• Title/Summary/Keyword: 혈액호흡비

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Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

Design and Evaluation of a Lung Assist Device for Patients with Acute Respiratory Syndrome using Hollow Fiber Membranes (중공사 막을 이용한 급성호흡곤란증후군 환자용 폐 보조 장치의 설계와 평가)

  • Lee, Sam-Cheol;Kwon, O-Sung;Kim, Ho-Cheol;Hwang, Young-Sil;Lee, Hyun-Cheol
    • Membrane Journal
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    • v.15 no.3
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    • pp.224-232
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    • 2005
  • The use of the lung assist device (LAD) would be well suited for acute respiratory failure (ARF) patients, combining the simplicity of mechanical ventilation with the ability of extracoporeal membrane oxygenators (ECMO) to provide temporary relief for the natural lungs. This study's specific attention was focused on the effect of membrane vibration in the LAD. Quantitative experimental measurements were performed to evaluate the performance of the device, and to identify membrane vibration dependence on blood hemolysis. We tried to decide upon excited frequency band of limit hemolysis when blood hemolysis came to through a membrane vibration action. The excited frequency of the module type 5, consisted of 675 hollow fiber membranes, showed the maximum gas transfer rate. We concluded that the maximum oxygen transfer rate seemed to be caused by the occurrence of maximum amplitude and the transfer of vibration to hollow fiber membranes. It was excited up to $25{\pm}5$ Hz at each blood flow rate of module type 5. We found that this frequency became the 2nd mode resonance riequency of the flexible in blood flow. Blood hemolysis was low at the excited frequency of $25{\pm}5$ Hz. Therefore, we decided that limit hemolysis frequency of this LAD was $25{\pm}5$ Hz.

Changes of Minute Blood Flow in the Large Vessels during Orthostasis and Antiorthostasis, before and after Atropine Administration (체위변화가 두부 및 하지의 분시혈류량에 미치는 영향)

  • Park, Won-Kyun;Chae, E-Up
    • The Korean Journal of Physiology
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    • v.19 no.2
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    • pp.139-153
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    • 1985
  • The passive tilt has been performed to study the orthostasis on the cardiovascular system. The orthostasis due to upright tilt was demonstrated as follows: the venous return, cardiac output and systemic arteiral blood pressure were decreased, whereas there was concomitant increase of heart rate, through the negative feedback mediated by such as the baroreceptor . Previous investigators have suggested that the tolerance to the orthostasis could he increased by blocking the cholinergic fiber with atropine which prevented vasodilation and bradycardia through the vasovagal reflex during the orthostasis. However, this hypothesis has not been clearly understood. This study was attempted to clarify the effect of atropine on the tolerance of the cardiovascular system to the upright and head-down tilt, and to investigate the change of the blood flow through head and lower leg with Electromagnetic flowmeter in both tilts before and after atropine state. Fourteen anesthetized dogs of $10{\sim}14kg$ were examined by tilting from supine position to $+77^{\circ}$ upright position (orthostasis), and then to $-90^{\circ}$ head-down position (antiorthostasis) for 10 minutes on each test. And the same course was taken 20 minutes after intravenous administration of 0.5mg atropine. The measurements were made of the blood flow(ml/min.) on the carotid artery, external jugular vein, femoral artery and femoral vein. At the same time pH, $PCO_2$, $PO_2$ and hematocrit (Hct) of the arterial and venous blood, and heart rate(HR) and respiratory rate (RR) were measured. The measurements obtained from upright and head-down tilt were compared with those from supine position. The results obtained are as follows: In upright tilt, the blood flow both on the artery and the vein through head and lower leg were decreased, however the decrement of blood flow through the head was greater than the lower leg And the atropine attenuated the decrement of the blood flow on the carotid artery, but not on the vessels of the lower leg. HR was moderately increased in upright tilt, but slightly in head-down tilt. The percent change of HR after the atropine administration was smaller than that before the atropine state in both upright and head-down tilts. Before the atropine state, RR was decreased in upright tilt, whereas increased in head-down tilt. However after the atropine state, the percent change of RR was smaller than that of before the atropine state in both upright and head-down tilts. In upright tilt, venous $PCO_2$ was increased, but arterial $PO_2$ and venous $PO_2$ were slightly decreased. Hct was increased in both upright and head-down tilts. The findings of blood $PCO_2$, $PO_2$ and Hct were not interferred by the atropine. In conclusion, 1;he administration of atropine is somewhat effective on improving the cardiovascular tolerance to postural changes. Thus, atropine attenuates the severe diminution of the blood flow to the head during orthostasis, and also reduces the changes of HR and RR in both orthostasis and antiorthostasis.

