• Journal of Trauma and Injury
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• 제20권2호
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• pp.115-118
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• 2007

Purpose: A eutectic mixture of local anesthetics (EMLA$^{(R)}$) cream has been used as a topical anesthetic to reduce the pain of procedures penetrating the skin. It is generally applied for 40 to 60 minutes before the painful procedure. Because of the long application period, EMLA$^{(R)}$ is not useful in the emergency department (ED). The purpose of this study was to determine whether a 20-minute application of 9.6% lidocaine would be useful in reducing the pain of routine peripheral intravenous cannulation in the ED. Methods: We examined 27 male and 19 female patients ages over 18 years of age who required intravenous cannula insertion. Intravenous insertion was performed on 46 patients: 24 patients in the placebo group (mean age: 40.0 years) and 22 in the 9.6% lidocaine group (mean age: 37.6 years). The 9.6% lidocaine or placebo gel was applied and covered with an occlusive dressing for 20 minutes. Pain was scored by the patients using a 0- to 10-cm visual analogue scale. Results: The patients in the 9.6% lidocaine group (mean pain score: 3.4) experienced less pain than those in the placebo group (mean: 5.3), and the difference was statistically significant (p=0.029). Conclusion: We concluded that a 20-minute application of 9.6% lidocaine is safe and effective for reducing pain associated with venipuncture.

• 한국임상약학회지
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• 제33권3호
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• pp.195-201
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• 2023

Background: Hematocrit is usually measured from venous blood collected by invasive venipuncture. This study was performed to determine hematocrit accurately and precisely using minimally invasive volumetric absorptive microsampling (VAMS) technique. Such technique is to be applied to determining hematocrit in various clinical settings for the care, including therapeutic drug monitoring, of neonatal or epileptic patients, or patients with high risk of infection or bleeding. Methods: The study was performed using 31 VAMS samples obtained from 21 pancreatic cancer patients. Hematocrit was determined using the values of potassium concentrations obtained from blood in VAMS tips (Hct_VAMS). Hct_VAMS was compared with hematocrit measured from blood collected by venipuncture (Hct_VP). The accuracy and precision of Hct_VAMS in comparison to Hct_VP were evaluated using Bland-Altman plot, Deming regression and mountain plot. Results: Bland-Altman plot displayed a random scattering pattern of the differences between Hct_VAMS and Hct_VP with the mean bias of -0.010 and the 95% limit of agreement ranging from -0.063 to 0.044. Deming regression for Hct_VAMS and Hct_VP line demonstrated very small proportional and constant biases of 1.04 and -0.003, respectively. Mountain plot exhibited a narrow and symmetrical distribution of the differences with their median of -0.011 and central 95% range from -0.049 to 0.033. Conclusion: Hematocrit was accurately and precisely determined using less invasive VAMS technique. Such technique appears to be applicable to determining hematocrit in situations that venipuncture is not favorable or possible.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.388-393
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• 2006

목 적 : 신생아에서 포도당의 경구 투여, 국소 마취 크림인 $EMLA^{(R)}$와 노리개 젖꼭지의 통증 감소 효과를 비교하고자 하였다. 방 법 : 2003년 3월부터 12월까지 조선대학교병원 신생아실에 입원한 신생아들을 대상으로 4가지 방법으로 통증 감소를 측정하였다. 제 A군(대조군)은 아무것도 투여하지 않은 군, 제 B군은 $EMLA^{(R)}$ 크림을 바른 군, 제 C군은 10% 포도당액을 먹인 군, 제 D군은 30% 포도당액을 먹인 군, 마지막 제 E군은 노리개 젖꼭지를 물린 군으로 나누어서 통증의 감소를 비교하였다. 통증의 평가는 PIPP 점수를 측정하였다. 결 과 : 미숙아와 만삭아 사이에서 평균 PIPP 점수에는 유의한 차이가 없었다. 각 군의 평균 PIPP 점수를 보면 A군 $12.5{\pm}2.5$, B군 $10.1{\pm}2.6$, C군 $9.4{\pm}2.0$, D군 $6.5{\pm}2.1$, E군이 $8.7{\pm}2.3$로 대조군에 비해서 다른 군들이 유의하게 낮았다($EMLA^{(R)}$ 크림군 P<0.05, 그 외 모두, P<0.001). D군의 평균점수가 B, C, E군들의 평균 PIPP 점수에 비해 유의하게 낮았다(각각, P<0.001, P<0.005, P<0.05). 통증을 느끼는 PIPP 6점 이상의 비율을 비교하면 A군 100%, B군 82%, C군 56%, D군 40%, E군은 70%로 D군에서 가장 낮았다. 심한 통증을 느끼는 PIPP 12점 이상의 비율을 비교하면 A군 72%, B군 30%, C군 22%, D군 0%, E군은 14%로 D군이 가장 낮았다. 결 론 : 신생아에서 통증의 감소에 포도당액의 경구 투여, $EMLA^{(R)}$ 크림, 노리개 젖꼭지가 모두 효과가 있었으며, 특히 30% 포도당액의 경구 투여가 가장 효과적이었다.

