• Title/Summary/Keyword: 흡인시간

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Mechanism of Gel Layer Removal for Intermittent Aeration in the MBR Process (MBR 공정에서 간헐공기주입에 따른 겔층 제거 메커니즘)

  • Noh Soo-Hong;Choi Young-Keun;Kwon Oh-Sung;Park Hee-Sung
    • Membrane Journal
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    • v.16 no.3
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    • pp.188-195
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    • 2006
  • The purpose of this study was to investigate the effect of an intermittent aeration mode to reduce the membrane fouling in a submerged membrane process using the specifically devised module (YEF 750D-2). The fluid velocity on the module increased with increasing the supplied air volume, and decreased with the increment of MLSS in the biological reactor. The reduction rate of the fluid velocity was found to be $3\times10^{-4}m{\cdot}min/sec{\cdot}L$ per 1,000 mg MLSS/L increased. In the operation of the intermittent aeration, the intermitted stop of the aeration provoked the formation of a cake layer on the gel layer which was previously formed during the aeration, resulting in the highly increased TMP level. However, the TMP level could be significantly lowered by the subsequent backwashing and aeration that effectively removed the cake along with the gel layer on the membrane surface. In this study, the optimum condition for the intermittent aeration was determined to be aeration for 20 sec and pause for 20 sec.

Evolutionary Patterns with Age of Acetylcholinesterase Activity of Rect al Suction Biopsies in Hirschsprung's Disease (Hirschsprung씨 질환에서 직장 흡인 생검의 Acetylcholinesterase 활성도의 연령에 따른 변화)

  • Park, Woo-Hyun;Choi, Soon-Ok;Kim, Sang-Pyo;Chang, Eun-Soak;Paik, Tae-Won
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.1-7
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    • 1995
  • The acetylcholinesterase(ACHE) activity in 37 biopsies from the patients with Hirschsprung's disease was analyzed for histochemical patterns according to age, and its evolutional behavior was also assessed. The histochemical criterion used for the diagnosis of Hirschsprung's disease was that of Chow, i.e., "the presence of many coarse discrete cholinergic fibers in the muscularis mucosae and in the immediately subjacent submucosa regard less of an infiltration of cholinergic fibers in the lamina propria." The acetylcholinesterase activity in Hirschsprung's disease was further classified into 3 patterns, advocated by de Brito and Maksoud : Pattern I-many thick fibers exclusively in the muscularis mucosae and submucosa(newborn pattern). Pattern II-many thin fibers in the muscularis mucosae and submucosa with a clear infiltration of cholinergic fibers in the lamina propria(classical pattern). Pattern III-an intermediate pattern showing morphological characteristics of the two patterns with predominance of one or the other. Of 37 biopsies, Pattern 1 was seen exclusively in 16 biopsies taken from the neonates. Pattern III was 11 of 37 biopsies and it was mainly seen in children between 2 to 12 months of age. Pattern II was seen in all 3 biopsies of older than 1 year of age and in 6 ones of 3 to 12 months of age. In summary, this study reinforces the impression that there is an evolutional character of the distribution and morphology of the cholinergic ACHE positive fiber with age. In other words, ACHE activity in Hirschsprung's disease appears to evolve with age from the newborn pattern to the intermediate pattern finally to the classical pattern.

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Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units (시뮬레이션 학습을 위한 호흡곤란증후군 환아 시나리오 개발 및 학습 수행 평가)

  • Lee, Myung-Nam;Kim, Hee-Soon;Jung, Hyun-Chul;Kim, Young-Hee;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.1-11
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    • 2013
  • Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

Pathological Factors Affecting DNA Quality in BRAF, EGFR, and KRAS Gene Molecular Tests (BRAF, EGFR, KRAS 유전자 분자병리검사에서 DNA 품질에 영향을 미치는 병리학적인 인자에 관한 연구)

  • Yun, Hyon-Goo;Kim, Bo-Ra;Lee, Joo-Mi;Song, Eun-Ha;Kim, Dong-Hoon
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.4
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    • pp.381-388
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    • 2020
  • The quality control of pathological specimens is important for accurate molecular pathology testing. This study evaluated that specimen factors affecting the DNA quality during tissue processing and sample types for BRAF, EGFR, and KRAS mutations tests. One thousand seven hundred and seventy-two molecular pathology tests were investigated for the factors influencing the DNA quality, such as sample type, formalin fixation time, and reexamination status. Cytology samples stored in a saline solution had better DNA quality than commercial cytology preservation. Tissue samples fixed in formalin within 24 hours had better DNA quality than the samples fixed over 24 hours. Between the types of samples, fresh tissue samples and tissue samples with a high tumor cell density had relatively better DNA quality than the formalin-fixed paraffin-embedded (FFPE) tissues and cytology specimens. Of real-time PCR, the non-PNA Ct value increased proportionally with samples held for longer than 24 hours in formalin, and that the formalin-fixed time affects the sample DNA quality. In conclusion, the appropriate tumor cellularity and 10% neutral formalin fixation time are the most important factors for maintaining the DNA quality. These factors should be managed properly for an accurate pathological molecular test to ensure optimal DNA quality.