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The Tissues and Blood Components of Opsariichthys uncirostris amurensis in the Muddy Water Area (탁수역에 서식하는 끄리의 조직과 혈액 성분의 변화)

  • Shin, Myung-Ja;Lee, Jong-Eun;Seo, Eul-Won
    • Journal of Life Science
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    • v.17 no.1 s.81
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    • pp.97-104
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    • 2007
  • Present study aims to investigate the effect of muddy water on gill and kidney tissues and blood components of Opsariichthys uncirostris amurensis in Imha reservoir. As a result of observing the gill tissues in muddy water with light and scanning electron microscopes, the edema, the exfoliation of epithelial cells and fusion of the secondary lamellae were observed. The space between gill lamellae was irregular, and a lots of muddy debris around the secondary lamellae were observed. In case of kidney tissues, the size of glomerulus was smaller and thickness of basal membrane was broader and the empty space in Bowman's capsule was wider than those of the control. The blood cells of O. uncirostris amurensis in muddy water were increased in number. Of the white blood cells, acidophilic granulocytes were highly distributed, and the shapes were irregular. Among the plasma components, the concentration of TP, ALB, A/G ratio, TG, CHOL, and AST were low, whereas that of the inorganic materials was high. Based on the above results, it is considered that muddy water possibly involves in the decrease of respiratory and excretory rates, giving rise to secondary lesion of tissues.

Factors Associated with Early Death in Patients with Community-Acquired Pneumonia (지역사회획득폐렴에서 조기 사망과 관련된 인자)

  • Park, Hun-Pyo;Seo, Yong-Woo;Lee, Jeong-Eun;Kim, Young-Ho;Jang, Young-Yun;Park, Soon-Hyo;Seo, Chang-Kyun;Jeon, Young-June;Lee, Mi-Young;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.607-613
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    • 2005
  • Background : Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. Methods : From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n = 30) were compared with those of an age and gender matched control population (n = 60). Results : In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p < 0.05 for all), while the arterial pH, systolic pressure, and $PaO_2$ were significant lower (p < 0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). Conclusion : The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.

A Study about Clinical Characteristics of Methicillin Resistant-Coagulase Negative Staphylococcus Infections in Neonatal Intensive Care Unit (신생아 중환자실에서 Methicillin Resistant-Coagulase Negative Staphylococcus 감염에 대한 임상적 고찰)

