• Title/Summary/Keyword: Total pressure recovery

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A retrospective analysis of outpatient anesthesia management for dental treatment of patients with severe Alzheimer's disease

  • So, Eunsun;Kim, Hyun Jeong;Karm, Myong-Hwan;Seo, Kwang-Suk;Chang, Juhea;Lee, Joo Hyung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.271-280
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    • 2017
  • Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

An Experimental Study on the Myocardial Protection Effects of the Cardioplegic Solution (Cardioplegic Solution의 심근보호 효과에 관한 실험적 연구)

  • 이종국
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.321-337
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    • 1980
  • The increasing use of cardioplegic solution for the reduction of ischemic tissue injury requires that all cardiplegic solution be carefully assessed for any protective or damaging properties. This study describes functional, enzymatic and structural assessment of the efficiency of three cardioplegic solutions (Young & GIK, Bretschneider, and $K^{+}$ Albumin solution) in a Modified Isolated Rat Heart Model of cardiopulmonary bypass and ischemic arrest. Isolated rat heart were subjected to a 2-minute period of coronary infusion with a cold cardioplegic or a noncardioplegic solution immediately before and also at the midpoint of a 60-minute period of hypothermic ($10{\pm}1$. C) ischemic cardiac arrest. The results of this study were as follow: 1. Spontaneous heart beat after ischemic arrest occured 16 seconds later after Langendorff reperfusion in the Young & GIK group (n=6), and 40 second later in the Bretschneider group (n=6) and 6 minute later in the $K^{+}$ Albumin group (n=6), and 16 minute later in the control group (non-cardioplegia). A good recovery state of spontaneous heart beat was shown in the Young & GIK and Bretschneider groups. 2. The percentage of recorveries of heart function at 30 minute after postischemic working heart perfusion were : heart rate $91.6{\pm}3.1$% (P<0.01)m oeaj airtuc oressyre $83{\pm}3$% (P<0.01), coronary flow $70{\pm}8$% (P<0.05) and aortic flow flow rate $39{\pm}9.3$% (P<0.05) in the Young & GIK group. This percentage of recoveries of the Young & GIK group was significantly greater than the control group. In the Bretschneider group, the percentage of recoveries were : heart rate $87.8{\pm}7.5$%(P<0.05), peak aortic pressure $71{\pm}2.3$% (P<0.05) and aortic flow rate $33.2{\pm}6.6$%(P<0.05). hte percentage of recoveries were significantly greater than in the control group. In the $K^{+}$ Albumin group, recoveries of heart function were poor. 3. Total CPK leakage was $131.2{\pm}12.75$IU/30 min/gm. dry weight in the control group, $50.65{\pm}12.75$IU in the Young & GIK gruop, $69.40{\pm}32.21$Iu in Bretschneider group, and $103.65{\pm}15.47$IU in the $K^{+}$ Albumin group during the 30 minute postischemic Langendorff reperfusion. Total CPK leakage was significantly less (P<0.001) in the Young & GIK group, than in the control group. 4. Direct correlatin between percentage recovery of aortic flow rate and total amount of CPK leakage from Myocardium was noticed.(Correlation Coefficient r = 0.76, P<0.001). 5. Mild perivascular edema was the only finding of light microscopic study of myocardium after 60 minute ischemic arrest with cold cardioplegic solutions and hypothermla.

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Optimal aerodynamic design of hypersonic inlets by using streamline-tracing techniques

  • Xiong, Bing;Ferlauto, Michele;Fan, Xiaoqiang
    • Advances in aircraft and spacecraft science
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    • v.7 no.5
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    • pp.441-458
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    • 2020
  • Rectangular-to-Ellipse Shape Transition (REST) inlets are a class of inward turning inlets designed for hypersonic flight. The aerodynamic design of REST inlets involves very complex flows and shock-wave patterns. These inlets are used in highly integrated propulsive systems. Often the design of these inlets may require many geometrical constraints at different cross-section. In present work a design approach for hypersonic inward-turning inlets, adapted for REST inlets, is coupled with a multi-objective optimization procedure. The automated procedure iterates on the parametric representation and on the numerical solution of a base flow from which the REST inlet is generated by using streamline tracing and shape transition algorithms. The typical design problem of optimizing the total pressure recovery and mass flow capture of the inlet is solved by the proposed procedure. The accuracy of the optimal solutions found is discussed and the performances of the designed REST inlets are investigated by means of fully 3-D Euler and 3-D RANS analyses.

