Background: Patient-controlled analgesia (PCA) has been widely used as an effective medical treatment for pain and for postoperative analgesia. However, improper dose errors in intravenous (IV) administration of narcotic analgesics from a PCA infusion pump can cause patient harm. Furthermore, opioid overdose is considered one of the highest risk factors for patients receiving pain medications. Therefore, accurate delivery of opioid analgesics is a critical function of PCA infusion pumps. Methods: We designed a microbalance method that consisted of a closed acrylic chamber containing a layer and an oil layer with an electronic balance. A commercially available infusion analyzer (IDA-5, Fluke Co., Everett, WA, USA) was used to measure the accuracy of the infusion flow rate from a commercially available smart PCA infusion pump (PS-1000, UNIMEDICS, Co., Ltd., Seoul, Korea) and compared with the results of the microbalance method. We evaluated the uncertainty of the flow rate measurement using the ISO guide (GUM:1995 part3). The battery life, delay time of the occlusion alarm, and bolus function of the PCA pump were also tested. Results: The microbalance method was good in the short-term 2 h measurement, and IDA-5 was good in the long-term 24 h measurement. The two measurement systems can complement each other in the case of the measurement time. Regarding battery performance, PS-1000 lasted approximately 5 days in a 1 ml/hr flow rate condition without recharging the battery. The occlusion pressure alarm delays of PS-1000 satisfied the conventional alarm threshold of occlusion pressure (300-800 mmHg). Average accuracy bolus volume was measured as 63%, 95%, and 98.5% with 0.1 ml, 1 ml, and 2 ml bolus volume presets, respectively. A 1 ml/hr flow rate measurement was evaluated as 2.08% of expanded uncertainty, with a 95% confidence level. Conclusion: PS-1000 showed a flow accuracy to be within the infusion pump standard, which is ± 5% of flow accuracy. Occlusion alarm of PS-1000 was quickly transmitted, resulting in better safety for patients receiving IV infusion of opioids. PS-1000 is sufficient for a portable smart PCA infusion pump.
We introduce a personal identification method which can find user's ID without any help of the user. To do this, there has been two approaches, vision-based and pressure-based. Pressure-based approach has some advantages compared than vision-based one in the aspects of illumination, occlusion, and the amount of data. In the previous study about pressure-based personal identification, there are some restrictions about human body posture for extracting normalized footprints. Since this approach cannot be extended unconscious and continuos identification, we suppose more natural method and verified it by experiments.
In the manufacture of ceramo-metal crown, difference of fracture strength according to the metal depth has been known to be an important influence on enough intensity and internal stress to endure an occlusion-pressure as well as aesthetics of rehabilitating similar colour such as natural teeth. Depth of ceramic material could be determined by that of metal in three groups: first case of thin depth, second case of thick depth, and third case of constant depth. For the enhancement of the fracture strength between metal and ceramic materials and aesthetic satisfaction, a study on the bonding force, fracture strength, and aesthetics have been required more. In this study, therefore metal coping were made in three groups of A, B and C by using both ceramic powder of Norithe and metal of Columbium, which have been used primarily in the market. A group was made in $0.2mm\times10mm\times10mm$, B group was made in $0.4mm\times10mm\times10mm$, and, C group was made in $0.8mm\times10mm\times10mm$, respectively. The number of metal coping in each group was 10, and total sample numbers used in this study were 30 metal copings. After these metal coping tissue were in the process of build-up in 1.5mm constant depth of porcelain, firing, and glazing, the fracture strength about each metal coping tissue was investigated using oil press. It was found that the average values of durable occlusion pressure for separation of ceramic material in the porcelain fused to metal crown (PFM) in the each group showed the increasing order of A group (30 bar), B group (42 bar), and C group (44 bar), respectively. Proper depth of metal coping in the PFM was considered to be 0.4mm in the B group because this metal size showed higher durable property to the occlusion pressure and better coupling strength in the ceramo-metal crown.
Journal of Advanced Marine Engineering and Technology
/
v.20
no.5
/
pp.103-113
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1996
The properties of the deposited film depend on the deposition condition and these, in turn depend critically on the morphology and crystal orientation of the films. Therefore, it is important to clarify the nucleation occurrence and growth stage of the morphology and orientation of the film affected by deposition parameters, e.g. the gas pressure and bias voltage etc. In this work, magnesium thin flims were prepared on cold-rolled steel substrates by a thermo-eletron activation ion plating technique. The influence of nitrogen gas pressure and substrate bias voltage on their crystal orientation and morphology of the coated films were investigated by scanning electron microscopy (SEM) and X-ray diffraction, respectively. The diffraction peaks of magnesium film became less sharp and broadened with the increase of nitrogen gas pressure. With an increase in nitrogen gas pressure, flim morphology changed from colum nar to granular structure, and surface crystal grain-size decreased. The morphology of films depended not only on gas pressure but also on bias voltage, i.e., the effect of increasing bias voltage was similar to that of decreasing gas pressure. The effect of crystal orientation and morphology of magnesium films on corrosion behaviors was estimated by measuring anodic polarization curves in deaerated 3%NaCl solution. Magnesium, in general, has not a good corrosion resistance in all environments. However, these magnesium films prepared by changing nitrogen gas pressure showed good corrosion resistance. Among the films, magnesium films which exhibited granular structure had the highest corrosion resistance. The above phenomena can be explained by applying the effects of adsorption, occlusion and ion sputter of nitrogen gas.
