The purpose of this study is to examine the feeding and nutritional status of enteral tube-fed elderly patients. Subjects included 77 elderly hospitalized patients who had received enteral nutrition more than one week before admission. Medical records on admission and actual feeding volume were used to assess anthropometric, biochemical, and nutritional status. Most patients manifested disorders of the nervous system (93.5%) and the average duration of tube feeding was 13.9 months. The average feeding volume of formula was 1,107 mL per day and the mean ratios of calorie and protein (supplied vs. required) were 81.7% and 80.9%, respectively. At admission, 57.4% of the patients were malnourished according to the institutional criteria. Patients receiving less than 80% of the required calories were in worse nutritional status compared with those receiving more than 80% of the required calories. Body mass index, percent ideal body weight, serum albumin level and blood lipid levels (total cholesterol, HDL-cholesterol, triglyceride) were significantly lower in patients receiving less than 80% of the required calories. These results indicate the high prevalence of malnutrition and the need for increased attention and nutritional care of elderly patients undergoing long-term enteral nutrition.
In this study, Injection rate tests of a Diesel common-rail injector have been performed with injection volume measurement type injection rate test system EMI21 for construction of injector model can be used in an engine calibration mean valued model. The measuring principle of the test system is based on measurement of dispalcement of a movable measurement piston by the volume of fluid released by the injector. From these injection rate test results, the characteristics on shape of instantaneous injection rate and injection fuel amount have been investigated and injection fuel amount calculation equation based on test results has been newly constructed. This equation is very simple and calculation error is less than 5% with test results for wide range injection pressure (200~1800 bar) and injection duration ($200{\sim}1800{\mu}s$) conditions. So, it is anticipated that newly constructed simple injection fuel amount model in this study can be efficiently used on engine calibration and control model.
Infiltration facilities are effective instruments to mitigate flood and can increase base runoff in urban watersheds. In order to analyze effects of infiltration trenches physical model experiments were conducted. The physical model facility consists of two soil tanks, artificial rainfall generators, tensiometers, and piezometers. The experiment was conducted by nine times and each case differed in rainfall intensity, rainfall duration and the type of ground surface. Measured quantities in the experiments are as follows: surface runoff, subsurface runoff, trench pipe runoff, groundwater level, water content, etc. The following resulted from the model experiment: The volume of subsurface runoff at trench watershed was maximum 78.3% compared with rainfall. This value is bigger than that of ordinary rate of subsurface runoff, and shows a groundwater recharge effect of trench. The time of runoff passing through the trench became earlier and the volume of runoff became larger with the increase of inflow into the trench, while trench exfiltration into ground became relatively smaller. The results of this study presented above show that infiltration trenches are effective instruments to increase base runoff during dry periods.
Purpose: This study aimed to compare the effect of chest compression and the resulting ventilation volume in walking cardiopulmonary resuscitation (CPR), straddling CPR, and mechanical CPR while moving manikins to main stretchers. Methods: We compared the chest compressions in terms of compression depth, number of incomplete releases, complete release depth, compression rate, duration between peak time of previous compression and peak time of current compression, and respiration. We analyzed the compression comparatively with the ventilation volume in three different types of CPR. Results: The chest compression depth was significantly improved during straddling CPR as compared to walking CPR, during which women were unable to achieve sufficient chest compression depth. A constant chest compression depth was maintained during mechanical CPR. Conclusion: High-quality chest compressions were difficult to achieve in moving spaces. Further, walking CPR may be helpful in men, but straddling or applying automatic chest compressions in women would result in more effective CPR. Our findings demonstrate the limitations and trends in administering CPR in men and women, which may be useful in devising better education and training methods in the future.
Despite provision of drinking water as the most common method of occupational heat stress prevention, there remains confusion in hydration messaging to workers. During work site interactions in a hot and humid climate, workers commonly report being informed to consume tepid fluids to accelerate rehydration. When questioned on the evidence supporting such advice, workers typically cite that fluid absorption is delayed by ingestion of chilled beverages. Presumably, delayed absorption would be a product of fluid delivery from the gut to the intestines, otherwise known as gastric emptying. Regulation of gastric emptying is multifactorial, with gastric volume and beverage energy density the primary factors. If gastric emptying is temperature dependent, the impact of cooling is modest in both magnitude and duration (${\leq}5$ minutes) due to the warming of fluids upon ingestion, particularly where workers have elevated core temperature. Given that chilled beverages are most preferred by workers, and result in greater consumption than warm fluids during and following physical activity, the resultant increased consumption of chilled fluids would promote gastric emptying through superior gastric volume. Hence, advising workers to avoid cool/cold fluids during rehydration appears to be a misinterpretation of the research. More appropriate messaging to workers would include the thermal benefits of cool/cold fluid consumption in hot and humid conditions, thereby promoting autonomy to trial chilled beverages and determine personal preference. In doing so, temperature-based palatability would be maximized and increase the likelihood of workers maintaining or restoring hydration status during and after their work shift.