  • Yoon, Soon Hwa;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.112-120
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    • 2004
  • Purpose : Methicillin Resistant-Coagulase Negative Staphylococcus(MR-CNS) infection has become an increasingly important cause of morbidity in NICU infants. We investigated the c linical characteristics of MR-CNS sepsis. Methods : This study included 40 neonates with MR-CNS sepsis who were admitted to the neonatal intensive care unit of Kangnam Sacred Heart Hospital, Hallym University from January 1998 to July 2002. MR-CNS sepsis was defined as MR-CNS recovery from blood with clinical symptoms and signs of infection. Retrospective analyses of the medical records of patients with MR-CNS sepsis were performed. The analyses included demographic findings, clinical features, hospital courses, risk factors for infection including invasive procedures and mortality. Results : From 1998 to 2002, there were 40 cases of MR-CNS sepsis, comprising 17.7% of late onset infections in NICU of Kangnam Sacred Heart Hospital. The male/female ratio was 1.5 : 1. The mean gestational age of infected babies was $32.4{\pm}4.3$ weeks at birth. And the first positive MR-CNS culture was done in the day $10.6{\pm}9.3$ after birth. Clinical symptoms such as fever, dyspnea, cyanosis, grunting, bradycardia, vomiting and diarrhea were frequent in MR-CNS. Mechanical ventilation was applied in 12 cases and catheter was inserted in 11 cases. The mortality(12.5%) directly attributable to MR-CNS sepsis was similar to other late onset infections. Conclusion : MR-CNS is a pathogen responsible for most late onset and nosocomial infections. And it will be life-threatening in high-risk neonate. Awareness of increasing infections due to MR-CNS in NICU is important not only for infection control but also placing a great limit in use of antibiotics and invasive procedures, especially in premature infants.

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A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION (체질진단분류(體質診斷分類)에 따른 질병(疾病) 및 증상유형(症狀類型)에 관한 임상적(臨床的) 연구(硏究) II (문진표를 중심으로))

  • Kim, Young-woo;Kim, jing-weon
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.1
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    • pp.119-135
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    • 1999
  • The object of this study is 196 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 33 months from January 1996,3 to June 1998,11. We proceeded the judgment of Sasang Constitution by 'Questionnaire of Sasang Constitution Classification(I)' and 'Questionnaire of Sasang Constitution Classification II(QSCCII)'. The following conclusion were made in comparison with Sasang Constitution and Questionnaire about disease and style of symptoms. 1. The subject of "increase of the weight of a body(gain weight), sweatier, the body swelled out, a lame pain, more like fat food, more like salty food", has significant differences in sasang constitution classification. The frequency of Taeeum group is more than that of Soeum group and Soyang group. 2. The subject of "the complextion is bas, uncomfortable feeling in the throat, insomnia, loss of appetite, apt to be fatigued easily, gastralgia what is not connected with food, diarrhea, headache, menorrhalgia, less like fat food, more like fresh food", has significant differences in sasang constitution classification. The frequency of Soeum group is more than that of Taeeum group and Soyang group. 3. It has not significant differences, but the frequency of Soyang group is more than that of Taeeum group and Soeum group in the subject of "the cough in the disease of the respiratory organs, hypomotility of the joint in the disease of the musculo-skeletal systems, menoxenia like menorrhagia and menostaxia and itching sensation of genitals in the disease of the gynecological organs, itching or boil in the dermatological disease", and fewer in the cardio-vascular disease, urinary disease and hematic disease. The frequency of Soeum group is more than that of Taeeum group and Soyang group in the subject of "the general disease of the digestive organs, uncomfortable feeling or pain of the throat in the disease of the respiratory organs, the general hematic disease, numbness or pain of the musculo-skeletal disease, psychical disease in the psychoneurotical disease, menorrhalgia, a lump of the breasts, leukorrhea in the gynecological disease, eruption or urticaria in the dermatological disease, the general visual and auditory disease". The frequency of Taeeum group is more than that of Soyang group and Soeum group in the subject of "a hoarseness in the disease of the respiratory organs, A lame pain of the musculo-skeletal disease, neurotical disease in the psychoneurotical disease, eruption or urticaria in the dermatological disease", and fewer in the the gynecological disease.

