• Title/Summary/Keyword: Weaned

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The Feasibility of the DKUH-75 Left Ventricular Assist Device for Acute Cardiogenic Shock in Pigs (돼지의 급성 심인성 쇼크 모델에서 DKUH-75 좌심실보조키의 유용성에 관한 연구)

  • Park, Seong-Sik
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.168-179
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    • 2007
  • Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

Effect of Warm Curtain Installation on Growth Performance, Blood Hormone Levels and Immunity of Weaning Pigs (보온막 설치가 이유자돈의 생산성 및 혈중 호르몬과 면역성분의 농도에 미치는 영향)

  • Kim, Y.H.;Lee, S.D.;Kim, D.H.;Jeong, H.J.;Kim, D.W.;Cho, K.H.;Sa, S.J.;Hur, T.Y.;Kim, S.H.;Kim, I.C.
    • Journal of Animal Environmental Science
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    • v.17 no.2
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    • pp.115-122
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    • 2011
  • This study was conducted to investigate the changes in growth performance, blood hormone levels and immunity of weaning pigs by the installation of warm curtain for keeping warmth in pigpen. A total of sixty-four piglets was weaned at 21 d of age with an average body weight of 5.8 kg. Each thirty-two piglets were allocated into the pens with (TRT) or without warm curtain (CONT). Daily gain and feed intake were increased by 17% and 9% in TRT from 2nd week to 4th week compared with CONT, respectively. The occurrence of diarrhea was decreased by 62% in TRT from initial to 2nd week compared with CONT. There were no significant differences in blood hormone levels and immunity of weaning pigs between treatments. In conclusion, the installation of warm curtain, which supported high temperature in pigpen, was considered to be effective in improving growth performance and reducing diarrhea occurrence of weaning pigs.

Evaluation on Cooling Effects of Geothermal Heat Pump System in Farrowing House (지열 냉방시스템을 이용한 분만돈사의 냉방효과 분석)

  • Choi, H.C.;Song, J.I.;Na, J.C.;Kim, M.J.;Bang, H.T.;Kang, H.G.;Park, S.B.;Chae, H.S.;Suh, O.S.;Yoo, Y.S.;Kim, T.W.;Park, J.H.
    • Journal of Animal Environmental Science
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    • v.16 no.2
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    • pp.99-108
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    • 2010
  • The principal objective of this study was to investigate the cooling effects of geothermal heat pump system (GHPS) in farrowing house. A total of 96 sows were allocated to 2 pig housings (GHPS and conventional housing) with 48 for four weeks in summer season. During the experimental period of four weeks, the highest outside temperature observed was approximately $34.1^{\circ}C$, GHPS decrease indoor temperature of pig housing up to $30.9^{\circ}C$, but conventional pig housing was similar to outside temperature. Dust concentrations (maximum 61.4%) of particulate matter less than $10{\mu}m$ (PM 10) in GHPS-housing were lower than the conventional housing. GHPS showed no signigicant difference in carbon dioxide emission, whereas the ammonia gas concentration was significantly decreased in GHPS-housing compared to that of conventional housing. Sows in GHPS-housing showed significantly lower respiratory rate than those of the control group. GHPS did not affect hormone level, litter size and birth weight, but weaning weight of piglets was influenced by GHPS. Feed consumption of sows was significantly increased in GHPS-housing compared to the conventional hosing. These results suggest that GHPS decrease dust concentration, ammonia gas emission and indoor temperature of pig housing and may affect performance in sows and weaned piglets.

