• Title/Summary/Keyword: pump-and-treat

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The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery (하행대동맥 및 흉복부 대동맥 수술의 임상적 경험)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.584-589
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    • 2002
  • Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.

A Study on the Prescription Patterns of Gastrointestinal Protective Agent with Non-Steroidal Anti-Inflammatory Drugs in Korean Elderly Patients with Osteoarthritis (골관절염을 진단받고 비스테로이드성 항염제 복용 중인 65세 이상 환자의 위장관보호제 처방양상 연구)

  • Chun, Seongmin;Choi, Yoonhee
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.79-92
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    • 2020
  • Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

Pulmonary artery rupture due to bacterial endocarditis complicated by patent ductus arteriosus. (동맥관개존증에 합병한 심내막염에 의한 폐동맥파열 실험 1례)

  • 조순걸
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.537-541
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    • 1985
  • Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

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Efficacy of Korean Red Ginseng Supplementation on Eradication Rate and Gastric Volatile Sulfur Compound Levels after Helicobacter pylori Eradication Therapy

  • Lee, So-Jung;Park, Ji-Young;Choi, Ki-Seok;Ock, Chan-Young;Hong, Kyung-Sook;Kim, Yoon-Jae;Chung, Jun-Won;Hahm, Ki-Baik
    • Journal of Ginseng Research
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    • v.34 no.2
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    • pp.122-131
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    • 2010
  • This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. $^{13}C$-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p<0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p<0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.

A Case Study of Taeumin Patient with Gastro-esophageal reflux disease(GERD) who Treated Successfully with Yeoldahanso-tang(Reduohanshao-tang) (열다한소탕(熱多寒少湯)으로 호전된 역류성 식도염 환자 1례)

  • Kim, Yun-Hee;Kim, So-Yeon;Hwang, Min-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.1
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    • pp.132-138
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    • 2011
  • 1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.

A Study on Oriental Medicine Hybrid Multi-cup Electric Cupping Contents using Vacuum Pressure (진공압을 이용한 한방 하이브리드 멀티 전동 부항 콘텐츠에 관한 연구)

  • Kim, Jong-Chan;Wei, Tung-Shuen;Ko, Jae-Sub;Choi, Heung-Kook;Tak, Myung-Ja;Kim, Cheeyong
    • Journal of Korea Multimedia Society
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    • v.17 no.11
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    • pp.1363-1373
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    • 2014
  • In this study, a hybrid multi-cup electric cupping system (HMECS) was proposed, based on the ancient cupping method. HMECS consisted of several cups that could be used simultaneously to treat different areas of the patient's body. Each cup was equipped with its own pump and pressure-monitoring system. Moreover, the vacuum pressure of the cups was controlled using fuzzy logic. Through automated control of the vacuum pressure, long-term relief of muscle tightness was achieved. To develop a scientific foundation for this alternative treatment, we compared the VAS(Visual Analog Scale) and ODI(Oswestry Disability Index) scores from conventional basic cupping to the VAS and ODI scores for our proposed HMECS. The improvement rate in the VAS and ODI scores using HMECS after three treatments was higher than that achieved by basic cupping. These results, combined with the convenience offered by enhanced IT capabilities, should increase the popularity of this device among an aging society, and facilitate the opportunity to further explore the potential of Oriental medical practices.

Multi-Institute, Single Group, Prospective Observational Study to Evaluate the Efficacy of Mucomyst® in Relieving Symptoms of Globus Pharyngeus Refractory to Proton Pump Inhibitor (양성자펌프억제제에 반응하지 않는 인두이물감 환자에서 "뮤코미스트Mucomyst®" 객담제거 및 상기도 염증치료를 통한 증상개선효과 평가 다기관, 단일군, 전향적 관찰 연구)

  • Park, Hannah;Park, Il-Seok;Lee, Sang Hyuk;Lee, Seung-Won;Lee, Sang Joon;Lee, Byung-Joo;Cheon, Yong-Il;Park, Jun-Ook;Oh, Kyoung Ho;Shin, Yoo Seob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.20-25
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    • 2022
  • Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

