• Title/Summary/Keyword: 산소 포화도

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Surgical Treatment of Acyanotic Tetralogy of Fallot (비청색성 팔로사징의 외과적 치료)

  • 천종록;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.749-755
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    • 1998
  • Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.

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Development of an Analytical Method for the Determination of Pyriofenone residue in Agricultural Products using HPLC-UVD (HPLC-UVD를 이용한 농산물 중 살균제 pyriofenone 분석법 확립)

  • Park, Hyejin;Kim, HeeJung;Do, Jung-Ah;Kwon, Ji-Eun;Yoon, Ji-Young;Lee, Ji-Young;Chang, Moon-Ik;Rhee, Gyu-Seek
    • The Korean Journal of Pesticide Science
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    • v.18 no.2
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    • pp.79-87
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    • 2014
  • Pyriofenone is an aryl phenyl ketone fungicide that is newly registered in Korea in 2013 to control powdery mildew on food. The objective of this study was to develop reliable and sensitive analytical method for determination of pyriofenone residue in agricultural products for ensuring the food safety. The pyriofenone residues in all samples(Korean melon, pepper, potato, mandarin, soybean, and hulled rice) were extracted with acetonitrile, partitioned with dichloromethane, and then purified with a silica cartridge. The purified samples were analyzed by HPLC-UVD and confirmed with LC-MS. The linear range of pyriofenone was 0.05~5 mg/kg with the correlation coefficient ($r^2$) > 0.999. Average recoveries of pyriofenone ranged from 72.8% to 99.5% at the spiked level of 0.05 and 0.5 mg/kg, while the relative standard deviation was 2.3%~6.4%. In addition, the limit of detection and limit of quantification were 0.01 and 0.05 mg/kg, respectively. The results revealed that the developed and validated analytical method was suitable for pyriofenone determination in agricultural products.

Use of Nitrate and Ferric Ion as Electron Acceptors in Cathodes to Improve Current Generation in Single-cathode and Dual-cathode Microbial Fuel Cells (Single-cathode와 Dual-cathode로 구성된 미생물연료전지에서 전류발생 향상을 위한 전자수용체로서의 Nitrate와 Ferric ion의 이용)

  • Jang, Jae Kyung;Ryou, Young Sun;Kim, Jong Goo;Kang, Youn Koo;Lee, Eun Young
    • Microbiology and Biotechnology Letters
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    • v.40 no.4
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    • pp.414-418
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    • 2012
  • The quantity of research on microbial fuel cells has been rapidly increasing. Microbial fuel cells are unique in their ability to utilize microorganisms and to generate electricity from sewage, pig excrement, and other wastewaters which include organic matter. This system can directly produce electrical energy without an inefficient energy conversion step. However, with MFCs maximum power production is limited by several factors such as activation losses, ohmic losses, and mass transfer losses in cathodes. Therefore, electron acceptors such as nitrate and ferric ion in the cathodes were utilized to improve the cathode reaction rate because the cathode reaction is very important for electricity production. When 100 mM nitrate as an electron acceptor was fed into cathodes, the current in single-cathode and dual-cathode MFCs was noted as $3.24{\pm}0.06$ mA and $4.41{\pm}0.08$ mA, respectively. These values were similar to when air-saturated water was fed into the cathodes. One hundred mM nitrate as an electron acceptor in the cathode compartments did not affect an increase in current generation. However, when ferric ion was used as an electron acceptor the current increased by $6.90{\pm}0.36$ mA and $6.67{\pm}0.33$ mA, in the single-cathode and dual-cathode microbial fuel cells, respectively. These values, in single-cathode and dual-cathode microbial fuel cells, represent an increase of 67.1% and 17.6%, respectively. Furthermore, when supplied with ferric ion without air, the current was higher than that of only air-saturated water. In this study, we attempted to reveal an inexpensive and readily available electron acceptor which can replace platinum in cathodes to improve current generation by increasing the cathode reaction rate.

