The purpose of the present study was to explore the most effective body region and cooling temperature to alleviate heat strain of workers in hot environments. We developed liquid cooling hood, vest, sleeves and socks and applied the water temperatures of 10, 15, 20, and 25℃ through the liquid cooling garments in a hot and humid environment (33℃ air temperature and 70% RH air humidity). A healthy young male participated in a total of 16 experimental trials (four cooling garments × four cooling temperatures) with the following protocol: 10-min rest, 40-min exercise on a treadmill and 10-min recovery. The results showed that rectal temperature, mean skin temperature, and ratings of perceived exertion during exercise; heart rate and diastolic blood pressure during recovery; and total sweat rate were lower for the vest condition than other garment conditions(p < .05). However, there was no differences in mean skin temperature among the four cooling garments when we compared the values converted by covering area(%BSA). When we classified the results by cooling temperature, there were no consistent differences in thermoregulatory and cardiovascular responses among the four temperatures, but 25℃ water temperature was evaluated as being the most ineffective cooling temperature in terms of subjective responses. In conclusion, the results indicated that wearing cooling vest with < 20℃ cooling temperature can alleviate heat strain of workers in hot and humid environments. If the peripheral body regions are cooled with liquid cooling garments, larger cooling area with lower cooling temperature than 10℃ would be effective to reduce heat strain of workers. Further studies with a vaild number of subjects are required.
The treatment of wounds of the lower extremity caused by diabetes or vascular dysfunction remains a difficult problem for the plastic surgeon. The use of negative pressure in wound healing is a relatively new method to facilitate chronic wound healing by secondary healing. The use of vacuum-assisted closure(VAC) system is purposed to reduce local edema, increase regional blood flow, enhance epithelial migration, preserve a moist wound environment, reduce bacterial colonization, promote granulation tissue formation, and mechanically enhance wound closure. The VAC also can be used as a dressing for anchoring an applied split thickness skin graft. We reviewed the data from 20 consecutive patients with non-healing wound in lower extremity at Dong-A University from March 2002 to December 2004. We used the VAC in 20 patients and compared the results with the control group. In the VAC using group, mean application duration was about 3 weeks and dressing change was done every other day. The follow-up period of patients ranged from 3 months to 30 months with a mean of 17 months. The points of comparison with control group are wound size, granulation tissue proliferation rate, operation method, preoperative time, postoperative healing time, complication, and cost. With those points, we propose to approve the efficiency of the VAC in non-healing wound. As a result, the VAC used in non-healing wound decrease wound size, accelerate granulation tissue formation, do a wound closure with less invasive operation method, make less postoperative complication, can make operation time shorter. Therefore it is cost effect. Our results demonstrate the usefulness of VAC as an adjunct in management of chronic wounds with other extrinsic factors.
Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.
Purpose: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). Methods: Forty seven patients with CHF (males 33, females 14, age $61.3{\pm}9.8years$) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. Results: The NHE group significantly showed lower peak $VO_2$ and a higher $VE/VCO_2$ slope than the MIHE (p<0.05) and HIHE (p<0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. Conclusion: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.
Purpose: Numerous studies have investigated the pattern of traumatic death with a focus on the injury mechanism, the severity of the injury and the presence of hemorrhage. Acute coagulopathy has been treated as only one of many complications. The purpose of this study was to investigate the influence of acute coagulopathy on acute and early death due to trauma. Methods: A retrospective analysis of trauma patients with injury severity score (ISS)${\geq}25$ who had been treated between January 2011 and December 2012 was conducted. Based on the time of injury, traumatic death was categorized into acute (within 48 hours) and early (from 3 to 7 days). The correlations between various parameters within 24 hours after injury and time of death were analyzed. Results: A total of 124 patients were enrolled. Of them, 8.1% (n=10) of the patients experienced acute mortality. For those patients, significant differences in initial systolic blood pressure, coagulopathy score, amount of transfusion, abbreviated injury scale of the head and neck, the abdomen and the extremities were noted. Early mortality was experienced by 7.0% (n=8) of the patients, only coagulopathy score was found to be a significant independent risk factor for acute (odds ratio: 3.127; 95% confidence interval: 1.185-8.252; p=0.021) and early mortality (odds ratio: 2.470; 95% confidence interval: 1.029-5.929; p=0.043). Conclusion: Acute traumatic coagulopathy has an important role in the mortality, even after the acute phase. Early management and prevention of acute coagulopathy may improve survival of trauma patients.
