• Title/Summary/Keyword: Release pressure

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The Study of Pain and Pain Management of Cancer Patients (악성종양 환자의 통증 및 통증관리에 관한 연구)

  • Yoon Gwi-Ok;Park Hung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.299-316
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    • 1996
  • This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionaries. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows : 1. In population-sociological characteristics : in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics : stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were 'dully pain' as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91subjects complained pain. And mean pain score was $287.1{\pm}116.1$ The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. The duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary, Response of Analgesic after Medication was usually 'moderate release'. The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference : whether subjects had been operated or not : (t=2.88, p=0.005), time of pain is(t=3.34, p=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, p=0.0008). In the pain level of diagnosis, Colon cancer was $353.3{\pm}81.7$(F=2.34, p=0.049), the origin of pain, nerve pressure $316.3{\pm}98.5$(F=2.44, P=0.045), In the complication, ascites and obstruction $324.9{\pm}96.8$(T=2.60, P=0.04).

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A Study on the Full-scale Soil Washing Process Improved by Multi-stage Continuous Desorption and Agitational Desorption Techniques to Remediate Petroleum-contaminated Soils (현장규모의 유류오염토양 세척공법에 다단연속탈착 및 교반탈착기법을 이용한 세척공정 성능향상에 관한 연구)

  • Seo, Yong-Sik;Choi, Sang-Il;Jang, Min
    • Journal of Soil and Groundwater Environment
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    • v.13 no.5
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    • pp.81-87
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    • 2008
  • In accompany with the transfer of US army bases, recent surveys reported serious contamination of soils by the release of petroleum from storage facilities and heavy metals accumulated in rifle-ranges. These problems have made an increased concerns of cleanup technology for contaminated soils. In this study, a full-scale soil washing process improved by multistage continuous desorption and agitational desorption techniques was examined for petroleum-contaminated soils obtained from three different remedial sites that contained 29.3, 16.6, and 7.8% of silt and clay, respectively. The initial concentrations of total petroleum hydrocarbon (TPH) were 5,183, 2,560, and 4,860 mg/kg for each soil. Pure water was applied to operate washing process, in which water used for washing process was recycled 100% for over 6 months. The results of full-scale washing tests showed that the TPH concentrations for soils (> 3.0 mm) were 50${\sim}$356 mg/kg (85.2${\sim}$98.2% removal rates), regardless of the contents of silt and clay from in A, B and C soil, when the soils were washed at 3.0 kg/$cm^2$ of injection pressure with the method of wet particle separation. Based on the initial TPH concentration, the TPH removal rates for each site were 85.2, 98.2 and 89.9%. For soils in the range of 3.0${\sim}$0.075 mm, the application of first-stage desorption technique as a physical method resulted 834, 1,110, and 1,460 mg/kg of TPH concentrations for each soil, also additional multi-stage continuous desorption reduced the TPH concentration to 330, 385, and 245 mg/kg that were equivalent to 92.4, 90.6, and 90.1% removal rates, respectively. The result of multi-stage continuous desorption for fine soil (0.075${\sim}$0.053 mm) were 791, 885, and 1,560 mg/kg, and additional agitation desorption showed 428, 440, and, 358 mg/kg of TPH concentrations. Compared with initial concentration, the removal rates were 92.0, 93.9 and 92.9%, respectively. These results implied we could apply strategic process of soil washing for varies types of contaminated soils to meet the regulatory limit of TPH.

Effect of Ischemic Preconditioning on the Oxygen Free Radical Production in the Post-ischemic Reperfused Heart

