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Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, 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, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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Impact of the Silicate Polymerization on the Formation of Insoluble Aluminium Silicate (수 중 존재하는 실리케이트의 존재형태가 불용성 알루미늄실리케이트 형성에 미치는 영향)

  • Gwon, Eun-Mi;Hong, Seung-Kwan;Kim, Ji-Hyong;Jung, Wook-Jin;Yoo, Myung-Jin
    • Journal of Korean Society of Environmental Engineers
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    • v.29 no.6
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    • pp.654-661
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    • 2007
  • The goal of this research was to identify the impact of silicate polymerization on the formation of insoluble aluminiumsilicate salts which could be a cause of irreversible fouling in the membrane process by lab-scale test. For this, the amount and characteristics of precipitates that were formed in six samples with different Al and Si concentration were analyzed. And the particles was also observed by SEM-EDS(Scanning Electron Microscope - Electron Dispersion Spectrophotometer) to compare morphology and ratio of Al and Si in each precipitates. Finally the reactive and nonreactive silicate contents in the solution and precipitates were analyzed to calculate silicate form content in each fraction. The amount of precipitates was in proportion to the total concentration of both element in solution. And the amount of insoluble particle that was not dissolved in the acid solution was recorded the highest in the sample 2 of which Si concentration was lower than the saturation concentration, 50 mg/L. The content of reactive silicate in precipitates was also recorded the highest value in sample 2 of which almost silicate form was reactive. When the silicate concentration is same, that value was recorded the highest in the sample with highest Al concentration. The SEM morphology of the precipitates was similar to that of Aluminiumhydroxide and the insoluble precipitates was not dissolved in acidic solution with pH 2.7 was able to observed only in sample 2. The ratio of Al and Si in the precipitates was ranged $0.48\sim3.14$, thai of sample 2 was recorded the highest value, 3.14. It is concluded that the insoluble aluminiumsilicate could be easily formed in the solution of which silicate exist as a reactive form and coexisting Al is sufficient.

Study on the Improvement of Gill Nets and Trap Nets Fishing for the Resource Management at the Coastal Area of Yellow Sea - On the Entrapping Behavior of Fishes into Trap Nets in the Water Tank Experiment - (서해구 자원관리형 자망ㆍ통발 어구어법 기술개발에 관한 연구 - 수조에서의 통발에 대한 어군의 입롱행동 -)

  • 장호영;조봉곤;고광수;한민숙
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.39 no.1
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    • pp.56-62
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    • 2003
  • To investigate the entrapping behavior of blue crab, rock shell and green ling, which are mainly caught with the other trap nets in the coastal area of Yellow Sea, by the using duration of trap nets through the water tank experiment. We select the three kinds of trap nets which have different using duration such as new, 6 months and 12 months used one, and observe the entrapping ratio into the trap nets, respectively. In the mean while, in order to obtain the basic data for the estimate of mesh selectivity of the other trap nets, the entrapping behavior into the trap nets for green ling which has high activity compared to blue crab and rock shell, are examined to the three kinds of mesh size (35mm, 50mm and 65mm). The results are as follows ; 1. The mean entrapping ratio of blue crab by the using duration of trap nets in high with 4.4 fishes (44.0%) in the 6 months used one, become lower with 2.9 fishes (28.0%) in the new one, and with 2.0 fishes (20.0%) in the 12 months used one. 2. The mean entrapping ratio of rock shell by the using duration of trap nets in high with 7.3 fishes (36.7%) in the new one, and become lower with 7.2 fishes (35.8%) in the 6 months used one, and with 5.7 fishes (28.3%) in the 12 months used one. 3. The mean entrapping ratio of green ling by the using duration of trap nets in high with 3.4 fishes (34.0%) in the 6 months used one, and become lower with 3.0 fishes (30.0%) in the new one, and with 2.8 fishes (28.0%) in the 12 months used one. 4. The mean residual ratio of green ling by the mesh size of trap nets is high with 2.4 fishes (24.0%) in the 35mm mesh size, and become lower with 2.2 fishes (22.0%) in the 50mm mesh size and 2.0 fishes (20.0%) in the 65mm mesh size.

