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Evaluation of Parameters of Gas Exchange During Partial Liquid Ventilation in Normal Rabbit Lung (토끼의 정상 폐 모델에서 부분액체환기 시 가스교환에 영향을 주는 인자들에 대한 연구)

  • An, Chang-Hyeok;Koh, Young-Min;Park, Chong-Wung;Suh, Gee-Young;Koh, Won-Jung;Lim, Sung-Yong;Kim, Cheol-Hong;Ahn, Young-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.14-23
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    • 2002
  • Background: The opitmal ventilator setting during partial liquid ventilation(PLV) is controversial. This study investigated the effects of various gas exchange parameters during PLV in normal rabbit lungs in order to aid in the development of an optimal ventilator setting during PLV. Methods: Seven New-Zealand white rabbits were ventilated in pressure-controlled mode with the following settings; tidal volume($V_T$) 8 mL/kg, positive end-expiratory pressure(PEEP) 4 $cmH_2O$, inspiratory-to-expiratory ratio(I:E ratio) 1:2, fraction of inspired oxygen($F_TO_2$) 1.0. The respiration rate(RR) was adjusted to keep $PaCO_2$ between 35~45 mmHg. The ventilator settings were changed every 30 min in the following sequence : (1) Baseline, as the basal ventilator setting, (2) Inverse ratio, I:E ratio 2:1, (3) high PEEP, adjust PEEP to achieve the same mean inspiratory pressure (MIP) as in the inverse ratio, (4) High $V_T$, $V_T$ 15 mL/kg, (5) high RR, the same minute ventilation (MV) as in the High $V_T$. Subsequently, the same protocol was repeated after instilling 18 mL/kg of perfluorodecalin for PLV. The parameters of gas exchange, lung mechanics, and hemodynamics were examined. Results: (1) The gas ventilation(GV) group showed no significant changes in the $PaO_2$ at all phases. The $PaCO_2$ was lower and the pH was higher at the high $V_T$ and high RR phases(p<0.05). No significant changes in the lung mechanics and hemodynamics parameters were observed. (2) The baseline $PaO_2$ for the PLV was $312{\pm}$ mmHg. This was significantly lower when decreased compared to the baseline $PaO_2$ for GV which was $504{\pm}81$ mmHg(p=0.001). During PLV, the $PaO_2$, was significantly higher at the high PEEP($452{\pm}38$ mmHg) and high $V_T$ ($461{\pm}53$ mmHg) phases compared with the baseline phase. However, it did not change significantly during the inverse I:E ratio or the high RR phases. (3) The $PaCO_2$ was significantly lower at high $V_T$ and RR phases for both the GV and PLV. During the PLV, $PaCO_2$ were significantly higher compared to the GV (p<0.05). (4) There were no important or significant changes in of baseline and high RR phases lung mechanics and hemodynamics parameters during the PLV. Conclusion: During PLV in the normal lung, adequate $V_T$ and PEEP are important for optimal oxygenation.

The Geochemical and Zircon Trace Element Characteristics of A-type Granitoids in Boziguoer, Baicheng County, Xinjiang (중국 신장 위그루자치구 바이청현 보즈구얼의 A형화강암류의 지화학 및 지르콘 미량원소특징에 대한 연구)

