• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.9
• /
• pp.3977-3980
• /
• 2015

Background: To investigate the effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma. Materials and Methods: Fifty-seven patients with thyroid carcinoma who underwent thyroidectomy selectively in Laiwu Hospital Affiliated to Taishan Medical University and Binzhou People's Hospital were selected and randomly divided into three groups, 19 cases in each group. The control group was intravenously injected 0.9% sodium chloride injection before anesthesia induction; trial group I was intravenously injected with parecoxib sodium 20 min before anesthesia induction; based on trial group I, trial group II was injected with parecoxib sodium again 12 h after surgery. The levels of plasma norepinephrine (NE), cortisol (Cor) and blood glucose before, 12 and 24 h after surgery and changes of haemodynamics before surgery, at the end of surgery and 12, 24 and 48 h after surgery were compared in the three groups. Besides, visual analogue scale (VAS) scores were recorded 4, 8, 12 and 24 h after surgery. Results: 12 and 24 h after surgery, the levels of plasma NE and Cor in three groups rose dramatically (P<0.05 or (P<0.01); The levels of plasma NE and Cor in trial groups I and II were evidently lower than in control group (P<0.05 or P<0.01), and those in trial group II slightly lower than in trial group I. 12 h after surgery, the heart rates (HR) and systolic pressures (SBP) in trial groups I and II increased obviously by comparison to surgery before (P<0.05 or P<0.01), but gradually returned to the preoperative level. HR, SBP and diastolic pressures (DBP) in trial groups I and II at the end of surgery and 12 h after surgery were all lower than in the control group, and significant differences were present (P<0.05 or (P<0.01). At 4, 8, 12 and 24 h after surgery, VAS scores in trial groups I and II were markedly lower than in the control group (P<0.05 or (P<0.01), the scores in trial group II being the lowest. Conclusions: Combined application of parecoxib sodium for preemptive analgesia before anesthesia and after surgery can effectively reduce the levels of plasma stress hormones and improve analgesic effects in surgical patients with thyroid carcinoma, and without conspicuous impact on haemodynamics.

• Journal of the Korea Society of Computer and Information
• /
• v.19 no.12
• /
• pp.227-237
• /
• 2014

The purpose of this paper is to implement a multiple bio-signal central monitoring system based on textile fabrics flexible platform which can obtain and monitor bio signals(heart rate, body temperature, electrocardiography, electromyogram) of workers in special working environments and additional situational information (3-axis acceleration, temperature, humidity, illumination, surrounding image). This system can prevent various accidents that may occur in the remote work environment and provide fast and efficient response by detecting workers' situations in real-time. For it, the textile fabrics flexible platform was made as innerwear or outerwear so that it does not interfere with workers' performance while collecting bio-signal and situational information, and obtained information is sent to the central monitoring system through wireless communication. The central monitoring system is based on wireless medical telemetry service of WMTS (Wireless Medical Telemetry Service); can monitor from 2 to 32 people simultaneously; and was designed so that it can be expanded. Also, in this study, to verify performance of the WMTS communication model, packet transmission rates were compared according to the distance.

• Pediatric Infection and Vaccine
• /
• v.15 no.1
• /
• pp.30-35
• /
• 2008

Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

• Journal of Veterinary Clinics
• /
• v.22 no.4
• /
• pp.450-452
• /
• 2005

A 3-year-old, 43kg, pregnant Great Pyrenese was examined for clinical signs of acute weakness and anorexia for 4 days. The dog was in lateral recumbency at referral. The rectal temperature was within reference range, and the respiratory and heart rates were 36 breaths/min and 58 beats/min, respectively. The abdomen was distended, and several puppies were palpated. The mean fetal head diameter was 2.8cm in the ultrasonographic examination. The initial complete blood count and serum biochemical examinations revealed mild dehydration, mud hyperglycemia, hypochloremia, hyperkalemia, hyponatremia, and low sodium-potassium ratio. Serum BUN and total cholesterol values were slightly high. Hypoadrenocortical crisis was suspected on the basis of signs of acute collapse, hyponatremia and hyperkalemia. Adrenal gland function was evaluated by an ACTH stimulation test. The baseline cortisol concentration was $18.6{\mu}g/dl$ and the concentration at 1 hour after administration of tetracosactrin (ACTH, Synacthen) was $8{\mu}g/dl$. The dog was treated for the correction of assumed hypoadrenocortical crisis and substantial hyperkalemia. In addition to rapid infusion with saline solution, other medications administered intravenously included sodium bicarbonate and cimetidine hydrochloride. The dog was monitored with repeated serum electrolyte examination. After clinical stabilization, cesarean section was performed. All of 13 puppies were delivered, and the dog recovered from anesthesia without complications. The values of postpartum blood tests returned to normal or within reference range. The dog remained healthily.

