Nitrous oxide has acquired widespread use as a tool for management of anxious and comprehensive pediatric dental patients. Clinical impressions have suggested that inhalation sedation with $N_2O/O_2$ reinforces the effect of other sedatives. Fifteen uncooperative children, mean age of 37months, who were regarded as fail in the first treatment using chloral hydrate-hydroxyzine orally, midazolam orally or intranasally, were sedated with the same sedatives in conjunction with $N_2O/O_2$. All the children were restrained in a pediwrap and were monitored with pulse oximeter for their heart rate and oxygen saturation. Degree of sleep, crying and movement were evaluated. The clinical results indicated that a satisfactory level of sedation was achieved in approximately two thirds of the cases (about 66 %) under those sedation manner. Complications were rare and those of treatments were successfully completed without difficulty.
This paper describes a development of a fiber optic common-path optical coherence tomography (OCT) based imaging and guided system that possess ability to reliably identify optically transparent targets that are on the micron scale; ability to maintain a precise and safe position from the target; ability to provide spectroscopic imaging; ability to imaging biological target in 3-D. The system is based on a high resolution fiber optic Common-Path OCT (CP-OCT) that can be integrated into various mini-probes and tools. The system is capable of obtaining >70K A-scan per second with a resolution better than $3\;{\mu}m$. We have demonstrated that the system is capable of one-dimensional real-time depth tracking, tool motion limiting and motion compensation, oxygen-saturation level imaging, and high resolution 3-D images for various biomedical applications.
Purpose: The aims of this study were to evaluate the clinical characteristics and polysomnographic results of patients visited the Seoul National University Dental Hospital (SNUDH) and to suggest guidelines for the management of sleep disordered-breathing patients in a dental clinic. Methods: Five hundred sixty-two patients who visited the Snoring and Sleep Apnea Clinic of SNUDH were evaluated for clinical characteristics including associated comorbidities, age, gender, body mass index (BMI), neck circumference, and daytime sleepiness and among them 217 patients were performed nocturnal polysomnography for evaluating respiratory disturbance index, apnea-hypopnea index (AHI), oxygen saturation levels, and sleep stages. The associations among clinical characteristics, sleep parameters, and positional and rapid eye movement (REM) dependencies of the patients were analyzed. Results: The most common co-morbidities of the patients were cardiovascular (30.2%), endocrine (10.8%), and respiratory diseases (7.9%). Age (${\beta}=0.394$), total AHI (${\beta}=0.223$), and lowest $O_2$ saturation levels (${\beta}=0.205$) were significantly associated with the number of co-morbidities in patients with obstructive sleep apnea (OSA). Mean $O_2$ saturation was not significantly associated with number of co-morbidities. Non-positional OSA patients had higher BMI, longer neck circumferences, more severe AHI values, and lower mean and lowest $O_2$ saturation levels compared to positional OSA patients. Not-REM-related patients were older and had more severe AHI values compared to REM-related patients. Not-REM-related patients have longer duration of stage I sleep and shorter stage II, III, and REM sleep than REM-related patients. There were no significant differences in each sleep stage between positional and non-positional patients. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA. Conclusions: Age, total AHI, and lowest $O_2$ saturation level were significantly associated with the number of co-morbidities in patients with OSA. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA.
Total body perfusion using Sarns Heart-Lung-Machine, five head pump motor system with Travenol disposable bubble oxygenator was attempted in the dogs by the hemodilution method with total prime of buffered Hartman`s solution under moderate hypothermia. The first of all, the functions of Sarns Heart-Lung-Machine and effects of the hemodilution perfusion by buffered Hartman`s solution was studied. At the same time the changes of pressure of artery and vein, gas contents of the blood, and influence on the blood pictures were observed before, during, and after perfusion in 1-2 days. Hemodilution rates were the ranges of 85.0ml/kg to 97.3ml/kg and perfusion flow rates were maintained with the average 80. 5ml/kg/min [the ranges of 73.3ml/kg/min to 92.8ml/kg/min]. Hypothermia was employed between $35^{\circ}C$ and $31^{\circ} of the esophageal temperature. The total body perfusion was continued for 50-60 minutes. In the total cardiopulmonary bypass, atriotomy, ventriculotomy, and atrioventriculotomy were performed respectively. Arterial pressure was ranged approximately between 50 mmHg and 140 mmHg, but generally, it was maintained over 75 mmHg. Venous pressure was measured between 3.8 cm$H_2O$ and 16.0 cm$H_2O$. Optimum oxygenation could be achieved when oxygen flow into the oxygenator was maintained approximately at 5. 5L/min. In this way, the $pO_2$, $pCO_2$, and oxygen saturation were measured before, during, and afterperfusion in 1-2 days. The $pCO_2$ ranged approximately between 26.0 mmHg and 38.5 mmHg, but generally, it was maintained in the average 30.9-32.5mmHg. The $pO_2$ was ranged between 73.0mmHg and 332.2 mmHg, but it was maintained in the average 103.0-219.0 mmHg. Oxygen saturation was measured over 95. 0% during and after extracorporeal circulation respectively. Erythrocyte count, hemoglobin, hematocrit, and leucocyte count were decreased to 49.2%, 49.0%, 49.4%, and 21. 1% of the preoperative value during extracorporeal circulation respectively and these reductions were not recovered until 1-2 days after perfusion. These. resulted from relatively high degree of hemodilution rate and operative bleeding during these experimental studies. The platelets count was also decreased about to 71% during perfusion, on the contrary, it was increased progressively after perfusion and in 1-21 days after perfusion, the value was returned to preoperative contro1 level. Three dogs were all recovered after extracorporeal circulation.
