• 제목/요약/키워드: Venous

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Hemodynamic Evaluation of Acute Mitral Valve Insufficiency Model induced by Chordae Tendinae Rupture in Normal Dogs (개에서 건삭파열로 유발한 급성 이첨판 폐쇄부전 모델의 혈류역학적 평가)

  • Kim, Sehoon;Kim, Nam-Soo;Lee, Ki-Chang;Kim, Jong Min;Kim, Min-Su
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.367-370
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    • 2014
  • The study was to observe hemodynamic alterations of cardiac function to design a model of canine mitral valve insufficiency (MVI) based on chordae tendinae rupture (CTR). Ten healthy beagles with normal heart function were used in this study. To measure hemodynamics, the patient monitor was equipped for invasive blood pressure and a Swan-Ganz catheter. Hemodynamic alterations were checked promptly during CTR procedures. MVI model was made by transection of the chordae tendinae with small arthroscopy hook knife through $5^{th}$ intercostal open chest. Color Doppler at the level of the mitral valve showed high-velocity regurgitant flow immediately after CTR at intraoperative echocardiography. In hemodynamic measurements, pulmonary capillary wedge pressure (PCWP) was significantly increased, while mean arterial pressure (MAP), venous pressure (VP), pulmonary arterial pressure (PAP), cardiac output (CO) and cardiac index (CI) were significantly decreased after CTR. It was known that the left atrium was overloaded by regurgitant volume from the left ventricle. In conclusion, the MVI model induced by CTR technique in this study should be used as suitable one for the effective research of canine mitral valve disease. Further study should be needed to measure the chronic alternation of mitral valve in the model.

Cadiorespiratory effects of isoflurane-anesthetized dogs with closed chest during spontaneous two-lung and one-lung ventilation (마취된 개의 자발호흡상태에서 일측폐환기 및 양측폐환기가 심순환기 및 호흡기계에 미치는 영향)

  • Song, Young-sung;Chang, Hwa-seok;Kim, Hye-jin;Kim, Soon-shin;Choi, Joon-chul;Yang, Hee-taek;Chung, Dai-jung;Kim, Hwi-yool
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.279-285
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    • 2005
  • One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

Elliptical Centric Techniques and Tricks About the Usefulness of the Clinical Application (Elliptical Centric과 TRICKS 기법의 임상 적용에 관한 유용성 연구)

  • Kim, Sae-Ssak;Goo, Eun-Hoe;Dong, Kyung-Rae;Kweon, Dae-Chel;Lee, Jae-Seung;Cho, Jae-Hwan;Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.2
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    • pp.83-90
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    • 2011
  • To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.

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A Study on Needle Stick Injuries in Health Professionals (의료인의 바늘자상 실태에 관한 연구)

  • 김영분
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.605-622
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    • 1996
  • Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.

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Bone formation effect of $HA/{\beta}-TCP$ composite powders in rabbit calvarial bone defects;Histologic study (토끼의 두개골내에 형성된 골결손부에서 $HA/{\beta}-TCP$ composite powders의 골형성에 관한 조직학적 연구)

  • Lee, Kwang-Ho;Jang, Hyun-seon;Park, Joo-Cheol;Kim, Heung-Joong;Kim, Chong-Kwan;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.1-14
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    • 2006
  • The purpose of the present study was to evaluate the histologic results of bone cavities that were surgically created in the calvaria of rabbit and filled with $HA/{\beta}-TCP$ composite powders, which had been developed in Korea (Dentium, Korea). Ten young adult rabbits were used. Four defects were surgically produced in calvaria of each rabbit. Each rabbit was anesthetized with Ketamine-HCI (5 mg/kg, Yuhan Cor. Korea) and Xylazine-HCI (1.5 ml/kg, Yuhan Cor. Korea)). An incision was made to the bony cranium and the periosteum was reflected. Using a trephine bur (external diameter: 8 mm, 3i, USA), 4 'through-and-through' bone defects were created with copious irrigation, and classified into 4 groups: control group: no graft materials, experimental group I: normal saline + graft materials: experimental group II: venous blood + graft materials: experimental group III: graft materials only. The defects were randomly filled with graft materials. The defects were closed with resorbable suture material. At the end of the surgical procedure, all animals received a single intramuscular injection of antibiotics Gentamicin (0.1 mg/kg, Dae Sung Microb. Korea). Rabbits were sacrificed with phentobarbital (100 mg/kg) intravenously at 1-, 2-, 4-, 6- and 8-week after. Specimens were treated with hydrochloric acid decalcifying solution (Fisher Scientific, Tustin, CA) and sectioned by bisecting the 8 mm diameter defects. The histologic specimens were prepared in the general method with H & E staining at 6 ${\mu}m$ in thickness. The results were as follows; 1. New bone formation showed from after 2-week of surgery in defect area. As time lapsed, lots of new bone formation and mature bones showed. 2. Histologically, degree of new bone formation could not be discerned among the experimental groups. But, for experimental group II, lots of cells gathered around graft materials after 1-week of surgery, new bone formed slightly faster and than the others at 1-week after. For experimental group I, a few inflammatory finding showed around graft material at after 1-week and after 2-week of surgery. 3. No bone formation did show for control group. Based on histologic results, the new $HA/{\beta}-TCP$ composite powders appeared to act as a scaffolding material for regeneration of osseous defects.

