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Young Lan Kwak Korean Society of Critical Care Medicine 1997 Acute and Critical Care Vol.12 No.1
No abstract available.
Choi, Lan,Kwak, Min Young,Kwak, Eun Hwa,Kim, Dong Hyun,Han, Eun Young,Roh, Taehyun,Bae, Jung Yun,Ahn, Il Young,Jung, Jea Yeon,Kwon, Mi Jung,Jang, Dong Eun,Lim, Seong Kwang,Kwack, Seung Jun,Han, Soon Y Taylor Francis 2010 Journal of toxicology and environmental health. Pa Vol.73 No.21
<P>Acute nephrotoxicities of melamine (MEL), cyanuric acid (CA), and a mixture of both melamine and cyanuric acid (MC) were comparatively investigated in male Sprague-Dawley rats at 5 doses each with 10-fold dose interval as follows: MEL at 0.0315, 0.315, 3.15, 31.5, and 315 mg/kg; CA at 0.025, 0.25, 2.5, 25, and 250 mg/kg, and MC: [1×: (0.0315 + 0.025), 10×: (0.315 + 0.25), 100×: (3.15 + 2.5), 1000×: (31.5 + 25), and (315 + 250) mg/kg]. No marked adverse effects in renal function were observed in animals treated with MEL alone or CA alone, but evidence related to nephrotoxicity was noted in rats administered MC. Renal calculi and increased kidney weights were found in rats 7 d after daily oral administration of MC. Blood urea nitrogen (BUN) and creatinine were significantly elevated in the high dose MC groups at 100× or 1000×. In addition, elevated numbers of white blood cells (WBC), neutrophils, and lymphocytes in vivo and increased levels of prostaglandin E(2) (PGE(2)) in vitro were found in the MC group. Based on these data, the NOAEL (no-observed-adverse-effect level) for nephrotoxicity for MC was estimated to be 3.15 mg/kg body weight (bw)/d (MEL) plus 2.5 mg/kg bw/d (CA). If a safety factor of 1000 or more were applied to NOAEL, tolerable daily intake (TDI) would be 0.00315 and 0.0025 mg/kg/d or less for MEL and CA, respectively, which is far below the TDI of 0.2 mg/kg/d set by World Health Organization (WHO). In addition, in vitro cytotoxicity assays showed that the ACHN human renal adenocarcinoma cell line was more sensitive to MEL, CA, and MC than the MDCK canine kidney epithelial cell line. The 24-h half maximal inhibitory concentration (IC(50)) values for MEL (4792, 2792 관g/ml) were less than those of CA (9890, 6725 관g/ml, respectively) in MDCK and ACHN cell lines, suggesting that MEL may be more cytotoxic than CA. Furthermore, the 24-h IC(50) value for MC was found to be 208 관g/ml in ACHN cells. Data suggest that NOAELs based upon acute nephrotoxic parameters for MC were low, which might require further reassessment of the current TDI.</P>
Ji Young Kim,Young Lan Kwak,Wol Sun Jung,Dong Chul Lee,Jung Ju Choi,Hyun Jeong Kwak 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Background: Among various measures to prevent deep venous thrombosis (DVT) in surgical patients, intermittent pneumatic compression of the legs is known to be effective without increasing the risk of bleeding. In this study, the coagulation/ fibrinolysis profile in patients undergoing gastrectomy with SCD Response Compression System, which detects individual venous refill time, was compared to that with elastic stocking using thromboelastography (TEG). Methods: Fifty-eight ASA class I-II patients undergoing gastrectomy were randomized into two groups. Patients in ES group (n = 29) were treated with elastic stocking and patients in SCD group (n = 29) were treated with SCD Response Compression System. TEG analysis and traditional coagulation tests were performed on arrival in the operating room, after surgery in the postanesthetic care unit and on the morning of postoperative day 1. Results: There was no significant difference in laboratory data between the two groups. Laboratory data at all time points were within normal limit in all patients. There was no significant difference in TEG data between the two groups. No evidence of a postoperative clinical coagulopathy (DVT or pulmonary embolism) was observed on routine history and physical examinations in any patient during hospitalization. Conclusions: The effectiveness of SCD Response Compression System in patients undergoing major abdominal surgery on coagulation/fibrinolysis system was similar to that of elastic stocking during perioperative period. (Korean J Anesthesiol 2007; 53: S 1∼6)
중환자실 입원환자 가족의 스트레스, 사회적 지지 및 대처에 관한 연구
김은성,박영우,김경애,김정연,이은숙,윤혜영,이현심,곽혜경,윤차영,주유란,최진영,유지수 병원간호사회 2007 임상간호연구 Vol.13 No.3
Purpose: This study was aimed to investigate stress, social supports, stress coping, and the relationships between the factors among the family member of the patients in ICU. Method: The subject of this study was 100 family members who were primary caregivers of the patients in medical, surgical, and neurosurgical ICU in a general hospital in Seoul. The data was collected between May 3, and August 20, 2007 using a structured questionnaire. Result: The mean score of the family stress was 4.29 out of 5. There was a significant difference on the stress level depending on having or not surgical operation (p=.021). The mean score of the family's coping was 3.05. The family's social support was significantly correlated to income (p=.0001), health (p=.002), and care giver's degree of education. This study revealed that there was a significant positive correlation between family's stress and coping (p=.000) and between coping and social support (p=.000). Conclusion: The stress level of the ICU patients' family was assessed high. So nursing intervention needs to be developed for reducing their stress, improving their coping, making the best use of the social support.