• Journal of Chest Surgery
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• 제53권6호
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• pp.408-410
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• 2020

Iatrogenic vascular injuries may occur during venipuncture, arterial cannulation, or catheterization procedures. Brachial arteriovenous fistula (AVF) resulting from antecubital vascular access is rare and develops slowly. We report the case of an 18-year-old man who had developed iatrogenic brachial AVF. He had a history of several venipunctures in the left arm at the age of 10 months. Doppler ultrasonography and computed tomographic angiography were used to establish a diagnosis of brachial AVF, and surgical correction of the AVF was performed. As our case indicates, delayed surgery can be considered as a treatment option and may be associated with a decreased risk of vascular complications in the management of iatrogenic brachial AVF in infants.

• Journal of Chest Surgery
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• 제42권1호
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• pp.41-45
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• 2009

배경: 혈액투석을 하는 만성신부전 환자는 반복된 혈관천자로 인해 정맥의 보존상태가 좋지 않아서 동정맥루 조성술이 어려운 경우가 많다. 이에 저자는 혈관천자 등으로부터 보호된 상완동맥 주위의 동반정맥(vena comitantes)을 정맥측 문합으로 이용하여 인조혈관 동정맥루 조성술을 시행하였고 이의 개존율, 합병증 등을 알아보고자 하였다. 대상 및 방법: 2006년 1월부터 2008년 5월까지 전주주름 부위의 표재정맥의 보존상태가 불량하여 심부정맥인 동반정맥을 정맥 유출로로 이용하여 수술한 12예의 인조혈관 동정맥루 환자를 대상으로 임상분석을 시행하였다. 동맥측 문합은 상완동맥에 단측문합하였으며 루프형태로 수술하였다. 대상환자의 남녀비는 7 : 5이고 평균연령을 $59{\pm}17$세이며 당뇨병을 동반한 경우가 6예, 고혈압을 동반한 경우가 10예였다. 결과: 수술 후 감염이나 출혈 등의 합병증은 없었고 5명의 환자에서 술 후 평균 3개월에 협착의 소견을 보였다. 3, 6, 12개월의 일차 개통율은 각각 75.0%, 65.6%, 52.5%였다. 협착이 있었던 환자들도 중재적 시술 후 혈류가 개선되어 현재까지 혈액투석이 가능하였고 12개월의 이차 개통율은 100%였다. 결론: 인조혈관을 이용한 동정맥루 조성술시 정맥천자 등에 의해 손상되지 않은 동반정맥을 이용하여 정맥문합 하면 비교적 양호한 개통율을 보이므로 표재정맥이 적당치 않은 경우 대체혈관으로 사용해도 무방할 것으로 생각된다.

• 대한치과마취과학회지
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• 제12권4호
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• pp.215-221
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• 2012

The loss of consciousness in the dental office have many causes, such as, vasodepressor syncope, drug administration, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, acute allergic reaction, acute myocardial infarction, cerebrovascular accident, hyperglycemic reaction and hyperventilation. Patients have fainted during all phases of dental care: during tooth extraction and other surgical procedures, during local anesthetic injections, or during procedures such as venipuncture, on being seated in the dental chair, and even on first entering the dental office. If an elderly patient with known cardiovascular or cerebrovascular problems experiences a syncopal episode, differentiation from cerebrovascular insufficiency of more serious etiology, such as cerebrovascular accident, must be considered. And anaphylactic shock is also suggested during intravenous drug administration. This is a case report of syncope care during venous injection of cephalosporin in patient with cerebrovascular accident.

• Journal of Korean Biological Nursing Science
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• 제17권2호
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• pp.89-96
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• 2015

Purpose: Despite well-known benefits of walking on cardiovascular health, no structured walking exercise program has been formally tested on elderly Korean immigrants (EKIs). This pilot randomized controlled trial study assessed the effect of a walking program on walking behavior (pedometer steps count), stress (cortisol), depressive symptoms (CESD-10), and cardiovascular disease biomarkers (hs-CRP and fibrinogen) via venipuncture in EKIs. Methods: Seventy EKIs recruited from a Korean community were randomly assigned to a 12-week walking group or control group in a 3:2 ratio. The working program included a pedometer, buddy, monthly coffee card, weekly call for goal setting, and physical activity consultation. Walking group EKIs maintained the Centers for Disease Control and Prevention recommended exercise guidelines and good mental health status over 12 weeks. Results: There was no significant difference in the outcomes between control and walking groups. Conclusion: Social networking with Koreans in the senior center and church from a well-established Korean community might have positive effects on mental health.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.403-409
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• 1994