The physical geography in general:yesterday and tomorrow (자연지리학 일반: 회고와 전망)

  • Son, Ill
    • Journal of the Korean Geographical Society
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    • v.31 no.2
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    • pp.138-159
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    • 1996
  • There has been a tendency for Geomorphology and Climatology to be dominant in Physical Geography for 50 years in Korea. Physical Geography is concerned with the study of the totality of natural environment through the integrated approaches. But, an overall direction or a certain paradigm could not be found, because major sub-divisions of Physical Geography have been studied individually and the subjects and the approaches in studying Physical Geography are enormously diverse. A consensus of opinion could not also exist in deciding what kind of the sub-divisions should be included in the physical geography in general and how those should be summarized. Furthermore it would be considered imprudent to survey the studies of Physical Geography besides those of Geomorphology and Climatology due to the small number of researchers. Assuming that the rest of Physical Geographical studies with the exception of Geomorphological and Climatological studies are the Physical Geography in general, the studies of Physical Geogrpahy in general are summarized and several aspects are drown out as follows. First the descliption of all possible factors of natural environments was the pattern of early studies of Physical Geography and the tendency is maintained in the various kinds of research and project reports. Recently Physical Geographers have published several introductory textbooks or research monographs. In those books, however, the integrated approaches to Physical Geography were not suggested and the relationship between man and nature are dealt with in the elementary level. Second, the authentic soil studies of Physical Geographers are insignificant, because the studies of soil in Physical Geography have been mostly considered as the subsidiary means of Geomorphology Summarizing the studies of Soil Gegraphy by physical geographers and other Pedologists, the subjects are classified as soil-forming processes, soil erosions, soil in the tidal flat and reclaimed land, and soil pollution. Physical Geographers have focused upon the soil-forming processes in order to elucidate the geomorphic processes and the past climatic environment. The results of other subjects are trifling. Thirdy Byogeygrayhers and the results of studies are extremely of small number and the studies of Biogeography in Korea lines in the starting point. But, Biogeography could be a more unifying theme for the Physical-human Geography interface, and it would be expected to play an active part in the field of environmental conservation and resource management. Forth, the studies of Hydrogeography (Geographical Hydrology) in Korea have run through the studies of water balance and the morphometric studies such as the drainage network analysis and the relations of various kinds of morphometric elements in river. Recently, the hydrological model have introduced and developed to predict the flow of sediment, discharge, and ground water. The growth of groundwater studies is worthy of close attention. Finally, the studies on environmental problems was no mole than the general description about environmental destruction, resource development, environmental conservation, etc. until 1970s. The ecological perspectives on the relationship between man and nature were suggested in some studies of natural hazard. The new environmentalism having been introduced since 1980s. Human geographers have lead the studies of Environmental Perception. Environmental Ethics, Environmental Sociology, environmental policy. The Physical geographers have stay out of phase with the climate of the time and concentrate upon the publication of introductory textbooks. Recently, several studies on the human interference and modification of natural environments have been made an attempt in the fields of Geomorphology and climatology. Summarizing the studies of Physical Geography for 50 years in Korea, the integrated approaches inherent in Physical Geography disappeared little by little and the majol sub-divisions of Physical Ceography have develop in connection with the nearby earth sciences such as Geology, Meteorology, Pedology, Biology, Hydrology, etc been rediscovered by non-geographers under the guise of environmental science. It is expected that Physical Geography would revive as the dominant subject to cope with environmental problems, rearming with the innate integrated approaches.