• Journal of Veterinary Clinics
• /
• v.29 no.4
• /
• pp.297-300
• /
• 2012

In the present study, we investigated and compared the oxidant-antioxidant status of dogs undergoing open and laparoscopic cholecystectomy. Ten male beagle dogs, 4-6 years old, weighing 7-12 kg were used. The animals were randomly assigned to one of two groups according to the type of surgical procedure; open (group 1, n = 5) or laparoscopic cholecystectomy (group 2, n = 5). Heart rate, mean arterial pressure, end-tidal carbon dioxide, peripheral oxygen saturation, and respiratory rates were measured. Plasma total oxidant status (TOS) and total antioxidant status (TAS) levels for the evaluation of oxidative stress were measured. The ratio of the TOS to the TAS gave oxidative stress index (OSI), which is an indicator of the degree of oxidative stress. TOS, OSI and TAS levels were significantly changed after surgery in comparison to levels of before anesthesia. There were no significant different between groups. In the present study, we showed that oxidative stress parameters were found similar in dogs underwent laparoscopic or open cholecystectomy.

• Journal of Chest Surgery
• /
• v.50 no.2
• /
• pp.86-93
• /
• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Journal of Chest Surgery
• /
• v.50 no.2
• /
• pp.78-85
• /
• 2017

Background: Closure of a secundum atrial septal defect (ASD) is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was $40.9{\pm}13.1years$, and 199 (28.7%) were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6%) and significant tricuspid regurgitation (TR) in 137 patients (19.8%). The mean follow-up duration was $12.4{\pm}4.7years$. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023) and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001) were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518). Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

• Korean Journal of Adult Nursing
• /
• v.23 no.5
• /
• pp.503-513
• /
• 2011

Purpose: The purpose of this study was to identify a model based on f the learning objectives in adult health nursing curriculums. The model can be eventually reflected in Korean National Nurse's Licensing Examination (KNNLE). Methods: The model was developed through a series of practical analysis by the task force team from June to October, 2011. The research team conducted the data synthesis and analysis from the learning objectives of adult health nursing drawn from selected national and international universities, from the adult health nursing areas in KNNLE, and from the current disease prevalence from clinical data in the representative university hospitals in Korea. Results: The current disease prevalence and mortality rates are on the increase especially for malignant neoplasm, heart diseases, suicide and diabetes. The items on the KNNLE of adult nursing are categorized by body systems into digestive system (15%), introduction (13.8%), respiratory system (11.3%), and cardiac system (11.3%). While the current system-based learning objectives covers extensive areas of adult health nursing, the core items are required to be selected based on core competences and core learning objectives to restructure the items of KNNLE. The first revised model is to consolidate and restructure the items microscopically in the subjects of adult health nursing by system. The second proposed model from macroscopic perspective is to build a comprehensive scheme of nursing curriculum by encompassing 8 subjects under current KNNLE and adjust the number of items accordingly. Conclusion: The items of KNNLE need to be gradually redesigned by considering the intervention need at clinical practice and the modified learning objectives of adult health nursing. Based on the job analysis on core competences for newly employed nurses performed by the Korean Accreditation Board of Nursing, it is necessary to establish the core learning objectives of adult health nursing and set up standards for core items in KNNLE.

• Asian-Australasian Journal of Animal Sciences
• /
• v.19 no.2
• /
• pp.189-197
• /
• 2006

