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Intravenous Fluid Selection for Unruptured Intracranial Aneurysm Clipping : Balanced Crystalloid versus Normal Saline

  • Kang, Jian;Song, Young Joo;Jeon, Sujeong;Lee, Junghwa;Lee, Eunsook;Lee, Ju-Yeun;Lee, Euni;Bang, Jae Seung;Lee, Si Un;Han, Moon-Ku;Oh, Chang Wan;Kim, Tackeun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.534-542
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    • 2021
  • Objective : While balanced crystalloid (BC) could be a relevant fluid regimen with buffer system compared with normal saline (NS), there have been no studies on the optimal fluid for surgery of an unruptured intracranial aneurysm (UIA). This study aimed to compare the effects of fluid regimens between NS and BC on the metabolic and clinical outcomes of patients who underwent surgery for UIA. Methods : This study was designed as a propensity score matched retrospective comparative study and included adult patients who underwent UIA clipping. Patient groups were categorized as NS and BC groups based on the types of pre-operative fluid and the amount of fluid administered during surgery. The primary outcomes were defined as electrolyte imbalance and acidosis immediately after surgery. The secondary outcomes were the length of stay in the intensive care unit (ICU) and duration from the end of the operation to extubation. Results : A total of 586 patients were enrolled in this study, with each of 293 patients assigned to the NS and BC groups, respectively. Immediately after surgery, serum chloride levels were significantly higher in the NS group. Compared to the NS group, the BC group had lower incidence rates of acidemia (6.5% vs. 11.6%, p=0.043) and metabolic acidosis (0.7% vs. 4.4%, p=0.007). As compared to NS group, BC group had significantly shorter duration from the end of the operation to extubation (250±824 vs. 122±372 minutes, p=0.016) and length of stay in ICU (1.37±1.11 vs. 1.12±0.61 days, p=0.001). Throughout multivariable analysis, use of BC was found to be significant factor for favorable post-operative results. Conclusion : This study showed that the patients who received BC during UIA clipping had lower incidence of metabolic acidosis, earlier extubation and shorter ICU stay compared to those who received NS. Therefore, using BC as a peri-operative fluid can be recommended for patients who undergo surgery for UIA.

Korean Red Ginseng aqueous extract improves markers of mucociliary clearance by stimulating chloride secretion

  • Cho, Do-Yeon;Skinner, Daniel;Zhang, Shaoyan;Lazrak, Ahmed;Lim, Dong Jin;Weeks, Christopher G.;Banks, Catherine G.;Han, Chang Kyun;Kim, Si-Kwan;Tearney, Guillermo J.;Matalon, Sadis;Rowe, Steven M.;Woodworth, Bradford A.
    • Journal of Ginseng Research
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    • v.45 no.1
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    • pp.66-74
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    • 2021
  • Background: Abnormal chloride (Cl-) transport has a detrimental impact on mucociliary clearance in both cystic fibrosis (CF) and non-CF chronic rhinosinusitis. Ginseng is a medicinal plant noted to have anti-inflammatory and antimicrobial properties. The present study aims to assess the capability of red ginseng aqueous extract (RGAE) to promote transepithelial Cl- secretion in nasal epithelium. Methods: Primary murine nasal septal epithelial (MNSE) [wild-type (WT) and transgenic CFTR-/-], fisher-rat-thyroid (FRT) cells expressing human WT CFTR, and TMEM16A-expressing human embryonic kidney cultures were utilized for the present experiments. Ciliary beat frequency (CBF) and airway surface liquid (ASL) depth measurements were performed using micro-optical coherence tomography (μOCT). Mechanisms underlying transepithelial Cl- transport were determined using pharmacologic manipulation in Ussing chambers and whole-cell patch clamp analysis. Results: RGAE (at 30㎍/mL of ginsenosides) significantly increased Cl- transport [measured as change in short-circuit current (ΔISC = ㎂/㎠)] when compared with control in WT and CFTR-/- MNSE (WT vs control = 49.8±2.6 vs 0.1+/-0.2, CFTR-/- = 33.5±1.5 vs 0.2±0.3, p < 0.0001). In FRT cells, the CFTR-mediated ΔISC attributed to RGAE was small (6.8 ± 2.5 vs control, 0.03 ± 0.01, p < 0.05). In patch clamp, TMEM16A-mediated currents were markedly improved with co-administration of RGAE and uridine 5-triphosphate (8406.3 +/- 807.7 pA) over uridine 5-triphosphate (3524.1 +/- 292.4 pA) or RGAE alone (465.2 +/- 90.7 pA) (p < 0.0001). ASL and CBF were significantly greater with RGAE (6.2+/-0.3 ㎛ vs control, 3.9+/-0.09 ㎛; 10.4+/-0.3 Hz vs control, 7.3 ± 0.2 Hz; p < 0.0001) in MNSE. Conclusion: RGAE augments ASL depth and CBF by stimulating Cl- secretion through CaCC, which suggests therapeutic potential in both CF and non-CF chronic rhinosinusitis.