This study was conducted to investigate of water qualities in the upper and middle reaches of the Han River. For this purpose, water was sampled at Kwangjin and 1st Han-River Bridges of the Han River in Seoul and analysed from August, 1988 to September, 1989. The results are summarized as follows : 1. Water quality at 1st Han-River Bridge was more polluted than that at Kwangjin Bridge. 2. Except biological oxygen demand (BOD), turbidity, suspended solid (SS), dissolved oxygen (DO), DO saturation (DOS), ammonia nitrogen ($NH_3-N$), nitrite nitrogen ($NO_2-N$) and chloride ion ($Cl^-$) at Kwangjin and 1st Han-River Bridges were lower as compared with the previous data before redevelopment of the Han River. 3. SS, DO and pH at Kwangjin and 1st Han-River Bridges could be classified to the 1st grade in environmental water quality standard. DOS at Kwangjin Bridge was over 100% and that at 1st Han-River Bridge was below 100% in the Han River. BOD at Kwangjin Bridge could be classified to End grade and that at 1st Han-River Bridge to 3rd grade in environmental water quality standard. 4. The higher the level of water was, the lower the levels of turbidity and SS, and $NH_3-N$ was decreased with increasing water level at 1st Han-River Bridge. DO was decreased as water temperature went up but DOS was increased with DO. BOD was positively correlated with nitrite-nitrogens. 5. Turbidity and SS at the both sites and Chloride ion ($Cl^-$) at Kwangjin Bridge were increased in July and August. And DO at the both sites and $NH_3-N$ at 1st Han-River Bridge were decreased in at July and August.
Purpose: This study was done to verify the effects of preeducation and health contract on anxiety and adaptability of children with leukemia when undergoing a spinal puncture. Methods: Children in experimental group 1 (10) were given preeducation prior to the procedure and children in experimental group 2 (13), a health contract. Children in the control group (16) received the regular hospital preparation. Observation tools were used to evaluate adaptability and anxiety. Heart rate and oxygen saturation was also used as a measure of anxiety. The data were analyzed using the SPSS program. Results: Compared with the control group, experiment groups 1 and 2 showed significant difference in adaptability regarding the number of assistants and test posture. Experiment groups 1 and 2 showed significant difference in voice tone and movement level when compared with the control group. Elevation level in heart rate showed significant differences between the three groups. Conclusions: Preeducation and nursing mediation through health contracts were shown to be effective methods to reduce anxiety and increase adaptability in children with leukemia who were undergoing a spinal tap.
Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.
The effects of fast neutron irradiation on the electrical and optical properties of Li (3 at%) doped ZnSnO (ZTO) thin films fabricated using a sol-gel process are investigated. From the results of Li-ZTO TFT characteristics according to change of neutron irradiation time, the saturation mobility is found to increase and threshold voltage values shift to a negative direction from 1,000 s neutron irradiation time. X-ray photoelectron spectroscopy analysis of the O 1s core level shows that the relative area of oxygen vacancies is almost unchanged with different irradiation times. From the results of band alignment, it is confirmed that, due to the increase of electron carrier concentration, the Fermi level (EF) of the sample irradiated for 1,000 s is located at the position closest to the conduction band minimum. The increase in electron concentration is considered by looking at the shallow band edge state under the conduction band edge formed by fast neutron irradiation of more than 1,000 s.
Albino, Frank P.;Wood, Benjamin C.;Han, Kevin D.;Yi, Sojung;Seruya, Mitchel;Rogers, Gary F.;Oh, Albert K.
Archives of Plastic Surgery
/
제43권6호
/
pp.506-511
/
2016
Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.
The effect of electron beam (EB) irradiation on the electrical properties of Zn-Sn-O (ZTO) thin films fabricated using a sol-gel process was investigated. As the EB dose increased, the saturation mobility of ZTO thin film transistors (TFTs) was found to slightly decrease, and the subthreshold swing and on/off ratio degenerated. X-ray photoelectron spectroscopy analysis of the O 1s core level showed that the relative area of oxygen vacancies ($V_O$) increased from 10.35 to 12.56 % as the EB dose increased from 0 to $7.5{\times}10^{16}electrons/cm^2$. Also, spectroscopic ellipsometry analysis showed that the optical band gap varied from 3.53 to 3.96 eV with increasing EB dose. From the results of the electrical property and XPS analyses of the ZTO TFTs, it was found that the electrical characteristic of the ZTO thin films changed from semiconductor to conductor with increasing EB dose. It is thought that the electrical property change is due to the formation of defect sites like oxygen vacancies.
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