Clinical Outcome of Emergency Coronary Artery Bypass Grafting after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 실패에 의해 발생한 응급환자의 임상경과)

  • Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.209-214
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    • 2007
  • Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

A Simple and Easy Method to Prevent Intravenous Fluid Heat Loss in Hypothermia (저체온 환자 치료에서 정맥주입 수액의 열손실을 막는 간단한 방법에 관한 고찰)

  • Lee, Sun Hwa;Choi, Yoon Hee;Lee, Dong Hoon
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.255-260
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    • 2013
  • Purpose: For the treat hypothermia patients, active warming might be needed. In most emergency departments, IV warm saline infusion is used for treatments. However, during IV warm saline infusion, heat loss from the warm saline may occur and aggravate hypothermia. Thus, in this study, we conducted an experiment on conserving heat loss from warm saline by using a simple method. Methods: Four insulation methods were used for this study. 1) wrapping the set tube for the administration of the IV fluid with a cotton bandage, 2) wrapping the set tube for the administration of the IV fluid with a cotton bandage with aluminum foil, 3) wrapping the warm saline bag and tube with a cotton bandage, and 4) wrapping the warm saline bag and tube with a cotton bandage with aluminum foil. Intravenous fluid was preheated to a temperature between $38-40^{\circ}C$. The temperatures of the saline bag temperature and the distal end of the IV administration set were measured every ten minutes for an hour. The infusion rate was 1000 cc/hr, and to obtain an accurate infusion rate, we used an infusion pump. Results: The mean initial temperature of the saline bag was $39.11^{\circ}C$. An hour later, the fluid temperature at the distal end of the fluid temperature ranged from $39.11^{\circ}C$ to $34.3^{\circ}C$. Without any insulation, the initial temperature of the pre-heated warm saline, $39^{\circ}$ had decreased to $34.8^{\circ}C$ after having been run through the 170-cm-long IV administration tube, and after 1-hour, the temperature was $29.63^{\circ}C$. As we expected, heat loss was prevented most by wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil. Conclusion: Wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil can prevent heat loss during IV infusion in Emergency departments.

Culture of the Olive Flounder, Paralichthys olivaceus in a Marine Recirculating System (해수 순환 여과 사육 시스템에서 넙치 사육 시험)

  • Bang, Jong-Deuk;Choi, Yong-Suk;Seo, Hyung-Chul
    • Journal of fish pathology
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    • v.18 no.1
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    • pp.91-97
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    • 2005
  • Bio-secure culture of olive flounder Paralichthys olivaceus in the IBK (Intensive Bioproduction Korean) recirculating system with dry pellet was tested for 6 months. The IBK system consists of 12 rearing tanks, 6 sedimentation tanks. 4-sectioned submerged biofilter chamber and channels. The size of each rearing tank was 3m in diameter and 1m in depth. The size of each biofilter chamber was $3.1\times3.3\times2.0$ m (D) and was filled with corrugated plastic plates as a biofilter medium. Total surface area of the biofilter was 3,789.7 $m^2$ Water was circulated by one of two vertical axial pump and circulating rate was about 34 times per day. A UV light sterilizer was used to treat inlet sea water with the flow rate of 4 ton/hr. All fish were treated with 150 ppm formalin 3 times with 5 day interval before stocking. It took 60 days for 'conditioning' the biofilter with the stocking density of 4.5 kg of fish $m^2$. The concentrations of ammonium-nitrogen, nitrite-nitrogen and nitrate-nitrogen in the system remained at the range of 0.096-0.315 mg/L, 0.015-0.504 mg/L, and 2.530-39.517 mg/L, respectively. Water temperature fluctuated from 17.5 to 25.1$^{\circ}C$ and salinity was from 30.1 to 33.5 ppt during rearing period. The fish grew from the average weight of 615.2 g to 1,201.1 g for 180 days. Initial and final fish densities were 8.4 and 15.9$kg/m^2$, Survival rate was 97.1 %. Neither parasites nor noticeable diseases was observed during the raring period even Vibrio spp. were detected from some fish in the system.