Effect of Tauroursodeoxycholic Acid on Ischemia/Reperfusion Injury in Isolated Rat Heart (타우로우루소데옥시콜린산이 흰쥐의 적출심장에서 허혈 및 재관류 손상에 미치는 영향)

  • 한석희;이우용;박진혁;이선미
    • Biomolecules & Therapeutics
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    • v.7 no.4
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    • pp.354-361
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    • 1999
  • In this study, the effects of tauroursodeoxycholic acid (TUDCA) on ischemia/ reperfusion injury were investigated on isolated heart perfusion models. Hezrts were perfused with oxygenated Krebs-henseleit solution (pH 7.4, $37^{\cire}C$) on a Langendorff apparatus. After equilibration, isolated hearts were treated with TUDCA 100 and 200 $\mu\textrm{M}$ or vehicle (0.02% DMSO) for 10 min before the onset of ischemia in single treatment group. In 7 day pretreatment group. TUDCA 50, 100 and 200 mg/kg body weight were given orally for 7 days before operation. After global ischemia (30 min), ischemic hearts were reperfused for 30 min. The physiological (i.e. heart rate, left ventricdular developed pressure, coronary flow, double product, time to contracture formation) and biochemical (lactate dehydrogenase; LDH) parameters were evaluated. In vehicle-treated group, time to contracture formation was 810 sec during ischemia, LVDP was 34.0 mmHg at the endpoint of reperfusion and LDH activity in total reperfusion effluent was 34.3 U/L. Single treatment with TUDCA did not change the postischemic recovery of cardiac function, LDH and time to contractur compared with ischemic control group. TUDCA pretreatment showed the tendency to decrease LDH release and to increase time to contracture and coronary flow. Our findings suggest that TUDCA does not ameliorate ischemia/reperfusion-reduced myocardial damage.

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Case Studies for Optimizing Heat Exchanger Networks in Steam-assisted Gravity Drainage Oil Sands Plant (SAGD 법을 이용한 오일샌드 플랜트 열교환기망 최적화를 위한 사례연구)

  • Cho, Eunbi;Jeong, Moon;Kang, Choonhyoung
    • The KSFM Journal of Fluid Machinery
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    • v.19 no.3
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    • pp.19-24
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    • 2016
  • Oil sands are a mixture of sand, clay, and a high-viscosity petroleum called bitumen. Steam-Assisted Gravity Drainage (SAGD) is the most viable and environmentally safe recovery technology for extracting bitumen. It extracts the viscosity-lowered bitumen by high pressure, high temperature steam injected into the bitumen reservoir. The steam is produced at the Central Processing Facility (CPF). Typically, more than 90% of the energy consumed in producing bitumen are used to generate the steam. Fuels are employed in the process, which cause economic and environmental problems. This paper explores the retrofit of heat exchanger network to reduce the usage of hot and cold utilities. The hot and cold utilities are reduced respectively 6% and 37.3% which in turn resulted in 5.3% saving of total annual cost by improving the existing heat exchanger network of the CPF.

Numerical Study on Turbulent Flow in a Conical Diffuser (원추형 디퓨져 내의 난류운동에 관한 수치해석적 연구)

  • 강신형;최영석
    • Transactions of the Korean Society of Mechanical Engineers
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    • v.16 no.10
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    • pp.1971-1978
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    • 1992
  • A turbulent flow in a conical diffuser with total divergence angle of 8.deg. was numerically studied. The low Reynolds number k-.epsilon. model(Launder-Sharma model) was adopted to simulate the turbulence. The continuity and time averaged Navier-Stokes equations in a nonorthogonal coordinate system were solved by a finite volume method based on the fully elliptic formulation. The low Reynolds number k-.epsilon. model reasonably simulates the pressure recovery and the mean velocity components. However, there are also considerable discrepancies between predicted and measured shear stress distribution on the wall and turbulent kinetic energy distributions. It is necessary to investigate the flow structure at the entry of the diffuser, numerically as well as experimentally.

Performance Load Balancing and Sensitivity Analysis of Ramjet/Scramjet for Dual-Combustion/Dual-Mode Ramjet Engine Part II. Performance Sensitivity (이중램제트(이중연소/이중모드)엔진을 위한 램제트/스크램제트의 작동영역분배 및 성능민감도분석 Part II. 성능민감도)

  • Kim, Sun-Kyoung;Jeon, Chang-Soo;Sung, Hong-Gye;Byen, Jong-Ryul;Yoon, Hyun-Gull
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.38 no.6
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    • pp.596-604
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    • 2010
  • In order to investigate the operating conditions and major design parameters of a dual ramjet propulsion system, an theoretical analysis of ramjet and scramjet propulsion systems was performed. The performance characteristics of each engine are delivered by thermo-dynamical cycle analysis, considering loss effects in a real engine. The performance sensitivity analysis is conducted by investigating various performance parameters, such as an intake efficiency, combustor inlet Mach number, configuration of the combustor, fuel flow rate, and exhaust nozzle efficiency. Based on these analysis results, the processes of application to dual ramjet cycle engines are specified.

