• Journal of Chest Surgery
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• v.21 no.4
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• pp.649-655
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• 1988

One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

• Korean Journal of Community Nutrition
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• v.3 no.4
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• pp.556-564
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• 1998

The purpose of this study was to assess the iron nutritional status of college women residing in the Kyungin area. The anthropometric parameters, nutrient intake, and biochemical status of iron were measured for 102 college women. The mean height and weight were 160.3cm and 52.4kg, respectively. The proportion of subjects whose BMI was less than 20 was 41.3%. The proportion of subjects assessed as overweight(25$\geq$25%) assessed by the fat percent(FP) was 53.9%. The mean daily intake of iron was 13.90mg(77.1% of RDA), composed of 0.97mg of heme iron and 12.44mg(69.0% of RDA). When the sources of iron were grouped as rice(including bread), noodle, soup, side dish, and snack, noodle provided, 3.95mg of iron regarded as the highest amount. Subjects were taking 6.72mg(51.4% of RDA) of iron per day from main dishes(rice, bread and noodle). The fifty five percent of the subjects showed iron depletion(serum femitin<20ng/ml)and 33.4% showed suppressed erythropoiesis with iron deficiency(serum ferritin<10ng/ml). The anemic subjects assessed with transferrin saturation (<15%) represented 33.3% of the test population, whereas 11.8% of the subjects possessed less than 12g/dl of hemoglobin. Subjects not satisfied with their body shape were having significantly lower amount of energy intake(p<0.05) than the subjects satisfied with their body shape. College women having mothers who graduated from university had a significantly decreased amount of energy, carbohydrates, fat and vitamin C(p<0.05). The mean RBC and serum iron of the subjects who were on a diet more than one month were lower than those of the subjects who were not on a diet(p<0.05).

• Proceedings of the SCSK Conference
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• 2003.09a
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• pp.162-177
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• 2003

It has been known that the color of skin reflects the blood flow within. In lips, the capillaries close to the skin surface are numerous; hence lips are redder than the rest of face. However, dermatological research on lips is not as advanced as research on facial or body skin, and little was known about the relationship between relatively dull-colored lips and skin blood flow. The physiological differences between colorful and dull-colored lips were studied by a two-dimensional laser Doppler blood flow analyzer, a spectrometer for the measurement of the degree of oxygen saturation, and a confocal microscope for observing inside lips non-invasively. Dull-colored lips and the corner of lips (dull-colored compared to the center) showed relatively poor blood flow and lower oxygenated hemoglobin. It was found that colorful lips (generally the young) had a blood flow that tended to run straight in parallel with the skin surface. This unique blood-capillary structure can express clear red blood. Those with dull-colored lips had lost this unique structure. Their blood ran perpendicularly from the deep of the skin and down back again into the deep part as like the blood circulation patterns of facial skin. Therefore, the lips of the latter group had fewer blood capillaries near skin surface in the lips than that of the colorful-lips group. A lipstick containing a-glucosyl-hesperidin, which is derived from certain citrus fruits and can enhance blood circulation, was applied for evaluating its effects. Blood flow was increased 30 min after the application. After two weeks of daily application, the lips' condition became noticeably less dull. These findings suggest that the decrease of blood flow in dull-colored lips is caused by the loss of the unique capillary structure and the use of the lipstick to increase blood flow can give a vivid color to lips.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.226-238
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• 2001

Background: Anemia in chronic renal failure plays an important role in increasing morbidity of dialysis patients. The causes of the anemia are multifactorial. With using of erythropoietin(EPO) most of uremia-induced anemia can be overcome. However, about 10% of renal failure patients shows EPO-resistant anemia. Hyporesponsiveness to EPO has been related to many factors: iron deficiency, aluminum intoxication, inflammations, malignancies and secondary hyperparathyroidism. So I evaluated the improvement of EPO responsiveness after correction of above several factors. Materials and Methods: Seventy-two patients on hemodialysis over 6 months were treated with intravenous ascorbic acid(IVAA, 300 mg t.i.w. for 12 weeks), After administration of IVAA for 12 weeks, patients were classified into several groups according to iron status, serum aluminum levels and i-PTH levels. Indivisualized treatments were performed: increased iron supplement for absolute iron deficiency, active vitamin D3 for secondary hyperparathyroidism and desferrioxamine(DFO, 5 mg/kg t.i.w.) for aluminum intoxication or hyperferritinemia. Results: 1) Result of IVAA therapy for 12 weeks on all patients(n=72). Hemoglobin levels at 2, 4, 6 week were significantly elevated compared to baseline, but those of hemoglobin at 8, 10, 12 week were not significantly different. 2) Result of IVAA therapy for 20 weeks on patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and transferrin saturation(Tsat) below 30%(n=30). After treatment of IV AA for 12 weeks, patients were evaluated the response of therapy according to iron status. Patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and Tsat below 30% showed the most effective response. These patients were treated further for 8 weeks. Hemoglobin levels at 2, 4 week were significantly increased compared to baseline with significantly reduced doses of EPO at 2, 4, 6, 10, 12, 16, 20 week. Concomitantly significantly improvement of Tsat at 2, 6, 16, 20 week compared to baseline were identified. 3) Result of IVAA therapy for 12 weeks followed by DFO therapy for 8 weeks on patients with serum aluminum above 4 ${\mu}g/l$(n=12) Hemoglobin levels were not significantly increased during IVAA therapy for 12 weeks but dosages of EPO were significantly decreased at 2, 4, 6, 8 week during DFO therapy compared to pre-treatment status. Conclusion: IVAA can be helpful for the treatment of the anemia caused by functional iron deficiency and can reduce the dosage of EPO for anemia correction. And administration of low dose DFO, in cases of increased serum aluminum level, can reduce the requirement of EPO.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.13-18
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• 1980