Prognostic Significance of Lymphatic and Perineural Invasions in Patients with Gastric Cancer Who Have No Lymph Node and Serosal Involvement (장막 침윤과 림프절 전이가 없는 위암에서 림프관 및 신경초 침윤의 의의)

  • Kim Wook;Park Cho Hyun;Park Seung Man;Park Woo Bai;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.1 no.2
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    • pp.77-82
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    • 2001
  • Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

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Clinicopathologic Characteristics according to the Type of Recurrence in Curatively-resected Gastric Cancer Patients (위암환자의 재발유형에 따른 임상병리학적 특성)

  • Ha, Tae Kyung;Kwon, Sung Joon
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.23-30
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    • 2007
  • Purpose: Evaluating the clinicopathologic characteristics of recurred gastric cancer is essential for early detection of the recurrence and for better clinical outcome. The aim of this study was to establish the patterns of the recurrence, the timing of the recurrence, and the clinical result after recurrence according to the clinicopathologic characteristics of gastric cancer. Materials and Methods: From June 1992 to December 2005, of the 1338 gastric cancer patients who underwent a curative gastric resection, 241 patients who recurred during the follow-up period were selected and their cases were analyzed. The clinicopathologic characteristics of the patients, the time to recurrence after operation and survival were determined retrospectively according to the type of recurrence. Results: For the recurrent group, the numbers of total gastrectomies, advanced stages, lymphatic and/or venous infiltrations, whole stomach cancer cases, large tumors, undifferentiated tumors, and Borrmann type 4 tumors were higher than they were for the non-recurrent group, and the differences were statistically significant. When the recurrence types were classified as peritoneal seeding, hematogenous recurrence, and locoregional recurrence, independent risk factors were female gender, stage III, upper third, and whlole stomach cancer, and undifferentiated- type, diffuse-type, and Borrmann type 4 tumors for peritoneal seeding; early gastric cancer, stage I for hematogenous recurrence; and Borrmann type 1, 2, and 3 tumors for locoregional recurrence. Survival duration after detection of the recurrence was shorter for peritoneal seeding than for hematogenous or locoregional recurrence (7.0 months vs. 9.5 months and 12.5 months). Conclusion: For early detection of the recurrence after curative surgery for gastric cancer, it is important to recognize that the high risk factors for recurrence vary with the clinicopathologic data for the patients.

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Alterations of Cerebral Metabolic Activation Following Electro-Acupuncture Stimulation on ST36 and LR3 Acu-Points in Rats (흰쥐의 족삼리 및 태충 전침자극에 따른 뇌대사활성의 변화)

  • Sohn, Young-Joo;Jung, Hyuk-Sang;Ku, Ja-Seung;Won, Ran;Kim, Yong-Suk;Park, Young-Bae;Sohn, Nak-Won
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.159-174
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    • 2002
  • Objective : The meridian theory in oriental medicine explains that each acu-point has a characteristic functional effect. It will be supposed that an acupuncture stimulation on different acu-point evokes different activation on different areas in the central nervous system(CNS) according to the meridian theory. On this supposition, our group tried the semi-quantitative [14C]2-deoxyglucose([14C]2-DG) autoradiography on the acupuncture stimulation to the hindlimb acu-points of Sprague-Dawley rats. Methods : A venous catheter for the intravenous administration of isotope was equipped in the right external jugular vein on 3 days prior to the [14C]2-DG study. On the day of the study, two acupuncture needles were inserted into the ST36(Zusanli) or LR3(Taichong) on the left hindlimb. Electro-acupuncture stimulation (2 Hz, 5 ms, 1~3 mA, 15 minutes) started just before the i.v. injection of [14C]2-DG ($25{\mu}Ci/rat$). The brain and the spinal cord were removed and processed for the [14C] 2-DG autoradiography. Results : The EA stimulation on ST36 reveals over 120% metaboilc activation in Arcuate nucleus, Anterior pretectal nucleus, Dorsal cochlear nucleus, Interposed cerebellar nucleus, and Nucleus of Darkschewitsch. The EA stimulation on LR3 reveals over 120% metaboilc activation in Lateral habenula nucleus, Medial vestibular nucleus, Ventromedial thalamic nucleus, Anteroventral thalamic nucleus, Anterior cingulate cortex, Dentate gyrus, Antero cortical amygdaloid nucleus, Anterior pretectal nucleus, and Dorsal tegmental nucleus compared with the non EA stimulation control group. Conclusion : These results demonstrate that the different acu-points evoke the different activations in brain areas. And with this functional brain mapping study, a new scientific elucidation for the basis of the acupuncture-meridian theory in oriental medicine through differences of activated area in CNS according to the each acupuncture point.