Effect of Dietary Protein and Calcium Levels on Calcium Metabolism of the Rat (식이단백질과 칼슘 수준이 흰쥐의 칼슘대사에 미치는 영향)

  • Yoon, Gun-Ae;Hwang, Hye-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.2
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    • pp.176-180
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    • 2005
  • This study was conducted to examine effect dietary protein and calcium levels on calcium metabolism of the rat. Weaned 6-week old male rats were divided into 4 groups and were fed experimental diets for six weeks. Experimental groups were HPNC group-high protein normal calcium (protein: 400 g/kg diet, calcium: 0.5%), HPLC group-high protein low calcium (protein: 400 g/kg diet, calcium: 0.1%), NPNC group-normal protein normal calcium (protein: 200 g/diet, calcium: 0.5%), NPLC group-normal protein low calcium (protein: 200 g/diet, calcium: 0.1%). The calcium excretion in urine was higher in high protein group than in normal protein group, and it was highest in HPLC group. The activation of alkaline phophatase had a tendency to low in normal calcium group, and the concentration of parathyroid hormone (PTH) was the lowest in HPLC group. The deoxypyridinoline (DPD) concentration of urine was investigated as the highest in HPLC group and it was significantly lower in HPNC group that consumed normal calcium. The bone density of the femur was the highest in NPNC group and the lowest in NPLC group. As the results of this study, calcium excretion in urine and DPD density were the highest and the bone density was the lowest in HPLC group. It may suggest that the deficiency of calcium causes adversely effect in calcium metabolism upon consuming high protein diet. Therefore, it should be emphasized to consume enough calcium to prevent the hindrance of skeletal metabolism caused by deficiency of calcium upon consuming high protein diet.

Noncardiac Applications of Cardiopulmonary Bypass (비심장질환에서의 심폐바이패스 적용)

  • Kim, Won-Gon;Oh, Sam-Sae;Kim, Ki-Bong;Ahn, Hyuk;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.877-883
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    • 1998
  • Background: Cardiopulmonary bypass(CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. Material and Method: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava(MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm(GA), 1 for renal cell carcinoma(RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients(MOVC 4, GA 1, RC 1). Result: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26$^{\circ}C$ on average in MOVC, and 19$^{\circ}C$ in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients(malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. Conclusion: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.

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Postcardiotomy Ventricular Support with Biomedicus Pump (Biomedicus pump를 이용한 개심술후 심실보조)

  • Kim, Won-Gon;Lee, Chang-Ha;Kim, Ki-Bong;Ahn, Hyuk;Rho, Ryang-Joon
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1218-1222
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    • 1996
  • The reported incidence of postcardiotomy cardiogenic shock not responding to conventional therapy is still 0.1 to 0.8%. For this group of patients, more aggressive form of circulatory support must be employed. Centrifugal pumps are a ventricular assist device most commonly used on this purpose, due to low cost and easy availability. Currently, however, clinical experience of centrifugal pumps as a ventricular assist device is rarely reported in Korea. From January 1992 to January 1996, 2986 patients underwent cardiac operations on cardiopulmonary bypass at Seoul National University Hospital. Refractory postcardiotomy cardiac failure requring ventricular support with a Biomedicus centrifugal pump developed in ten of these patients. There were eight men and two women, ranged in age from nine years to 77 years with a mean of 50$\pm$20 years. The primary surgical procedures consisted of isolated coronary revascularization in four patients, combined coronary revascularization and aortic valve replacement in two, aortic dissection repair in two, pulmonary embolectomy in one, and heart transplantation in one. Of the ten patients, five had left ventricular assistance, one had right ventricular assistance, and four had biventricular assistance. Duration of ventricular assistance ranged from 24 to 175 hours, with a mean of 76$\pm$51 hours. Seven patients were weaned from ventricular assistance, and four of them discharged. The causes of death for nonsurvivors were progressive cardiac failure in two patients and multiorgan failure, intractable ventricular fibrillation, irreversible brain injury, and mechanical problem, respectively, in the other four. Survival was not predicted by time on cardiopulmonary bypass, aortic cross-clamp time, or duration of ventricular support. Major complications included bleeding(7), renal failure(6), infection(3) and neurologic complication(2). These results indicate that a centrifugal pump can provide reasonably satisfactory short-term circulatory support.