Communication Types in Nurses Caring for Patients on Hemodialysis (혈액투석실 간호사 의사소통 유형 분석)

  • Kim, Ri Whaol;Nam, Eun Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.42-50
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    • 2021
  • The purpose of this study was to identify and analyze the communication behavior styles of hemodialysis nurses based on the structured Q-methodology. The Q-population was formulated based on literature reviews and in-depth interviews with 10 hemodialysis nurses who were working in hospitals in Seoul and Anyang-si, Gyeonggi Province. A total of 50 Q-samples, which were believed to best represent the communication behavior styles of hemodialysis nurses, were selected from the Q-population by the author and a professor majoring in nursing. 30 P-samples were selected from hemodialysis nurses who were working in primary, secondary, and tertiary hospitals in Seoul. Q-sorting was performed by P-samples and data was analyzed through the pc-QUANL program. The results suggested that there are four types of communication behavior styles of hemodialysis nurses, namely: "type I: listening and speaking courteously with an active mind", "type II: listening and speaking courteously with a receptive mind", "type III: advising with an explanation" and "type IV: super-reasonable with a defensive mind". It is expected that the analytical results described here may provide basic information that can be used to develop educational material for hemodialysis nurses.

Effects of Zeolite Application on Yield and Yield Components in Rice (Zeolite 시용에 의한 벼의 증수효과 및 요인해석)

  • Kae, Bong-Myung;Sol, Kwon-Sok;Cho, Chang-Hwan
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.32 no.4
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    • pp.403-408
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    • 1987
  • The milled rice yield of the fertilized Zeolite in the sandy loam as 542 Kg/10a was increased by 11% compared with the check plat as a standard cultivation. Significant positive correlations of that were found between grain yield/plant and panicle/total weight ratio or average weight of panicle, while lower correlations between ratio of riqened grains and grain yield/ plant. But significant negative correlations were found between 1,000-grain weight of rough and 4th. 5th internode/culm length ratio. It was reavealed that there were higher direct effects for ratio of ripened grains and spikelets/panicle affecting grain yield/plant through path analysis among the yield components. Moreover, organic dry matter production at 35 days after heading were heavier by 26% in active leaves, 19% in stem + leaf sheath, and 5% in panicle, respectively. Ratio of settled spikelets on the terminal of primary rachis-branch was 47% to total spikelets, and 37% in half-upper of that, moreover many spikelets settled on the terminal of rachis. Therefore, it was recognized that there were a dominant effect of apical glumous flower by fertilized Zeolite.

