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Background : When local anesthetics for regional anesthesia is used, usually small amounts of bicar-bonate are added for rapid onset. This addition gives the mixed solution a more alkaline pH. The following result is an increased unionized form of the local anesthetic and rapid penetration of the drug into tiissue. Unfortunately, no data about adequate mixing volumes of domestic lidocaine and bicarbonate is available. Methods : We examined six mixing pairs of two kinds of 2% lidocaines and three kinds of 8.4% bicarbonates for minimum volumes of bicarbonate to cause a precipitation of 2% 20 ml lidocaine. Results : The mean volumes of bicarbonate to cause precipitation were 1.54 ml for Kwang-Myung lidocaine with Kwang-Myung bicarbonate, 2.90 ml for Kwang-Myung lidocaine with Dae-Won bicarbonate, 2.73 ml for Kwang-Myung lidocaine with Je-Il bicarbonate, 0.97 ml for Je-Il lidocaine with Kwang-Myung bicarbonate, 1.26ml for Je-Il lidocaine with Dae-Won bicarbonate and 1.39 ml for Je-Il lidocaine with Je-Il bicarbonate. Conclusions : We conclude that the Kwang-Myung lidocaine and the Je-Il lidocaine could cause precipitation when mixing with a smaller bicarbonate volume than foreign textbook recommended. (Korean J Anesthesiol 2000; 39: 726-729)
This study is a second paper of the re-structuring strategies of healthcare facilities in Kwang-ju and Jeon-nam province for it's competition power in the emerging global health care market. Kwang-Ju city and Jeon-nam province have had difficulties in building a balanced healthcare system because of rapidly declining population, weakened healthcare infra-structure and geographical problems of healthcare supply by numerous islands. This paper presents the new approaching process for re-building healthcare network in the regional healthcare facilities planning. In addition, it analyzes health planning index, healthcare system, the concept of health care networking, etc. Finally, this presents the case study of regional healthcare facilities planning in Kwang-ju city and Jeon-nam Prtvince.
This study aims to present the re-structuring strategies of healthcare facilities in Kwang-ju and Jon-nam province for it's competition power in the emerging global health care market. Kwang-Ju city and Jon-nam province have had difficulties in building a balanced healthcare system because of rapidly declining population, weakened healthcare intra-structure and geographical problems of healthcare supply by numerous islands. Now, Kwang-Ju city and Jon-nam province try to be a core place of economy and culture in the west-south asia. To do so, it is fundamentally necessary to reform their current social structure including healthcare system in large scale. This Study presents the current conditions and the problems of healthcare environment in these areas.
서광석 ( Kwang Suk Seo ), 김정수 ( Jung Soo Kim ), 안원식 ( Won Sik Ahn ), 박광석 ( Kwang Suk Park ), 김현정 ( Hyun Jeong Kim ), 염광원 ( Kwang Won Yum ), 구의경 ( Eui Kyoung Goo ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
Background: The amplitude (AMP) of Photoplethysmogram (PPG) is used as a marker of vasodilatation. The pulse transit time (PTT), which shows a good correlation with blood pressure (BP), is not strong enough to detect the changes in BP. This study examined the sensitivity of the combined effect of the finger and toe AMP, and the PTT of PPG as a marker of the changes in BP during general anesthesia. Methods: Forty patients receiving maxillofacial surgery under general anesthesia were enrolled in this study. During surgery, the intra-arterial BP, ECG, finger and toe PPG signals were measured. Using the R-wave from the ECG, the AMP and PTT was derived from PPG data. The correlation between BP and PPG parameters (AMP and PTT) were compared. New parameters that show high correlation with the BP were found. Regression equations for calculating the BP using the PPG parameters were formulated. Results: The new parameter, log (fingerAMP/toeAMP), showed the highest correlation in each patient (mean correlation coefficient in the systolic BP: -0.846, diastolic BP: -0.858). However, when the data from all 40 patients were combined, the correlation coefficient of the toe PTT was highest (systolic BP: -0.726, diastolic BP: -0.646). The regression equation showed the highest correlation between the actual BP and calculated BP when the toe PTT and log (fingerAMP/toeAMP) were included. Conclusions: The AMP of the toe and finger PPG can be used to estimate the invasive continuous blood pressure. (Korean J Anesthesiol 2007; 53: 159~68)