Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relatively high incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advanced pancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabine and 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy with gemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy. For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000 mg/$m^2$, given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (control group), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/$m^2$ gemcitabine being administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluated after 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3% versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) in the transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and medians for survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the same time, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy. Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusion chemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can be used for efficacy evaluation after chemotherapy in pancreatic carcinoma.
Bae, Young Hyeon;Lee, Chong Hwan;Kim, Hae Sol;Kim, Ho Sun;Suh, Chang Yong;Kim, No Hyeon;Lee, Jin Ho;Ha, In Hyuk;Kim, Me Riong;Chung, Hwa Jin;Lee, In Hee;Kim, Min Jeong;Kim, Eun Jee;Lee, Jae Woong
Journal of Acupuncture Research
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v.32
no.3
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pp.127-133
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2015
Objectives : Previous studies have shown that the amount of melittin, the main active ingredient in bee venom pharmacopuncture, tends to decrease substantially with time during pharmacopuncture manufacture. This study aimed to assess whether the stability of bee venom pharmacopuncture improved with pharmacopuncture additives. Methods : Components were measured using high performance liquid chromatography. Acute toxicity and antigenicity tests by subcutaneous and venous routes were conducted at Korea Pharmaceutical Test & Research Institute and mortality, adverse reactions, and body weight changes were assessed. Results : Stability tests using additives revealed that bee venom without additives was most stable. Bee venom pharmacopuncture without additives was further tested for toxicity in subcutaneous and venous administration in mice and no changes pertaining to toxicity were found over the testing period. Conclusions : Bee venom pharmacopuncture without additives was found to be most stable, and further, it did not show toxicity or antigenicity in subcutaneous and venous administration in mice.
Suture microvascular anastomosis is time-consuming and tedious and demands long and continuous training. Techinique of anastomosis of microvessel was presented interrupted suture and continuous suture. Recently the unilink instrument system is created as a fast and simple method to achieve high patency rates without long and continuous training in the anastomosis of small vessels. The author experimentally studied the femoral artery of 20 mice(0.5-1.0mm, av. 0.7mm), the femoral vein of 20 mice(0.8-1.6mm, av. 1.2mm) after anastomosis with interrupted suture in 20 cases and continuous sutre in 20 cases. For the unilink apparatus we used the carotid arteries of 15 cases in 14 rabbits(1.0-1.6mm, av. 1.3mm) and facial veins of 12 cases in 14 rabbits(0.9mm-2.2mm, av. 1.5mm). A total of 27 arterial and venous anastomoses were performed. We examined the postoperative patency at immediate, 2 weeks, and 8 weeks. The results were as followings, 1. In the arterial anastomosis the rate of patency was 90%(18/20) in interrupted suture, 90%(18/20) in continuous suture and 93%(13/15) in unilink apparatus. In the venous anastomosis the rate of patency was 90%(18/20) in interrupted suture, 80%(16/20) in continuous suture and 100%(9/9) in unilink apparatus. 2. The mean time for completion of the arterial anastomosis were 12.2 minutes in interrupted suture group, 10.3 minutes in continouous suture group and 8.5 minutes in unillnk apparatus group. The mean time for completion of the venous anastomosis were 13.6 minutes in interrupted suture group, 11.0 minutes in continuous suture group and 6.2 minutes in unilink apparatus group. 3. At the histological examination of suture group, hyperplastic reaction of middle layer and subintimal hyperplasia were observed. In unilink apparatus group, the endothelium layer was continued and the thickness of vessel wall was decreased due to moderate atrophy of the media and mild degree of nonspecific chronic inflammation were seen around the unilink apparatus. 4. No significants was noticied in foreign body reaction among the interrupted, continuous and unilink apparatus group. 5. A case of the arterial anastomosis was released with acting out at 15 minutes after operation. 6. The important factors in the technical problems were accurate apposition of the cut vessel edges in suture group and the proper selection of the ring size and optimal fitting between two rings in unilink apparatus group. Even though the outer diamater of vessel in suture group was different from that in unilink apparatus group the unilink method provides a very safe, fast, and simple way to perform microvascular anastomoses especially in anastomosis of vein. But howerver suture was needed in vessels below 1 mm outer diamater. In that situation continuous suture was benefit than the interrupted suture in operation time.
Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.
