• Title/Summary/Keyword: Puncture

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Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet

  • Jung, Gul;Byun, Woo-Mok;Lim, Hyung-Jun;Kim, Jong-Gyun;Kwak, Dong-Min;Lee, Deok-Hee;Kim, Sae-Yeon;Song, Sun-Ok;Seo, Il-Sook;Jee, Dae-Lim;Kim, Heung-Dae;Park, Dae-Pal
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.344-350
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    • 2007
  • Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

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Age-related Changes in Plasma Leptin from Early Growing to Late Finishing Stages of Castrated Holstein Steers: Utilizing Multi-species Leptin RIA

  • Vega, R.A.;Lee, H.G.;Kuwayama, H.;Matsunaga, N.;Hidari, H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.5
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    • pp.725-731
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    • 2002
  • This experiment was performed to understand the changes in plasma leptin in association with plasma IGF-1, body weight and ADG from early growing to late finishing stages of Holstein steers. Blood collection was performed by arterial vein puncture at selected monthly ages of 1 (54 kg), 2.6 (103 kg), 7.2 (205 kg), 13.5 (314 kg), 16.9 (414 kg), 22.2 (550 kg), 24.9 (626 kg) and 27.4 months (695 kg). The blood was analyzed for leptin using the multi-species leptin RIA with recombinant bovine leptin (rbleptin) as standard, plasma IGF-1 was also measured using RIA. Against the standard rbleptin, the multi-species Leptin RIA system's sensitivity, cross reactivity, slope and recovery of 41.0 ng/ml rbleptin in plasma were 4.9 ng/ml, 11.22%, -1.396 and 97.8%, respectively. Plasma leptin measured were more than 5.0 ng/ml, which enable multi-species RIA system to investigate plasma leptin in normal growing steers. Body weight resulted to a highly significant second-degree polynomial relationship with plasma leptin (q=0.54, p<0.0001) and plasma IGF-1 (q=0.44, p<0.0001) from 1 to 27.4 monthly ages. However, the second-degree polynomial curve of plasma leptin and IGF-1 differs showing a concave and convex curvilinear relationship, respectively. ADG was not significantly associated to plasma leptin (r=0.06, p>0.05) and plasma IGF=1 (r=0.06, p>0.05) from 1 to 27.4 monthly ages. Low coefficient, but significant associated increase of plasma leptin and IGF-1 (r=0.12, p<0.008) from 1 to 27.4 months was observed. The uncoordinated increases of plasma IGF-1 at growing and plasma leptin at fattening period, may indicate (1) indirect involvement of endogenous IGF-1 on leptin secretion, and (2) IGF-1 level may signify lean and bone accretion while plasma leptin may mirror body fatness across the monthly ages of Holstein steers.

TISSUE CHANGE AFTER EMBEDDING GELATIN MATRIX IMPLANT(FFIBREL®) IN SUBCUTANEOUS TISSUE OF RATS;HISTOLOGIC, IMMUNOHISTOCHEMICAL AND SCANNING ELECTRON MICROSCOPIC STUDY (백서의 피하조직에 Gelatin Matrix Implant (Fibrel®) 매식시 조직변화에 관한 연구)