The ultimate goal of treatment of carton monoxide poisoning is to promote dissociation of carboxyhemoglobin and to maintain arterial $PO_2$ above 50mmHg throughout the course of treatment to protect vital organs from damage caused by hypoxia. The hyperbaric chamber designed and manufactured for this purpose has obviousely made an enormous contribution and yet has several handicaps to be overcome by any means. These handicaps are: the financial impact to purchase the chamber (especially in a small, remote community), an extra manpower requirement to operate the device, limitation in the capacity of the chamber (one man type), and the possible hazard of oxygen intoxication and dysbarism. The primary objective of this study is to develope a new therapeutic measure as an alternative to the hyperbaric chamber when it is not available or contraindicated. The effect of intestinal perfusion with hydrogen peroxide has been studied by many investigators and was known to be an excellent way of extrapulmonary oxygen supply. the advantage of this method will include; 1) much more amount of oxygen is delivered to the tissue than one would expect from 100% saturation with oxygen at 1 ata, 2) the procedure is simple and most economical, 3) neither sophisticated equipment nor extra manpower is required. As a study preliminary to the clinical application, authors conducted a series of experiment to observe the effect of hydrogen peroxide enema on dissociation of carboxyhemoglobin in intoxicated rabbit blood. Using an animal gas chamber, 20 rabbits were exposed to CO gas of 6,000 ppm for 60 minutes. Ten rabbits of control group were given 10cc of warmed normal saline solution by reactal perfusion and for the other 10 of the experimental group, the same amount of 1% $H_{2}O_{2}$ solution was given by the same way. Two blood specimens were drawn from each rabbit: the first one immediately following the exposure and the second one after rectal perfusion, about 30 minutes after the first sampling. The result was as follows; 1) The decrease in carboxyhemoglobin concentration during the first 30 minutes in the control and experimental group were $18.18{\pm}4.49%\;and\;23.03{\pm}4.13%$ respectively shelving the significant difference (p<0.05) between the two groups. 2) Hemoglobin and hematocrit value showed no significant difference between two groups and not altered significantly by intestinal perfusion with $H_{2}O_{2}$.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.353-360
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• 2019

Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO₂) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO₂ monitoring did not present with sufficient benefits over the risk and cost.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.668-673
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• 2010

This study was to evaluate the effects of tramadol and medetomidine administration on minimum alveolar concentration (MAC) of isoflurane in dogs. MAC of isoflurane was determined in four occasions; 1 ml saline (Control), $2{\mu}g$/kg medetomidine (M2), 4 mg/kg tramadol (T4), $2{\mu}g$/kg medetomidine-4 mg/kg tramadol combination (M2T4). Heart rate, blood pressure, respiratory rate, end-tidal carbon dioxide concentration, saturation of hemoglobin with oxygen and body temperature were recorded. After administration of M2 ($0.81{\times}0.18%$), T4 ($0.81{\times}0.14%$) and M2T4 ($0.62{\times}0.12%$), less isoflurane was required than the control value ($1.13{\times}0.19%$). Significantly lower heart rate than the control value was detected after treatment of M2, T4, and M2T4. When only M2T4 was administered, blood pressure was significantly higher than the control value. In conclusion, administrations of tramadol, medetomidine and medetomidine-tramadol combination decreased the MAC of isoflurane in dogs. Especially, medetomidine-tramadol combinations could be useful as a premedication because of the anesthetic sparing effect and moderate changes in cardiovascular system.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.131-142
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• 1973

Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

• Journal of Nutrition and Health
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• v.7 no.3
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• pp.27-44
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• 1974