  • Park, Jong-Wan;Kim, Young-Hoon;Uhm, Chang-Sub;Bae, Jae-Moon;Park, Chan-Woong;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.30 no.3
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    • pp.321-330
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    • 1994
  • The protective effect of 'ischemic preconditioning (PC)' on ischemia-reperfusion injury of heart has been reported in various animal species, but without known mechanisms in detail. In an attempt to investigate the cardioprotective mechanism of PC, we examined the effects of PC on the myocardial oxidative injuries and the oxygen free radical production in the ischemia-reperfusion model of isolated Langendorff preparations of rat hearts. PC was performed with three episodes of 5 min ischemia and 5 min reperfusion before the induction of prolonged ischemia (30 min)-reperfusion(20 min). PC prevented the depression of cardiac function (left ventricular pressure x heart rate) observed in the ischemic-reperfused heart, and reduced the release of lactate dehydrogenase during the reperfusion period. On electron microscopic pictures, myocardial ultrastructures were relatively well preserved in PC hearts as compared with non-PC ischemic-reperfused hearts. In PC hearts, lipid peroxidation of myocardial tissue as estimated from malondialdehyde production was markedly reduced. PC did not affect the activity of xanthine oxidase which is a major source of oxygen radicals in the ischemic rat hearts, but the myocardial content of hypoxanthine (a substrate for xanthine oxidase) was much lower in PC hearts. It is suggested from these results that PC brings about significant myocardial protection in ischemic-reperfused heart and this effect may be related to the suppression of oxygen free radical reactions.

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The Effects of Aminophylline on the Superoxide Anion Generation of Neutrophils from Established Human Sepsis Caused by Acute Pneumonia (급성 폐렴에 의한 패혈증 환자에서 Aminophylline이 혈중 호중구의 과산화물 음이온 유리에 미치는 영향)

  • Kim, Yong-Hoon;Park, Jun-Young;Cha, Mi-Kyong;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Chung, Yeon-Tae;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.16-22
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    • 1993
  • Background: The Microbicidal and cytotoxic activities of neutrophils are to a large extent dependent on a burst of oxidative metabolism which generates superoxide anion, hydrogen peroxide, and other reactive products of oxygen. The respiratory burst of PMN is initiated by intracellular calcium mobilization that follows immune or particular stimulation and is very sensitive to modulation by c-AMP or adenosine. Despite its antagonism against adenosine, earlier study has demonstrated potent theophylline inhibition of the PMN respiratory burst at variable ranges of blood concentrations of theophylline in the healthy normal volunteers and in the septic animals pretreated or early post-treated with aminophylline (AMPH) or pentoxifylline. However it is unclear whether theophylline inhibits the superoxide generation or not in the established human sepsis caused by acute pneumonia, as taking into consideration of the fact that full activation of neutrophils have occurred within minutes after the septic insult in the animal experiments. Methods: We measured the $O_2$ generation of peripheral arterial neutrophils obtained from 11 human septic subjects caused by acute pneumonia before and 1 hour after completion of continuous AMPH infusion. Patients were identified and studied within 48 hour of admission. All subjects were administered an intravenous loading and maintenance dose of AMPH. The generation of $O_2$ was measured at a discrete time point (60 min) by the reduction of ferricytochrome c.PMA (10 ${\mu}g/ml$) was used as a stimulating agent. PMNs were isolated at a concentration of $2{\times}10^6$ cells/ml. The arterial oxygen tension, blood pressure and heart rates were also checked to evaluate the systemic effects of AMPH in the acute pneumonia. Results: The mean serum concentration of AMPH at 60 minutes was $8.8{\pm}0.6{\mu}g/ml$. Sixty minutes after AMPH infusion the generatition of $O_2$ was decreased from $0.076{\pm}0.034$ to $0.013{\pm}0.004$(OD) (p<0.05) and from $0.177{\pm}0.044$ to $0.095{\pm}0.042$(OD) (p<0.01) in the resting and stimulated PMNs respectively. $PaO_2$ was not changed after AMPH infusion. Conclusion: AMPH may compromise host defense by significant inhibition of neutrophil release of superoxide anion and it had no effect on improving $PaO_2$ in the acute pneumonia.