Occlusal force is a critical factor affecting the condition and structure of the periodontium. When the occlusal forces exceed the physiologic adaptive capacity of the tissues, tissue damage ensues. Such damage is referred to as trauma from occlusion. Excessive pressure causes compression, degeneration and realignment of the periodontal ligament fibers so that they are paralleled perpendicular to the tooth and bone. By inducing excessive occlusal forces with a high amalgam filling on rat's molar, the author observed histologic alterations of the periodontal ligament fibers by means of Hematoxylin-eosin, Van Gieson and Aldenyde fuchsin stainings. The results of the study were observed as follows: 1) The excessive occlusal forces altered arrangement of the collagenous fibers. 2) The arrangement of the oblique fibers showed appreciable differences between the control group and the group subjected to 10 days experimental trauma from occlusion. 3) The realignment of the transseptal fibers was not found. 4) The arrangement of the oblique fibers after 15 days of trauma from occusion was similar to that of 10 days experimental group. 5) The oxytalan fibers were more abundant at the cementum rather than at the alveolar bone. 6) The excessive occlusal forces produced funnel-shaped widening of the oxytalan fibers, which followed wavy course. 7) The oxytalan fibers appeared to be distributed mainly around the middle third of the root rather than that of the apical third of the root during the experimental trauma from occlusion.
Objective : This study was conducted to compare the effect of etomidate with that of thiopental on brain protection during temporary vessel occlusion, which was measured by burst suppression rate (BSR) with the Bispectral Index (BIS) monitor. Methods : Temporary parent artery occlusion was performed in forty one patients during cerebral aneurysm surgery. They were randomly assigned to one of two groups. General anesthesia was induced and maintained with 1.5-2.5 vol% sevoflurane and 50% $N_2O$. The pharmacological burst suppression (BS) was induced by a bolus injection of thiopental (5 mg/kg, group T) or etomidate (0.3 mg/kg, group E) according to randomization prior to surgery. After administration of drugs, the hemodynamic variables, the onset time of BS, the numerical values of BIS and BSR were recorded at every minutes. Results : There were no significant differences of the demographics, the BIS numbers and the hemodynamic variables prior to injection of drugs. The durations of burst suppression in group E ($11.1{\pm}6.8$ min) were not statistically different from that of group T ($11.1{\pm}5.6$ min) and nearly same pattern of burst suppression were shown in both groups. More phenylephrine was required to maintain normal blood pressure in the group T. Conclusion : Thiopental and etomidate have same duration and a similar magnitude of burst suppression with conventional doses during temporary arterial occlusion. These findings suggest that additional administration of either drug is needed to ensure the BS when the temporary occlusion time exceed more than 11 minutes. Etomidate can be a safer substitute for thiopental in aneurysm surgery.
These studies were investigated about influence of SKP 450, a $K^{+}$ channel opener, on the pressor actions induced by norepinephrine, angiotensin II and carotid artery occlusion in rats. Before these studies, effect of SKP 450 itself on blood pressure was examinated. SKP 450 produced the depressor action in proportionaly to dose of 0.3, 1.0 and 3.0 $\mu$g/kg given intravenously and this depressor action was weakened by pretreatment of glibenclamide, a $K^{+}$ channel blocker. The pressor action induced by norepinephrine, an alpha-adrenergic agonist, was blocked 1 hr after administation of SKP 450 in a dose of 3.0 $\mu\textrm{g}$/kg, i.v. and directly after in a dose of 6.0 $\mu\textrm{g}$/kg, i.v.. The pressor action induced by angiotensin II was blocked immediatly after treatment of SKP 450 in a dose of 3.0 $\mu\textrm{g}$/kg, i.v.. The pressor action caused by carotid artery occlusion was not affected by SKP 450 of 3.0 $\mu\textrm{g}$/kg, i.v., whereas markedly blocked by SKP 450 of 6.0 $\mu\textrm{g}$/㎦, i.v.. The potentiated-pressor actions of norepinephrine and angiotensin II by pretreatment of chlorisondamine, a autonomic ganglionic blocking agent, were also blocked by administration of SKP 450 in a dose of 6.0 $\mu\textrm{g}$/kg, i.v.. The weakened-pressor action of carotid artery occlusion by pretreatment of chlorisondamine was more weakened by SKP 450 6.0 $\mu\textrm{g}$/kg, i.v.. The results suggest that hyperpolarization formed through $K^{+}$ channel opening in cell membrane inhibits the pressor action induced norepinephrine ; angiotensin II ; and carotid artery occlusion.usion.