A general survey of 82 perschool children and 473 school children (from 1st to 3rd grade) residing in the Dongnae area of Shindong Myun, choonseoung Gun, Kangwon Province was conducted from June 12 to 21, 1973, to obtain information concerning nutritional status, especially the protein and iron nutrition of preschool and school children in a rural area of Korea. A sample of 58 children 2 to 9 years old was selected from these 555 children for hematological, biochemical and parasitological tests. The results of these tests are presented below, 1) Both the mean body height and mean body weight of these children were higher and heavier than the averages in the Korean Physical Standards. About 39 per cent were above the 90 th percentile of the Korean Physical Standards of height and 35 per cent were above the 90th percentile of the Korean Physical Standards of weight. 2) The rate of infestation by helminthes was 67.6 per cent and there were no cases of hookworm infestation Among the ascaris-infected children, 61.6 per cent fell within an Ascaris E.P.G. count range of $501{\sim}2,000$. This was considered a rather mild intensify of ascaris infection. Nutrient loss due to helminthes was also estimated to be low. 3) The mean hemoglobin level was 11.3gm% $({\pm}0.94)$, and 68.4 per cent of the children were anemic (less than 11gm% among those 5 years old or less, less than l2gm% among those 6 years old or more). The average hematocrit value was 36.1% $({\pm}2.36)$, and only 3.5 per cent showed more than 34% on the M.C.H.C. test. These results showed that the incidence of anemia, in these rural children was high, and that in general it displayed hypochromic characteristics. 4) The average serum iron level was $78.2{\mu}g%$\;({\pm}29.8). The Proportion of the children showing less than $50{\mu}g% in the serum iron level was 5.6 per cent, while 41.8 percent revealed $450{\mu}g% or more in the TIBC determination. Transferrin saturation was below 15% in 71.4 percent of the preschool children, and in 28.6 percent of the school children. Those who had a serum iron level of $50{\mu}g% or less and a TIBC of more than $450{\mu}g% constituted 11.9 percent of the children examined. From these results, it was concluded that especially preschool children were low in iron nutrition, and that most of the anemia might be iron-deficiency anemia. 5) The mean values of total serum protein and albumin were 6.98gm% and 4.99gm% respectively. Especially in serum albumin, all children stowed more than 4 gm%. 6) The mean urinary urea nitrogen Per creatinine ratio was 11.5 $({\pm}4.2)$, and 21.8 percent had a ratio of more than 15. Considering these results, it was suggested that protein nutrition in these children was relatively good.

• Korean Journal of Community Nutrition
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• v.6 no.1
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• pp.28-35
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• 2001

This study was designed to assess the iron nutritional status and anemia of high school students. 383 female subjects in Ulsan Metropolitan city were evaluated using a questionnaire, and a measurement of hematological indices. The average height and weight of the respondents were 161.24$\pm$4.90 cm and 53.12$\pm$6.37kg, repectively. The average BMI(body mass index) was 20.43$\pm$2.26 which was in the normal ramge. The average hemoglobin(Hb) concentration of the subjects was 13.14$\pm$0.97g/dl, and the average hematocrit(Hct) level was 40.84$\pm$17.40%. Transferrin saturation{TS(%)} was 20.86$\pm$10.32%, and the ferritin by Hct(＜36%), 27.2%by TS(＜14%),26.6% by ferritin(＜12 ng/ml). As for clinical symptoms, the greatest number of respondents reported that they experienced ‘decreased ability to concectrate’. Mean daily intakes of iron were 14.89$\pm$4.48 mg and heme iron intakes were 5.04$\pm$2.13 mg, which was 29.6% of total iron intake. The total iron binding capacity(TIBC) was negatively correlated with Hb concentration(r= -0.222, p＜0.01). Serum ferritin was positively correlated with Hb concentration(r= - 0.323, p＜0.05) and negatively correlated with TIBC(r= -0.367, p＜0.01). TS(%) was positively correlated with Hb concentration(r= 0.402, p＜0.01) and positively correlated with serum ferritin(r=0.413, p＜0.01). As for the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with ‘shortening of breath when going upstairs(p＞0.05)’ and ‘cold hands and feet’ significantly(r= -0.109, p＜0.05). The level of Mean corpuscular volume(MCV) was negatively correlated with ‘feel dizzy when standing up’,‘tired out easily’, and ‘decrease ability to concentrate’ significantly(p＜0.05). In particular, the level of Fe was negatively correlated with ‘shortening of breath when going upstairs’ and ‘feeling blue’ significantly(p＜0.01). These results suggest That the prevalence of iron deficiency of female high school students is very high, therefore guidelines for diet supports and nutrition education to improve their iron status should be provided.