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Protective effect of ethyl acetate extract of Ishige okamurae against carbon tetrachloride-induced acute liver injury in rats

  • Kang, Sohi;Yang, Wonjun;Oh, Hanseul;Bae, Yeonji;Ahn, Meejung;Kang, Min Chul;Ko, Ryeo Kyeong;Kim, Gi Ok;Lee, Jun Hwa;Hyun, Jin Won;Moon, Changjong;Shin, Taekyun
    • Korean Journal of Veterinary Research
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    • v.51 no.4
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    • pp.259-265
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    • 2011
  • Several compounds and extracts isolated from a brown alga, Ishige (I.) okamurae, exhibit anti-oxidant and anti-inflammatory effects. The present study investigated whether the ethyl acetate (EtOAc) fraction of I. okamurae (EFIO) could ameliorate carbon tetrachloride ($CCl_{4}$)-induced hepatotoxicity in rats. Sprague-Dawley rats were intraperitoneally (i.p.) administered with EFIO at 10 or 50 mg/kg per day for 2 consecutive days before $CCl_{4}$ injection (3.3 mL/kg, i.p.). Twenty four hours later, the rats were anesthesized with diethyl ether and dissected. Pretreatment with EFIO significantly reduced the increased serum levels of alanine aminotransferase and aspartate aminotransferase in $CCl_{4}$-treated rats. Pretreatment with EFIO also significantly inhibited the reduced activities of superoxide dismutase and catalase in the $CCl_{4}$-injured liver. Histopathological evaluations showed that hemorrhage, hepatocyte necrosis, inflammatory cell infiltration, and fatty degeneration induced by $CCl_{4}$ treatment were ameliorated by the administration of EFIO. Additionally, liver immunohistochemical analyses revealed the marked reduction in ED1-positive monocyte-like macrophages in EFIO-pretreated rats given $CCl_{4}$. These results suggest that EFIO ameliorates $CCl_{4}$-induced liver injury, possibly through the inhibition of oxidative stress.

Characterization of Alternative Anode Catalysts for Direct Formic Acid Fuel Cell (직접 개미산 연료전지용 연료극 촉매의 특성 연구)

  • Yu, Jae Keun;Lee, Hyo Song;Kim, Ki Ho;Kim, Young Chun;Han, Jong Hee;Oh, In Hwan;Rhee, Young Woo
    • Korean Chemical Engineering Research
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    • v.44 no.3
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    • pp.314-318
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    • 2006
  • Direct formic acid fuel cells (DFAFCs) are potential alternative power sources for portable devices such as cellular phone, personal digital assistants (PDA) and laptop computers. In this study, we developed the catalysts for great performance of fuel cell, and investigated their characteristics by using EDS and SEM. Pt-Pd catalysts showed uniform size and homogeneous distribution. As the content of palladium increased, the performance of DFAFC increased. Pd black showed the greatest performance among the five catalysts tested. Also, Pt-Pd (1:1) catalyst had an excellent maximum power density of $120mW/cm^2$. As the operating temperature increased, fuel cell performance was increased due to a reaction activity increases of catalyst. But, temperature had only a slight effect on the performance of fuel cell in the best activity range of membrane.

Effect of Sunghyangchungisan on Contractile Reactivity and $Ca^{2+}$ metabolism in Isolated Rabbit Carotid Artery (성향정기산(星香正氣散)이 가토의 경동맥(頸動脈) 평활근(平滑筋) 긴장(緊張) 및 $Ca^{2+}$ 대사(代謝)에 미치는 영향(影響))

