Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.
Korea has relatively less crime than other countries. However, the crime rate is steadily increasing. Many people think the crime rate is decreasing, but the crime arrest rate has increased. The goal is to check the relationship between CCTV and the crime rate as a way to lower the crime rate, and to identify the correlation between areas without CCTV and areas without CCTV. If you see a crime that can happen at any time, I think you should use a random forest algorithm. We also plan to use machine learning random forest algorithms to reduce the risk of overfitting, reduce the required training time, and verify high-level accuracy. The goal is to identify the relationship between CCTV and crime occurrence by creating a crime prevention algorithm using machine learning random forest techniques. Assuming that no crime occurs without CCTV, it compares the crime rate between the areas where the most crimes occur and the areas where there are no crimes, and predicts areas where there are many crimes. The impact of CCTV on crime prevention and arrest can be interpreted as a comprehensive effect in part, and the purpose isto identify areas and frequency of frequent crimes by comparing the time and time without CCTV.
Purpose: This study measured return of spontaneous circulation (ROSC) in relation to dispatch distance in patients with out-of-hospital cardiac arrest. Methods: Of 2,347 out-of-hospital cardiac arrest patients transported by emergency medical technicians in J Province between January 1 and December 31, 2015, those under age 18, those with reserved resuscitation, and those with traumatic cardiac arrest, leaving 855 patients in the study sample. ROSC was compared between those with dispatch distance ${\leq}4km$ (short dispatch distance, 465 patients) and those with dispatch distance >4 km (long dispatch distance, 390 patients). Results: The mean was 2.17 km in the short dispatch group and 9.87 km in the long dispatch group (p=.000). Mean distance from was 6.49 km and 13.39 km in the two groups, respectively (p=.000). ROSC differed significantly between the short and long dispatch distance groups (7.1% for short dispatch distance, 3.6% for long dispatch distance, p=.025). The length of time from to cardiopulmonary resuscitation also differed significantly between the short and long dispatch distance groups (8.77 minutes and 14.63 minutes, respectively, p=.000). Conclusion: ROSC was lower in areas of long dispatch distance compared to those of short dispatch distance. We expect this was most likely due to differences in response time by age and dispatch distance to the scene of cardiac arrest. However, no significant differences were found between the groups in the factors affecting ROSC.
Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.
Purpose: There has been an increase in the number of prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population, We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrest. Methods: We studied 57 victims with prehospilal cardiac arrest by EMT's Reports form January to December, 2004. Results: Fifty-seven of 92 victims were trasported with ECG in prehospital cardiac arrest. Ventricular fibrillation(VF)/ ventricular tachycardia was 56.2%, asystole was 33,3%, and pulseless electrical activity(PEA.) was 10.5% in initial rhythm analysis, There weren't attempt CPR in 14.0%. Twenty of the 32(62.5%) were shocked by AED for the adequacy method. There were no statistical differences the transportation time. Conclusion: With the increase in cardiovascular disease and old age, the number out-of-hospital cardiac arrests has risen accordingly. However, there were lack of CPR by bystander, defibrillation, advanced cardiac life support(ACLS) in prehospital stage. To improve the adequancy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.
From January 1991 to January 1995, 11 patients with aortic diseases underwent various surgical repairs. The age at operation ranged from 26 years to 63 years[ mean=50.9 years . The disease entities included 8 aortic dissections[ type I in 4, type II in 2 and type III in 2 cases , 2 Marfan`s syndrome with annuloaortic ectasia and 1 desecending thoracic aortic aneurysm The operative procedures we tried were 3 Bentall`s operation, 5 graft replacement of ascending aorta, and 3 graft interposition in descending thoracic aorta.Overall hospital mortality rate is 36.3%[4/11 . And causes of death are pump weaning failure in 2 cases and multiorgan failure in 2 cases. It was that 2 sternal dehiscence & mediastinitis, 1 acute renal failure, 2 hypoxic brain damages and 2 postoperative psychosis were complicated. Recently we tried surgical repair of aortic dissection five out of 6 cases using total circulatory arrest with deep hypothermia at 14$^{\circ}C$. Total circulatory arrest time ranged from 18 to 26 minutes[ mean 22.2 minutes , and mean aortic cross-clamping time was 48.2 minutes. One of 5 patient died on the 7th postoperative day due to multiorgan failure. Mortality of patients with TCA was 20%[1/5 , and it of remainders was 50%[3/6 . Our result for surgical repair using total circulatory arrest with deep hypothermia is satisfactory on the basis of our clinical data.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
/
2019.05a
/
pp.525-527
/
2019
Cardiac arrest is a series of conditions occur when the heart is stopped, regardless of the cause. one of the only ways to save a patient's life in the event of cardiac arrest is cardiopulmonary resuscitation, which is very important beacause it can maintain circulation through this technique, and high-quality CPR affects the survival rate and neurological prognosis of the patient. For infant cardiopulmonary resuscitation, use two finger to compress the chest. Hower, this method can be diffcult to reach the chest commpressions recommended by the American Heart Association because of the anatomically increased fatigue of the fingers and diffculty of vertical pressure. The study aims to verify the effects of new chest compressions in the implementation of chest compressions during infant cardiopulmonary resuscitation. The study also showed singnificant differences in chest depth and average rate of pressure(p<0.001). Based on the results of this study, we can see that the accuracy of the new chest compressions during infant cardiopulmonary resuscitation is increased, and the depth of chest compressions is improved, improving the quality index of chest compressions.
