• Radiation Oncology Journal
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• v.9 no.1
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• pp.7-15
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• 1991

Pentoxifylline (PENTO) has been known to improve RBC fluidity, and thus improve the flux of RBC through narrow capillaries. Additionally, PENTO also decreases the $O_2$ affinity of hemoglobin by increasing 2,3-DPG levels, thereby increasing the $O_2$ release from RBC. Nicotinamide (NA) has been reported to decrease the number of acutely hypoxic cells in tumors by temporarily increasing tumor blood flow. Therefore, the purpose of this study was to examine whether the combination of PENTO and NA (PENTO+NA) would reduce the radioresistance of the Fsall murine fibrosarcoma by oxygenating the hypoxic cells. We obsewed a significantly enhanced radiation-induced growth delay of the FSaII tumors by PENTO+NA. Thus the enhancement ratio was between 2.5 and 2.8 in growth delay assay. The $TCD_{50}$ of control tumors was about 57 Gy, but that of PENTO+NA treated tumors was about 32Gy. Thus $TCD_{50}$ was modified by a factor of 1.8. We also observed that PENTO+NA exerted no effect on the radiation-induced skin damage after the legs without bearing tumors were exposed to X-irradiation. In order to clarify radiosensitizing effects of PENTO+ NA, changes in tumor blood flow and intratumor pOf were measured using laser Doppler flowmetry and $O_2$ microelectrode methods. The tumor blood flow significantly increased at 10 min. after injection of PENTO+ NA. Furthermore, we also found that PENTO+ NA significantly increased intratumor $pO_2$ from 8 to 19 mmHg. We concluded that PENTO+MA was far more effective than NA alone or PENTO alone. The increase in the response of tumors in vivo to X-irradiation appeared to be due mainly to an increase in the tumor oxygenation. Further studies using various concentrations of PENTO alone and in combination with NA to obtain better sequencing and maximal radiosensitization are warranted.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.148-152
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• 2010

Purpose: In treating diabetic foot ulcers, satisfactory vascularity is an essential prerequisite. To improve vascularity, a bypass graft has long been carried out. Recently, however, percutaneous transluminal angioplasty (PTA) has also been tried since the PTA is less invasive than the bypass graft. However, publication demonstrating the improvement of vascularity after the PTA are lacking. Therefore, this study was designed to show usefulness of the PTA in treating vasculopathy of diabetic foot. Materials: and Methods This study included 30 feet of 24 ischemic diabetic foot patients. Inclusion criteria were diabetes (duration > 5 years) and a significant lower extremity ischemia, as determined by a transcutaneous oxygen pressure ($TcpO_2$) < 30 mmHg. The PTA was carried out in 61 arteries. PTA procedure was considered successful, when residual stenosis was less than 30%. The procedure was considered failed when residual stenosis was more than 50%. Residual stenosis between 30% and 50% was considered acceptable. For evaluation of PTA effect, foot $TcpO_2$ and infrared thermography were measured before and 7th day after PTA. Results: Immediately after PTA performed in 61 arteries, 58 and 3 arteries were evaluated as being successful and acceptable, respectively. Before PTA, average foot $TcpO_2$ was $12.6{\pm}8.8$ mmHg and its value was increased to $44.2{\pm}23.9$ on 7th day after PTA (p<0.01). Average skin temperature was $31.8{\pm}1.2^{\circ}C$ before PTA and it was increased to $33.5{\pm}1.1^{\circ}C$ on 7th day after PTA (p<0.01). Conclusion: PTA procedure increases tissue oxygenation of ischemic diabetic feet which do not have wound healing potential due to low tissue oxygenation, to the level of possible wound healing. In addition, PTA increases skin temperature of ischemic diabetic feet which can imply an improvement of peripheral circulation.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.318-327
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• 2015

Background: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with that of conventional CPR (CCPR). Methods: Between March 2009 and April 2014, CPR, including both in-hospital and out-of-hospital CPR, was carried out in 955 patients. The ECPR group, counted from the start of the ECPR program in March 2010, included 81 patients in total, and the CCPR group consisted of 874 patients. All data were retrospectively collected from the patients' medical records. Results: The return of spontaneous circulation (ROSC) rate was 2.24 times better in CPR of in-hospital cardiac arrest (IHCA) patients than in CPR of out-of-hospital CA (OHCA) patients (p=0.0012). For every 1-minute increase in the CPR duration, the ROSC rate decreased by 1% (p=0.0228). Further, for every 10-year decrease in the age, the rate of survival discharge increased by 31%. The CPR of IHCA patients showed a 2.49 times higher survival discharge rate than the CPR of OHCA patients (p=0.03). For every 1-minute increase in the CPR duration, the rate of survival discharge was decreased by 4%. ECPR showed superiority in terms of the survival discharge in the univariate analysis, although with no statistical significance in the multivariate analysis. Conclusion: The survival discharge rate of the ECPR group was comparable to that of the CCPR group. As the CPR duration increased, the survival discharge and the ROSC rate decreased. Therefore, a continuous effort to reduce the time for the decision of ECMO initiation and ECMO team activation is necessary, particularly during the CPR of relatively young patients and IHCA patients.

