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Short-term Mechanical Circulatory Support with Centrifugal Pump in Cardiac Arrest or Cardiogenic Shock - Report of 5 cases- (심정지 혹은 심인성 쇼크에서 원심성 펌프를 이용한 단기목표의 기계적 순환 보조)

  • 양희철;성기익;뱍계현;전태국;박표원;양지혁;이영탁
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1003-1009
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    • 2004
  • Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

Radiologic Findings of Cervical Mass Type Cervical Pregnancy (자궁경부 종괴형 자궁경부임신의 영상 소견)

  • Cho, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.43-51
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    • 2005
  • Background: To examine the ultrasonographic and magnetic resonance (MRI) imaging findings of a cervical mass type cervical pregnancy. Materials and Methods: The ultrasonographic and MRI findings of 5 patients pathologically confirmed as having a cervical pregnancy were analyzed retrospectively. On ultrasonography, the size and echo pattern of the uterine cervix, the shape and echo pattern of the lesion, the degree and the pattern of blood flow on the color Doppler study and the spectral Doppler pattern were analyzed. The shape, signal intensity, and degree and pattern of enhancement of the lesion were evaluated on MRI. Results: The uterine cervix was enlarged and the size of the lesion was 6.1 to 7.1 (average, 6.5) cm. The endocervical canal was irregularly dilated and showed heterogeneous echogenicity in all 5 cases. Four of the 5 lesions were heterogeneously hyper- or mixed echoic and remaining one was relatively homogeneous echogenic. Doppler ultrasonography revealed an increased vascularity of the peritrophoblastic flow pattern. In all 4 cases where MRI performed, the lesion was irregular in shape and the margin was not sharply demarcated. The T2-weighed image showed that the lesions were mixed signal intensity. Three of the 4 lesions contained high signal intensity nodular portions and a low signal intensity rim was observed along the margin of the nodular portions. The T1-weighted image revealed multiple signal voids along the periphery of the lesions and high signal intensity portions as a result of hemorrhage were noted. The dynamic enhanced study showed that the high signal intensity portions on the T2-weighted image were strongly enhanced similar to the vessels on the early phase and the contrast enhancement gradually decreased with time. Conclusion: A cervical mass type cervical pregnancy can be correctly diagnosed using the patient's clinical symptom, the elevation in the serum ${\beta}$-HCG level, and characteristic ultrasonographic and MRI findings.

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Agents Used for Pediatric Dental Sedation (소아치과 진정법에 사용되는 약제)

  • Kim, Jiyeon;Jeong, Taesung;Yang, Yeonmi;Yoo, Seunghoon;Choi, Sungchul;Shin, Teojeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.109-116
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    • 2016
  • Sedation is an indispensable part of contemporary pediatric dentistry. The Korean Academy of Pediatric Dentistry (KAPD) organized the dental sedation committee to help members perform safer and more effective sedation. The committee surveyed 111 members who practice dental sedation to figure out the present state of sedation in 2014. According to the survey, 86% of the respondents indicated that they were interested in continuing education of sedation. The most interesting topic was sedation related emergency management, followed by safe dosages of sedative drugs. However, it is not realistic to establish the recommended dosages as a guideline since the selection of agents and dosages depend on various factors. In order to provide successful sedation, pediatric dentist should make an individual sedation plan for each procedure. It is important to understand not only the properties of each sedative, but also interactions with other drugs. This article reviews useful information of commonly used agents for dental sedation and summarizes the recommended dosages from the Physicians' Desk Reference (PDR) and some famous pediatric dentistry textbooks.