체외순환 없는 관상동맥우회술 시행시 심장 고정기의 부착과 거상에 의한 혈역학적 변화
정성미,곽수달,신혜란,곽현주,최미영,곽영란 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5
Background: Coronary artery bypass grafting without cardiopulmonary bypass (Off-Pump Coronary Artery Bypass Grafting, OPCAB) causes significant hemodynamic derangement by displacement of the beating heart. The purpose of this study was to analyze the hemodynamic changes caused in relation to grafted arteries by displacing the heart and stabilizing the coronaty arteries in patients undergoing OPCAB. Methods: Nineteen patients underwent OPCSB using two deep pericardial sutures and tissue stabilizers (Octopus Tissue Stabilization Syetem, Medtronic, USA). The hemodynamic variables were obtained after induction of anesthesia, after deep pericardial sutures, before and after anastomosis of each coronary artery during epicardial stabilizing, after sternal closure, and after postoperative 6 hours and 12 hours in the intensive care unit. Results: The hemodynamic variables were maintained with the Trendelenburg position, volume loading and low dose vasopressors after deep pericardial stay sutures. Displacement of the heart and placement of the stabilizer on all coronary territories except the obtuse marginal artery before anastomosis showed no significant difference in hemodynamics compared with baseline. Positioning for the graft to the obtuse marginal artery decreased cardiac index (1.6 ± 0.4 L/min/m^2) and stroke index (27.6 ± 9.9 L/beat/m^2) and increased systemic vascular resistance (2318.9 ± 673.7 dyne·sec·cm^-5), resulting in gemodynamic compromise (P < 0.01). There were no significant hemodynamic and electrocardiographic changes before of after grafting of other coronary arteries but there was a significant increase in cardiac index after postoperative 6 and 12 hours compared with baseline values (P < 0.05). Conclusions: Although the complete revascularization of most coronary arteries is feasible on the beating heart without significant hemodynamic compromise with minimal vasopressor support, the positioning for the graft to the obtuse marginal artery needs special attention because two deep pericardial stay sutures and Octopus tissue stabilizers on the obtuse marginal artery territory induce significant hemodynamic disturbances. (Korean J Anesthesiol 2002; 43: 611~618)
공동조리 학교급식의 미생물적 품질보증을 위한 위험요인 분석
곽동경,김성희,서소영,최은희,남순란,김정리,박신정 한국조리과학회 1995 한국식품조리과학회지 Vol.11 No.3
6 Central commissary and 2 conventional school foodservice operations were assessed in terms of time-temperature relationship and microbiological quality, and monitoring control methods were identified through hazard analysis during the phases of prodution and distribution. 2 conventional schools from Seoul and 6 commissary schools from Kyungkido were participated in the survey. Meals produced in central commissary were distributed to satellites, therefore delivery practices of foods were identified as critical. Microbiological test results for commissary and conventional schools revealed that microbiological quality of foods was mainly related to time-temperature management, types of food, and equipment sanitation not to the foodservice system used. Time-temperature profiles at temperature danger zone (7.2∼60℃) observed were to be related to the following sanitary practices: cooked vegetables were held at temperature danger zone for relatively longer delayed time (15-38℃: 15-226 min, 7-60℃: 75-226 min), and same results were observed for deep-fat fried cutlets (15-38℃: 15-151 min, 7-60℃: 33-151 min). Menu items with various ingredients and frequent contacts with hands and equipments during the production flow were held at temperature danger zone for longer delaying time than other menu items with brief prodution stages. Based on hazard analysis critical control points, microbiological quality was collectively affected by time-temperature relationships, equipment sanitation, proper cooking methods, and sanitary management competencies of dietitians. Microbiological test results of working equipments and surface of dishes and trays showed that immediate action should be taken. Cutting boards used in central kitchen were also showed similar results of potential dager of cross-contamination. Effective sanitary control methods were urgently needed.