• Korean Journal of Adult Nursing
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• v.12 no.1
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• pp.122-133
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• 2000

The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.128-137
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• 2016

This study aimed to investigate the effect of kangaroo care on physical development adaptation of external environment of prematurity, and maternal role confidence of those who delivered preterm infants. The subjects were 38 preterm infants and mothers with cesarean section delivery in the hospital, located at B city. Eighteen premature infants were assigned to the kangaroo care (KC) group or the control group (CG). Data were collected between June 2013 and June 2015. KC was given 3 times a day (60 min at a time) and performed a total of 10 times. The physical development indicator (weight, height, and head circumference) as well as the adaptation of external environment (temperature, heart rate, oxygenation) of preterm infants were checked before the start of the program. Following the initial measurement, the program was performed, and measurements were taken again at the end of the program. For measurement of maternal role confidence, structured self-reported questionnaires were performed. The results showed that the KC group had a lower oxygenation compared with the CG (t=2.27, p=.02); however, the physical development indicator (weight t=-0.83, p=.21, height t=-0.34, p=.37, head circumference t=1.29, p=.10) and maternal role confidence (t=-0.41, p=.34) were not significantly compared with the CG. The results of this study suggest that the practice of KC helps the adaptation of external environment of preterm infants

• Journal of Chest Surgery
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• v.4 no.2
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• pp.69-80
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• 1971

Total body perfusion using Rygg-Kyvsgaard Heart-Lung-Machine, Mark IV, Polystan was attempted in the dogs by the hemodilution method with total prime of buffered Hartman's solution and under hypothermia. The first of all, the functions of Rygg--Kyvsgaard Heart-Lung-Machine and the effects of the hemodilution perfusion by buffered Hartman's solution was studied. At the same time the changes of blood pressure, oxygen consumption, and influence on the blood pictures were observed before, during, and in 1-3 days after perfusion. Hemodilution rates were the average 74. 22cc/Kg(the ranges of 67 to 81 cc/Kg) and perfusion flow rates were maintained in the mean 62. 6cc/Kg/min., Although it was possible to check up to 87 cc/ Kg/min. The total body perfusion continued for 60-80 minutes. Hypothermia was employed between $36^{\circ}C$ and $32^{\circ}C$ of the rectal temperature. Arterial pressure was ranged approximately between 68mmHg and 149mmHg, but generally, it was maintained over 80mmHg. Venous pressure was measured between 6.5cm $H_2O$and 11.5cm $H_2O$. Optimum oxygenation can be expected when oxygen flow into the disposable bubble oxygenator was maintained approximately at 3.5 L/min .. Inthis way, the oxygen contents were measured in the mean value of 13.11${\pm}$O.56 vol. % of arterial blood and 8.67+1.08 vol.% of venous blood(P${\pm}$0.86 vol.% in arteriovenous oxygen difference and 2. 97${\pm}$0.62cc/Kg in oxygen consumption were calculated. According to these dates, it is as plain as pikestaff that excellent oxygenation and good tissue perfusion was accomplished. Erythrocyte, hemoglobin and hematocrit were decreased about 38% during extracorporeal circulation and these were not recovered until 1-3 days after perfusion. These decrease was resulted from relatively high degree of hemodilution rate and no blood transfusion to compensate during these experimental studies. The platelets were also decreased about 76% during perfusion, but on the contrary, it was increased progressively after perfusion and in 1-3 days after perfusion was returned to the control level. Leucocyte were also decreased during perfusion, but it was increased progessively after perfusion and in 1-3 days after perfusion exceed the control level. This increase was resulted from postoperative infection of the wound, but its analysis were not changed significantly.

• Proceedings of KOSOMES biannual meeting
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• 2007.11a
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• pp.185-185
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• 2007