The Effect of Insomnia Severity on Daytime Sleepiness in Obstructive Sleep Apnea Syndrome (불면증 정도가 폐쇄성 수면무호흡 증후군에서의 주간졸림 정도에 끼치는 영향)

  • Nam, Ji-Won;Shin, Byoung-Hak;Shin, Hyeon-Sil;Park, Minji
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.11-19
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    • 2015
  • Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

Health-related Quality of Life Measurement with St. George's Respiratory Questionnaire in Post-tuberculous Destroyed Lung (결핵후 폐손상에서 한국어판 St. George's Respiratory Questionnaire를 이용한 건강 관련 삶의 질 평가)

  • Lee, Byoung Hoon;Kim, Young Sam;Lee, Ki Deok;Lee, Jae Hyung;Kim, Sang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.183-190
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    • 2008
  • Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean $VO_2max%$ predicted ($39.0%{\pm}10.9%$) and $O_2$ pulse% predicted ($61.3%{\pm}13.6%$) were markedly decreased. In the SGRQ, the impact score (mean $27.8{\pm}18.5$) was significantly lower than the symptom score (mean $53.9{\pm}20.9$) or activity score (mean $50.8{\pm}27.3$) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with $FEV_1%$ predicted (r=-0.46, p<0.05) and $SaO_2$ (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.

Is Premedication Necessary for Outpatient Fiberoptic Bronchoscopy (외래환자의 기관지내시경검사시 전처치의 필요성)

  • Won, Jun-Hee;Park, Jae-Yong;Cha, Seung-Ick;Kang, Tae-Kyong;Park, Ki-Su;Kim, Yeon-Jee;Kim, Chang-Ho;Jung, Tee-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.251-259
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    • 1999
  • Background: Even though the necessity for premedication has been questioned, some combinations of antisialogogues, sedatives and analgesics are usually employed by most bronchoscopists. The goal of this study was to determine whether fiberoptic bronchoscopy(FOB) could be performed safely and effectively without premedication while using a standardized topical anesthetic. Method: Eighty outpatients were randomized in a double-blind manner into group I(n=20) with 1 ml normal saline, group II(n=20) with 0.5mg of atropine, group III(n=20) with 0.5mg of atropine plus 5mg of midazolam, and group IV(n=20) with 0.5mg of atropine plus 50mg of meperidine, given intramuscularly 30 minutes before FOB as premedication Topical anesthetics administered were same in each group. Each patient was given 5ml(200mg) of 4% nebulized lidocaine and additional intratracheobronchial 2% lidocaine. Oxygen saturation, pulse rate and electrocardiogram were monitored and recorded before, during, just after and 2 minutes after FOB. Immediately after FOB, the bronchoscopists answered four questions such as ease of procedure, extent of coughing, extent of secretion, and overall impression. Before leaving bronchoscopy suite, patients completed similar questions on discomfort during procedure, and willingness to return for a repeat procedure. Results: Age, gender, baseline pulmonary function, dose of 2% lidocaine used for topical anesthesia, and duration of FOB were not significantly different. There was no statistical difference among group I to IV with regard to extent of coughing answered by bronchoscopist. But extent of secretion was significantly different between group I without atropine and group II-IV with atropine. And there was also significant difference in ease of procedure and overall impression among groups. There was no statistical difference in patient's willingness and level of discomfort among the groups. Thirteen patients(16%) showed hypoxemia(arterial oxygen saturation: <90%), and 3 patients(4%) showed significant tachyarrhythmia(heart rate: > l60/min), but the rate of complication was not statistically different among the groups. Conclusion: These results suggest that the value of premedication is questionable for outpatient FOB, although it may be necessary in excessively anxious patient.

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Pain reducing effect of vapocoolant spray during injection and heelstick procedure in neonates (신생아에서 근육 주사 및 발뒤꿈치 천자 시 냉각 분사의 통증감소효과: 냉각 분사와 30% 경구 포도당액의 비교)

  • Choi, Eun Kyong;Jung, Ji Mi;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.481-486
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    • 2008
  • Purpose : The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods : Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results : There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) $10.6{\pm}2.4$, Group 1B $5.5{\pm}2.0$, Group 1C $5.2{\pm}1.8$. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) $12.5{\pm}1.4$, Group 2B $7.0{\pm}1.7$, Group 2C $6.4{\pm}1.6$. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion : The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.