  • Kim, Hong-Jin;Lee, Chong-Heon;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.341-354
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    • 1998
  • GMI (Fibrel${(R)}$) is one of the dermal filling substances which have been successfully used for the treatment of depressed cutaneous scar and wrinkles. It's major components are; Gelatin powder, which provides a framework for the clot to form and remains stable under the scar, and ${\varepsilon}$-aminocaproic acid, which inhibits the production of fibrinolysin, and Plasma, which provides the necessary ingredients for collagen synthesis. GMI has advantages of low immunogenicity and increased longevity. It has been known to induce fibroblast activity and promote new collagen synthesis. We used 34 Sprague-Dawley rats which were bred under the same condition and duration. 18 of experimental animals were undergone cardiac puncture, and their blood were collected, centrifugated, and stored in freezer. Out of 16 animals, control group were injected with 2ml plasma into the subcutaneous tissue of Lt. scapular, while experimental group were implanted of 2 ml GMI into the Rt. same area. Experimental animals were sacrificed at the 3rd day, 5th day, 1st week and 2nd week respectively after implantation of GMI. To observe the histopathologic change of GMI and surrounding tissue reaction of GMI, we had examined with H&E staining, immunohistochemical staining with vimentin, ${\alpha}$-SMA, S-100 under LM and SEM. The obtained results were as follows ; 1. In LM study, the inflammatory cell infiltrations and granulation tissue formation were observed, and muscle tissues were well attached with adipose tissues in the control group. In the experimental group, inflammatory cell infiltrations had been observed by the 2nd week and irregular adipiose tissues and well differentiated mesenchymal tissues were examined. 2. In immunohistochemical study, the experimental group of ${\alpha}$-SMA study, there were a prominent positive response on endothelial development of granulation tissues and mesenchymal tissues compare with the control group. In vimentin study, positive response on mescenchymal fibroblast continued to 2nd week, but negative in the control group. In S-100 study, both groups were positively responded on irregular adipose tissues. 3. In SEM study, collagen fibers were embedded by the plasma by the 5th day in the control group, and in the 3rd day experiment GMI were resorved but communited with collagen fiber till the 1st week. Collagen fibers were infilt-rated into GMI at the 2nd week and the infilltrated GMI were conglomerated with the mature adipose cells and the collagen fibers. From the above results, GMI implantation in the subcutaneous tissue of Sprague-Dawley rat, the mild infiltration of inflammatory cells were showed till 2nd week and the granulation tissues were observed. GMI were nearly resorbed till 2nd week, but well attached with adipose tissue and collagen fibers. The endothelium and fibroblasts were actively proliferated. Adipose tissues and mesenchymal tissue cells were observed. As already expressed, GMI showed resorptive change in course of time without any early immune reaction, and seemed to induce fibroblast activity and promote new collagen synthesis.

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A study of metabolic effect in high and low fat diet on Albino Rat (지방 함량에 따르는 흰쥐의 체내 대사 연구)

  • Kim, Sook-He;Jo, Myuong-Jook
    • Journal of Nutrition and Health
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    • v.5 no.4
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    • pp.169-176
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    • 1972
  • The present study was undertaken to determine the metabolic effect of various levels of fat in the diet. Forty males and the same number of females weighing $35{\pm}29$ were divided into three experimental groups and one control group, 10 rats each in both sexes. The dietary lipid contents were included in three levels, 2% as low, 30% as high and fat free diet in order to reflect the lipid consumption of present Korean diet. 20% sugar casein diet were employed as standard for control animals. This study was carried for 16 weeks. After these period animals were sacrificed to collect the internal organs and blood samples by heart puncture. In the result of this study, high fat diet group is lower than low fat diet group in the body weight gain, food efficiency ratio, protein efficiency ratio, urinary nitrogen and organ nitrogen contents were same trend but there is no significant difference in these respects. It was noteworty that high, and free fat diet group revealed more glucose total protein, albumin and globulin contents in the serum than other compared groups. It can be concluded that fat content whether low or high are free in the diet did not show significant effect on body nitrogen metabolism. But 30% high fat diet increased the total lipid and total cholesterol contents in the liver and the serum. This fact can be interpreted that 2% low fat diet and fat free diet do not need to increase the amount of fat content in the diet as high as 30% fat diet. This result might indicate the one possible reason to decide the recommanded dietary fat levels in Korean diet.

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The Antiallodynic Effects of Intrathecal Zaprinast in Rats with Chronic Constriction Injury of the Sciatic Nerve (좌골신경 만성협착손상 흰쥐에서 척수강 내로 투여된 Zaprinast의 항이질통 효과)

