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Efficacy and Safety of Intraveous Iron Sucrose in the Perioperatively Anemic Patients of Gastrectomy (위 절제 수술 전후 빈혈 환자에 있어 철수크로오스의 유효성 및 안전성)

  • Yoo, Moon-Won;Cho, Jae-Jin;Lee, In-Kyu;Ahn, Hye-Seong;Jeong, Sang-Ho;Lee, Hyuk-Joon;Kim, Hyung-Ho;Lee, Kuhn-Uk;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.35-39
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    • 2008
  • Purpose: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose ($Venoferrum^{(R)}$) for treating the perioperative anemic gastrectomy patients. Materials and Methods: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl $\leq$ hemoglobin levels (Hb) < 11.0 g/dl) and who were admitted or visited the outpatient clinic of the Department of surgery, were divided into two groups. The preoperative (${\leq}\;2{\sim}3$ weeks before gastrectomy) or postoperative ($\geq$ 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. Results: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1ft, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. Conclusion: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.

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A COMPARATIVE STUDY OF WATER ABSORPTION AND RELATED CHANGES OF COMPRESSIVE STRENGTH IN THREE RESTORATIVE MATERIALS (치과용 수복재의 수분흡수도와 압축강도의 변화에 관한 연구)

  • Chang, Woo-Hyuck;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.161-170
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    • 2003
  • The aesthetic restorative materials are widely used in recent dentistry, showed not only the different quality between each component but also showed that the environment of the material has important effect on the physical properties of the material. Especially, when the restoratives are restored in the mouth, and since saliva is existing, the restoratives are always exposed to water and affected by the saliva. The purpose of this study was to research and compare the change of the degree of water sorption after water immersion of three types of the resin-based materials and the compressive strength, and observe the relation between the change of the water absorbing degree and the compressive strength. Z-100(3M, U.S.A) as a composite resin, F-2000(3M, U.S.A) as a compomer and Vitremer Restoratives(3M, U.S.A) as a resin-modified GIC were used, and each specimen was made to measure the water sorption and to evaluate the compressive strength. The specimens for measurement of the water sorption and the compressive strength were divided into 4 groups(1 day, 2 weeks, 4 weeks, and 8weeks). Each specimen was filled in the 30cc vial with 20cc of distilled water during the fixed amount of period in $37^{\circ}C$. The water sorption is decided by dividing the difference of weight before and after the immersion by the volume, and the compressive strength was measured by using the instron after the immersion. The following results were obtained ; 1. The more the water sorption increased, the more the immersion period of three restorative materials was long. And the most of water sorption was obtained during the first 2 weeks(P<0.001). 2. The water sorption of resin-modified GIC was higher than composite resin and compomer. 3. The more the compressive strength decreased, the more the immersion period of three restorative materials increased(composite resin and compomer: P<0.001, resin-modified GIC: P<0.05). Especially, the amount of the reduction in compressive strength of the composite resin was the highest. 4. The more the water sorption of all materials increased, the more the compressive strength decreased(P<0.05).

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THE EFFECT OF FERMENTED MILK ON VIABLE CELL COUNT AND BIOFILM FORMATION OF STREPTOCOCCUS MUTANS (유산균 발효유가 Streptococcus mutans의 생균수 및 biofilm 형성에 미치는 영향)

  • Shin, Hye-Sung;Kim, Seon-Mi;Choi, Nam-Ki;Yang, Kyu-Ho;Kang, Mi-Sun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.358-366
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    • 2009
  • Lactic acid bacteria worked positively on gastrointestinal tract and oral environment. So I selected commercial five fermented milks and milk, and then I evaluated their effect of growth inhibition and biofilm formation of cariogenic bacteria, Streptococcus mutans. And also calculated the acidity, buffering capacity, concentration of Ca and P ion and pH change of those drinks. After adding S. mutans to fermented milks viable cell count of S. mutans in milk was not statistically different but those in all fermented milks were decreased as concentration of fermented milk increased. When I measured the amount of formed biofilm in 10% fermented milks and milk with S. mutans and compared with those without S. mutans, the amount was decreased in Active GG and Bulgaris while being increased in Tootee, Ace and milk(P<0.05). The fermented milk with the lowest pH value was E5(3.48${\pm}$0.01), and the highest was Bulgaris(4.19${\pm}$0.02). pH change of the fermented milks and milk with S. mutans was measured. The highest acid producing fermented milk was Bulgaris, and followed by Active GG, Ace, Tootee, E5, Milk. These results indicated that fermented milks had caries activity due to the value of initial acidity and acid producing capacity. But, concentrated fermented milks had the inhibitory effect against S. mutans, and also had high volume of Ca and P ion that protected teeth. So I suggest that they have positive effect on teeth.