A Study on Epidemiology of Drowning Accidents associated with Recreational Aquatic Activity (여가 수중활동과 관련된 익사사고의 역학 분석 연구)

  • Son, Jae-Young;Ko, Wi-Sug;Cho, Byung-Jun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5060-5065
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    • 2012
  • The purpose of this study was to report the incidence of drowning accident in order to prevent and decrease the accidents of drowning. Data were obtained on all accidents of drowning accidents occurred from January to December 2007 were identified by using the Emergency Activity Daily Report Data from the National Emergency Management Agency (NEMA). The age, weather, date, location, time and case of the drowning accident were examined. The Chi-square test was used to compare each group. All comparisons were made at the p<0.05 level of significance. The result show that the age of drowning accidents for victims aged 20-29 was 27.9%, and for victims aged 30-39 years, 18.7%. In reguard to the age group, drowning accidents during recreational aquatic activity was age 20-39; 51(44.8%). In reguard to the locations, the number of drowning accidents in a lake or reservoir during recreational aquatic activity was 62(53.4%). The number of drowning accidents in a lake or reservoir during etc was 51(58%). In reguard to the days, the number of drowning accidents on Saturday during recreational aquatic activity was 30(25.8%), on Sunday 32(27.6%). The weather of drowning accidents during recreational aquatic activity was sunny 60(51.8%), rainy 40(34.4%), cloudy 16(13.8%). The season of drowning accidents during recreational aquatic activity was summer 53(45.7%). In reguard to season, two groups are significantly different. Drowning is a leading cause of injury related accidents. Understanding the characteristics of drowning is the first step to developing prevention strategies that may be beneficial for people of all ages and under nearly all circumstances are increased swimming ability, lifeguard staffing, providing life jackets, and public education activities.

An Efficient m-Healthcare Service Model using RFID Technique (RFID 기술을 이용한 효율적인 m-헬스케어 서비스 모델)

  • Jeong, Yoon-Su;Kim, Yong-Tae;Park, Gil-Cheol
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.149-156
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    • 2015
  • Due to a change of food culture, many patients suffering from various diseases such as hypertension, heart disease, stroke, cancer. However, it takes a long time in the hospital for many patients due to the administration before the patient care process. In this paper, we propose a m-Healthcare service model that patients can receive medical services without the inconvenience offers by reducing the administrative hospital treatment that can automatically recognize through the hospital installed RFID readers when the patient patients with various diseases are foreign to the hospital. In particular, the proposed model improves the operational efficiency of the existing healthcare system by shortening the treatment time for medical personnel to help patients in emergency situations can determine automatically the patient's status does not give the disease type and condition of the patient to health care personnel. Test results, service latency, efficiency, etc. patient satisfaction, and evaluate the existing health care system model results, the proposed method was improved service delay existing techniques average 16.5% efficiency was higher 27% of patients service satisfaction was improved by 22.4% on average.

Influence of Educational Experience and Attitude toward Performance Confidence of Cardiopulmonary Resuscitation in Care Helpers (요양보호사들의 심폐소생술 교육경험과 태도가 수행자신감에 미치는 영향)

  • Yoon, Susie;Seo, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.281-289
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    • 2017
  • This study was conducted to evaluate the influence of educational experience and attitude toward performance confidence of cardiopulmonary resuscitation amongcare helpers. This study was conducted using a descriptive survey design. Participants were 140 care helpers in C-province. Data were collected from February to April, 2017 using self-report questionnaires andthe collected data were analyzed using the SPSS WIN 20.0 program. Differences amongstudy variables by participants' characteristics were analyzed by a t-test, ANOVA, and Scheffe' test. Correlations between attitudes and confidence of CPR performance by Pearson's correlation coefficients. Factors influencing confidence in CPR were analyzed by Multiple regression. There were significant positive correlations between attitude and confidence in CPR(r=0.41, p<0.001). The result showed that the more than fourhours of education(${\beta}=0.28$) and a positive attitude toward CPR increased CPR performance confidence. Based on the present findings, CPR education should be included continuously in the workplace and developed to appropriately cope with cardiac arrest emergency situations in care facilitiesfor elderly people. Therefore, customized CPR education programs should be developed care helpers and included in job training and refresher education courses for care helpers.