  • Kim, Young-Gyun;Kweon, Jung-Nam;Kim, Jong-Hoon
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.377-388
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    • 2000
  • Objective : This study was undertaken to evaluate the effect of Sunghyangchungisan (SHCS) on the regulation of vascular tone and $Ca^{2+}$ metabolism in arterial tissues. Vascular rings isolated from rabbit carotid artery were myographed isometrically in isolated organ baths and the effect of SHCS on contractile activities, endothelial function and $Ca^{2+}$ metabolism were determined. Methods : In phentobarbital sodium-anesthetized rabbits, SHCS administered through ear vein (100 mg/Kg body wt.) or intragastric dwelling tube (300 mg/Kg body wt.) attenuated phenylephrine (PE, 10 ${\mu}g$/Kg, i.v.)-induced increases in both systolic and diastolic cartoid arterial blood pressure. Results : In experiments with isolated arterial strips, SHCS relaxed arterial rings which were pre-contracted by phenylephrine (PE, 1 ${\mu}M$). The responses to SHCS were partially dose-dependent at concentrations lower than 0.5 mg/ml. When SHCS was applied prior to the exposure to PE, it inhibited the PE-induced contraction by a similar magnitude which was comparable to the relaxation of pre-contracted arterial rings. Washout of SHCS after observing its relaxant effect resulted in a full recovery of PE-induced contractions, indicating that the action mechanism is reversible. The observation that SHCS did not change the $ED_{50)$ of PE oh its dose-response curve ruled out the possible interaction of SHCS with ${\alpha}$-receptors. The relaxant effect of SHCS was not affected by removal of endothelium or a nitric oxide synthase inhibitor, L-NAME. Methylene blue, an inhibitor of the soluble guanylate cyclase, did not affect the relaxant effect of SHCS. These results suggest that the action of SHCS is not mediated by the endothelium nor soluble guanylate cyclase. Constant cGMP production determined in arterial strips in the presence or absence of SHCS is consistent with this conclusion. When contraction was induced by additive application of $Ca^{2+}$ in arterial rings which were pre-depolarized by high $K^+$ in a $Ca^{2+}$-free solution, the relaxant effect of SHCS was attenuated by increasing the $Ca^{2+}$ concentration. SHCS, when applied to the arterial rings pre-contracted by PE and then relaxed by nifedipine, a $Ca^{2+}$ channel blocker, did not show additive relaxation. SHCS partially blocked $Ca^{2+}$ influx stimulated by PE and high $K^+$ which was determined by 5-min ^{45}Ca$ uptake, while it did not affect $Ca^{2+}$ efflux. Conclusions : From above results, it is suggested that SHCS relax PE-induced contraction of rabbit carotid artery in an endothelium independent manner, andinhibition of $Ca^{2+}$ influx may contribute to the underling mechanism.

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Effect of Adrenergic Receptors on the Nerve Conduction in Rat Sciatic Nerves (아드레날린 수용체가 백서 좌골신경의 신경전도에 미치는 영향)

  • Lee, Chung;Chung, Sung-Lyang;Choi, Yoon;Leem, Joong-Woo;Lim, Hang-Soo;Yang, Hyun-Cheol;Han, Sung-Min;Kong, Hyun-Seok;Lim, Seung-Woon
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.177-182
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    • 1999
  • Background: Clonidine, an ${\alpha}_2$ adrenergic agonist blocks nerve conduction. However, in our previous experiment we found that adrenaline neither blocks nerve conduction by itself nor augment nerve conduction blockade by lidocaine near clinical concentrations. Possible explanations are: 1) there may be antagonism between some of adrenergic receptors, 2) clonidine may block nerve conduction via non-adrenergic mechanism. The purpose of this study is to obtain dose-response curves of several different forms of adrenergic receptor agonist to see the relative potencies of each adrenergic receptors to block nerve conduction. Methods: Recordings of compound action potentials of A-fiber components (A-CAPs) were obtained from isolated sciatic nerves of adult male Sprague-Dawley rats. Nerve sheath of the sciatic nerve was removed and desheathed nerve bundle was mounted on a recording chamber. Single pulse stimuli (0.5 msec, supramaximal stimuli) were repeatedly applied (2Hz) to one end of the nerve and recordings of A-CAPs were made on the other end of the nerve. Dose-response curves of epinephrine, phenylephrine, isoproterenol, clonidine were obtained. Results: $ED_{50}$ of each adrenergic agonist was: $4.51\times10^{-2}$ M for epinephrine; phenylephrine, $7.74\times10^{-2}$ M; isoproterenol, $9.61\times10^{-2}$ M; clonidine, $1.57\times10^{-3}$ M. Conclusion: This study showed that only clonidine, ${\alpha}_2$ adrenergic agonist, showed some nerve blocking action while other adrenergic agonists showed similar poor degree of nerve blockade. This data suggest that non-effectiveness of epinephrine in blocking nerve conduction is not from the antagonism between adrenergic receptors.