  • Lee, Jae Do;Jun, In Gu;Choi, Yun Sik;Im, So Hyun;Park, Jong Yeon
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.16-20
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    • 2009
  • Background: Zaprinast is an inhibitor of phosphodiesterase 5, 6 and 9. Phosphodiesterase inhibitors could produce anti-nociceptive effects by promoting the accumulation of cGMP. We hypothesized that intrathecal zaprinast could attenuate the allodynia induced by chronic constriction injury of the sciatic nerve in rat. Methods: Sprague-Dawley rats were prepared with four loose ligations of the left sciatic nerve just proximal to the trifurcation into the sural, peroneal and tibial nerve branches. Tactile allodynia was measured by applying von Frey filaments to the lesioned hindpaw. The thresholds for the withdrawal responses were assessed. Zaprinast ($3-100{\mu}g$) was administered intrathecally by the direct lumbar puncture method to obtain the dose-response curve and the 50% effective dose ($ED_{50}$). Measurements were taken before and 15, 30, 45, 60, 90, 120, and 180 min after the intrathecal doses of zaprinast. The side effects were also observed. Results: Intrathecal zaprinast resulted in a dose-dependent antiallodynic effect. The maximal effects occurred within 15-30 min and then they gradually decreased down to the baseline level over time in all the groups. There was a dose dependent increase in the magnitude and duration of the effect. The $ED_{50}$ value was $17.4{\mu}g$ (95% confidence intervals; $14.7-20.5{\mu}g$). No severe motor weakness or sedation was observed in any of the rats. Conclusions: Intrathecally administered zaprinast produced a dose-dependent antiallodynic effect in the chronic constriction injury neuropathic pain model. These findings suggest that spinal phosphodiesterase 5, 6 and 9 may play an important role in the modulation of neuropathic pain.

Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

Optimal Insertion Angle between the Skin and Needle in Ultrasound-Guided Internal Jugular Vein Catheterization with Trauma Patients (외상 환자에서 초음파 유도 내경정맥 도관 삽입 시 카테터 바늘과 피부 사이의 적정 각도)

  • Jeon, Hyun Min;Jung, Sung Min;Jung, Ru Bi;Jeon, Jin;Hong, Chong Kun;Shin, Tae Yong;Ha, Young Rock;Kim, Young Sik
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.183-189
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    • 2013
  • Purpose: The aim of this study was to identify the optimal insertion angle between the skin and the needle in ultrasound-guided internal jugular vein (IJV) catheterization with trauma patients. Methods: From March 2012 to December 2012, consecutive trauma patients who were planned to receive IJV catheterization were prospectively enrolled. We measured the distances from the skin to IJV's anterior-posterior (AP) vessel wall on the longitudinal scan's midline in supine-positioned patients. We calculated the AP diameter of IJV and the angle between skin and the imaginary line from the puncture site to the IJV's internal center on screen's midline (defined as optimal angle which is considered as the safest approach) on the longitudinal scan. We divided the patients into 3 groups based on the CVP (low CVP <5 $cmH_2O$, $5{\leq}$ middle CVP ${\leq}10\;cmH_2O$, and high CVP>10 $cmH_2O$) and compared their mean anterior posterior (AP) diameters and optimal angles. Results: A total of 56 patients were enrolled. Of these 21 were women(35.4%). The mean AP diameter of low CVP group was significantly lower than middle and high CVP groups($0.68{\pm}0.30$, $1.06{\pm}0.31$, and $1.23{\pm}0.49$ cm respectively, p=0.003 vs. 0.002). There was no significant difference among 3 groups' mean optimal angles ($28.1{\pm}6.1$, $30.1{\pm}4.5$, and $28.0{\pm}5.0$ degree respectively). Conclusion: The optimal angle between the skin and the needle in ultrasound-guided IJV catheterization with trauma patients is not changed as about 30 degrees regardless of CVP even though IJV's diameter is altered in proportion to the CVP.

Effects of External Whole-Body gamma-Irradiation on Blood Picture and Growth in Young Rabbits (Cobalt-60 gamma 선(線) 외부전신조사(外部全身照射)가 어린 토끼의 혈액상(血液像)과 성장률(成長率)에 미치는 영향(影響))

