• Journal of Veterinary Clinics
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• v.34 no.5
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• pp.330-334
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• 2017

The aim of this study was to establish an injection protocol of a test bolus and a main bolus of contrast material for computed tomographic pulmonary angiography (CTPA) for visualizing optimal pulmonary arteries in normal beagle dogs. CTPA using a test bolus method from either protocol A or B were performed in each of four normal beagle dogs. In protocol A, CTPA was conducted with a scan duration for around 8 s, setting the contrast enhancement peak of the pulmonary trunk in the middle of the scan duration. The arrival time to the contrast enhancement peak was predicted from a previous dynamic scan using a test bolus (150 mg iodine/kg) injected with the same injection duration using for a main bolus (450 mg iodine/kg). In protocol B, CTPA was started at the predicted appearance time of contrast material in the pulmonary trunk based on a previous dynamic scan using a test bolus injected with the same injection rate as a main bolus. CTPA using protocol A showed the optimal opacification of the pulmonary artery with pulmonary venous contamination. Proper CTPA images in the absence of venous contamination were obtained in protocol B. CTPA with a scan duration for 8 s should be started at the appearance time of contrast enhancement in the pulmonary trunk, which can be identified exactly when a test bolus is injected at the same injection rate used for the main bolus.

• Korean Journal of Radiology
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• v.1 no.2
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• pp.91-97
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• 2000

Objective: To determine whether the time-intensity curves acquired by test and main dose contrast injections for MR angiography are similar. Materials and Methods: In 11 patients, repeated contrast-enhanced 2D-turbo-FLASH scans with 1-sec interval were obtained. Both test and main dose timeintensity curves were acquired from the abdominal aorta, and the parameters of time-intensity curves for the test and main boluses were compared. The parameters used were arterial and venous enhancement times, arterial peak enhancement time, arteriovenous circulation time, enhancement duration and enhancement expansion ratio. Results: Between the main and test boluses, arterial and venous enhancement times and arteriovenous circulation time showed statistically significant correlation (p < 0.01), with correlation coefficients of 0.95, 0.92 and 0.98 respectively. Although the enhancement duration was definitely greater than infusion time, reasonable measurement of the end enhancement point in the main bolus was impossible. Conclusion: Only arterial and venous enhancement times and arteriovenous circulation time of the main bolus could be predicted from the test-bolus results. The use of these reliable parameters would lead to improvements in the scan timing method for MR angiography.

• Journal of Veterinary Clinics
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• v.35 no.3
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• pp.93-96
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• 2018

This study aimed to establish an injection protocol to determine the precise CT scan timing in canine abdominal multi-phase CT using the test bolus method. Three dynamic scans with different contrast injection parameters were performed using a crossover design in eight normal beagle dogs. A contrast material was administered at a fixed dose of 200 mg iodine/kg as a test bolus for dynamic scans 1 and 2, and 600 mg iodine/kg as a main bolus for dynamic scan 3. The contrast materials were administered with 1 ml/s in dynamic scan 1, and 3 ml/s in dynamic scan 2 and 3. The mean arrival time to the appearance of aortic enhancement in dynamic scan 3 was similar to that in dynamic scan 2, and different significantly to that in dynamic scan 1. The mean arrival time to the peak aortic and pancreatic parenchymal enhancement in dynamic scan 3 was similar to that in dynamic scan 1, and different significantly to that in dynamic scan 2. In multi-phase CT scan, a test bolus should be injected with the same injection duration of a main bolus, to obtain the precise arrival times to peak of arterial or pancreatic parenchymal enhancement.