COMPUTATIONAL PREDICTION OF ICE ACCRETION AROUND A ROTORCRAFT AIR INTAKE (회전익기 공기흡입구의 표면발생 결빙에 관한 전산 예측)

  • Jung, K.Y.;Ahn, G.B.;Myong, R.S.;Cho, T.H.;Jung, S.K.;Shin, H.B.
    • Journal of computational fluids engineering
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    • v.17 no.2
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    • pp.100-106
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    • 2012
  • Ice accretion on the surface of aircraft in flight can adversely affect the safety of aircraft. In particular, it can cause degradation of critical aircraft performances such as maximum lift coefficient and total pressure recovery factor in engine air intake. In this study, computational prediction of ice accretion around a rotorcraft air intake is conducted in order to identify the impingement region with high droplet collection efficiency. Then the amount of ice accretion on the air intake, which is essential in determining the required power of ice protection system, is calculated. Finally, the effect of icing wind tunnel size is investigated in order to check the compatibility with the real in-flight test environment.

Accidental High Epidural Block -A case report- (우발성 고위경막외차단 경험 1예 -증례보고-)

  • Park, Jung-Goo;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.159-163
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    • 1995
  • Accidental high epidural block is a rare but serious complication. It can result from many factors, which include the volume and concentration of drug, posture, puncture site, age, pregnancy or intra-abdominal mass, and patients' height and weight. We had a case of accidental high epidural block recently. This is a case report which was confirmed by an epiduragram. A healthy 50-year-old woman with a huge uterine myoma was scheduled for a total abdominal hysterectomy under continous epidural analgesia. Epidural catheterization was carried out smoothly. However, an unexpected hypotension was noticed after an epidural injection of 2% lidocaine 25 ml. Thereafter, the patient was intubated and her respiration was controlled during the operation. Using the 5mg of ephedrine, her blood pressure and pulse were well maintained. The scheduled operation was carried out for one hour uneventfully, but after the operation, she felt paresthesia on her hands in the recovery room. To differentiate between the high epidural and the subdural blocks. We injected 5 ml of a water soluble Niopam 300 through the catheter postoperatively. It was observed on the epiduragram that the catheter was placed in the epidural space. It was suggested that the high epidural block was induced from the widespread diffusion through the narrowed epidural space due to the engorgement of the epidural venous plexus by the patient's huge uterine myoma.

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Effect of Ursodeoxycholic Acid on Ischemia/Reperfusion Injury in Isolated Rat Heart

  • Lee, Woo-Yong;Han, Suk-Hee;Cho, Tai-Soon;Yoo, Young-Hyo;Lee, Sun-Mee
    • Archives of Pharmacal Research
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    • v.22 no.5
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    • pp.479-484
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    • 1999
  • In this study, the effects of ursodeoxycholic acid (UDCA) on ischemia/reperfusion injury were investigated on isolated heart perfusion model. Hearts were perfused with oxygenated Krebs-Henseleit solution (pH 7.4, $37^{\circ}C$) on a Langendroff apparatus. After equilibration, isolated hearts were treated with UDCA 20 to 160 $\mu$M or vehicle (0.04% DMSO) for 10 min before the onset of ischemia. After global ischemia (30 min), ischemic hearts were reperfused and allowed to recover for 30 min. The physiological (i.e. heart rate, left ventricular developed pressure, coronary flow, double product and time to contracture formation) and biochemical (lactate dehydrogenase; LDH) parameters were evaluated. In vehicle-treated group, time to contracture formation was 21.4 min during ischemia, LVDP was 18.5 mmHg at the endpoint or reperfusion and LDH activity in total reperfusion effluent was 54.0 U/L. Cardioprotective effects of UDCA against ischemia/reperfusion consisted of a reduced TTC $(EC_{25}=97.3{\mu}M)$, reduced LDH release and enhanced recovery of cardiac contractile function during reperfusion. Especially, the treatments of UDCA 80 and $160 {\mu}M $ significantly increased LVDP and reduced LDH release. Our findings suggest that UDCA ameliorates ischemia/reperfusion-induced myocardial damage.

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