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Role of p-38 MAP Kinase in apoptosis of hypoxia-induced osteoblasts (저산소 상태로 인한 조골세포 고사사기전에서 p-38 MAP kinase의 역할에 관한 연구)

  • Yoon, Jeong-Hyeon;Jeong, Ae-Jin;Kang, Kyung-Hwa;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.169-183
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    • 2003
  • Tooth movement by orthodontic force effects great tissue changes within the periodontium, especially by shifting the blood flow in the pressure side and resulting in a hypoxic state of low oxygen tension. The aim of this study is to elucidate the possible mechanism of apoptosis in response to hypoxia in MC3T3El osteoblasts, the main cells in bone remodeling during orthodontic tooth movement. MC3T3El osteoblasts under hypoxic conditions ($2\%$ orygen) resulted in apoptosis in a time-dependent manner as estimated by DNA fragmentation assay and nuclear morphology stained with fluorescent dye, Hoechst 33258. Pretreatment with Z-VAD-FMK, a pancaspase inhibitor, or Z-DEVD-CHO, a specific caspase-3 inhibitor, completely suppressed the DNA ladder in response to hypoxia. An increase in caspase-3-like protease (DEVDase) activity was observed during apoptosis, but no caspase-1 activity (YVADase) was detected. To confirm what caspases are involved in apoptosis, Western blot analysis was performed using anti-caspase-3 or -6 antibodies. The 10-kDa protein, corresponding to the active products of caspase-3, and the 10-kDa protein of the active protein of caspase-6 were generated in hypoxia-challenged cells in which the processing of the full length form of caspase-3 and -6 was evident. While a time course similar to this caspase-3 and -6 activation was evident, hypoxic stress caused the cleavage of lamin A, which was typical of caspase-6 activity. In addition, the stress elicited the release of cytochrome c into the cytosol during apoptosis. Furthermore, we observed that pre-treatment with SB203580, a selective p38 mitogen activated protein kinase inhibitor, attenuated the hypoxia-induced apoptosis. The addition of SB203S80 suppressed caspase-3 and -6-like protease activity by hypoxia up to $50\%$. In contrast, PD98059 had no effect on the hypoxia-induced apoptosis. To confirm the involvement of MAP kinase, JNK/SAPK, ERK, or p38 kinase assay was performed. Although p38 MAPK was activated in response to hypoxic treatment, the other MAPK -JNK/SAPK or ERK- was either only modestly activated or not at all. These results suggest that p38 MAPK is involved in hypoxia-induced apoptosis in MC3T3El osteoblasts.

Study on the Consequence Effect Analysis & Process Hazard Review at Gas Release from Hydrogen Fluoride Storage Tank (최근 불산 저장탱크에서의 가스 누출시 공정위험 및 결과영향 분석)

  • Ko, JaeSun
    • Journal of the Society of Disaster Information
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    • v.9 no.4
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    • pp.449-461
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    • 2013
  • As the hydrofluoric acid leak in Gumi-si, Gyeongsangbuk-do or hydrochloric acid leak in Ulsan, Gyeongsangnam-do demonstrated, chemical related accidents are mostly caused by large amounts of volatile toxic substances leaking due to the damages of storage tank or pipe lines of transporter. Safety assessment is the most important concern because such toxic material accidents cause human and material damages to the environment and atmosphere of the surrounding area. Therefore, in this study, a hydrofluoric acid leaked from a storage tank was selected as the study example to simulate the leaked substance diffusing into the atmosphere and result analysis was performed through the numerical Analysis and diffusion simulation of ALOHA(Areal Location of Hazardous Atmospheres). the results of a qualitative evaluation of HAZOP (Hazard Operability)was looked at to find that the flange leak, operation delay due to leakage of the valve and the hose, and toxic gas leak were danger factors. Possibility of fire from temperature, pressure and corrosion, nitrogen supply overpressure and toxic leak from internal corrosion of tank or pipe joints were also found to be high. ALOHA resulting effects were a little different depending on the input data of Dense Gas Model, however, the wind direction and speed, rather than atmospheric stability, played bigger role. Higher wind speed affected the diffusion of contaminant. In term of the diffusion concentration, both liquid and gas leaks resulted in almost the same $LC_{50}$ and ALOHA AEGL-3(Acute Exposure Guidline Level) values. Each scenarios showed almost identical results in ALOHA model. Therefore, a buffer distance of toxic gas can be determined by comparing the numerical analysis and the diffusion concentration to the IDLH(Immediately Dangerous to Life and Health). Such study will help perform the risk assessment of toxic leak more efficiently and be utilized in establishing community emergency response system properly.

