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10% Pentastarch Versus 5% Albumin Solution for Volume Expansion Following Cariopulmonary Bypass in Patients Undergoing Open Heart Surgery (개심수술후 혈량 증가를 위한 10% Pentastarch와 5% Albumin 용액의 비교연구)

  • 장병철
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.177-186
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    • 1994
  • Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.

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Spatial Distribution of Epilithic Diatom Communities in the Estuary of Korean Peninsula (한반도 하구역 부착돌말류의 공간적 분포)

  • Kim, Ha-Kyung;Cho, In-Hwan;Kim, Young-Hyo;Lee, Min-Hyuk;Kim, Yong-Jae;Won, Du-Hee;Hwang, Su-Ok;Byun, Jung-Hwan;Hwang, Soon-Jin;Kim, Baik-Ho
    • Korean Journal of Ecology and Environment
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    • v.51 no.1
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    • pp.1-15
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    • 2018
  • With land-use (cover) and water quality, the distributional characteristics of epilithic diatom communities were studied with 193 samples from estuaries of Korean peninsula between 2015 and 2016. Of total 394 taxa classified, Nitzschia perminuta (19.6%) and N. inconspicua (14.0%) were the 1st and 2nd dominant species. Using a cluster analysis, the epilithic diatom communities of Korean estuaries were divided into four groups (G1-G4). Ecological characteristics of each group were followed: G1 was located in estuaries of the East Sea, and characterized by high forest land-use and high DO and low nutrients; G2 was the eastern part of the South Sea, and characterized by low turbidity and nutrients; G3 was the western part of the South Sea, and characterized by high agriculture, low electric conductivity and low salinity; G4 was the Yellow Sea, and characterized by high nutrients. The environmental factors having significant correlation with diatom distributions were as follows: TN to G1, turbidity to G2, agriculture to G3, and TP to G4. Moreover, the important factors affecting the occurrence of indicator species were forest land-use for Fragilaria construens var. venter in G1, turbidity for Rhoicosphenia abbreviata in G2, urban land- use and total phosphorus (TP) for Bacillaria paradoxa and Hantzschia amphioxys of G3, and TP and turbidity for N. ovalis and Stephanodiscus invistatus of G4. These results collectively indicate that the distribution of epilithic diatom communities in Korean peninsula was largely effected by water quality and land cover/use.

A STUDY ON THE STRESS DISTRIBUTION OF ABUTMENT TEETH AND RESIDUAL RIDGE AREA BETWEEN TELESCOPIC AND CLASP TYPE RPD BY FEM METHOD (telescope형 및 Clasp형 유지장치를 이용한 국소의치 지지조직의 응력분포에 관한 삼차원 유한요소법적 연구)

  • Koak, Jai-Young;Kim, Kwang-Nam;Chang, Ik-Tae;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.1
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    • pp.104-126
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    • 1999
  • The purpose of this study was to compare and evaluate the stress distribution and displacement developed in the abutment teeth and residual ridge area by madibular unilateral distal extension removable partial denture with 2 different retainer designs. The retainers on right and left canine and right 2nd molar were Alters clasp in one model and telescopic crown in the other model. The stress distribution of abutment teeth and residual ridge area on two model were compared and analyzed with 3-dimensional finite element method. 150N and 400N forces were applied vertically, 30 degree and horizontally on the central fossa area of left 1st molar of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows 1. As the magnitude and angulation of applied force were increased, the magnitude of stress on the right and central residual ridge area and the right canine of the telescopic type increased and comparing to those of the Alters clasp type. 2. As the magnitude and angulation of applied force were increased, the mesial direction of displacement on the right residual ridge area and the right tooth of the telescopic type increased and the distal direction of displacement on left residual ridge area and the left canine increased comparing to those of Akers clasp type. 3. As the vertical force was applied, the distal direction of the displacement of the right tooth were greater and that of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. 4. As the 30 degree force was applied, the mesial direction of the displacement of the right tooth were greater and the distal direction of the displacement of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. In the horizontal force the results were same in right area tooth but the distal direction of displacement was greater in left canine. 5. In both removable partial dentures, as the magnitude and degree of force were increased, the stress and displacement were increased. The compressive force was dominative than the ten sile force. 6. In both removable partial dentures, the magnitude of stress was greater on mucosal tissue area than that of the alveolar bone area on distal extension residual ridge area but the result was reversed on anterior residual ridge area. The displacement was always greater on mucosal tissue area than that of alveolar bone area.