Park, Sung-Min;Cho, Seong-Joon;Ryu, Se-Min;Lee, Kyung-Hak;Kang, Gu
Journal of Chest Surgery
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v.45
no.2
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pp.73-79
/
2012
Background: Aortic cross clamping is associated with spinal cord ischemia. This study used a rat spinal cord ischemia model to investigate the effect of distal aortic pressure on spinal cord perfusion. Materials and Methods: Male Sprague-Dawley rats (n=12) were divided into three groups. In group A (n=4), the aorta was not occluded. In groups B (n=4) and C (n=4), the aorta was occluded. In group B the distal aortic pressures dropped to around 20 mmHg. In group C, the distal aortic pressure was decreased to near zero. The carotid artery and tail artery were cannulated to monitor the proximal aortic pressure and the distal aortic pressure. Fluorescent microspheres were used to measure the regional blood flow in the spinal cord. Results: After aortic occlusion, blood flow to the cervical spinal cord showed no significant difference among the three groups. In groups B and C, the thoracic and lumbar spinal cord and renal blood flow decreased. No microspheres were detected in the thoracic and lumbar spinal cord of group C. Conclusion: The spinal cord blood flow is dependent on the distal aortic pressure after thoracic aortic occlusion.
Tarbiat, Masoud;Bakhshaei, Mohammad Hossein;Derakhshanfar, Amir;Rezaei, Mahmoud;Ghorbanpoor, Manoochehr;Zolhavarieh, Seyed Mohammad
Journal of Chest Surgery
/
v.54
no.5
/
pp.377-382
/
2021
Background: Subclavian vein (SV) catheterization is a method for the delivery of fluids, drugs, and blood products, venous blood sampling, and central vein pressure monitoring in cardiac surgery. Catheter occlusion is a serious complication of SV catheterization during cardiac surgery, especially after sternal retractor expansion. Methods: In this observational study, 303 patients who had successful right infraclavicular SV catheterization from September 2019 to April 2020 were enrolled to determine the incidence of catheter occlusion. After catheterization, the lumens of all catheters were checked for the ability to infuse and withdraw blood from the catheter before and after sternal retractor expansion. The patients' characteristics, cannulation approach, on-pump or off-pump technique, occlusion of the catheter and its lumens, and any associated complications were recorded. The data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Results: Of the 303 patients studied, 205 were male (67.7%) and 98 were female (32.3%). Catheter occlusion occurred in 11 patients with on-pump cardiopulmonary bypass (CPB) (227 patients) and 4 patients with off-pump CPB (76 patients) (p=0.863). The incidence of catheter occlusion was 4.95% (15 of 303 patients) with no cases of simultaneous 3-lumen occlusion in a catheter. The most commonly occluded lumen was the distal lumen (57.92%). Simultaneous 2-lumen occlusion occurred in 4 patients. Catheter occlusion was found in 3 of 13 malpositioned catheters (23.07%). Conclusion: The current study showed that malpositioning of the catheter tip was a risk factor for catheter occlusion and that the distal lumen of a triple-lumen catheter was the most commonly occluded lumen.
Superior vena cava to pulmonary arterial shunting operation was made between the superior vena cava and the right pulmonary artery in the fashion of end-to-end anastomosis in 20 mongrel dogs. The experimental animals were divided into three group and blood flow in the superior vena cava was occluded for 20, 30 and 60 minutes respectively, and observations were made for the changes in caval pressure and cerebrospinal fluid pressure. And pathologic examinations were also performed. On occluding the caval blood flow, the superior vena caval pressure was sharply and immediately elevated from $103.5{\pm}19.8mmH_2O$ at thoracotomy to $556.4{\pm}86.lmmH_2O$ within 2 minutes to make its plateau thereafter, and the cerebrospinal fluid pressure followed closely the changes of the superior vena caval pressure in its level and pattern being elevated from $102.0{\pm}19.9mmH_2O$ to $490.5{\pm}79.9mmH_2O$. The drops of both the caval and cerebrospinal fluid pressures were definite and marked on opening the shunt flow through the anastomosis, but these postoperative pressures retained still higher ones above their levels measured at thoracotomy. The pathological examinations of the brain and the spinal cord were also performed in six animals. Characteristic changes uniformly seen in all area and in all animals were the findings of capillary congestion and perivascular edema. On the other hand, ischemic nerve cell changes were rather evident, revealing their degrees and extents being related to the prolongation of the time of caval occlusion which has followed by the sustained high pressures in both the superior vena and the cerebrospinal fluid. The experiment suggests the safety of this surgical procedure with minimal, if any, permanent damage as long as the occlusion of the caval blood flow is not prolonged beyond the expected.
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