Earthquake impacts on hydrology: a case study from the Canterbury, New Zealand earthquakes of 2010 and 2011

  • Davie, Tim;Smith, Jeff;Scott, David;Ezzy, Tim;Cox, Simon;Rutter, Helen
    • Proceedings of the Korea Water Resources Association Conference
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    • 2011.05a
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    • pp.8-9
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    • 2011
  • On 4 September 2010 an earthquake of magnitude 7.1 on the Richter scale occurred on the Canterbury Plains in the South Island of New Zealand. The Canterbury Plains are an area of extensive groundwater and spring fed surface water systems. Since the September earthquake there have been several thousand aftershocks (Fig. 1), the largest being a 6.3 magnitude quake which occurred close to the centre of Christchurch on 22February 2011. This second quake caused extensive damage to the city of Christchurch including the deaths of 189 people. Both of these quakes had marked hydrological impacts. Water is a vital natural resource for Canterburywith groundwater being extracted for potable supply and both ground and surface water being used extensively for agricultural and horticultural irrigation.The groundwater is of very high quality so that the city of Christchurch (population approx. 400,000) supplies untreated artesian water to the majority of households and businesses. Both earthquakes caused immediate hydrological effects, the most dramatic of which was the liquefaction of sediments and the release of shallow groundwater containing a fine grey silt-sand material. The liquefaction that occurred fitted within the empirical relationship between distance from epicentre and magnitude of quake described by Montgomery et al. (2003). . It appears that liquefaction resulted in development of discontinuities in confining layers. In some cases these appear to have been maintained by artesian pressure and continuing flow, and the springs are continuing to flow even now. In spring-fed streams there was an increase in flow that lasted for several days and in some cases flows remained high for several months afterwards although this could be linked to a very wet winter prior to the September earthquake. Analysis of the slope of baseflow recession for a spring-fed stream before and after the September earthquake shows no change, indicating no substantial change in the aquifer structure that feeds this stream.A complicating factor for consideration of river flows was that in some places the liquefaction of shallow sediments led to lateral spreading of river banks. The lateral spread lessened the channel cross section so water levels rose although the flow might not have risen accordingly. Groundwater level peaks moved both up and down, depending on the location of wells. Groundwater level changes for the two earthquakes were strongly related to the proximity to the epicentre. The February 2011 earthquake resulted in significantly larger groundwater level changes in eastern Christchurch than occurred in September 2010. In a well of similar distance from both epicentres the two events resulted in a similar sized increase in water level but the slightly slower rate of increase and the markedly slower recession recorded in the February event suggests that the well may have been partially blocked by sediment flowing into the well at depth. The effects of the February earthquake were more localised and in the area to the west of Christchurch it was the earlier earthquake that had greater impact. Many of the recorded responses have been compromised, or complicated, by damage or clogging and further inspections will need to be carried out to allow a more definitive interpretation. Nevertheless, it is reasonable to provisionally conclude that there is no clear evidence of significant change in aquifer pressures or properties. The different response of groundwater to earthquakes across the Canterbury Plains is the subject of a new research project about to start that uses the information to improve groundwater characterisation for the region. Montgomery D.R., Greenberg H.M., Smith D.T. (2003) Stream flow response to the Nisqually earthquake. Earth & Planetary Science Letters 209 19-28.

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Analysis of Application of Massive Transfusion Protocol for Trauma Patients at a Single Tertiary Referral Hospital (단일 3차 의료기관에서 외상환자에 대한 대량수혈 프로토콜 적용 분석)

  • Kim, Hyerin;Yoo, Dong-Won;Kim, Hyerim;Shin, Kyung-Hwa;Lee, Hyun-Ji;Chang, Chulhun L.;Kim, Hyung-Hoi
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.262-272
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    • 2018
  • Background: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. Methods: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. Results: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. Conclusion: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.

Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets (급성 저산소성 허혈성 뇌손상이 유발된 신생자돈에서 재산소-재관류기 동안 NG-monomethyl-L-arginine과 L-arginine이 뇌의 혈역학 및 에너지 대사에 미치는 영향)

  • Ko, Sun Young;Kang, Saem;Chang, Yun Sil;Park, Eun Ae;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.317-325
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    • 2006
  • Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.