• Journal of Veterinary Clinics
• /
• v.34 no.5
• /
• pp.356-358
• /
• 2017

A dog (neutered male Schnauzer, 11 years old, 8 kg) presented with recurrence of immune-mediated hemolytic anemia. Rapid whole blood transfusion was initiated, and then sudden tachycardia and dyspnea were observed. Invasive arterial blood pressure, arterial blood gas analysis, and thoracic radiograph indicated transfusion-associated circulatory overload (TACO). Persistent high blood pressure of 160-205 mmHg was observed; the thoracic radiograph revealed interstitial infiltration and a fissure line, which suggested pulmonary edema and pleural effusion. Despite furosemide administration and nasal oxygen supplementation, hypertension and respiratory distress were not completely controlled. Finally, cardiac arrest occurred and the patient expired due to TACO 24 hours after the transfusion.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.10 no.1
• /
• pp.33-36
• /
• 2012

Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

• Journal of Forest and Environmental Science
• /
• v.33 no.2
• /
• pp.113-121
• /
• 2017

In flight particulate matter particularly emissions generated by incomplete combustion processes has become a subject of global concern due to the health problems and environmental impacts associated with them. This has compelled most countries to set standards for coarse and fine particles due to their conspicuous impacts on environment and public health. This contribution therefore explores forest fire emissions and how its particulates affects air quality, damage to vegetation, water bodies and biological functions as architects for lung diseases and other degenerative illnesses such as oxidative stress and aging. Soot was collected from simulated forest fire using a clean glass surface and carefully transferred into amber vials for analysis. Volatile components of soot were collected over 10 mL dichloromethane and analyzed using a QTOF Premier-Water Corp Liquid Chromatography hyphenated to a mass selective detector (MSD), and Gas Chromatograph coupled to a mass spectrometer (GC-MS). To characterize the size and surface morphology of soot, a scanning electron microscope (SEM) was used. The characterization of molecular volatiles from simulated forest fire emissions revealed long chain compounds including octadec-9-enoic acid, octadec-6-enoic acid, cyclotetracosane, cyclotetradecane, and a few aromatic hydrocarbons (benzene and naphthalene). Special classes of organics (dibenzo-p-dioxin and 2H-benzopyran) were also detected as minor products. Dibenzo-p-dioxin for instance in chlorinated form is one of the deadliest environmental organic toxins. The average particulate size of emissions using SEM was found to be $11.51{\pm}4.91{\mu}m$. This study has shown that most of the emissions from simulated forest fire fall within $PM_{10}$ particulate size. The molecular by-products of forest fire and particulate emissions may be toxic to both human and natural ecosystems, and are possible precursors for various respiratory ailments and cancers. The burning of a forest by natural disasters or man-made fires results in the destruction of natural habitats and serious air pollution.

• Transactions of the KSME C: Technology and Education
• /
• v.1 no.2
• /
• pp.193-198
• /
• 2013

The horseback riding simulator, an exercise training machine providing a simplified horse riding motion has been developed for aiming at healthcare. The purpose of this study was to estimate the energy expenditure without measuring bio-signals using the simulator. The test protocol was consisted of increase up to maximal intensity(Motion 9) and decrease down to minimal intensity(Motion 4) during 25 minutes, and energy expenditure was measured by portable cardiopulmonary exercise testing analyzer. There were significant differences in energy expenditure according to each riding motion. The result will be able to estimate energy expenditure using motion level, exercise time, age and gender during the riding.

• The Korean Journal of Pain
• /
• v.7 no.2
• /
• pp.181-187
• /
• 1994

The MAC($ED_{50}$)values of enflurane, fentanyl, and nalbuphine-enflurane under 65% $N_2O$ were determined in 76 Sprague-Dawley rats using the tail-clamp technique to compare the equipotent effects of intravenous and inhaled anesthetics. The rats were divided into 3 groups: enfluarne, fentanyl, and nalbuphine-enflurane. Results were as follows: 1) The MAC value of enflurane under 65% $N_2O$ was $1.160{\pm}0.05%$ and after subcutaneous nalbuphine 20 mg/kg injection, the values were 1.08% at 60min and 0.99% at 90min. 2) The lowest $ED_{50}$ for fentanyl was 26.8 ${\mu}g$/kg at 15 min, and the $ED_{50}$, 30, 45, and 60min after the injection were 36.2, 39.7, and 44.7 ${\mu}g$/kg, respectively. 3) On arterial blood gas analysis under 65% $N_2O$-1MAC($ED_{50}$), fentanyl and nalbuphine-enflurane groups showed mild increase in $PaCO_2$, but there were no significant differences among 3 groups. Fentanyl group showed significant difference in pH compared with enfluarane and nalbuphine-enflurane groups. 4) Rats injected with high dose fentanyl(above $40{\mu}g$) displayed rigidity and respiratory depression.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.13 no.1
• /
• pp.36-39
• /
• 2015