Twenty small-scale farms of two villages (A and B) were surveyed to identify the feeding traits, milk productivity and nutritional status of lactating cattle and buffalo in Terai, Nepal. Constituents and dry matter (DM) of feed supplied, body condition score (BCS), heart girth (HG), bodyweight (BW), milk yield (MY) and plasma metabolites were obtained in the pasture-sufficient, pasture-decreasing and fodder-shortage periods. Milk yield of 305-day lactation was estimated by the daily MY. The supplies of rice straw and native grass were lower and higher in the pasture-sufficient period than in the other periods, respectively (5.5 kg/day vs. 9.8 kg/day and 3.2 kg/day vs. 0.4 kg/day, respectively, p<0.01). The roughage-supplement rates of the animals were higher in village A than in village B (5.0 vs. 2.2 in cattle and 9.3 vs. 1.8 in buffalo, p<0.01). The variance of feed constituents among the periods and between the villages induced different supplies of CP, NDF and TDN. The concentrations of CP and TDN in the cattle feed were higher in the pasture-sufficient period than in the other periods (9.1% vs. 7.3% and 57.4% vs. 51.0%, respectively, p<0.01). The supplies of CP for cattle and buffalo, and of TDN for buffalo were lower in village A than in village B (7.5% vs. 8.7% and 6.6% vs. 9.1% [p<0.01], and 53.1% vs. 56.2% [p<0.05], respectively). The BCS, HG and BW of the animals were lower in village A than in village B (2.51 vs. 2.86, 156 cm vs. 170 cm and 300 kg vs. 318 kg, respectively in cattle, 2.83 vs. 4.00, 186 cm vs. 216 cm and 429 kg vs. 531 kg, respectively in buffalo, p<0.01). The cattle yielded more milk in the pasture-sufficient period than in the other periods (7.9 liters/day vs. 6.6 liters/day, p<0.01). The 305-day MY of cattle that calved in the fodder-shortage period was lower than that of cattle that calved in the other periods (1,900 liters vs. 2,251 liters, p<0.01). The MYs of cattle and buffalo were lower in village A than in village B (6.2 liters/day vs. 8.1 liters/day and 3.7 liters/day vs. 7.7 liters/day, respectively, p<0.01). The 305-day MY of cattle was lower in village A than in village B (1,935 liters vs. 2,409 liters, p<0.01). The concentrations of plasma albumin and urea nitrogen in cattle were lower in village A than in village B (3.2 g/dl vs. 3.4 g/dl [p<0.01] and 7.4 mg/dl vs. 10.2 mg/dl [p<0.05], respectively). The different supplies of CP, NDF and TDN among the periods and between the villages might have affected MY and nutritional status in cattle and buffalo. It was likely that the lower supplies of CP and TDN for cattle that calved in the fodder-shortage period and in village A lowered the 305-day MY of cattle.

• Journal of Chest Surgery
• /
• v.44 no.3
• /
• pp.220-224
• /
• 2011

Background: We investigated changes in the International Normalized Ratio (INR) and its measurement interval in patients with thromboembolic events who were treated by low intensity anticoagulation therapy after isolated mechanical aortic valve replacement. Materials and Methods: Seventy-seven patients who underwent surgery from June 1990 to September 2006 were enrolled in the study and observed until August 2008. The patients were followed up at 4~8 week intervals and their warfarin (Coumadin)$^{(R)}$ dosage was adjusted aiming for a target range of INR 1.5~2.5. The rate of thromboembolic events was obtained. Changes in the mean INR and INR measurement interval were comparatively analyzed between the normal group (event free group, N=52) who had no anticoagulation-related complications and the thromboembolic group (N=10). Hospital records were reviewed retrospectively. Results: The observation period was 666.75 patient-years. Thromboembolic events occurred in 10 patients. The linearized occurrence rate of thromboembolism was 1.50%/patient-years. Actuarial thromboembolism-free rates were $97.10{\pm}2.02%$ at 5 years, $84.30{\pm}5.22%$ at 10 years, and $67.44{\pm}12.14%$ at 15 years. The percentages of INR within the target range and mean INR were not statistically significantly different for the normal and thromboembolic groups. However, the mean INR during the segmented period just before the events showed a significantly lower level in the thromboembolic group (during a 4 month period: normal group, $1.86{\pm}0.14$ vs. thromboembolic group, $1.50{\pm}0.28$, p<0.001). The mean intervals of INR measurement during the whole observation period showed no significant differences between groups, but in the segmented period just before the events, the interval was significantly longer in thromboembolic group (during a 6 month period: normal group, $49.04{\pm}9.47$ days vs. thromboembolic group, $65.89{\pm}44.88$ days, p<0.01). Conclusion: To prevent the occurrence of thromboembolic events in patients who receive isolated aortic valve replacement and low intensity anticoagulation therapy, we suggest that it would be safe to maintain an INR level above 1.8 and to measure the INR at least every 7~8 weeks.