  • Sung, Jai Ki
    • Korean Journal of Veterinary Research
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    • v.13 no.1
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    • pp.85-102
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    • 1973
  • In the event a population of animals is exposed to ionizing radiation, proper disposition of animals will minimize loss to the farmer and protect the public from unwholesome meat and dairy products. Clinical response is an important factor in considering salvage of animals for food following exposure to ionizing radiation whether the dose is lethal or not. It is the purpose of this report to present the discussions of blood picture and growth of y ung growing rabbits exposed to cobalt-60 gamma-irradiation. The experimental animals were Hyrnalayan rabbits of 65 days old. The body weight for all animals of the time of irradiation was approximately 450g. The 96 rabbits used in the experiment were allotted t groups of eight. Rabbits in one group served as controls and the others were exposed to single doses of 100, 200, 300, 400, 500, 600 and 700 Roentgens (R). The exposure does rate averaged 15 R per minute. Central blood was obtained by heart puncture. Erythrocyte and leukocyte enumerations and, determinations of hemoglobin in blood and hematocrit value were made in the usual manner. Erythrocyte counts, concentrations of hemoglobin in blood, and hematocrit readings dropped to the lowest value between 1 and 4 weeks postirradiation, returning towards the control values. But recovery was not complete at the time of the last determination on 6 weeks postirradiation. There was a progressive decrease with increasing radiation does in the above values. Mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were not affected by the irradiation. After irradiation of each does the numbers of total leukocyte and the absolute numbers of various types of white cell began to decrease rapidly, and reached a minimum after 2 weeks, returning towards normal levels. But recovery was not complete at the time of the last determination on 6 weeks postirradiation. The reductions in total leukocyte and differential counts as the radiation does increases were apparent. Relative neutrophilia was observed in each irradiated group because of more expense of lymphocytes after irradiation. Growth rate of the rabbits was not affected by 100 R of whloe-body irradiation, while rabbits irradiated with 200, 300, 400 and 500 R showed marked depression of growth rate. As the radiation does increases, a depression of growth rate was apparent. The rabbits exposed to 600 and 700 R ceased from growing and recovery was not recognized during the experimental period.

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Extrusion Process of Barley Flour for Snack Processing (스낵제조를 위한 보리의 압출성형공정)

  • Mok, Chul-Kyoon;Pyler, R.E.;Mcdonald, C.E.;Nam, Young-Jung;Min, Byong-Yong
    • Korean Journal of Food Science and Technology
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    • v.16 no.4
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    • pp.429-436
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    • 1984
  • To expand the utility of barley the experiments on the extrusion characteristics of barley flour for snack processing were carried out and the effects of the extrusion conditions on the quality of the extrudates were investigated. The optimum moisture content of barley flour for snack processing was 20%. The moisture content and the density of the extrudates decreased with increasing extrusion temperature and decreasing die size. The die swell ranged from 0.98 to 2.18 according to various extrusion conditions and decreased with increasing temperature above $150^{\circ}C$. The lightness, redness and yellowness increased at higher temperature. The water absorption index and the water solubility index showed their maximum values at $180^{\circ}C$.The gelatinization degree of the extrudates increased with increasing temperature. The fracture fore, Young's modulus and maximum fiber stress decreased, but the deformation to fracture increased, with increasing temperature and decreasing die size. The yield force in puncture test showed lower values at higher temperature. The size and the fraction of the air cells increased with increasing temperature and decreasing die size. The optimum extrusion conditions of barley for snack processing were at the temperature of $180^{\circ}C$, with the die size of 4.5mm when processed at 160 rpm.

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The Usefulness of 48 Hour Imaging in Tc-99m DTPA Cisternography (Tc-99m DTPA 뇌조조영술에서 48시간 지연영상의 유용성)

  • Bom, Hee-Seung;Song, Ho-Chun;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.313-316
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    • 1994
  • Usually the persistence of ventricular activity in Tc-99m DTPA cisternography is deter mined using 24 hour images in our country. However, the 24 hour image is regarded as an in-sufficient data by many investigators. They prefer 48 hour image. The aim of the present study was to evaluate the feasibility and usefulness of 48 hour delayed imaging in Tc-99m DTPA cisternography. We performed 48 hour cisternography using Tc-99m DTPA in 38 patients with known hydrocephalus. 37-111 MBq (1-3mCi) of Tc-99m DTPA were injected by lumbar puncture. Anterior and both lateral Images were obtained at 2, 6, 24 and 48 hours. The classification of hydrocephalus was done at 24 and 48 hours by two independent nuclear medicine physicians. The 48 hour images were interpretable in all cases. In seven patients, the clearance of ventricular activity was noted only on 48 hours images. Therefore, their classification was changed from type W to type III. Sixteen of 38 patients were underwent shunt operations. Clinical improvement was noted in 13 patients(1/1 of type II, 3/6 of type III 8/9 of type IV). One case who showed a changing pattern from IV to IIIa showed no clinical improvement after shunt operation. In conclusion, the 48 hour delayed imaging was feasible and useful technique in Tc-99m DTPA cisternography.

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