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Finite Element Stress Analysis of Bone Tissue According to the Implant Connection Type (2종의 임플란트 내부결합구조체에 따른 치조골상 유한요소응력 분석)

  • Byun, Ook;Jung, Da-Un;Han, In-Hae;Kim, Seong-Ryang;Lee, Chang-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.3
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    • pp.259-271
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    • 2013
  • The purpose of this study was to make the stress distribution produced by simulated different load under two types of internal connection implant system (stepped and tapered type) by means of 3D finite element analysis, The finite element model was designed with the parallel placement of the one fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st molar. Two models were loaded with 200 N magnitude in the vertical direction on the central position of the crown, the 1.5 mm and 3 mm buccal offset point from the central position of the fixture. The oblique load was applied at the angle of $30^{\circ}$ on the crown surface. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual dimension. The results were as follows; 1. The loading conditions of two internal connection implant systems (stepped and tapered type) were the main factor affecting the equivalent bone strain, followed by the type of internal connections. 2. The stepped model had more mechanical stability with the reduced max. stress compared to $11^{\circ}$ tapered models under the distributed oblique loading. 3. The more the contact of implant-abutment interface to the inner wall of implant fixture, the less stress concentration was reduced.

Assessment of Allograft Function in Dog Single Lung Transplantation on CT (한국산 잡견에서 컴퓨터단층촬영을 이용한 이식폐의 기능평가)

  • 박기성;박창권
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1055-1061
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    • 1997
  • In the field of the experimental lung transplantation, we analyzed the CT findings of acute rejection, infection in the left single allotransplanted lung of adult mongrel dogs, and the CT findings were compared with the histological findings obtained by the lung biopsy Twenty two adult mongrel dogs were divided into two groups(Donor and recipient group). Donor lungs were flushed with LPDG(low pota,ilium dextral glucose) solution(n=4) or modified Euro-collins solution(n=7) and preserved over 20 hours with $10^{\circ}C(1$ case preservation for 4hours). After left single lung transplantation, the chest X-ray and sequential computed tomogram were performed with concomitant hemodynamic study and arterial blood gas analysis on immediate postoperative period, postoperative 3rd day and postoperative 7th day. Two of eleven transplanted lungs had acute rejection which was represented as moderate infiltration at immediate or 1st postoperative d y but became extensive infiltration at postoperative 3rd day on CT. There were showed one case of bronchopleural fistula, six cases of pneumonia and two cases of pulmonary infarction. In one rejection cases, the opacity of transplanted lung was improved by injection of methylprednisolone 500mg daily during 3 days. We concluded that CT was a useful noninvasive evaluation parameter after lung transplantation and the serial CT scan enabled early detection of acute rejection.

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Parents' Perceptions toward Students' Adjustments after Grade Skipping and Early Graduation (조기전급 및 조기졸업 이후 학생적응에 대한 부모지각)

  • Lee, Mi-Soon;Cho, Seok-Gee
    • Journal of Gifted/Talented Education
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    • v.19 no.3
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    • pp.411-432
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    • 2009
  • This study analyzed the differences in parents' perceptions toward children's adjustments after grade skipping and early graduation. Parents of an early entrancer to K university(n=43) and parents of a non-early entrancer to K university(n=12) responded two kinds of questionnaires, one is for parents' perceptions towards children's needs for grade skipping and early graduation, and the other is for parents' perceptions toward children's adjustments to university experiences. Parents' responses were analyzed by MANOVA and MANCOVA. Results indicated that there was the significant difference in parents' perceptions for 'information about early graduation.' That is, parents of an early-entrancer had more 'information about early graduation' than their counterparts. However, there was no significant difference in parents' perceptions, after the effect of 'information about early graduation' on parents' perceptions toward children' academical and social-emotional adjustments. Thus, parents having more 'information about early graduation' considered more seriously the needs of grade skipping and early graduation in their children and worried less about their children's adjustments to university experiences.

Effects of Disinfectant Concentration, pH, Temperature, Ammonia, and Suspended Solids on the Chlorine Disinfection of Combined Sewer Overflow (소독제 농도, pH, 온도, 암모니아 농도, 부유물질이 강우 월류수 염소 소독에 미치는 영향)

  • Kim, Sang-Hyoun
    • Journal of Korean Society of Environmental Engineers
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    • v.36 no.10
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    • pp.685-690
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    • 2014
  • The treatment of combined sewer overflow (CSO) is one of potential concerns in domestic wastewater treatment in Korea due to the pre-announce of CSO regulations. This work investigated the effects of disinfectant (NaOCl) concentration (0.11 to 4.0 mg $Cl_2/L$), pH (6.5 to 8.0), temperature (15 to $25^{\circ}C$), ammonia (10 to 41 mg N/L), and suspended solids (91 to 271 mg SS/L) on the chlorine disinfection of CSO. The effect of NaOCl concentration on the pseudo-$1^{st}$ order reaction rate for total coliform inactivation was described well with a saturation-type model with the half-velocity constant of 1.212 mg/L. The total coliform inactivation reaction rate decreased with SS and pH, and increased with temperature. Ammonia in the examined range did not affect the disinfection kinetics. A chlorine contact tank with the injection chlorine level of 1 mg $Cl_2/L$ and the hydraulic retention time of 1.25 min is estimated to reduce total coliform from $1{\times}10^5MPN/mL$ to 1,000 MPN/mL at 271 mg SS/L, $15^{\circ}C$, and pH 8.0. Chlorine would be a proper option for the disinfection of CSO.