  • Yin, Jingwu;Liu, Chunhua;Park, Jung Hyun;Shao, Xingkun;Yang, Haitao;Xu, Haiming;Wang, Jun
    • Economic and Environmental Geology
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    • v.46 no.2
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    • pp.179-198
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    • 2013
  • The Boziguoer A-type granitoids in Baicheng County, Xinjiang, belong to the northern margin of the Tarim platform as well as the neighboring EW-oriented alkaline intrusive rocks. The rocks comprise an aegirine or arfvedsonite quartz alkali feldspar syenite, an aegirine or arfvedsonite alkali feldspar granite, and a biotite alkali feldspar syenite. The major rock-forming minerals are albite, K-feldspar, quartz, arfvedsonite, aegirine, and siderophyllite. The accessory minerals are mainly zircon, pyrochlore, thorite, fluorite, monazite, bastnaesite, xenotime, and astrophyllite. The chemical composition of the alkaline granitoids show that $SiO_2$ varies from 64.55% to 72.29% with a mean value of 67.32%, $Na_2O+K_2O$ is high (9.85~11.87%) with a mean of 11.14%, $K_2O$ is 2.39%~5.47% (mean = 4.73%), the $K_2O/Na_2O$ ratios are 0.31~0.96, $Al_2O_3$ ranges from 12.58% to 15.44%, and total $FeO^T$ is between 2.35% and 5.65%. CaO, MgO, MnO, and $TiO_2$ are low. The REE content is high and the total ${\sum}REE$ is $(263{\sim}1219){\times}10^{-6}$ (mean = $776{\times}10^{-6}$), showing LREE enrichment HREE depletion with strong negative Eu anomalies. In addition, the chondrite-normalized REE patterns of the alkaline granitoids belong to the "seagull" pattern of the right-type. The Zr content is $(113{\sim}1246){\times}10^{-6}$ (mean = $594{\times}10^{-6}$), Zr+Nb+Ce+Y is between $(478{\sim}2203){\times}10^{-6}$ with a mean of $1362{\times}10^{-6}$. Furthermore, the alkaline granitoids have high HFSE (Ga, Nb, Ta, Zr, and Hf) content and low LILE (Ba, K, and Sr) content. The Nb/Ta ratio varies from 7.23 to 32.59 (mean = 16.59) and the Zr/Hf ratio is 16.69~58.04 (mean = 36.80). The zircons are depleted in LREE and enriched in HREE. The chondrite-normalized REE patterns of the zircons are of the "seagull" pattern of the left-inclined type with strong negative Eu anomaly and without a Ce anomaly. The Boziguoer A-type granitoids share similar features with A1-type granites. The average temperature of the granitic magma was estimated at $832{\sim}839^{\circ}C$. The Boziguoer A-type granitoids show crust-mantle mixing and may have formed in an anorogenic intraplate tectonic setting under high-temperature, anhydrous, and low oxygen fugacity conditions.

Oxidative Inactivation of Peroxiredoxin Isoforms by H2O2 in Pulmonary Epithelial, Macrophage, and other Cell Lines with their Subsequent Regeneration (폐포상피세포, 대식세포를 비롯한 각종 세포주에서 H2O2에 의한 Peroxiredoxin 동위효소들의 산화에 따른 불활성화와 재생)

  • Oh, Yoon Jung;Kim, Young Sun;Choi, Young In;Shin, Seung Soo;Park, Joo Hun;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.31-42
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    • 2005
  • Background : Peroxiredoxins (Prxs) are a relatively newly recognized, novel family of peroxidases that reduce $H_2O_2$ and alkylhydroperoxide into water and alcohol, respectively. There are 6 known isoforms of Prxs present in human cells. Normally, Prxs exist in a head-to-tail homodimeric state in a reduced form. However, in the presence of excess $H_2O_2$, it can be oxidized on its catalytically active cysteine site into inactive oxidized forms. This study surveyed the types of the Prx isoforms present in the pulmonary epithelial, macrophage, endothelial, and other cell lines and observed their response to oxidative stress. Methods : This study examined the effect of exogenous, excess $H_2O_2$ on the Prxs of established cell lines originating from the pulmonary epithelium, macrophages, and other cell lines, which are known to be exposed to high oxygen partial pressures or are believed to be subject to frequent oxidative stress, using non-reducing SDS polyacrylamide electrophoresis (PAGE) and 2 dimensional electrophoresis. Result : The addition of excess $H_2O_2$ to the culture media of the various cell-lines caused the immediate inactivation of Prxs, as evidenced by their inability to form dimers by a disulfide cross linkage. This was detected as a subsequent shift to its monomeric forms on the non-reducing SDS PAGE. These findings were further confirmed by 2 dimensional electrophoresis and immunoblot analysis by a shift toward a more acidic isoelectric point (pI). However, the subsequent reappearance of the dimeric Prxs with a comparable, corresponding decrease in the monomeric bands was noted on the non-reducing SDS PAGE as early as 30 minutes after the $H_2O_2$ treatment suggesting regeneration after oxidation. The regenerated dimers can again be converted to the inactivated form by a repeated $H_2O_2$ treatment, indicating that the protein is still catalytically active. The recovery of Prxs to the original dimeric state was not inhibited by a pre-treatment with cycloheximide, nor by a pretreatment with inhibitors of protein synthesis, which suggests that the reappearance of dimers occurs via a regeneration process rather than via the de novo synthesis of the active protein. Conclusion : The cells, in general, appeared to be equipped with an established system for regenerating inactivated Prxs, and this system may function as a molecular "on-off switch" in various oxidative signal transduction processes. The same mechanisms might applicable other proteins associated with signal transduction where the active catalytic site cysteines exist.