Purpose : In contrast with traditional time-cycled, pressure-limited ventilation, during volume-controlled ventilation, a nearly constant tidal volume is delivered with reducing volutrauma and the episodes of hypoxemia. The aim of this study was to compare the efficacy of pressure-regulated, volume controlled ventilation (PRVC) to Synchronized intermittent mandatory ventilation (SIMV) in VLBW infants with respiratory distress syndrome (RDS).Methods : 34 very low birth weight (VLBW) infants who had RDS were randomized to receive either PRVC or SIMV with surfactant administration : PRVC group (n=14) and SIMV group (n=20). We compared peak inspiratory pressure (PIP), duration of mechanical ventilation, and complications associated with ventilation, respectively with medical records. Results : There were no statistical differences in clinical characteristics between the groups. After surfactant administration, PIP was significantly lower during PRVC ventilation for 48hrs and accumulatevive value of decreased PIP was higher during PRVC ventilation for 24hrs (P<0.05). Duration of ventilation and incidence of complications was no significant difference. Conclusion : PRVC is the mode in which the smallest level of PIP required to deliver the preset tidal volume in VLBW infants with RDS, adaptively responding to compliance change in lung after surfactant replacement.
Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.
Kim, Han-Soo;Baik, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
The Korean Journal of Pain
/
v.1
no.2
/
pp.192-198
/
1988
Sixty patients, of ASA physical status class I for elective operations in the lower abdomen, perineum, or lower extremities, were studied in a comparative prospective trial to evaluate the efficacy of epidural morphine and ketamine for postoperative analgesia. They were divided into two groups: an epidural morphine sulfate group (EMS group; 30 patients), and an epidural ketamine hydrochloride group (EKH group; 30 patients). Indwelling epidural catheters were placed in the patients' lumber areas (L3-4) and then all patients were anesthetized with thiopental, nitrous oxide, and halothane. After the patients had fully recovered from the anesthesia, the analgesic agents were administered epidurally via the catheter when the patients complained of pain in the postoperative period. The groups were given either 0.1 mg/kg of morphine sulfate or 0.5 mg/kg of ketamine hydrochloride administered in a volume of 10 ml of normal saline. Patients were observed for the onset and duration of postoperative analgesia and for other effects. Total doses were $5.7{\pm}0.6\;mg$ of morphine sulfate in the EMS group and $27.9{\pm}3.3\;mg$ of ketamine hydrochloride in the EKH group. The onset of analgesia was detectable within 35 min.($23.5{\pm}6.3$ min) in 86.7% (26 cases) of the EMS group and within 10 min. ($7.8{\pm}3.7$ min.) in 76.7% (23 cases) of the EKH group. Mean duration of postoperative analgesia was $22.3{\pm}2.1\;hr$. in the EMS group. In the EKH group, the duration of analgesia was shorter and variable, the range of duration was from 2 hr. to 24 hr., Cardiopulmonary changes were statistically insignificant ih both groups. Side effects such as nausea, vomiting, urinary retention, pruritus, dizziness, and headache were observed in EMS group. In the EKH group, there was no discomfort except dizziness (3 cases) and headache (1 case). Epidural ketamine was a safe technique for postoperative analgesia, but because of the variability and relative shortness in the duration of analgesia the use of this technique will require further clinical trials.
Transactions of the Korean Society of Mechanical Engineers B
/
v.39
no.2
/
pp.135-146
/
2015
This paper is the fourth on the combustion characteristics of the landfill gas in a constant volume combustion chamber for a large displacement volume commercial engine and the second dealing with torch ignition. It discusses the combustion characteristics of torch ignition on the basis of the heat release and visualization. The results show that the jet and/or spout from the torch promote combustion by accelerating the flame front in the main combustion chamber. In addition, a hot gas jet exists when the orifice diameter is 4 mm, whereas the flame passes directly through the orifice if the diameter is 6 mm or greater. In addition, the effect of torch ignition differs according to the combination of the methane fraction, torch volume, and orifice size because various combustion processes occur as a result of the interaction of these parameters. Finally, it was found that the most suitable torch should have an orifice diameter of not less than 6 mm and an area ratio of not more than 0.15 to secure a consistent combustion process in a real engine.
A standard air flow generator system was developed to generate air flows of various levels simultaneously applied to two different air flow transducer modules. Axes of two identical standard syringes for spirometer calibration were connected with each other and driven by a servo-motor. Linear displacement transducer was also connected to the syringe axis to accurately acquire the volume change signal. The user can select either sinusoidal or square waveform of volume change and manually input any volume as well as maximal flow rate levels ranging 0~3 l and 0~15 l/s, respectively. Various volume and flow levels were input to operate the system, then the volume signal was acquired followed by numerical differentiation to obtain the air flow signal. The measured volumes and maximal air flow rates were compared with the user input data. The relative errors between the user-input and the measured stroke volumes were all within 0.5%, demonstrating very accurate driving of the system. In case of the maximal flow rate, relatively large error was observed when the syringe was driven very fast within a very short time duration. However, except for these few data, most measured flow rates revealed relative errors of approximately 2%. When the measure and user-input stroke volume and maximal flow rate data were analyzed by linear regression analysis, respectively, the correlation coefficients were satisfactorily higher than 0.99 (p < 0.0001). These results demonstrate that the servo-motor controls the syringes with enough accuracy to generate standard air flows. Therefore, the present system would be very much practical for calibration process as well as performance evaluation and comparison of two different air flow transducer modules.
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