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A Case of Atypical Pathogen Pneumonia, associated with Recurrent into Diffuse Pneumonic Consolidation (재발성 경과를 취한 비정형 병원균주 폐렴 환자 1예)

  • Oh, Jong-Kap
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.391-400
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    • 2011
  • Pneumonia is an infection of the lungs and respiratory system and can be classified by a variety of factors such as infectious agents, etiology, infection area, and other criteria. From a 46-year-old male, who was suspected of being infected with atypical pathogen pneumonia and underwent such tests as serological testing, examination of sputum, urine examination, parasite examination, bronchoscopy, needle biopsy and so on, no significant abnormality was found. This patient also showed no specific symptoms like auscultatory abnormalities, high fever, nonproductive cough, muscle stiffness, sputum production, dyspnea. Prescription of broad-spectrum oral antibiotics and ant-parasitic didn't seem to be effective against bacterial and atypical pathogen. The patient's condition alternately repeated between natural cure and recurrence. The average healing process during which scarring, nodule recurrence and disappearance on the lungs happened was about 20 days. Chest radiography and chest high resolution computerized tomographic scans(HRCT scan) was performed to depict parenchymal aberrations and demarcate the extent and distribution of atypical pathogen pneumonia. As a result, chest radiography did not show the specific symptoms, whereas areas of opacity (seen as white) which represent consolidation were revealed in chest HRCT scan. This indicates that only chest radiography is not that useful for early diagnosis of atypical pathogen pneumonia in patients, since it can't show exactly what the symptom is because of the barriers such as diaphragm, liver, and spine. Therefore, it is desirable that chest HRCT should be used in the diagnosis to compare with the results of chest radiography. Here, report with literature investigations the case of recurrent atypical pathogen pneumonia.

Successful Management of Feline Infectious Peritonitis with Human Recombinant Interferon-alpha and Pentoxifylline in a Cat (재조합 인간 인터페론 알파와 Pentoxifylline을 이용한 고양이 전염성 복막염의 치료 증례)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.4
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    • pp.427-430
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    • 2011
  • A 6-month-old intact female, domestic short hair cat was presented with dyspnea and anorexia for 2 days. Physical examination revealed muffled heart sound with labored breaths. Hyperproteinemia and hyperglobulinemia with polyclonal gammapathy was revealed. Pleural effusion was non-septic exudates, it also had hyperglobulinemia with decreased albumin: globuline ration. In addition, effusion RT-PCR for feline coronavirus was positive in this cat. Feline infectious peritonitis (FIP) was strongly suspected and aggressive treatments with human interferon-alpha, pentoxifylline, and glucocorticoids were initiated. The cat remained healthy without recurrence of pleural effusion during 5 months follow-up periods. To the author's knowledge, this is the first case report describing successful management of FIP with human interferon-alpha and pentoxifylline in Korea.

Medetomidine Sedation and Its Antagonism by Yohimbine in Dogs (개에서 Medetomidine 진정에 대한 Yohimbine의 길항작용)

  • Heo, Keong-Hee;Lee, Jae-Yeon;Choi, Kyeong-Ha;Cho, Jin-Haeng;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.343-347
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    • 2010
  • The purpose of this study was to determine the antagonistic effects of yohimbine on sedation induced in dogs with medetomidine. Six mixed breed dogs were repeatedly used at a 2 weeks withdrawal time in this study. The dogs received $40\;{\mu}g/kg$ of medetomidine followed 15 minutes later by 0.2 ml/kg saline solution (group M) or 0.11 mg/kg yohimbine (group MY). All the dogs were examined before and 5, 15, 30, 45, 60, 75, 90, 120 and 150 minutes after the injection of medetomidine, and the induction and recovery times, vital signs, blood biochemistry and anesthetic quality were recorded. There were significant differences in the recovery of anesthesia between the groups. In both groups the heart rate decreased rapidly down to five minutes after the administration of medetomidine. The activity of ALT, AST and the protein concentration did not change significantly in either group and there was no significant difference between them at any time. Response to noise, muscle tone and analgesic score in the MY group at 30 minutes were significantly lower than those of the M group. When recovering from anesthesia, the dogs treated with yohimbine took less time to achieve sternal recumbency and less time to be able to stand and walk. It was concluded that yohimbine reversed effectively medetomidine sedation in dogs.