Metabolic Abnormalities in Patients with Mitochondrial Myopathy Evaluated by In Vivo $^{31}$P Magnetic Resonance Spectroscopy (인($^{31}$P) 자기공명분광법을 사용하여 사립체 근질병환자와 정상인과의 대사물질 비교조사)

  • Bo-Young Choe
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.89-95
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    • 1998
  • Purpose : To investigate the phosphorus metabolic abnormalities in skeletal muscle of patients with mitochondrial myopathy using in vivo $^{31}P$ magnetic resonance spectroscopy(MRS). Materials and Methods : Patients with mitochondrial myopathy(N=10) and normal control subjects (N=10) participated. All in vivo $^{31}P$ MRS examinations were performed on 1.5T whole-body MRI/MRS system by using an image selected in vivo spectroscopy (ISIS) pulse sequence that provided a $4{\times}4{\times}4{\;}cm^{3}$ volume of interest (VOI) in the right thigh muscle tissue. Peak areas for each phophorus methabolite were measured using a Marquart algorithm. Results : The specific features in patients with mitochondrial myopathy were a significant increase of Pi/PCr ratio (p=0.003) and a significant decrease of ATP/PCr ratio (p=0.004) as compared with normal controls. In particular, the ${\beta}-ATP/PCr$ ratio between controls and patients with mitochondrial myopathy was predominantly altered. Conclusions : In vivo $^{31}P$ MRS may be a useful modality in the clinical evaluation of patients with mitochondrial myopathy based on ATP/PCr and Pi/PCr ratios in skeletal muscle tissue and provides a valuable information in further understanding disorders of muscle metabolism.

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Seasonal Variations of Water Quality and Periphyton in the Cheonggyecheon (청계천의 수질과 부착조류의 계절적 변동)

  • Shin, Myoung-Sun;Kim, Bom-Chul;Kim, Jai-Ku;Park, Mi-Suk;Jung, Seong-Min;Jang, Chang-Won;Shin, Yoon-Keun;Bae, Yeon-Jae
    • Korean Journal of Ecology and Environment
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    • v.41 no.1
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    • pp.1-10
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    • 2008
  • The seasonal variations of water quality and periphyton were investigated in an artificial stream (the Cheonggyecheon Stream) flowing through the Seoul City. TP showed a longitudinal gradient: 10 to $59{\mu}gP\;L^{-1}$ in the upper stream sites, and 15 to $90{\mu}gP\;L^{-1}$ in downstream sites. POP was a major form of TP in the water, occupying over 60%, while the proportion of DIP was less than 10% except for St. 4. N/P atomic ratio ranged from 78 to 554, which implies phosphorus would limit algal growth more than nitrogen. The biomass of periphyton did not show much difference among sites, and it was relatively higher in spring and fall season $(10\sim20{\mu}gChl\;{\alpha}cm^{-2})$ and lower in August $(<5{\mu}gChl\;{\alpha}cm^{-2})$, possibly because biofilms were washed off during spates of summer monsoon. Cyanobacteria was the dominant taxon in the periphyton community throughout the year. The periphyton standing crop can be classified as a nuisance level. It seems that phosphorus level is sufficiently high even though the input water is treated chemically, and modest water velocity $(20\sim90cm\;sec^{-1})$ and rocky bottom provide optimal conditions for periphyton growth.

Effect of Death Education Program on Self-Esteem, Spiritual Well-Being, and Pain of Adults (죽음교육 프로그램이 성인의 자아존중감, 영적안녕, 통증에 미치는 효과)

  • Kim, Bock-Ryun;Oh, Chung-uk;Kang, Hye-kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.9
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    • pp.156-162
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    • 2016
  • This study was conducted to investigate the effects of a death education program on self-esteem, spiritual well-being, and pain in adults. This investigations employed a nonequivalent control group non-synchronized design, and was performed in C hospital located in Chungju, Chungcheongbukdo province, Korea from January 4-13, 2016. The study included 48 participants who agreed to enrolled. Participants were randomly divided into an experimental and a control group of 22 and 26 applicants each. Participants (n=22) in the experimental group participated in the death education program for 2 hours, three times a week for 2 weeks. The effects of treatment were measured using a structured questionnaire to evaluate self-esteem, spiritual well-being, and pain before and after 2 weeks of intervention. Data were analyzed using a t-test, chi-squared test, Fisher's Exact-test and a paired t-test. The experimental group showed significantly increased self-esteem (P<0.002) and spiritual well-being (P<0.015), and significantly reduced pain (P<0.014) compared to the control group after 2 weeks of intervention. Overall, the death education program was shown to be an effective nursing intervention for adults; therefore, of its use in various fields should be considered.