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Cloning and Expression of A Liquefying $\alpha$-Amylase Gene from Bacillus amyloliquefaciens in Bacillus subtilis (Bacillus amyloliquefaciens 액화형 $\alpha$-amylase 유전자의 클로닝 및 Bacillus subtilis에서의 발현)

  • 김사열;송방호;이인구;서정환;홍순덕
    • Microbiology and Biotechnology Letters
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    • v.14 no.6
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    • pp.479-485
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    • 1986
  • A 5200 basepair DNA fragment containing the Bacillus amyloliquefaciens amyE gene, encoding liquefying $\alpha$-amylase (1,4-$\alpha$-1)-glucan glucanohydrolase, EC 3.2.1.1), has been inserted into BamHI site of the pUB110 and the hybrid plasmid was designated as pSKS3. The pSKS3 was transformed into the Bacillus subtilis KM2l3 as a host which is a saccharifying $\alpha$-amylase deficient mutant of Bacillus subtilis NA64, and the plasmid in the transformed cell was expressed $\alpha$-amylase production and kanamycin resistance. The $\alpha$-amylase production of the transformed cell was reduced to one fifth of that of the donor strain. The Bacillus subtilis KM2l3 tarring pSKS3 indicated that the amyE gene product is a polypeptide which has the same electrophoretic mobility with that of the Bacillus amyloliquefaciens, but different from the saccharifying $\alpha$-amylase of Bacillus subtilis NA64. It means that the amyE gene of pSKS3 originales from the Bacillus amyloliquefaciens.

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Vasorelaxing Activity of Ulmus davidiana Ethanol Extracts in Rats: Activation of Endothelial Nitric Oxide Synthase

  • Cho, Eun-Jung;Park, Myoung-Soo;Kim, Sahng-Seop;Kang, Gun;Choi, Sung-A;Lee, Yoo-Rhan;Chang, Seok-Jong;Lee, Kwon-Ho;Lee, Sang-Do;Park, Jin-Bong;Jeon, Byeong-Hwa
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.6
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    • pp.339-344
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    • 2011
  • Ulmus davidiana var. japonica Rehder (Urticales: Ulmaceae) (UD) is a tree widespread in northeast Asia. It is traditionally used for anticancer and anti-inflammatory therapy. The present study investigated the effect of an ethanol extract of UD on vascular tension and its underlying mechanism in rats. The dried root bark of UD was ground and extracted with 80% ethanol. The prepared UD extract was used in further analysis. The effect of UD on the cell viability, vasoreactivity and hemodynamics were investigated using propidium iodide staining in cultured cells, isometric tension recording and blood pressure analysis, respectively. Low dose of UD ($10{\sim}100{\mu}g/ml)$ did not affect endothelial cell viability, but high dose of UD reduced cell viability. UD induced vasorelaxation in the range of $0.1{\sim}10{\mu}g/ml$ with an $ED_{50}$ value of $2{\mu}g/ml$. UD-induced vasorelaxation was completely abolished by removal of the endothelium or by pre-treatment with L-NAME, an inhibitor of nitric oxide synthase. UD inhibited calcium influx induced by phenylephrine and high $K^+$ and also completely abolished the effect of L-NAME. Intravenous injection of UD extracts (10~100 mg/kg) decreased arterial and ventricular pressure in a dose-dependent manner. Moreover, UD extracts reduced the ventricular contractility (+dP/dt) in anesthetized rats. However, UD-induced hypotensive actions were minimized in L-NAME-treated rats. Taken together, out results showed that UD induced vasorelaxation and has antihypertensive properties, which may be due the activation of nitric oxide synthase in endothelium.