Effect of Hydrogen Peroxide Enema on Recovery of Carbon Monoxide Poisoning (과산화수소 관장이 급성 일산화탄소중독의 회복에 미치는 영향)

  • Park, Won-Kyun;Chae, E-Up
    • The Korean Journal of Physiology
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    • v.20 no.1
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    • pp.53-63
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    • 1986
  • Carbon monoxide(CO) poisoning has been one of the major environmental problems because of the tissue hypoxia, especially brain tissue hypoxia, due to the great affinity of CO with hemoglobin. Inhalation of the pure oxygen$(0_2)$ under the high atmospheric pressure has been considered as the best treatment of CO poisoning by the supply of $0_2$ to hypoxic tissues with dissolved from in plasma and also by the rapid elimination of CO from the carboxyhemoglobin(HbCO). Hydrogen peroxide $(H_2O_2)$ was rapidly decomposed to water and $0_2$ under the presence of catalase in the blood, but the intravenous administration of $H_2O_2$ is hazardous because of the formation of methemoglobin and air embolism. However, it was reported that the enema of $H_2O_2$ solution below 0.75% could be continuously supplied $0_2$ to hypoxic tissues without the hazards mentioned above. This study was performed to evaluate the effect of $H_2O_2$ enema on the elimination of CO from the HbCO in the recovery of the acute CO poisoning. Rabbits weighting about 2.0 kg were exposed to If CO gas mixture with room air for 30 minutes. After the acute CO poisoning, 30 rabbits were divided into three groups relating to the recovery period. The first group T·as exposed to the room air and the second group w·as inhalated with 100% $0_2$ under 1 atmospheric pressure. The third group was administered 10 ml of 0.5H $H_2O_2$ solution per kg weight by enema immediately after CO poisoning and exposed to the room air during the recovery period. The arterial blood was sampled before and after CO poisoning ana in 15, 30, 60 and 90 minutes of the recovery period. The blood pH, $Pco_2\;and\;Po_2$ were measured anaerobically with a Blood Gas Analyzer and the saturation percentage of HbCO was measured by the Spectrophotometric method. The effect of $H_2O_2$ enema on the recovery from the acute CO poisoning was observed and compared with the room air group and the 100% $0_2$ inhalation group. The results obtained from the experiment are as follows: The pH of arterial blood was significantly decreased after CO poisoning and until the first 15 minutes of the recovery period in all groups. Thereafter, it was slowly increased to the level of the before CO poisoning, but the recovery of pH of the $H_2O_2$ enema group was more delayed than that of the other groups during the recovery period. $Paco_2$ was significantly decreased after CO poisoning in all groups. Boring the recovery Period, $Paco_2$ of the room air group was completely recovered to the level of the before CO Poisoning, but that of the 100% $O_2$ inhalation group and the $H_2O_2$ enema group was not recovered until the 90 minutes of the recovery period. $Paco_2$ was slightly decreased after CO poisoning. During the recovery Period, it was markedly increased in the first 15 minutes and maintained the level above that before CO Poisoning in all groups. Furthermore $Paco_2$ of the $H_2O_2$ enema group was 102 to 107 mmHg and it was about 10 mmHg higher than that of the room air group during the recovery period. The saturation percentage of HbCO was increased up to the range of 54 to 72 percents after CO poisoning and in general it was generally diminished during the recovery period. However in the $H_2O_2$ enema group the diminution of the saturation percentage of HbCO was generally faster than that of the 100% $O_2$ inhalation group and the room air group, and its diminution in the 100% $O_2$ inhalation group was also slightly faster than that of the room air group at the relatively later time of the recovery period. In conclusion, the enema of 0.5% $H_2O_2$ solution is seems to facilitate the elimination of CO from the HbCO in the blood and increase $Paco_2$ simultaneously during the recovery period of the acute CO poisoning.