Hantaviruses are found worldwide and are known to cause two serious and often fatal human disease: hemorrhagic fever with renal syndrome(HFRS) and hantavirus pulmonary syndrome(HPS). The typical clinical prodrome consists of fever, chills, myalgia, headache, and gastrointestinal symptoms. Treatment usually involves maintenance of fluids, blood pressure, ventilation and electrolytes. We report a patient who had multisystem inflammatory symptom with Hantaan virus antibody positive accompanied by mild fever and myalgia. This case was diagnosed as HFRS. This patient was treated by Galgun hegi-tang. As a result of this treatment, symptoms were markedly improved.
This study was undertaken to define the effect of SoPung-Tang extract on hypertension in spontaneous hypertensive rat and norepinephrine- induced arterial contraction in rabbit. In order to investigate the effect of SoPung-Tang extract on contracted rabbit carotid arterial strips, transverse strips with intact or damaged endothelium were used for the experiment using organ bath. To analyze the mechanism of SoPung-Tang extract-induced relaxation, SoPung-Tang extract infused into contracted arterial strips induced by norepinephrine after treatment of indomethacin, Nu-nitro-L-arginine, methylene blue or tetraethylammonium chloride. Blood pressure was significantly decreased five days after administration of SoPung-Tang extract. SoPung-Tang extract relax arterial strip with endothelium contracted by norepinephrine, but in the strips without endothelium, SoPung-Tang extract- induced relaxation was significantly inhibited. SoPung-Tang relax arterial strip contracted by norepinephrine, but in the strips contracted by high $K^+$, SoPung-Tang extract-induced relaxation was significantly inhibited. The endothelium-dependent relaxation induced by SoPung-Tang extract was decreased by the pre-treatment of $N{\omega}$-nitro-L-arginine or methylene blue, but it was not observed in the strips pre-treated with indomethacin or tetraethylammonium chloride. When $Ca^{2+}$ was applied, the strips which were contracted by norepinephrine in a $Ca^{2+}$-free solution, arterial contraction was increased. But pre-treatment of SoPung-Tang extract inhibited contractile response to $Ca^{2+}$. We suggest that SoPung-Tang could be applied effectively for hypertension and may suppress influx of extra-cellular $Ca^{2+}$ through the formation of nitric oxide in the vascular endothelial cells.
'BUDDEUMI and BUDDEUMI's treatment; is a new remedy of the synchronous combination of cupping boil and moxibustion for the exclusion of human body's waste product. 'BUDDEUMI and BUDDEUMI's' treatment' wishes the reachfor improving the effect of cupping boil and moxibustion by the synchronous combination. As the negative pressure of cupping and the hot cure of moxa are made up of BUDDEUMI structural character. The effects of BUDDEMI's treatment are observed on the strengthening of skin breation and the detoxification of blood waste material. Therefor 'BUDDEUMI and BUDDEMI's treatment' is expected for the healthy article of Senior-Friendly.
General pharmacological effects of SB-31$^{R}$, the extracts of Pulsatilla koreana, were investigated in mice, rats and guinea-pigs. Intravenous injection of SB-31 (3 and 6 ml/kg) produced almost no effect on central nervous system no effects on the general symptom and behaviors of mice, spontaneous locomotor activity, pentobarbital- induced sleeping time , rotared performance , electroshock and pentylenetertrazole -induced seizures, acetic acid-induced writhing and normal body temperature in mice. SB-31 showed little effects on the spontaneous movement of the isolated ileum and contraction induced by agonists in isolated ileum, suggesting no influence on autonomic nervous system. Administration of SB-31 also did not show any effect on blood pressure in conscious rats. However, a slight decrease in heart rate was observed at high doses (6 and 10 ml/kg) of SB-31 in conscious rats. Similarly, a slight increase in respiratory rate was observed at 6 m1/kg of SB-31 in anesthetized rats. SB-31 did not produce any effect at the dose of 3 ml/kg, but showed a tendency to increase the urinary volume at 6 ml/kg, and produced a decrease in urinary excretions of N $a_{+}$and $K_{+}$at 6 ml/kg. However, transport capacity within the gastrointestinal tract and the secretion of the gastric juice were not influenced by 6 ml/kg of SB-31. In conclusion, these results suggest that SB-31 did not pro-duce any acute effects on the central nervous system, autonomic nervous system, respiratory and circulatory systems, digestive system and kidney function at the dose of below 3 ml/kg.ml/kg.
In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.
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