A questionnaire survey wds conducted to assess the experience of the needle stick injury in 144 seniors of a medical school during the previous 10 months. One hundred and five of them (73%) had responded. About sixty-nine percent (72 cases) of the respondents had suffered at least one u and there had been 129 injuries in total. Seventy-eight (56.6%) of the injuries took place at the time of the venipuncture. The emergency and operating room incurred 76.7% and 23.3% of the injury, respectively. Injuries with bleeding account for 50.4%. None of the respondents was systematically educated about the prevention of injury. This survey shows that the needle-stick Injury is a great risk for the medical students' health, and that educational effort for its prevention is warranted.

• Asian-Australasian Journal of Animal Sciences
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• 제20권1호
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• pp.41-44
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• 2007

The callipyge mutation in sheep is a polar overdominant mutation that results in post-natal muscle hypertrophy in the loin and hindquarters of paternal heterozygotes (+/CLPG). Sheep that are homozygous for the callipyge allele (CLPG/CLPG) do not express the muscle hypertrophy phenotype, but serve as carriers for the mutation. Callipyge sheep are characterized by improved feed efficiencies and leaner carcasses. Leptin is a protein hormone secreted from adipose tissue and has been found to affect appetite and serve as an indicator of body fat mass. To date, very little knowledge is available as to the effect of the callipyge mutation on circulating leptin levels. Due to the interaction of leptin with feed intake and energy availability, and the fact that the majority of fetal growth occurs in late gestation, it is important to understand if the callipyge mutation interacts with leptin production in late gestational ewes. Therefore, our objective was to characterize serum concentrations of leptin in late gestational callipyge ewes vs. non-callipyge ewes. We evaluated genetically verified callipyge (n=6), homozygous (n=8) and normal (n=8) ewes weekly during the last eight wks of gestation through one wk post-partum. Weights were taken and body condition scores were assigned by trained personnel weekly. Blood was collected via jugular venipuncture on each sampling date and subjected to an ovine-specific leptin RIA. Genotype influences on peripheral concentrations of leptin were found to be highly significant (p=0.0005). Total leptin means for +/CLPG were 5.41${\pm}$0.40 ng/ml, CLPG/CLPG 8.11${\pm}$0.70 ng/ml, and +/+ 9.13${\pm}$0.93 ng/ml. Sampling date was also significant (p=0.0098) with all ewes showing a decrease in leptin levels throughout gestation and parturition. Using repeated measures, we were able to detect lower levels of plasma leptin in callipyge ewes, which may be indicative of their lower overall body fat content. These results indicate that the callipyge phenotype decreases the levels of adipose tissue and leptin production in gestating ewes.

• Asian-Australasian Journal of Animal Sciences
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• 제30권9호
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• pp.1253-1260
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• 2017

Objective: Purpose was to determine the effects of grazing system and floor type on concentrations of blood metabolites, activity of creatine kinase, body weight and carcass characteristics of castrated Nguni goats. Methods: Forty eight, 7 month old goats were randomly allocated to herding and tethering treatments from 0800 to 1300 hours and accommodated on slatted and earth floors daily. Blood samples were collected by jugular venipuncture every fifteenth day for metabolite analysis. Slaughter was done at a commercial abattoir following 5 months of monitoring. Results: Tethered goats had significantly higher concentrations of urea (5.19 mmol/L) (p<0.001), creatinine ($55.87{\mu}mol/L$) (p<0.05), total protein (64.60 g/L) (p<0.01), and globulin (49.79 g/L) (p<0.001), whereas herded goats had higher glucose (3.38 mmol/L) (p<0.001), albumin (15.33 g/L) (p<0.05), albumin/globulin ratio (0.34) (p<0.01), and body weight (24.87 kg) (p<0.001). Slatted floors caused higher (p<0.01) albumin at 15.37 g/L. The interaction of grazing system and floor type affected creatinine, total protein, globulin at (p<0.01) and albumen/globulin ratio at (p<0.01). The least creatinine concentration and albumin/globulin ratio was in herded and tethered goats that were accommodated on earth floors, respectively. The highest total protein and globulin concentrations were in serum of tethered goats that were accommodated on earth floors. The highest (p<0.05) dressing percentage (45.26%) was in herded goats accommodated on slatted floors. Conclusion: Herding of goats lowered globulin concentration, improved estimated feed intake, blood glucose and albumin concentrations, albumin globulin ratio, increased body weights and weight related carcass characteristics. Floor type had very little effects on metabolites where earth floors only reduced albumin concentration. Tethering and housing goats on earth floors resulted in double stress that increased chronic infections.