• Journal of Veterinary Clinics
• /
• v.27 no.4
• /
• pp.336-342
• /
• 2010

The purpose of this study was to determine the antagonistic effects of flumazenil on anesthesia induced with tiletamine/zolazepam in dogs. The anesthetic effects (sedation, analgesic, muscle relaxation, posture and auditory response score), vital signs (heart rate, respiratory rate and rectal temperature) and blood biochemistry (glucose (GLU), total protein (TP), alanine aminotransferase (ALT), aspartate aminotransferase (AST)) were examined as indicators of the antagonistic effects. A total of 6 clinically healthy mongrel dogs were used in this study. The dogs in TZ group received administration of tiletamine/zolazepam 10 mg/kg IV. The dogs in TZF group received administration dose of TZ 10 mg/ kg IV followed by the administration of flumazenil 0.1 mg/kg 20 minutes after administering a TZ 10 mg/kg dose. There were significant differences in the recovery of anesthesia between the groups. The GLU level in the TZF group after the administration of flumazenil was significantly higher than that of the TZ group. There was a larger change in the HR in the TZF group than in the TZ group until 30 minutes after flumazenil administration. The sternal recumbency, standing and walking times of the TZF group were faster than those of the TZ group. In conclusion, flumazenil showed antagonistic effect against tiletamine/zolazepam in dogs. When recovering from anesthesia, flumazenil reduced sternal recumbency, standing and walking times.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.5
• /
• pp.540-547
• /
• 2006

Background : Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism. Methods : Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared. Results : The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively. Conclusion : This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.

• Neonatal Medicine
• /
• v.15 no.1
• /
• pp.61-66
• /
• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• The Journal of the Korea Contents Association
• /
• v.15 no.1
• /
• pp.350-356
• /
• 2015

The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

• Journal of Chest Surgery
• /
• v.37 no.12
• /
• pp.999-1002
• /
• 2004

Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.

• Archives of Craniofacial Surgery
• /
• v.17 no.1
• /
• pp.28-30
• /
• 2016

Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.

• Women's Health Nursing
• /
• v.20 no.2
• /
• pp.126-136
• /
• 2014

Purpose: The purpose of this study was to examine the effects of aroma hand massage on anxiety and immune function in patients who had gynecology surgery under local anesthesia. Methods: The research design was a nonequivalent control group with pre-and posttest design. Data were collected from June 5 to October 6, 2010. Participants included 20 patients in the aroma hand massage group, 20 patients in a hand massage group, and 20 in a control group. As an experimental treatment, hand massage was carried out following the hand massage protocol. Measures consisted of the State Trait Anxiety, Numeric Rating Scale (NRS) for anxiety, vital signs (systolic and diastolic blood pressure, pulse rate), and salivary cortisol for anxiety, and immunoglobulin A for immune function. Results: Aroma hand massage and hand massage group showed lower levels in NRS for anxiety, systolic and diastolic blood pressure, and pulse rate (p<.001) compared to controls. No group differences were found for state anxiety, salivary cortisol and immunoglobulin A. Conclusion: The results indicate that aroma hand massage and hand massage are effective in reducing anxiety and can be complementary alternative interventions for women having gynecology surgery under local anesthesia.

• Journal of Korean Academy of Nursing
• /
• v.36 no.4
• /
• pp.630-636
• /
• 2006

Purpose. To determine the effects of music therapy on pain, discomfort, and depression for patients with leg fractures. Methods. Data were collected from 40 patients admitted in an orthopedic surgery care unit. The subjects included 20 intervention group members and 20 control group members. Music therapy was offered to intervention group members once a day for 3 days for 30-60 minutes per day. Pain was measured with a numeric rating scale and by measuring vital signs. Discomfort and depression were measured with self-administered questionnaires. Results. Patients who received music therapy had a lower degree of pain than patients who did not receive music therapy as measured by the numeric pain score (p < 0.001), systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.001), pulse rate (p < 0.001) and respiration (p < 0.001). Patients who were provided with music therapy also had a lower degree of discomfort than patients who were not provided with this therapy (p < 0.01). Effects of Music Therapy on Pain, Discomfort, and Depression for Patients with Leg Fractures Conclusions. These results demonstrate that music therapy is an effective method for decreasing pain and discomfort for patients with leg fractures.

• Korean Journal of Adult Nursing
• /
• v.23 no.1
• /
• pp.1-9
• /
• 2011

Purpose: To evaluate undergraduate nursing students' ability in clinical competence, critical thinking, and problem solving following enrollment in a clinical reasoning course. Methods: A clinical reasoning course utilizing a human patient simulator and scenarios was offered to 22 senior students at a College of Nursing in Seoul. Students' clinical competence was measured with a checklist of 15 items by analyzing students' performance recorded on video tapes for eight scenarios. Critical thinking disposition and problem solving were measured by a self-administered questionnaire before and after the course. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test. Results: The high scored items of clinical competence were: 'obtain relevant subjective/objective data', 'interpret vital signs', 'communicate with healthcare providers', and 'utilize standard precautions including handwashing.' Students' critical thinking and problem solving scores following the course were increased with statistical significance. Conclusion: A clinical reasoning course utilizing a human patient simulator creates a realistic clinical environment for nursing students and provides the opportunity to obtain clinical competence, critical thinking, and problem solving skills.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• v.7 no.5
• /
• pp.967-979
• /
• 2013

Now a day, Wireless Sensor Networks (WSNs) are being widely used in different areas one of which is healthcare services. A wireless medical sensor network senses patient's vital physiological signs through medical sensor-nodes deployed on patient's body area; and transmits these signals to devices of registered medical professionals. These sensor-nodes have low computational power and limited storage capacity. Moreover, the wireless nature of technology attracts malicious minds. Thus, proper user authentication is a prime concern before granting access to patient's sensitive and private data. Recently, P. Kumar et al. claimed to propose a strong authentication protocol for healthcare using Wireless Medical Sensor Networks (WMSN). However, we find that P. Kumar et al.'s scheme is flawed with a number of security pitfalls. Information stored inside smart card, if extracted, is enough to deceive a valid user. Adversary can not only access patient's physiological data on behalf of a valid user without knowing actual password, can also send fake/irrelevant information about patient by playing role of medical sensor-node. Besides, adversary can guess a user's password and is able to compute the session key shared between user and medical sensor-nodes. Thus, the scheme looses message confidentiality. Additionally, the scheme fails to resist insider attack and lacks user anonymity.