Starting at the beginning q the 20th century, increasing amounts of tetrach1oroethene (PCE) and trichloroethene (TCE)were manufactured due to the extensive use of these compounds in industry, in the military, and in private households, mainly as nonflammable solvents. This widespread use, along with careless handling and storage, are among the most serious contaminants of soil, sediment and groundwater. Highly chlorinated ethenes are typically not degraded through oxygenation by aerobic bacteria Since complete reductive dechlorination of PCE and TCE to ethene (ETH) has been observed in anaerobic enrichment culture, anaerobic dehalorespiring bacteria have received increased attention in the last decade. Under anaerobic conditions, these compounds con be reductively dehalogenated to less-chlorinated ethenes or innocuous ethene by microorganism through dehalorespiration. We have been studying anaerobic enrichment culture which used lactate as the electron donor for reductive dechlorination of PCE to ETH the anaerobic mixed microbial culture was enriched from the sediment sample taken from site contaminated with PCE. PCE was consistently and completely converted to ethene. In addition, the accumulation of intermediate products such as 1,2-ds-dichloroethene (cis-DCE) and vinyl chloride (VC) was observed in the anaerobic mixed microbial culture. the established dechlorinating enrichment culture was analyzed by DGGE using primers specific to DefrJ1ococcoides 16S rRNA gene sequences. In conclusion, we established the PCE dechlorinating enrichment culture and confirmed the existence of Dehalococcoides in an enrichment culture.

• Neonatal Medicine
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• v.18 no.1
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• pp.124-129
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• 2011

Purpose: To evaluate the effect of oral sildenafil therapy in neonates with persistent pulmonary hypertension of the newborn (PPHN) Methods: We conducted a retrospective review of 32 neonates ${\geq}$35 weeks' gestation and fraction of inspired oxygen ($FiO_2$) 1.0 with PPHN. The first dose (0.5 mg/kg) of oral sildenafil was started and 1 mg/kg was given every 6 hour thereafter. Mean airway pressure (MAP), $FiO_2$, oxygenation index (OI), mean arterial blood pressure (MBP) were documented before and 6, 12, 24, and 48 hours after sildenafil. For adverse effects, gastrointestinal symptoms, brain ultrasound, funduscopy and auditory brainstem response results were evaluated. Results: The underlying diseases of PPHN (n=32) were meconium aspiration syndrome (n=9), respiratory distress syndrome (n=8), pneumonia (n=3), and idiopathic (n=12). Thirty-one neonates survived; 3 neonates were transferred for inhaled nitric oxide (iNO) and all of them survived. In 28 infants, $FiO_2$ and OI improved significantly by 6 hours and MAP improved significantly by 48 hours after initiation of sildenafil. There were no clinically significant adverse effects of sildenafil. Conclusion: Sildenafil may be an effective and safe agent for near-term and term neonates with PPHN, providing significant improvement in oxygenation, and thus may be especially useful in the treatment of PPHN in hospitals without iNO.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.1-6
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• 1990

In the present study, a perfluorchemical emulsion (Fluosol-DA $20\%$) did not alter $D_o\;and\;D_q$ values on cell survival curve, indicating that the lack of a direct effect of Fluosol-DA $20\%$ on cellular radiosensitivity in vitro. The effect of Fluosol-DA $20\%$ injection in combination with carbogen breathing was determined on the hypoxic cell fraction in SCK tumors. The hypoxic cell fraction in control SCK tumors was 0.39. This value decreased to 0.05 when the mice were i.v. injected with 12 ml/kg of Fluosol-DA $20\%$ in a carbogen atomosphere. The measured mean and median $PO_2$ values with a microelectrode in the control tumors was 9 mmHg and 4 mmHg, respectively. The treatment of the SCK tumors in the host mice with injected Fluosol-DA $20\%$ in combination with carbogen breathing increased the mean and median $PO_2$ values to 67 mmHg and 62 mmHg, respectively. Using carbogen breathing alone caused a moderate increase of tumor $PO_2$. But Fluosol-DA $20\%$ injection alone caused little change $PO_2$ in the tumor. It was concluded that the combination of Fluosol-DA injection and carbogen breathing is an effective means to improve oxygenation of tumors.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.17-25
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• 1994

We evaluated the effect of nicotinamide on cellular $O_{2}$ consumption and metabolic status i.e., adenylate phosphates and $NAD^{+}$in-vitro, and changes in blood flow in-vivo, to determine whether changes in cellular metabolism or increased oxygen availability, was responsible for increased tumor oxygenation. Thirty min, pre-incubation of cells with$\∼$4mM (= 500mg/kg) nicotinamide resulted in no change in cellular $O_{2}$ consumption. Similarly neither the adenylate Phosphates nor the cellular $NAD^{+}$levels were altered in the presence of $\∼$4mM nicontinamide. In-vivo, nicotinamide (500mg/kg) increased $O_{2}$ availability as estimated by changes in relative tumor blood flow (RBC flux). The changes in RBC flux measured by the laser Doppler method, were tumor volume dependent and increased from$\∼$35$ \% $ in$\∼$ 150$mm_{3}$tumors to$\∼$~75$ \% $ in$\∼$500$mm^{3}$ tumors. In conclusion, these observations indicate a reduction in local tissue $O_{2}$ consumption is not a mechanism of improved tumor oxygenation by nicotinamide in FSa II murine tumor model. The primary mechanism of increased $pO_{2}$ appears to be an increased local tumor blood flow.