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Quantitative Indices of Small Heart According to Reconstruction Method of Myocardial Perfusion SPECT Using the 201Tl (201Tl을 이용한 심근관류 SPECT에서 재구성 방법에 따른 작은 용적 심장의 정량 지표 변화)

  • Kim, Sung Hwan;Ryu, Jae Kwang;Yoon, Soon Sang;Kim, Eun Hye
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.18-24
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    • 2013
  • Purpose: Myocardial perfusion SPECT using $^{201}Tl$ is an important method for viability of left ventricle and quantitative evaluation of cardiac function and now various reconstruction methods are used to improve the image quality. But in case of small sized heart, you should always be careful because of the Partial Volume Effect which may cause errors of quantitative indices at the reconstruction step. So, In this study, we compared those quantitative indices of left ventricle according to the reconstruction method of myocardial perfusion SPECT with the Echocardiography and verified the degree of the differences between them. Materials and Methods: Based on ESV 30 mL of Echocardiography, we divided 278 patients (male;98, female;188, Mean age;$65.5{\pm}11.1$) who visited the Asan medical center from February to September, 2012 into two categories; below the criteria to small sized heart, otherwise, normal or large sized heart. Filtered and output each case, we applied the method of FBP and OSEM to each of them, and calculated EDV, ESV and LVEF, and we conducted statistical processing through Repeated Measures ANOVA with indices that measured in Echocardiography. Results: In case of men and women, there were no significant difference in EDV between FBP and OSEM (p=0.053, p=0.098), but in case of Echocardiography, there were meaningful differences (p<0.001). The change of ESV especially women in small sized heard, significant differences has occurred among FBP, OSEM and Echocardiography. Also, in LVEF, there were no difference in men and women who have normal sized heart among FBP, OSEM and Echocardiography (p=0.375, p=0.969), but the women with small sized heart have showed significant differences (p<0.001). Conclusion: The change in quantitative indices of left ventricle between Nuclear cardiology image reconstruction, no difference has occurred in the patients with normal sized heart but based on ESV, under 30 mL of small sized heart, especially in female, there were significant differences in FBP, OSEM and Echocardiography. We found out that overestimated LVEF caused by PVE can be reduced in average by applying OSEM to all kinds of gamma camera, which are used in analyzing the differences.

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The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma (간세포암에서 방사선 치료의 역할)

  • Eun, Jong Ryul;Choi, Kyo Won;Lee, Heon Ju;Kim, Mung Se
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.137-145
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    • 2000
  • Background: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and Methods: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. Results: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. Conclusions: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Estimation of Reliability of Real-time Control Parameters for Animal Wastewater Treatment Process and Establishment of an Index for Supplemental Carbon Source Addition (가축분뇨처리공정의 자동제어 인자 신뢰성 평가 및 적정 외부탄소원 공급량 지표 확립)

  • Pak, JaeIn;Ra, Jae In-
    • Journal of Animal Science and Technology
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    • v.50 no.4
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    • pp.561-572
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    • 2008
  • Responses of real-time control parameters, such as ORP, DO and pH, to the conditions of biological animal wastewater treatment process were examined to evaluate the stability of real-time control using each parameter. Also an optimum index for supplemental carbon source addition based on NOx-N level was determined under a consideration of denitrification rate by endogenous respiration of microorganism and residual organic matter in liquor. Experiment was performed with lab-scale sequencing batch reactor(SBR) and working volume of the process was 45L. The distinctive nitrogen break point(NBP) on ORP-and DO-time profiles, which mean the termination of nitrification, started disappearing with the maintenance of low NH4-N loading rate. Also the NBP on ORP-and DO-time profiles was no longer observed when high NOx-N was loaded into the reactor, and the sensitivity of ORP became dull with the increase of NOx-N level. However, the distinctive NBP was constantly occurred on pH(mV)-time profile, maintaining unique profile patterns. This stable occurrence of NBP on pH(mV)-time profile was lasted even at very high NOx-N:NH4-N ratio(over 80:1) in reactor, and the specific point could be easily detected by tracking moving slope change(MSC) of the curve. Revelation of NBP on pH(mV)-time profile and recognition of the realtime control point using MSC were stable at a condition of over 300mg/L NOx-N level in reactor. The occurrence of distinctive NBP was persistent on pH(mV)-time profile even at a level of 10,000mg/L STOC(soluble total organic carbon) and the recognition of NBP was feasible by tracing MSC, but that point on ORP and DO-time profiles began to disappear with the increase of STOC level in reactor. The denitrfication rate by endogenous respiration and residual organic matter was about 0.4mg/L.hr., and it was found that 0.83 would be accepted as an index for supplemental carbon source addition when 0.1 of safety factor was applied.

Validity of Peak Expiratory Flow for Assessing Reversible Airflow Obstruction (기류 가역성 평가에 있어서 최대호기유속 측정의 유용성)

  • Chol, Won-Il;Kwak, Jin-Ho;Kwon, Doo-Young;Han, Seung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.522-529
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    • 2000
  • Backgrounds : Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and $FEV_1$ in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. Methods : PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 g salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second($FEV_1$). Reversible airflow obstruction was analyzed according to American Thoracic Society(ATS) criteria. Results : A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ reversibility were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30 l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30 l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%). Conclusions : Absolute changes in PEF can be used to diagnose reversible airflow obstruction.