Copper sulfate is a copper compound used widely in the chemical and agriculture industries. Most intoxication occurs in developing countries of Southeast Asia particularly India, but rarely occurs in Western countries. The early symptoms of intoxication are nausea, vomiting, diarrhea, and abdominal cramps, and the most distinguishable clue is bluish vomiting. The clinical signs of copper sulfate intoxication can vary according to the amount ingested. A 75-year old man came to our emergency room because he had taken approximately 250 ml copper sulfate per oral. His Glasgow Coma Scale (GCS) score was 14 and vital signs were blood pressure 173/111 mmHg, pulse rate 24 bpm, respiration rate 24 bpm, and body temperature $36.1^{\circ}$ .... Arterial blood gas analysis (ABGa) showed mild hypoxemia and just improved after 2 L/min oxygen supply via nasal cannula. Other laboratory tests and chest CT scan showed no clinical significance. Three hours later, the patient's mental status showed sudden deterioration (GCS 11), and ABGa showed hypercarbia. He was arrested and his spontaneous circulation returned after 8 minutes CPR. However, 22 minutes later, he was arrested again and returned after 3 minutes CPR. The family did not want additional resuscitation, so that he died 5 hours after ED visit. In my knowledge, early deaths are the consequence of shock, while late mortality is related to renal and hepatic failure. However, as this case shows, consideration of early definite airway preservation is reasonable in a case of supposed copper sulfate intoxication, because the patients can show rapid deterioration even when serious clinical manifestation are not presented initially.

• Journal of Veterinary Clinics
• /
• v.17 no.2
• /
• pp.359-367
• /
• 2000

The aim of this study was to evaluate the effects of propofol on cortical electroencephalogram (EEG) in seven dogs. Propofol infusion was accomplished from low concentration to high concentration in series, and each concentration was infused for 20 minutes (M0: 0, M0.5: 0.5, M1.0:1.0, and M1.5: 1.5 mg/kg/min of infusion rate). EEG was recorded via needle electrode placed at Cz, which was applied to International 10-20 system. Arterial blood pressure. blood gas analysis and ECG were also measured. Hoemodynamics, Pa$CO_2$, PaO$_2$, heart rate and respiratory rate were variable, but were net significant(p>0.05). The power spectra of EEG in every concentration was compared wish those of control (MO). The powers at a1l frequencies at M1.0 and Ml.5 were decreased. Especially, the powers of the frequencies over 20 Hz were significantly decreased (p<0.O5). Powers at frequencies between 8 and 15Hz at MO.S were significantly increased (p<0.05) in response to the painful stimuli. It was inferred that they may reflect activity of the brain which is consciously processing the external Stimuli. Like the Power spectra, al1 the band powers of He EEG ($\delta$ 1-4, $\theta$4-8, $\alpha$ 8-13, $\beta$L13-21. $\beta$H 21-30, \ulcorner 30-50, and total 1-5OHz) were decreased in proportion to the increase of infusion rate at M1 .0 and M1.5. Especially, decrease of $\beta$H and ${\gamma}$ were significant(p<0.01). At M0.5, $\alpha$ band was significantly increased(p<0.05) among all the bands. Seizure activities which were concide with occurrence of spike wave were shown in all dogs at Ml .0 and M1.5.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.6 no.2 s.11
• /
• pp.89-97
• /
• 2006

Background: The aim of this study was to examine the difference of $SpO_2$, PR, $EtCO_2$, RR with submucosal injection of midazolam to oral chloral hydrate and hydroxyzine for pediatric patients Methods: Thirty two sedation cases were performed in this study. Patients were randomly classified into one group taking oral CH (60 mg/kg). hydroxyzine (1 mg/kg) and submucosal injection of midazolam (0.1 mg/kg) and the other group recieving oral CH (50 mg/kg), hydroxyzine (1 mg/kg) and submucosal injection of midazolam (0.2 mg/kg). For evaluating the depth of sedation. data including saturation percentage of oxygen ($SpO_2$), pulse rate (PR), end-tidal carbon dioxide ($EtCO_2$), respiratory rate (RR) and the behavior scale were checked every 2 minutes and were collected for only 40 minutes from the beginning of treatment and were analyzed using Two independent sample T-test. Results: Analysis showed no significant difference in the mean $SpO_2$, PR, $EtCO_2$, RR during sedation between two groups (P > 0.05). The values of $SpO_2$, PR, $EtCO_2$ and RR for both groups remained within the normal values. Conclusions: The results of this present study indicate that combination of oral CH, hydroxyzine, nitrous oxide gas inhalation and submucosal injection of midazolam improved the sedation quality without compromising safety.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.3
• /
• pp.283-291
• /
• 1993

Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.6
• /
• pp.600-610
• /
• 2004

Background : The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). Method : We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared. Results : Multiple logistic regression analysis identified three independent predictors of mortality: $FEV_1$, APACHE II score and plasma BNP level. The decedents group showed a lower $FEV_1$($28{\pm}7$ vs. $37{\pm}15%$, p=0.005), a higher APACHE II score($22.4{\pm}6.1$ vs. $15.8{\pm}4.7$, p=0.000) and a higher BNP level ($201{\pm}116$ vs. $77{\pm}80pg/mL$, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL. Conclusion : The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the $FEV_1$ and APACHE II score.