A Dynamic Behavior Evaluation of the Curved Rail according to Lateral Spring Stiffness of Track System (궤도시스템의 횡탄성에 따른 곡선부 레일의 동적거동평가)

  • Kim, Bag-Jin;Choi, Jung-Youl;Chun, Dae-Sung;Eom, Mac;Kang, Yun-Suk;Park, Yong-Gul
    • Proceedings of the KSR Conference
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    • 2007.11a
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    • pp.517-528
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    • 2007
  • Domestic or international existing researches regarding rail damage factors are focused on laying, vehicle conditions, driving speed and driving habits and overlook characteristics of track structure (elasticity, maintenance etc). Also in ballast track, as there is no special lateral spring stiffness of track also called as ballast lateral resistance in concrete track, generally, existing study shows concrete track has 2 time shorter life cycle for rail replacement than ballast track due to abrasion. As a result of domestic concrete track design and operation performance review, concrete track elasticity is lower than track elasticity of ballast track resulting higher damage on rail and tracks. Generally, concrete track has advantage in track elasticity adjustment than ballast track and in case of Europe, in concrete track design, it is recommended to have same or higher performance range of vertical elastic stiffness of ballast track but domestically or internationally review on lateral spring stiffness of track is very minimal. Therefore, through analysis of service line track on site measurement and analysis on performance of maintenance, in this research, dynamic characteristic behaviors of commonly used ballast and concrete track are studied to infer elasticity of service line track and experimentally prove effects of track lateral spring stiffness that influence curved rail damage as well as correlation between track elasticity by track system and rail damage to propose importance of appropriate elastic stiffness level for concrete and ballast track.

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The Changes of Cerebral Metabolic Parameters, Serum Levels of Neuron-Specific Enolase and S-100$\beta$ Protein During Retrograde Cerebral Perfusion Under Profound Hypothermic Total Circulatory Arrest (초저체온하 완전순환정지 시에 이용되는 역행성 뇌관류의 시간에 따른 뇌대사 지표, 혈청 내 neuron-specific enolase, 및 S-100 베타단백의 변화)

  • 김경환
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.653-661
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    • 2001
  • Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

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The Effect of Nasal CPAP in Obstructive Sleep Apnea Syndrome (폐쇄형 수면무호흡증후군 환자에서 Nasal CPAP의 치료 효과)

  • Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.501-508
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    • 1993
  • Background: Sleep apnea syndrome is a common disorder which is estimated to affect about 1~4% of adult male population. And if untreated, sleep apnea can cause significant sequelae, such as hypertension, nocturnal cardiac arrhythmia, daytime hypersomnolence, and cognitive impairment. Various kinds of treatment for obstructive sleep apnea (OSA) have been developed. Among them nasal CPAP, first introduced by Sullivan et al in 1981, has received widespread interest and acclaim as a treatment of OSA, and is currently recommended as first-line treatment for OSA. We evaluated the effect of nasal CPAP in OSA and the side effects of nasal CPAP hindering patients from using nasal CPAP. Methods: We performed sleep studies in 20 OSA patients at 2 consecutive nights; baseline night at first day and CPAP night at second day. We compared apnea index, lowest oxygen concentration during apnea, maximal apnea time, and total apnea duration per total sleep time before and after CPAP. We also evaluated the side effects of CPAP with inquiry to the patients. Results: 1) Apnea index was significantly decreased after CPAP in 17 out of 20 OSA patients (85%) and increased in 3 patients (15%). 2) Average apnea index was significantly decreased after CPAP ($34.1{\pm}18.9/h{\rightarrow}15.4{\pm}10.3/h$, p<0.01). 3) Total apnea duration per total sleep time was also significantly decreased after CPAP ($28.5{\pm}16.0%{\rightarrow}11.9{\pm}9.3%$, p<0.05). 4) The lowest oxygen satuation and maximal apnea time were not significantly changed after CPAP. 5) The most frequent side effect of nasal CPAP was mask discomfort (80%), and the next was drying of nasal passages (65%). Conclusion: Nasal CPAP is an effective treatment for OSA. Futher studies should be concentrated on long term follow up of nasal CPAP for its therapeutic effects and the study of methods to enhance patients' compliance.

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