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Protective Effect of Plantago asiatica L. Leaf Ethanolic Extract Against Ferric Nitrilotriacetate-Induced Prostate Oxidative Damage in Rats (랫드에서의 Fe-NTA 유발 산화스트레스에 대한 차전초 에탄올 추출물의 전립선보호 효과)

  • Hong, Seung-Taek;Hong, Chung-Oui;Nam, Mi-Hyun;Ma, Yuan-Yuan;Hong, Yun-Jin;Son, Da-Hee;Chun, Su-Hyun;Lee, Kwang-Won
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.260-265
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    • 2011
  • Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets (급성 저산소성 허혈성 뇌손상이 유발된 신생자돈에서 재산소-재관류기 동안 NG-monomethyl-L-arginine과 L-arginine이 뇌의 혈역학 및 에너지 대사에 미치는 영향)

  • Ko, Sun Young;Kang, Saem;Chang, Yun Sil;Park, Eun Ae;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.317-325
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    • 2006
  • Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.

Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats (STZ-당뇨쥐에서 운동부하가 골격근 및 간의 항산화효소 활성도에 미치는 영향)

  • Seok, Kwang-Ho;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.21-30
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    • 2000
  • Background: The purpose of the present study was to investigate the effect of exercise on the activities of antioxidant enzymes, super oxide dismutase(SOD), glutathione peroxidase(GPX) and catalase(CAT) of skeletal muscle(gastrocnemius) and liver in streptozotocin(STZ) induced diabetic rats. The malondialdehyde(MDA) concentration was also measured as an index of lipid poroxidation of tho tissues by exercise-induced oxidative stresses in diabetic rats. Material and Methods: Male Sprague-Dawley rats were randomly divided into control and STZ-induced diabetic rats. The STZ in citrate buffer solution was injected twice at S days intervals intraperitoneally(50, 70 mg/kg respectively). On the 28th day after the first STZ injection, the diabetic animals were randomly divided into pre- and post-exercise groups, The exercise was introduced to the rats of post-exercise group by treadmill running until exhaution with moderate intensity ($V_{O2max}$: 50-70%) of exercise. The duration of average running time was 2 hours and 19 minutes. Results: The blood glucose concentration was increased(p<0.001) and plasma insulin concentration was decreased(p<0.001) in the diabetic rats. The glycogen concentration in the muscle and liver was decreased by exhaustive exercise in the diabetic rats(p<0.001), In the skeletal muscle, the activities of GPX was increased(p<0.05) and the activities of SOD and CAT were not changed in the diabetic rats compare to those of the control rats. The activities of GPX was not changed by exercise but the activities of SOD(p<0.01) and CAT(p<0.01) were decreased by exercise in the diabetic rats, The concentration of MDA was not changed by exercise in diabetic rats, and the values of pre-exercise and post-exercise diabetic rats were not different from the value those of control rats, In the liver, the activities of SOD was decreased(p<0.01), and the activities of GPX and CAT were not changed in diabetic rats compared to the values of control rats, The activities of SOD, GPX and CAT were not changed by exercise in diabetic rats but the activity of SOD seemed to decrease slightly, The MDA concentration was increased in the diabetic rats compared to the values of control rats(p<0.001), but there was no change of MDA concentration by exercise in diabetic rats, Conclusions: In summary, exhaustive physical exercise did not seem to impose oxidative stress on the skeletal muscle because of due to oxygen free radicals, regardless of the decrease in SOD and CAT in the diabetic rats, In liver tissue, the tissue damage by oxidative stress was observed in diabetic rats but the additional tissue damage by exhaustive physical exercise was not observed.

