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극단 저체중 신생아에서의 동맥관 개존증 결찰술을 위한 진정맥 마취 경험 2례
최영균,고명진,이상은,조광래,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-
Running title: Cases of anesthesia for extremely low birth weight infant. Extremely low birth weight infants (birth weight < 1000 g) are prone to various morbidities such as respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, patent ductus arteriosus, necrotizing enterocolitis and retinopathy. To accomplish successful anesthetic management, many precautions must be continuously taken during the operation. First, inspired oxygen concentration should be adjusted to avoid oxygen toxicity. Second, body temperature must be maintained adequately. Third, hemodynamic parameters should be kept stable. We report 2 cases of successful anesthetic management for extremely low birth weight infant who underwent ligation of patent ductus arteriosus at the neonatal intensive care unit.
Ko, Tae-Jun,Kim, Eunkyung,Nagashima, So,Oh, Kyu Hwan,Lee, Kwang-Ryeol,Kim, Soyoun,Moon, Myoung-Woon The Royal Society of Chemistry 2013 Soft matter Vol.9 No.36
<P>The control of cancer cell adhesion behavior on certain surfaces has been widely studied in recent years to enhance cell adhesion, which is required for bio-sensing, implant biomaterials, or to prevent infections from bacteria or germs. In addition, it helps to preserve the original functions of medical devices such as implants, catheters, injection syringes, and vascular stents. In this study, we explored the behavior of mouse liver cancer cells on nanostructured surfaces in extreme wetting conditions of a superhydrophobic or superhydrophilic nature. Oxygen plasma treatment of polymeric surfaces induced the formation of nanostructures such as bumps or hairs with various aspect ratios, which is defined as the height to diameter ratio. A superhydrophobic surface with a contact angle (CA) of 161.1° was obtained through the hydrophobic coating of a nanostructured surface with a high aspect ratio of 25.8. On the other hand, an opposite extreme wetting surface with a superhydrophilic nature with a CA of 1.7° was obtained through the hydrophilic coating of the same structured surface. The mouse liver cancer cells significantly proliferated on a mild hydrophilic surface with a low aspect ratio nanostructure due to the mild roughness and improvements of mechanical anchoring. However, the superhydrophilic surface with a high aspect ratio nanostructure (<I>i.e.</I>, hair shaped) suppressed the growth of the cancer cells due to the limited number of sites for focal adhesion, which restricted the adhesion of cancer cells and resulted in a decrease in the cell-covered area. The superhydrophobic nanostructured surface with a high aspect ratio further restricted the adhesion and growth of the cancer cells; the cell activity was extremely suppressed and the spherical shape of the cancer cells was maintained. Thus, this simple method for fabricating nanostructured surfaces with various wetting conditions might be useful for producing biomedical devices such as stents, implants, drug delivery devices, and detection and/or sensing devices for cancer cells.</P> <P>Graphic Abstract</P><P>The cancer cell adhesion behavior on the superhydrophobic or superhydrophilic surfaces has been explored to enhance cell adhesion required for bio-sensing, implant, biomaterials, or to prevent infections from bacteria or germs. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c3sm51147b'> </P>
Ko Ryoung-Eun,Kwon Oyeon,Cho Kyung-Jae,Lee Yeon Joo,Kwon Joon-myoung,Park Jinsik,Kim Jung Soo,Kim Ah Jin,Jo You Hwan,Lee Yeha,Jeon Kyeongman 대한의학회 2022 Journal of Korean medical science Vol.37 No.16
Background: The quick sequential organ failure assessment (qSOFA) score is suggested to use for screening patients with a high risk of clinical deterioration in the general wards, which could simply be regarded as a general early warning score. However, comparison of unselected admissions to highlight the benefits of introducing qSOFA in hospitals already using Modified Early Warning Score (MEWS) remains unclear. We sought to compare qSOFA with MEWS for predicting clinical deterioration in general ward patients regardless of suspected infection. Methods: The predictive performance of qSOFA and MEWS for in-hospital cardiac arrest (IHCA) or unexpected intensive care unit (ICU) transfer was compared with the areas under the receiver operating characteristic curve (AUC) analysis using the databases of vital signs collected from consecutive hospitalized adult patients over 12 months in five participating hospitals in Korea. Results: Of 173,057 hospitalized patients included for analysis, 668 (0.39%) experienced the composite outcome. The discrimination for the composite outcome for MEWS (AUC, 0.777; 95% confidence interval [CI], 0.770–0.781) was higher than that for qSOFA (AUC, 0.684; 95% CI, 0.676–0.686; P < 0.001). In addition, MEWS was better for prediction of IHCA (AUC, 0.792; 95% CI, 0.781–0.795 vs. AUC, 0.640; 95% CI, 0.625–0.645; P < 0.001) and unexpected ICU transfer (AUC, 0.767; 95% CI, 0.760–0.773 vs. AUC, 0.716; 95% CI, 0.707–0.718; P < 0.001) than qSOFA. Using the MEWS at a cutoff of ≥ 5 would correctly reclassify 3.7% of patients from qSOFA score ≥ 2. Most patients met MEWS ≥ 5 criteria 13 hours before the composite outcome compared with 11 hours for qSOFA score ≥ 2. Conclusion: MEWS is more accurate that qSOFA score for predicting IHCA or unexpected ICU transfer in patients outside the ICU. Our study suggests that qSOFA should not replace MEWS for identifying patients in the general wards at risk of poor outcome.