conclusions: Tumors found in male breast cancer patients were similar in size to tumors found in females, but they advanced to T4 stage more rapidly because of the lack of breast parenchymal tissues. The rate of estrogen receptor expression tended to be higher in male breast cancer patients than in female breast cancer patients. Metastasis is the most important problem in initially non-metastatic male breast cancer patients.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.247-253
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• 2012

Purpose: Hemorrhage is a main cause of death in trauma patients. The goal of this study is to describe the characteristics of trauma patients with massive bleeding and to evaluate the prognostic factors concerning their survival. Methods: This study was performed retrospectively and included trauma patients with massive bleeding who had been treated from March 2007 to August 2012. The inclusion criterion was patients who received more than 10 U of packed red blood cells within the first 24 hours after visiting the emergency department. Based on their medical records, we collected data in terms of demographic findings, mechanisms of injury, initial clinical and laboratory findings, methods for hemostasis (emergency surgery and/or angioembolization), transfusion, injury severity score (ISS), revised trauma score (RTS) and trauma and injury severity score (TRISS). We used the Mann-Whitney U test and Fisher's exact test to compare the variables between the patients that survived and those that did not. We performed a logistic regression analysis with the significant variables from the univariate test. Results: Thirty-two(32) patients were enrolled. The main mechanisms of injury were falls and motor vehicle accidents. The mean transfusion amount of packed red blood cells (PRBC) was 17.4 U. The mean elapsed time for the first hemostasis (surgery or embolization) was 3.5 hours. The initial technical success rates were 83.3%(15/18) in angioembolization and 66.7%(8/12) in surgery. The overall mortality rate was 34.4%(11/32). The causes of death were bleeding, brain swelling and multiple organ failure. The ISS(25.5 vs 46.3, p=0.000), TRISS(73.6 vs 45.1, p=0.034) and base excess(<-12 mmol/L, p=0.020) were significantly different between the patients who survived and those who did not. Conclusion: The ISS was a prognostic factor for trauma patients with massive bleeding.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.234-246
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• 2007

The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and $N_2O/O_2$ inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and $N_2O/O_2$ in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of $30{\pm}8$ months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more $N_2O/O_2$ administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by only oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and $N_2O/O_2$ using tine, but no correlation between weight and $N_2O/O_2$ using time. There was no statistically significant difference among variables of treatment duration, $N_2O/O_2$ administration and adverse event.

• Journal of the Korean Institute of Gas
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• v.14 no.1
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• pp.28-36
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• 2010

We have garnered 3,593 data of gas accidents reported for 12 years from 1995, and then analyzed the LPG vaporizer accidents according to their types and causes based on the classified database. According to the results the gas rupture has been the most common accident followed by the release, explosion and then fire accidents, the most frequent accident-occurring sub-cause is LPG check floater faults. In addition, we have applied the Poisson Probability Functions to predict the most-likely probabilities of fire, explosion, release and rupture with the LPG vaporizer in the upcoming 5 years. In compliance with Poisson Probability Functions results, in the item which occurs below 3 "LPG-Vaporizer-Fire", in the item which occurs below 5 "LPG-Vaporizer-Products Faults-Check Floater" and the item which occurs below 10 appeared with "LPG-Vaporizer-Products Faults". From this research we have assured the successive database updating will highly improve the anticipating probability accuracy and thus it will play a key role as a significant safety- securing guideline against the gas disasters.

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.7
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• pp.912-918
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• 2011

Newly born lambs have to face challenges in a new environment totally different from that of the uterus. Adaptation to extra-uterine life involves functional changes with almost each organ and system in the body undergoing a series of metabolic and anatomical modifications. Failure to adapt the extra-uterine environment can not only lead to homeostatic disturbances but also lead to the death of the affected lambs. Hematological parameters of newly born lambs show variability that differs between breeds of lambs. The purpose of present study was to determine homeostatic responses and physiological reference values in Kajli breed lambs occurring in the neonatal period through changes in blood profile, respiratory rate, heart rate, live weight and rectal, scrotal and skin temperatures. For this purpose, sixteen clinically fit lambs (males = 10 and females = 6) with a mean body weight $6.92{\pm}0.46$ kg were selected. Physiological data of selected parameters of each Kajli lamb was recorded at three day intervals and hematological parameters at five days for a period of 30 days. In general, statistical analysis showed a significant effect of time (p<0.001) on all the studied physiological and hematological parameters except platelets counts, white blood cells and hemoglobin concentration. The results documented in the current study are an addition to existing knowledge of the physiology of Kajli sheep breed should be helpful in developing feeding, disease diagnoses and treatment protocols for newborn Kajli stock.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.151-155
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• 1985

Female BALB/c mice weighing 18~20g were immunized by three injections of $1{\times}10^6$ Naegleria iowleri trophozoites intraperitoneally at the interval of one week 6 times for the pregnant mice and 3 times for the offspring mice. One week after immunization the mice were challenged intranasally with N. fcwleri trophozoites $5{\times}10^4$ under secobarbital anesthesia. Experimental primary amoebic meningoencephalitis developed between day 7 and 16 after infection. All mice were dead due to amoebic meningoencephalitis in all experimental groups except in the offspring born to non-immune mothers. Mean of survival time, which is the duration of survival of mice from infection to death, was delayed in the groups of mice born to immune mothers, immune mice born to immune mothers. Active or passive protective immunity against N. fowleri infection was demonstrated in the ismunized mice and mice born to immune mothers. But the effectiveness of immunization was greatly impaired in terms of mortality in the immune mice born to immune mothers when N. fowulsri was infected intranasally.

• Convergence Security Journal
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• v.11 no.6
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• pp.73-80
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• 2011

In this study, software products developed in the course of testing, software managers in the process of testing software and tools for effective learning effects perspective has been studied using the NHPP software. The delayed software S-shaped reliability model applied to distribution was based on finite failure NHPP. Software error detection techniques known in advance, but influencing factors for considering the errors found automatically and learning factors, by prior experience, to find precisely the error factor setting up the testing manager are presented comparing the problem. As a result, the learning factor is greater than automatic error that is generally efficient model could be confirmed. This paper, numerical example of applying using time between failures and parameter estimation using maximum likelihood estimation method, after the efficiency of the data through trend analysis model selection were efficient using the mean square error and $R^2$(coefficient of determination).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.470-476
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• 2006

Low-dose rate brachytherapy(LDR) has been effective modality for treatment of oral cancer. But the disadvantage of LDR is radioexposure of medical staff. To overcome this problem, high dose rate(HDR) brachytherapy has been developed. Our study evaluates the outcomes of patients with tongue cancer as treated by HDR brachytherapy. Between 2002 and 2005, eight patients with carcinoma of the tongue were treated with HDR brachytherapy. Five patients had AJCC stage I or II disease and the remaining three patients had AJCC stage III or IV. The male-to-female ratio was 2:6 and the mean age was 60.1 years (range: 21-80 years).The median follow-up time was 23.8 months (range: 7-55 months). There was no local failure until now. Three patients showed some complications. Two patients showed soft tissue necrosis. There was no bone sequela in all cases. Our experience in treating tongue cancer with HDR brachytherapy is encouraging, because it gave a satisfactory local control. Prospective studies are necessary to delineate the optimum indication for this treatment modality and long-term outcome.