Han Won-Jeong;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won
Imaging Science in Dentistry
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v.30
no.1
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pp.71-79
/
2000
Purpose : This study was aimed to evaluate the cell cycle arrest and apoptosis induction after irradiation and epidermal growth factor (EGF) treatment in three human epithelial tumor cell lines (A431, Siha, KB). Materials and Methods: Single irradiation of 2, 5 and 10 Gy was done on three cell lines with 5.38 Gy/min dose rate using Cs-137 irradiator at room temperature. Also, EGF of 10 ng/ml was added immediately after 10 Gy irradiation. Cell growth was evaluated by counting the living cell number using a hemocytometer at 1 day, 2 days, 3 days, 4 days and 5 days after irradiation. Cell cycle arrest and apoptosis induction were assayed with the flow cytometry at 8 hours, 12 hours, 1 day, 2 days, 3 days, 4 days and 5 days after irradiation. Results : Growth of irradiated three cell lines were inhibited in proportion to radiation dose. EGF treatment after irradiation showed various results according to cell lines. On all cell lines, G2 arrest was detected after 8 hours and maximized after 12 hours or 1 day. Amount of G2 arrest was positively dose dependent. However, EGF showed no significant change on G2 arrest. G2 arrest was recovered with time at 2 Gy and 5 Gy irradiation. However, at 10 Gy irradiation, G2 arrest was continued. Apoptosis was detected at 10 Gy irradiation. On EGF treated group after irradiation, A431 and Siha cell lines showed slightly increased apoptosis but there was no statistically significant difference. KB cell line showed no marked change of apoptosis induction. Conclusion : Irradiation effects on cell cycle arrest and apoptosis induction in three human epithelial tumor cell lines, however epidermal growth factor doesn't effect on.
The increasing use of cardioplegic solution for the reduction of ischemic tissue injury requires that all cardiplegic solution be carefully assessed for any protective or damaging properties. This study describes functional, enzymatic and structural assessment of the efficiency of three cardioplegic solutions (Young & GIK, Bretschneider, and $K^{+}$ Albumin solution) in a Modified Isolated Rat Heart Model of cardiopulmonary bypass and ischemic arrest. Isolated rat heart were subjected to a 2-minute period of coronary infusion with a cold cardioplegic or a noncardioplegic solution immediately before and also at the midpoint of a 60-minute period of hypothermic ($10{\pm}1$. C) ischemic cardiac arrest. The results of this study were as follow: 1. Spontaneous heart beat after ischemic arrest occured 16 seconds later after Langendorff reperfusion in the Young & GIK group (n=6), and 40 second later in the Bretschneider group (n=6) and 6 minute later in the $K^{+}$ Albumin group (n=6), and 16 minute later in the control group (non-cardioplegia). A good recovery state of spontaneous heart beat was shown in the Young & GIK and Bretschneider groups. 2. The percentage of recorveries of heart function at 30 minute after postischemic working heart perfusion were : heart rate $91.6{\pm}3.1$% (P<0.01)m oeaj airtuc oressyre $83{\pm}3$% (P<0.01), coronary flow $70{\pm}8$% (P<0.05) and aortic flow flow rate $39{\pm}9.3$% (P<0.05) in the Young & GIK group. This percentage of recoveries of the Young & GIK group was significantly greater than the control group. In the Bretschneider group, the percentage of recoveries were : heart rate $87.8{\pm}7.5$%(P<0.05), peak aortic pressure $71{\pm}2.3$% (P<0.05) and aortic flow rate $33.2{\pm}6.6$%(P<0.05). hte percentage of recoveries were significantly greater than in the control group. In the $K^{+}$ Albumin group, recoveries of heart function were poor. 3. Total CPK leakage was $131.2{\pm}12.75$IU/30 min/gm. dry weight in the control group, $50.65{\pm}12.75$IU in the Young & GIK gruop, $69.40{\pm}32.21$Iu in Bretschneider group, and $103.65{\pm}15.47$IU in the $K^{+}$ Albumin group during the 30 minute postischemic Langendorff reperfusion. Total CPK leakage was significantly less (P<0.001) in the Young & GIK group, than in the control group. 4. Direct correlatin between percentage recovery of aortic flow rate and total amount of CPK leakage from Myocardium was noticed.(Correlation Coefficient r = 0.76, P<0.001). 5. Mild perivascular edema was the only finding of light microscopic study of myocardium after 60 minute ischemic arrest with cold cardioplegic solutions and hypothermla.
The Increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter(group A, n: 10) or 15mMo1 per liter(group B, n: 10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas'Hospital solution) was infused for 2 minutes, and prepared within 4$^{\circ}C$ Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfuslon was reestablished after I hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, $\pm$ dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and flutamic oxaloacetic transaminase) were performed each other at whic rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, + dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P < 0.05). But, there were no signicant differences in the recovery rate of dp/dt max, and reperfunion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid (P > 0.05).
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