Oral Sildenafil in Persistent Pulmonary Hypertension of the Newborn (신생아의 지속성 폐동맥 고혈압증에서 Sildenafil 치료 경험)

  • Son, Su-Bin;Kim, Kyung-Ah;Yun, So-Young;Ko, Sun-Young;Lee, Yeon-Kyung;Shin, Son-Moon
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.124-129
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    • 2011
  • Purpose: To evaluate the effect of oral sildenafil therapy in neonates with persistent pulmonary hypertension of the newborn (PPHN) Methods: We conducted a retrospective review of 32 neonates ${\geq}$35 weeks' gestation and fraction of inspired oxygen ($FiO_2$) 1.0 with PPHN. The first dose (0.5 mg/kg) of oral sildenafil was started and 1 mg/kg was given every 6 hour thereafter. Mean airway pressure (MAP), $FiO_2$, oxygenation index (OI), mean arterial blood pressure (MBP) were documented before and 6, 12, 24, and 48 hours after sildenafil. For adverse effects, gastrointestinal symptoms, brain ultrasound, funduscopy and auditory brainstem response results were evaluated. Results: The underlying diseases of PPHN (n=32) were meconium aspiration syndrome (n=9), respiratory distress syndrome (n=8), pneumonia (n=3), and idiopathic (n=12). Thirty-one neonates survived; 3 neonates were transferred for inhaled nitric oxide (iNO) and all of them survived. In 28 infants, $FiO_2$ and OI improved significantly by 6 hours and MAP improved significantly by 48 hours after initiation of sildenafil. There were no clinically significant adverse effects of sildenafil. Conclusion: Sildenafil may be an effective and safe agent for near-term and term neonates with PPHN, providing significant improvement in oxygenation, and thus may be especially useful in the treatment of PPHN in hospitals without iNO.

Surgical Treatment of Varicose Vein - TIPP(Transilluminated Powered Phlebectomy) - (정맥류 환자의 수술적 치료 -광투시 전도형 정맥적출요법-)

  • 이교준;김해균;정은규;강두영
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.144-148
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    • 2002
  • The present study was done to determine the efficacy and safety of varicose vein removal using a minimally invasive, powered vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compared this to a retrospective group of conventional phlebectomy operations. There were 133 limbs in 104 patients(72 women, 32 men) treated with the use of the vein extractor aided by transcutaneous illumination. The hydrodissection was performed with Trivex™ Irrigated illuminator(Smith & Nephe $w^{ R}$) system using normal saline after the 2~3mm sized skin incision. Varicose clusters were extracted by the use of TriveTM esector(Smith & Nephe $w^{ R}$) system under transillumination. After the varisoce vein extraction, the operation area was compressed with surgical pad for bleeding control. The complication rate was 3.84% The mean number of incisions was 3.24 and mean operative time per limb was 65.9 minutes. The mean hospitalization was 1.86 days. The varicose vein extraction using transilluminated powered phlebectomy(TIPP) is a safe, efficacious and cosmetically satisfactory method. The procedure decreases the operating time and the number of incisions required to remove varicose clusters. Further evaluation and long term follow up will be necessary to determine the recurrence rate and long termcomplications.to determine the recurrence rate and long termcomplications.

EXPERIMENTAL RECONSTRUCTION OF LARYNX WITH STERNOMASTOID MYOPERIOSTEAL FLAP (흉유돌근골막 피판을 이용한 후두 재건)

  • 조재식;안병현;김선태;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.28-28
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    • 1991
  • 후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

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The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation (기관내 삽관이 힘든 경우에서 Bonfils Intubation Fibrescope 사용의 임상적인 효과)

  • Lee, Deok-Hee;Kwon, Il-Chi
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.154-161
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    • 2007
  • Background : This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. Materials and Methods : For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. Results : The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a $SpO_2$<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). Conclusion : In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

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Development and Evaluation of a Dysphagia Assessment Tool and an Intervention Program for the Elderly in the Long-Term Care Facilities (노인요양시설 노인의 연하곤란 사정도구, 중재프로그램 개발 및 평가)

  • Kim, Chi-Young;Lee, Young-Mi;Ha, Eun-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.2
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    • pp.685-693
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    • 2012
  • The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and $x^2$-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased.

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess (인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병)

  • Kim, Eu Jin;Lim, Young Su;Yoon, Ji Eun;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.251-255
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    • 2009
  • Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.