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No Association Between Single Nucleotide Polymorphisms in Distal-Less Homeobox-6 (DLX6) and Autism Spectrum Disorders (ASD) from the Korean Male Population (한국인 남성에서 자폐스펙트럼장애와 DLX6 유전자 단일염기다형성간 연관성 연구)

  • Kim, Hyoun-Geun;Won, Seong-Sik;Lee, Seung-Ku;Nam, Min;Bang, Hee-Jung;Park, Hyun-Jung;Yoon, Jin-Young;Choi, Kyung-Sik;Hong, Mee-Sook;Chung, Joo-Ho;Kwack, Kyu-Bum
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.1
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    • pp.17-22
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    • 2010
  • Objectives : Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by abnormalities of social functioning, communication and behavior. The association of the 7q21-34 region with ASD has been reported. The DLX6 gene, which is located at the 7q22 region, is one of the positional and functional candidate genes for ASD. We found that there is no association between DLX6 polymorphisms and ASD in the Korean male population. Methods : We selected three single nucleotide polymorphisms (SNPs) that might be implicated in the change of the DLX6 gene expression. The genomic DNA was collected from the venous blood of 147 male controls and 179 male patients with ASD. The genotypes of the selected SNPs were determined using the Illumina GoldenGate assay, and the statistical analyses were performed using HapAnalyzer software and SAS Enterprise. Results : We found no association of the three SNPs in the DLX6 gene with ASD in the Korean male population. Conclusion : Our study suggests that the three SNPs in the DLX6 gene are not associated with ASD, and we need to analyze the previously reported regions for their associations with ASD.

Prevention Effects of Graduated Compression Stockings and Intermittent Pneumatic Compression on Deep Vein Thrombosis in SICU Patients: Pilot Study (항혈전스타킹과 간헐적공기압박기 적용이 중환자의 심부정맥혈전 발생 예방에 미치는 효과: 예비조사)

  • Kim, Hwasoon;Cho, Ok Min;Kim, Ji Sun;Jang, Hai Ok;Kim, Yeo Kyeong;Kim, Seol Hee;Min, Hyo Nam;Kwak, Kyung Sun;Hong, Kee Chun;Kim, Jang Yong;Chung, Joonho
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.3
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    • pp.249-257
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    • 2015
  • Purpose: The purpose of this pilot study was to investigate the effects of mechanical interventions for deep vein thrombosis (DVT) prophylaxis in surgical intensive care unit (SICU) patients. Methods: The participants were assigned to the intermittent pneumatic compression (IPC) and graduated compression stocking (GCS) intervention. Patients who met the criteria were selected for comparison from our previous study. Data for 140 patients were included in the final analysis. Results: The mean age was 57.5 (${\pm}15.7$) and 61.4 % were men. About forty-seven percent of the participants were 61 years or over. In the second duplex scan, 3, 2 and 1 critically ill patients developed deep vein thrombosis in the control, GCS, and IPC groups, respectively. Incidences of DVT were 6.0%, 5.0%, and 2.0% for the control, GCS, and IPC groups, respectively. This difference was not significant. Relative risks of no intervention were 3.0 and 1.2 compared with IPC and GCS application. There were no significantly different variables among the three groups before the intervention except for diagnosis on admission. Conclusion: Although it may difficult to conclude that mechanical prophylaxis effectively prevents DVT among SICU patients because there was no statistical significance in this study, but incidence rates among the three groups differed greatly. The findings reveal that further study should be conducted with larger samples and randomized controlled trial for SICU patients.