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Effect of n-3 fatty acid deficiency on fatty acid compositions of nervous system in rats reared by artificial method. (N-3 지방산 결핍이 혈청 및 신경조직의 지방산 조성에 미치는 영향)

  • Lim, Sun-Young
    • Journal of Life Science
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    • v.17 no.5 s.85
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    • pp.634-640
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    • 2007
  • Our previous study suggested that n-3 fatty acid deficiency was associated with significantly reduced spatial learning as assessed by Morris water maze test. Here we investigated an effect of n-3 fatty acid deficiency on rat brain, retina and serum fatty acyl compositions at 15 wks age using a first generational artificial rearing technique. Newborn Rat pups were separated on day 2 and assigned to two artificial rearing groups or a dam-reared control group. Pups were hand fed artificial milk via custom-designed nursing bottles containing either 0.02%(n-3 Deficient) or 3.1% (n-3 Adequate) of total fatty acids as a-linolenic acid(LNA). At day 21, rats were weaned to either n-3 deficient or n-3 adequate pelleted diets and fatty acid compositions of brain, retina and liver were analyzed at 15 wks age. Brain docosahexaenoic acid(DHA) was lower(58% and 61%, P<0.05) in n-3 deficient in comparison to n-3 adequate and dam-reared groups, receptively, while brain docosapentaenoic acid(DPAn-6) was increased in the n-3 deficient group. In retina and serum fatty acid compositions, the decreased precentage of DHA and increased precentage of DPAn-6 were observed. These results suggested that artificial rearing method can be used to produce n-3 fatty acid deficiency in the first generation and that adequate brain DHA levels are required for optimal brain function.

A Survey on Effects of Weaning Age on Market Weights of Steers and Calf Mortality in Hanwoo (설문을 통한 한우 송아지 이유월령이 거세한우 출하체중 및 송아지 폐사에 미치는 영향 조사 연구)

  • Yeo, J.M.;Lee, S.H.;Hwang, J.H.;Lee, S.S.;Ki, K.S.;Lee, J.H.;Nho, W.G.;Kim, W.Y.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.13 no.1
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    • pp.103-114
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    • 2011
  • The present survey was conducted to investigate effects of weaning age on market weights of steers and calf mortality in Hanwoo. Eight hundred and sixty-two Hanwoo cow-calf operations from all nine provinces were surveyed via personal interviews. The number of farms categorized by herd (heifer plus cow) size were 188, 364, 227 and 83 for <20 heads, 20~49 heads, 50~99 heads and >100 heads, respectively. Approximate 40% of farms surveyed weaned calves at three months of age. The percentages of farms weaning calves over three months of age were 53.5%, 37.5%, 43.7% and 39.0% for <20 heads, 20~49 heads, 50~99 heads and >100 heads, respectively. The herd size did not affect market weights of Hanwoo steers. However weaning age was negatively correlated to carcass weight of Hanwoo steers, showing that as weaning age decreased, carcass weights of Hanwoo steers increased. The average calf mortality was 5.6% and the herd size did not affect calf mortality. But weaning age was shown to be positively correlated to calf mortality and the rate of diarrhea that caused calf death, suggesting that as weaning age decreased, calf mortality and the rate of diarrhea decreased. Overall, the results of present study suggest that a decrease of calf weaning age in Hanwoo can increase the profit of Hanwoo cow-calf operations by increasing carcass weight of Hanwoo steers and by decreasing calf mortality.

Effect of Nasal Continuous Positive Airway Pressure after Early Surfactant Therapy in Moderate Respiratory Distress Syndrome (중등도 신생아 호흡 곤란 증후군에서 폐 표면 활성제 조기 투여 후 Nasal CPAP의 치료 효과)

  • Kim, Eun Ji;Kim, Hae Sook;Hur, Man Hoe;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1204-1212
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    • 2002
  • Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

The Usefulness of Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure after Extubation (기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성)

  • Na, Joo-Ock;Lim, Chae-Man;Shim, Tae-Sun;Park, Joo-Hun;Lee, Ki-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.350-362
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    • 1999
  • Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

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