The Study on Cardiopulmonary Resuscitation(CPR) Willingness to Perform and Confidence according to Converged Job Experience of School Health Teacher (보건교사의 융합적 직무경험에 따른 심폐소생술 수행 의지 및 자신감 연구)

  • Park, Yeon-Suk
    • Journal of the Korea Convergence Society
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    • v.8 no.2
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    • pp.137-147
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    • 2017
  • The purpose of this study is to analyze the difference about cardiopulmonary resuscitation(CPR) willingness to perform and confidence according to job experience of school health teacher. Measuring tools consist of general and job experience characteristics, cardiopulmonary resuscitation willingness to perform and confidence. The results of this study were as follows. Difference of willingness to perform CPR according to job experience of participants have a significant differences in teaching experience career (${\chi}^2=15.991$, p=.000), clinical nursing experience(${\chi}^2=13.808$, p=.003), if you meet someone who meets cardiac arrest(${\chi}^2=8.455$, p=.004). Difference of CPR performance confidence according to job experience of participants have a significant differences in religion(${\chi}^2=18.994$, p=.025), the working school system(p=.000), teaching experience career(.003), number of educated CPR (p=.000), if you meet someone who meets cardiac arrest(p=.036).

SURGICAL REPAIR OF COMPLETE BONY BILATERAL CHOANAL ATRESIA VIA TRANSPALATAL APPROACH (완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례)

  • Kim, Kyoung-Won;Cho, Yong-Seok;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.133-138
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    • 1998
  • Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

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POSTSEDATION EVENTS IN PEDIATRIC PATIENTS SEDATED FOR DENTAL TREATMENT (진정법을 이용한 치과 치료 시 소아 환자의 진정 후 반응에 대한 연구)

  • Koo, Jung-Eun;Baek, Kwang-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.209-216
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    • 2009
  • The purpose of this retrospective study was to examine twenty four hour postsedation events after discharge in children sedated for dental treatment. The sedation sheets of 355 children were selected. Selection criteria excluded no midazolam or nasal route of midazolam, no ASA class I, absent or incomplete questionnaire. Children received orally chloral hydrate and hydroxyzine, nitrous oxide was maintained during the sedation. Midazolam was injected to buccal submucosa with titration. Parents were interviewed via telephone within twenty four hours after sedation. Questionnaire included sleeping response, sleeping time, sleeping behavior, vomiting response at home. Two hundred twenty four (67.8%) children slept and twenty one(6.3%) children had abnormal sleeping behavior. One hundred four(31.0%) children had abnormal behavior after sleep and ten(3.0%) children had vomiting response. In the children took the higher dose of midazolam, there were the great tendency to sleep after discharge (p<0.05), the more negative response to sleeping behavior(p = 0.055), the longer sleeping time(p=0.054). In this study many children slept after sedation and a few children showed negative response. However there were not any considerable emergency events. Further study is required to determine the postsedation safety for the use of submucosal midazolam combination with chloral hydrate and hydroxyzine.

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Retrospective Study of Traumatic Dental Injuries among Children Aged 0 - 15 Years in Wonju (원주세브란스기독병원 응급실로 내원한 0 - 15세 어린이의 치과적 외상에 관한 후향적 분석)

  • Bae, Doo-Hwan;Kim, Ji-Hun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.64-71
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    • 2017
  • This study was designed to evaluate the age, gender, location of trauma, etiology, injury site, types of treatment, elapsed time after trauma, and arrival time of children who visited trauma center of Wonju Severance Christian Hospital. Records of a total of 841 patients who were 0 - 15 years old and received care in the period from March 2011 to October 2015 at the Trauma Center, Wonju Severance Christian Hospital were analyzed. This study showed that traumatic dental injuries were more common in boys and patients between 0 - 3 years old. Under 6 years old, fall was the most common etiology and home was the most common place of trauma. However, fall decreased, and sports and etc increased largely in etiologic factors over 6 years old. Besides, home decreased, and road and kindergarten school increased largely in the place of trauma. Etiology and location of trauma were statistically influenced by the age (p < 0.05). The most commonly affected injury sites were maxillary incisors and lips. The most patients visited trauma center between 18 - 24 o'clock (53.3%), and the least patients visited between 0 - 6 o'clock (4.6%). 51.5% of patients visited the trauma center within 1 hour of sustaining trauma, and 26.8% and 11.5% of patients visited between 1 - 2 hours and 2 - 3 hours respectively. The most common treatment of traumatic dental injuries was observation, and the second most common treatment was suture. Traumatic dental injuries in children exhibit specific epidemiological features according to children's gender, age, and other conditions. These result from combination of social, developmental, and physiologic factors.