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A Review on the Change in Submarine Roles in Naval Warfare: Based on Warfare Paradigm (전쟁 패러다임의 전환에 따른 잠수함의 역할 변화에 대한 고찰)

  • Jang, Jun-Seop
    • Strategy21
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    • s.46
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    • pp.89-122
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    • 2020
  • The longing for submarine manufacture and the fear of her power had exited for a long time, but submarine that could submerge and attack was built from 20th century by science technology development. The question, 'Submarine can exercise her power in naval warfare?' had exited before World War I, but the effective value of submarine was shown in the procedure of a chain of naval warfare during World War I and World War II. Germany and the United States made the best use of submarines at that time. The submarines of these nations mounted fierce attack on the enemy's battleships and merchant ships and blocked the sea lanes for war material. These fierce attack on ships became impossible After World War II, and the major powers reduced and coordinated the defence budget, so they considered the role of submarine. However, submarine is still powerful weapon system because she can secretly navigate under the water, and one of the most important force in the navy. The aim of this thesis is analyzing submarine roles in each naval warfare and integrating maritime strategy and weapon system technology into her roles. First, the research about represent submarine roles like anti-surfaceship warfare, anti-submarine warfare, intelligence gathering, land attack, supporting special operation and mine landing warfare will be presented, then the major naval warfare where submarine participated(during ex-World War I, World War I, World War II, The Cold War Era and post Cold War) and the analyzing of submarine roles by time will be presented. Submarine was developed for anti-surfaceship warfare during ex-World War I but could not make remarkable military gain in naval warfare because her performance and weapon was inadequate. However, the effective value of submarine in the procedure of a chain of naval warfare was shown during World War I and World War II. The major powers put battleships into naval warfare undiscriminatingly to command the sea power and submarines did massive damage to enemy navy power, so put a restraint the maritime power of enemy, and blocked the sea lanes for war material. After World War II, the battlefield situation changed rapidly and the concept of preemption became difficult to apply in naval warfare. Therefore, the submarine was unable to concentrate on anti-surfaceship mission. Especially during the Cold War era, nuclear submarine came to appear and her weapon system developed rapidly. These development gave submarines special missions: anti-submarine warfare and intelligence gathering. At that time, United States and Soviet submarines tracked other nation's submarines loaded with nuclear weapons and departing from naval their base. The submarines also collected information on the volume of ships and a coastal missile launching site in company with this mission. After Cold War, the major powers despatched forces to major troubled regions to maintain world peace, their submarines approached the shores of these regions and attacked key enemy installations with cruise missiles. At that time, the United States eased the concept of preemption and made the concept of Bush doctrine because of possible 911 terrorism. The missiles fired from submarines and surface battleships accurately attacked key enemy installations. Many nations be strategically successful depending on what kind of mission a submarine is assigned. The patterns of future naval warfare that my country will provide against will be military power projection and coalition/joint operations. These suggest much more about what future missions we should assign to submarines.

Structural change and electrical conductivity according to Sr content in Cu-doped LSM (La1-xSrxMn0.8Cu0.2O3) (Sr 함량이 Cu-doped LSM(La1-xSrxMn0.8Cu0.2O3)의 구조적변화와 전기전도도에 미치는 영향)

  • Ryu, Ji-Seung;Noh, Tai-Min;Kim, Jin-Seong;Lee, Hee-Soo
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.22 no.2
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    • pp.78-83
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    • 2012
  • The structural change and the electrical conductivity with Sr content in $La_{1-x}Sr_xMn_{0.8}Cu_{0.2}O_3$ (LSMCu) were studied. $La_{0.8}Sr_{0.2}MnO_3$ (LSM) and $La_{1-x}Sr_xMn_{0.8}Cu_{0.2}O_3$ ($0.1{\leq}x{\leq}0.4$) were synthesized by EDTA citric complexing process (ECCP). A decrease in the lattice parameters and lattice volumes was observed with increase of Sr content, and these results were attributed to the increasing $Mn^{4+}$ ions and $Cu^{3+}$ ions in B-site. The electrical conductivity measured from $500^{\circ}C$ to $1000^{\circ}C$ was increased with increase of Sr content in the $0.1{\leq}x{\leq}0.3$ composition range, and it was 172.6 S/cm (at $750^{\circ}C$) and 177.7 S/cm (at $950^{\circ}C$, the maximum value) in x = 0.3. The electrical conductivity was decreased in x = 0.4 because of the presence of the second phase in the grain boundaries. The lattice volume was contracted by increase of $Mn^{4+}$ ions and $Cu^{3+}$ ions in B-site according to increase of Sr content and the electrical conductivity was increased with increase of charge carriers which were involved in the hopping mechanism.