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Hematological Characteristics of the Cultured Eel, Anguilla japonica by Vibration Stress

  • Kim, Dae-Hee;Nam, Myung-Mo;Lee, Si-Woo;Kang, Kyoung Ho;Kang, Yue Jai;Hur, Jun Wook
    • Journal of Marine Life Science
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    • v.3 no.2
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    • pp.81-86
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    • 2018
  • The purpose of this study is to determine the effects of vibration on primary (e.g. plasma cortisol), secondary (e.g. plasma glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), Na+, K+ and Cl- and tertiary (e.g. mortality) stress responses in cultured eel, Anguilla japonica. For this purpose, three groups (including one control group and two stress groups) were set up. The control group was made exposed to vibration corresponding to 48 decibel (dB, V) (produced using electric vibrators) for 15 minutes per hour every day, and the two stress groups was made exposed to vibration corresponding to 58 and 68 dB (V) (produced using the same electric vibrators), equally, for 15 minutes per hour every day. Blood was sampled at day 0 (before starting vibration stress tests, BS), and days 1, 3, 5, 7, 9 and 11 (after starting vibration stress tests). As a result, plasma cortisol showed trend to continuously rise by consecutive stress from 4.1±0.1 ng/ml in BS. In 48 dB group (control), cortisol showed the highest level with 7.6±0.9 ng/ml after 7 days (p<0.05), but at 9 and 11 days was not significantly compared with BS level. In 58 dB group, the cortisol showed the highest level with 43.1±4.8 ng/ml after 1st day. Cortisol of 68 dB group increased significantly during the experimental period (14.4±2.3~32.0±5.7 ng/ml) (p<0.05). In 58, and 68 dB groups during the experimental period differed significantly compared to 48 group (p<0.05). Glucose in 48 dB were increased from 42.0 ±5.7 (BS) to 52.5±2.1 (1 day), the level was not significantly from 1 to 11 days. Glucose in 58 and 68 dB groups was increased significantly than BS during experimental period (p<0.05). K+ in 68 dB increased significantly (p<0.05) from 2.3±0.2 mE/ql (BS) to 3.3±0.5 mE/ql at 5 days. In 48 and 58 dB groups during the experimental period differed significantly (p<0.05). Na+ and Cl- levels were not differed significantly during the experimental period. AST and ALT in 58 and 68 dB groups showed trend to continuously rise by consecutive stress. At 7 and 9 days in AST, between 48, 58 and 68 dB groups differed significantly (p<0.05). In 48, 58 and 68 dB groups at 1 day, blood hematocrit increased significantly higher than BS. The 11 days after vibration stress, the mortality in 48, 58 and 68 dB groups was 1.1, 5.1 and 5.8%, respectively. The present results have shown that A. japonica exhibited ''typical'' physiological responses when exposed to chronic vibration stress. These data suggested that chronic vibration stress caused substantial stress in the fish; especially the persisting elevated plasma AST and ALT levels observed would be expected to adverse effect. In conclusion, chronic vibration stress could greatly affects the hematological characteristics in A. japonica.

FOLFIRI Regimen as a Second-line Chemotherapy after Failure of First-line Chemotherapy in Advanced Gastric Cancer (진행성 위암에서 1차 항암화학요법에 실패한 환자에서 2차 항암화학요법으로 FOLFIRI요법의 효용성에 대한 연구)