• The Korean Journal of Pain
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• v.28 no.3
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• pp.210-216
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• 2015

Background: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.59-69
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• 2016

The objective of this study was to analyze the factors influencing integrated bolus peak timing in contrast-enhanced computed tomographic angiography (CTA) and to determine a method of calculating personal peak time. The optimal time was calculated by performing multiple linear regression analysis, after finding the influence factors through correlation analysis between integrated peak time of contrast medium and personal measured value by monitoring CTA scans. The radiation exposure dose in CTA was $716.53mGy{\cdot}cm$ and the radiation exposure dose in monitoring scan was 15.52 mGy (2 - 34 mGy). The results were statistically significant (p < .01). Regression analysis revealed, a -0.160 times decrease with a one-step increase in heart rate in male, and -0.004, -0.174, and 0.006 times decrease with one-step in DBP, heart rate, and blood sugar, respectively, in female. In a consistency test of peak time by calculating measured peak time and peak time by using the regression equation, the consistency was determined to be very high for male and female. This study could prevent unnecessary dose exposure by encouraging in clinic calculation of personal integrated peak time of contrast medium prior to examination.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.786-792
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• 2013

In this study was explored minimize side effects due to the additional injection of contrast medium and maintaining a high resolution imaging applied to the inspection and analysis of the contrast medium that affect the peak time biomechanics factors. Included 48 patients using the test bolus method, after measuring a patient's biomechanics factors of inspection before and during the test, correlation between contrast medium peak time and learn, matches the regression equation calculated and measured contrast medium peak time was assessed by the Bland Altman plot. Research result, inspections of SBP, HR contrast medium peak time and a significant negative correlation was, step 1, every increase, the contrast medium peak time significantly to -0.018 and -0.159 decreased, a fairly high concordance no difference between the two method. In conclusion, the regression equation using the existing methods, while maintaining excellent image quality that contrast medium is reduced to a patient, it can conclude that the alternative to the existing methods.

• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.61-72
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• 1995

The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2 % and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm (DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

• Journal of Pharmaceutical Investigation
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• v.24 no.3
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• pp.1-9
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• 1994

In order to assay the human plasma concentration of nifedipine in patients with bronchopulmonary dysplasia (BPD) and pulmonary hypertension, a modified high performance liquid chromatography (HPLC) method was applied. The retention times for nifedipine and an internal standard (11-ketoprogesterone) were $10.5\;{\pm}\;0.41$ and $13.1\;{\pm}\;0.63$ min, respectively. Absolute recovery from the plasma was $102.9\;{\pm}\;7.07%$. Reproducibility was excellent and variability between the runs was small. There was a negligible degradation during the assay procedure. The calibration curve shows a good linearity in the range of the desired plasma concentrations of nifedipine. A stability test of nifedipine in the human plasma shows 8 and 13% degradation during the storage of 5 and 9 months, respectively. There were no interferences on the HPLC assay with any possible medications for the BPD. The method has been used to monitor the drug concentrations in a patient. The concentration-time curve of a patient after a single oral dose of 0.3 mg/kg shows a double-peak phenomenon that was quite different from the previous report, suggesting non-bolus administration. However the hemodynamic responses were corresponding to the plasma concentration levels of nifedipine.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.645-654
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• 2002

Purposes : This study was conducted to examine nursing effects after using a new method of nasogastric tube feeding with recycled PETE bottle making use of gravity, and to compare with those of bolus method using syringe and pressure. Methods : The data collected from patients with nasogastric tube feeding more than a week at an internal medicine unit of C university hospital located in G-city from January 1st, 1998 through June 30th, 2000. For this nonequivalent control group posttest non-synchronized design, 28 patients were assigned to an experimental group and 35 patients to a control group. The homogeneity of two groups and the dependent variables were tested with use of $x^2-test$ and t-test. Results : The duration of hemostatic use was significantly shorter in the experimental group than control group(t=2.63, p=0.02). Also, the patients with PETE bottle feeding had a lower cost of material(t=3.51, p=0.01) and a lower rate of the time of direct nursing care(t=2.44, p=0.04) than those of control group. But, there was no significant difference between two groups in the length of hospital stay. Conclusion : This results indicates that nasogastric tube feeding with PETE bottle is superior to nasogastric tube feeding with syringe. This findings gave us an evidence to enhance nursing effectiveness in clinical setting.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.109-119
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• 2021

Purpose: The purpose of this study was to identify and analyze the characteristics of nurses' medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, 𝑥²-test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses' career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion: The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.