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Hydrochemical and Isotopic Characteristics, and Origin of Noble Gas for Low-temperature Hot Spring Waters in the Honam Area (호남지역 저온형 온천수의 수리지화학적 및 안정동위원소 특성과 영족기체의 기원에 관한 연구)

  • Jeong, Chan-Ho;Hur, Hyun-Sung;Nagao, Keisuke;Kim, Kyu-Han
    • Economic and Environmental Geology
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    • v.40 no.5
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    • pp.635-649
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    • 2007
  • Geochemical composition, stable isotopes $({\delta}^{18}O,\;{\delta}D,\;{\delta}^{34}S)$ and noble gases(He, Ne and Ar) of nine hot spring water and three groundwater for five hot springs(Jukam, Hwasun, Dokog, Jirisan, Beunsan) from the Honam area were analyzed to investigate the hydrogeochemical characteristics and the hydrogeochemical evolution of the hot spring waters, and to interpret the source of sulfur, helium and argon dissolved in the hot spring waters. The hot spring waters show low water temperature ranging from 23.0 to $30.5^{\circ}C$ and alkaline characteristics of pH 7.67 to 9.98. Electrical conductivity of hot spring waters is $153{\sim}746{\mu}S/cm$. Groundwaters in this area were characterized by the acidic to neutral pH range$(5.85{\sim}7.21)$, the wide electrical conductivity range $(44{\sim}165{\mu}S/cm)$. The geochemical compositions of hot spring and groundwaters can be divided into three water types: (1) $Na-HCO_3$ water type, (2) Na-Cl water type and (3) $Ca-HCO_3$ water type. The hot spring water of $Ca-HCO_3$ water type in early stage have been evolved through $Ca(Na)-HCO_3$ water type into $Na-HCO_3$ type in final stage. In particular, Jurim alkaline(pH 9.98) hot spring water plotted at the end point of $Na-HCO_3$ type in the Piper diagram is likely to arrive into the final stage in geochemical evolution process. Hydrogen and oxygen isotopic data of the hot spring water samples indicate that the hot spring waters originated from the local meteoric water showing latitude and altitude effects. The ${\delta}^{34}S$ value for sulfate of the hot spring waters varies widely from 0.5 to $25.9%o$. The sulfur source of most hot spring waters in this area is igneous origin. However, The ${\delta}^{34}S$ also indicates the sulfur of JR1 hot water is originated from marine sulfur which might be derived ken ancient seawater sulfates. The $^3He/^4He\;and\;^4He/^{20}Ne$ ratios of the hot spring waters range from $0.0143{\times}10^{-6}\;to\;0.407{\times}10^{-6}\;and\;6.49{\sim}584{\times}10^{-6}$, respectively. The hot spring waters are plotted on the mixing line between air and crustal components. It means that the He gas in the hot spring waters was mainly originated from crustal sources. However, the JR1 hot spring water show a little mixing ratio of the helium gas of mantle source. The $^{40}Ar/^{36}Ar$ ratios of hot spring water are in the range from $292.3{\times}10^{-6}\;to\;304.1{\times}10^{-6}$, implying the atmospheric argon source.

The National Survey of Acute Respiratory Distress Syndrome in Korea (급성호흡곤란증후군의 전국 실태조사 보고)

  • Scientific Subcommittee for National Survey of Acute Respiratory Distress Syndrome in Korean Academy of Tuberculosis and Respiratory Disease
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.25-43
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    • 1997
  • Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

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Medical Information Dynamic Access System in Smart Mobile Environments (스마트 모바일 환경에서 의료정보 동적접근 시스템)

  • Jeong, Chang Won;Kim, Woo Hong;Yoon, Kwon Ha;Joo, Su Chong
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.47-55
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    • 2015
  • Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.