  • Yong Kang Lee;Jae Hyun Kim;Jun Chul Park;Hee Seok Moon;Sung Eun Kim;Jin Seok Jang;Joo Young Cho;Eun Sun Kim;Si Hyung Lee;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.113-119
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    • 2017
  • Background: Second line chemotherapy is often considered in advanced gastric cancers. We assessed irinotecan in combination with fluorouracil in patients experienced diseases progression after first line chemotherapy. Methods: Prospective trial was done at 7 centers in republic of Korea. Patients aged 18 years or older with advanced gastric adenocarcinoma and disease progression on or within 4 months after first-line chemotherapy were assigned to receive irinotecan 180 mg/m2 and 5-fluorouraicl 400 mg/m2 intravenously bolus injection on days 1 and leucovorin 200 mg/m2 for 2 hours and 5-fluorouracil 600 mg/m2 for 22 hours intravenously infusion on day 2 of a 14-day cycle (FOLFIRI group). The primary endpoint was objective tumor response (OR). Efficacy analysis was by per-protocol, and safety analysis included all patients who received at least one treatment with study drug. Results: Between January 1, 2014 and December 31, 2016, 28 patients were assigned to FOLFIRI treatment. Of those 20 patients were completed the study protocol. Per-protocol analysis, two patients among 20 subjects (10.0%) showed partial response. Overall survivals of FOLFIRI group; median 10.1 months [95% CI 4.9-15.3] Grade 3 and higher adverse event that occurred about 5%, but grade 3 or higher febrile neutropenia or life threatening complication was not reported. Conclusion: Combination chemotherapy with irinotecan, 5-FU, and LV is feasible in gastric cancer patients previously treated with platinum-based chemotherapy

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Increased Utilization of LTE-Maritime Networks Based on User Requirements (사용자 요구사항 기반 초고속 해상무선통신망 활용성 증대 방안에 대한 연구)

  • Sangjin JANG;Bu-Young KIM;Si-Hwan LEE;Hyo-Jeong KIM;Taehan SONG;Woo-Seong Shim
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.29 no.7
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    • pp.812-818
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    • 2023
  • During the years 2016 to 2020, the Ministry of Oceans and Fisheries embarked on a strategic initiative to develop a comprehensive Korean e-navigation system, which encompassed the establishment of an 'Long Term Evolution for Maritime (LTE-M).' The primary objectives were to proactively align with international navigation standards and enhance maritime safety for small vessels, particularly fishing boats. However, limitations were identified in the utilization of this network, primarily its constrained application for specific purposes. In response to these limitations, this study delves into user-centric investigations through surveys and interviews, with the goal of expanding the horizon of network utilization. User requirements emerged as the result of study, emphasizing the need for broader network applications, a wider range of target users, diverse network utilization methods, and regulatory streamlining. The user-driven insights gleaned from this study hold the potential to inform and shape future legislative measures, fostering more versatile and inclusive LTE-M network utilization for enhanced maritime safety.

A Study on the Optimum Stocking Density of Abalone, Haliotis discus hannai, reared in Net Cage Culture (북방전복, Haliotis discus hannai의 해상가두리 양성 시 적정 수용밀도에 관한 연구)

  • Kim, Byeong-Hak;Park, Min-Woo;Son, Maeng-Hyun;Kim, Tae-Ik;Lee, Si-Woo
    • The Korean Journal of Malacology
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    • v.30 no.3
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    • pp.219-226
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    • 2014
  • The effects of different stocking densities on the growth and survival rate of the abalone, Haliotis discus hannai, were investigated in marine net cage for two years. Stocking density was set 15, 30, 45 and 60 percentage $(=per.)/m^2$ with share to cross-sectional area per shelter. The primary rearing period (PRP) and the secondary rearing period (SRP) were conducted by a year. One year mean water temperature of PRP and SRS showed the difference about $2^{\circ}C$. In the growth (initial mean shell length of abalone : $36.14{\pm}2.28mm$) of PRP, the absolute growth rate (ARG), daily growth rate (DGR) and specific growth rate (SGR) of the $15per./m^2$ were higher than those of density groups (P < 0.05). Survival rates of all density groups were showed no significant difference. In the growth (mean shell length of abalone : $55.26{\pm}6.93mm$) of SRP, ARG, DGR and SGR of stocking density groups showed no significant difference except for $45per./m^2$ density group. Survival rate in the low-density (15, $30per./m^2$) was more than 70%, and those of the high-density (45, $60per./m^2$) were less than 31% and 9%, respectively. These results showed that the appropriate stocking density for $15per./m^2$ was seven hundred fifty number per one net cage ($2.4{\times}2.4m$), during PRP using 3-4 cm abalone in length. Also for the secondary rearing period, the optimal stocking density (shell length 5-6 cm of abalone) consider with the economical efficiency was determined to be $30per./m^2$, resulting the productivity improved.

Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents (통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인)

  • Hwang, Tae-Yoon;Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Young-Ah
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.107-126
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    • 2002
  • Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

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Population density of potato virus vectors In the Kwanghwal Area, Kimje-gun, Cholla-Pukto, on the western coast (씨감자 생산을 위한 매개 진딧물 조사 - 전북 김제군 광활면의 진딧물 분포상 -)

  • Paik Woon Hah
    • Korean journal of applied entomology
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    • v.7
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    • pp.5-13
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    • 1969
  • Present system of seed potato production in Korea has several weak points and consequently has difficulties in covering annual shortage of 60,000 tons of seed potatoes. The author has an opinion that this so called 'High land system' of seed potato production adopted by the Government should be replaced by the 'Coastal area system' which is proposed by the author and has many advantages over present 'High land system'(2). In coastal areas where enormous acreage of rice paddies are spread, mostly around the villages. the primary host plants of the vectors are found. Therefore, the only source of aphid vectors are limited to the villages. The farmer's houses scattered more sparsely also have minor importance. In the previous paper(2), the author reported that the aphid vector populations were lower in the coastalareas than at Taegwanryong where the Alpine Experiment Station for the production. of seed potatoes is located. However, the number to vectors at Okku showed rather high density, where the trap was placed at the distance of 200 m from a village where peach and Hibiscus trees, the primary hosts of Myzus pesrsicae and Aphis gossypii were grown. To clarify the flight distance from the source of the aphid vectors, a trial was carried out in the Kwanghwal area, Kimje-gun, Cholla-pukto. on the western coast. 13 traps were placed at four directions and the distances between the traps were 250 m. (Fig. I) The traps 'Were operated from June 21 to October 31. The results are shown in Table 1. A total of some 70 species of aphids were found, including 5 speceis of potato virus vectors. The vectors are as follows: I. Myzus persicae (Sulzer) 2. Aphis gossypii Glover 3. Aulacorthum solani (Kaltenbach) 4. Lipaphis erysimi (Kaltenbach) 5. Macrosiphoniella sanborni (Gillette) Out of a total of 12,797 aphids, 5,187$(48\%)$ vectors were found. The trap catches at the 13 locations are shown in Fig. 2 and the numbers of the vectors at each location for each vector, except Macro-siphoniella sanborni. of which only a single individual was caught, are shown in Fig. 3-6. Number of vectors at C (3,279) (Centre of the village) is considerably higher than that at Suwon (763); however, EI. SI. WI and NI. where the distanecs from Care 250 m, showed lower numbers of vectors than that at Taegwanryong (347). The number of vectors at NI was rather than at the other 3 locations at the distance of 250m from the village. This was because C was in the southern part of the village. Consequently NI was much closer to the village than the other 3 locations of the same distance from C. Numbers of catches of the most important vector. Myzus persicae, are shown in Fig.3. The distribution pattern is typical except $S-2\;and\;W_3$, where several farmer's houses were found. If only the rice paddies were found in these locations. the numbers of the vectors would be small as the distances increase. Numbers of catches of the other 3 vectors are shown in Fig. 4-6. From these results. the author has drawn the following conclusions: 1. The aphid vector sources at the rice paddy belt in the western coast are the villages. 2. The vector densities at the locations where the distances are 250 m from the centre of the village are lower than that at Taegwanryong. 3. The vector densities become gradually lower as the distances from the centre of village increase. However. depending on the host plant situation at each location, the vector densities are variable. These minor sources of aphid vectors may be eliminated so that seed potatoes can be grown. 4. Thus. under the direction of specialists, fields suitable for seed potato production can be found in the coastal areas.

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