Kim, Tae-Kwang;Yang, Jae-Young;Choi, Seok-Tai;Jeon, Hee-Kyung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun;Ko, Seung-O
Maxillofacial Plastic and Reconstructive Surgery
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v.34
no.6
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pp.488-493
/
2012
Hemangioma and vascular malformation are the most common benign tumors that are caused by congenitally or traumatic events. Theses tumors represent approximately 1/3~1/4 of all hemangiomas and vascular malformations in the head and neck. There are many forms of treatment for hemangioma and vascular malformation including closed observation, surgery, radiotherapy, laser therapy, steroid therapy, compression, embolization, and sclerotherapy. Ethanolamine oleate is an unsaturated fatty acid salt that has been used as a sclerosing agent because of its excellent thrombosing properties. This paper presents 1 case of intraoral multiple venous malformations treatment with 1.25% ethanolamine oleate (3.6~9.6 mg dose) intralesionally injected for 6 to 14 weeks over 2 week intervals. After the sclerotherapy, lesions almost completely disappeared without side effects. In conclusion, sclerotherapy using ethanolamine oleate is very effective against venous malformations, and sufficiently provides alternative support for surgical and other methods.
Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.
The Present study attempted to analyze the fate of CO diffused into the circulating blood through the alveoli. Dogs were induced to CO poisoning by rebreathing CO gas mixture contained in Krog's spirometer, by closed circuit method, for 60 minutes. The spirometer was filled initially with 282 ml of CO and 20 liters of air and oxygen, so the composition of gases were arranged as 1.4% in CO and 50% in $O_2$ at the begining of the rebreathing. Oxygen was added corresponding to the utilization of $O_2$ by the animal in proceeding of the experiment. At 60th minutes of CO rebreathing, the concentration of CO in arterial blood and in mixed venous blood were analysed and compared with each other after the CO contents were corrected with the hematocrit measured in the arterial and mixed venous blood. The distribution of CO gas to other tissues was estimated by the analysis of CO diffused into the cystic bile and into the peritoneal gas pocket which was formed by injection of 300 ml air into the peritoneal cavity prior to the CO gas rebreathing. The blood volume was measured by dilution method using $^{51}Chromium$ tagged red cells. CO amount vanished in the animal body was calculated by subtraction of total CO content in blood stream and the CO remained in closed circuit breathing system from the CO amount given to the breathing system at the begining of the experiment. Results obtained are summarized as follows: 1. The content of CO corrected by the hematocrit value was slightly less in mixed venous blood than in arterial blood. The amount of CO diffused into the cystic bile and into the peritoneal cavity was averaged to 0.1% and 0.4% of the CO amount in 100 ml of blood, respectively. 2. For 60 minutes of CO rebreathing, CO-hemoglobin saturation reached about 77% at the 60th minutes, CO amount vanished in the experimental animal averaged 36.1 ml/dog/hr., or 21% of the total CO volume in the blood stream. The average vanishing rate of CO during 60 minutes of CO rebreathing per kg of body weight was 2.71 ml/hr. Production of CO measured in ten dogs under hypoxic condition averaged 0.023 ml/kg/hr. The major part of the CO vanished in the dogs seemed to be oxidized to $CO_2$ by various tissues of the animal. The conclusion might be delivered as such oxidation of CO to $CO_2$ by animal tissues can play a role in part of the process of recovery and protection of animal from CO-poisoning.
Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.
Park, Kyung-Soon;Song, Yeon-Yi;Park, Mi-Sook;Kim, Kyoung-Oak;Choi, Seong-Su;Kim, Kyung-Ah;Ryu, Jae-Duck;Cha, Eun-Jong
Journal of the Korea Academia-Industrial cooperation Society
/
v.10
no.9
/
pp.2451-2459
/
2009
The present study aimed to evaluate the accuracy of the blood glucose test with almost painless vacuum assisted auto-lancing technique. The blood glucose concentration measurements in the capillary blood sampled from the alternative (forearm) site were compared with the standard venous or finger sampling techniques. Capillary blood was sampled from both the left index finger and the forearm, followed by the venous blood sampling in 531 patients who visited the C University Hospital. Blood sugar test was performed for each blood samples for comparative analysis. Mean blood glucose concentration measured on the forearm was closer to the venous glucose level than that of the finger, but the difference was approximately 10 mg/dL small enough to ignore from the clinical point of view. The correlation coefficients of the measured blood glucose levels between finger and vein and between forearm and vein were 0.94 and 0.92, respectively (p<0.001). The blood glucose measurement on the forearm also well correlated with the finger, showing a correlation coefficient of 0.94, and both data were very much close to each other. Therefore, the blood sugar test on the alternative capillary blood sampling site such as forearm was accurate enough for clinical practice. The vacuum assisted auto-lancing technique on the alternative site would be of particular interest for the disease management of the chronic diabetes, since it induces almost no pain when sampling blood from the capillaries.
Cho, Yong Ae;Eun, Young;Lee, Seon Heui;Jeon, Mi Yang;Jung, Jin Hee;Han, Min Young;Kim, Nari;Huh, Jin Hyung
Journal of Korean Clinical Nursing Research
/
v.29
no.1
/
pp.24-41
/
2023
Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.
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