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Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality

  • Byeong A Yoo;Seungmo Yoo;Eun Seok Choi;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun;Dong-Hee Kim
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.162-170
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    • 2023
  • Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021. Results: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant. Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.

Consideration of Predictive Indices for Metabolic Syndrome Diagnosis Using Cardiometabolic Index and Triglyceride-glucose Index: Focusing on Those Subject to Health Checkups in the Busan Area (Cardiometabolic Index, Triglyceride-glucose Index를 이용한 대사증후군 진단 예측지수에 대한 고찰: 부산지역 건강검진대상자 중심으로)

  • Hyun An;Hyun-Seo Yoon;Chung-Mu Park
    • Journal of radiological science and technology
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    • v.46 no.5
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    • pp.367-377
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    • 2023
  • This study investigates the utility of the Triglyceride-glucose(TyG) index and Cardiometabolic Index(CMI) as predictors for diagnosing metabolic syndrome. The study involved 1970 males, 1459 females, totaling 3429 participants who underwent health checkups at P Hospital in Busan between January 2023 and June 2023. Metabolic syndrome diagnosis was based on the presence of 3 or more risk factors out of the 5 criteria outlined by the American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI), and participants with 2 or fewer risk factors were categorized as normal. Statistical analyses included independent sample t-tests, chi-square tests, Pearson's correlation analysis, Receiver Operating Characteristic(ROC) curve analysis, and logistic regression analysis, using the Statistical Package for the Social Sciences(SPSS) program. Significance was established at p<0.05. The comparison revealed that the metabolic syndrome group exhibited attributes such as advanced age, male gender, elevated systolic and diastolic blood pressures, high blood sugar, elevated triglycerides, reduced LDL-C, elevated HDL-C, higher Cardiometabolic Index, Triglyceride-glucose index, and components linked to abdominal obesity. Pearson correlation analysis showed strong positive correlations between waist circumference/height ratio, waist circumference, Cardiometabolic Index, and triglycerides. Weak positive correlations were observed between LDL-C, body mass index, and Cardiometabolic index, while a strong negative correlation was found between Cardiometabolic Index and HDL-C. ROC analysis indicated that the Cardiometabolic Index(CMI), Triglyceride-glucose(TyG) index, and waist circumference demonstrated the highest Area Under the Curve(AUC) values, indicating their efficacy in diagnosing metabolic syndrome. Optimal cut-off values were determined as >1.34, >8.86, and >84.5 for the Cardiometabolic Index, Triglyceride-glucose index, and waist circumference, respectively. Logistic regression analysis revealed significant differences for age(p=0.037), waist circumference(p<0.001), systolic blood pressure(p<0.001), triglycerides(p<0.001), LDL-C(p=0.028), fasting blood sugar(p<0.001), Cardiometabolic Index(p<0.001), and Triglyceride-glucose index (p<0.001). The odds ratios for these variables were 1.015, 1.179, 1.090, 3.03, and 69.16, respectively. In conclusion, the Cardiometabolic Index and Triglyceride-glucose index are robust predictive indicators closely associated with metabolic syndrome diagnosis, and waist circumference is identified as an excellent predictor. Integrating these variables into clinical practice holds the potential for enhancing early diagnosis and prevention of metabolic syndrome.

Implementation of Non-Stringed Guitar Based on Physical Modeling Synthesis (물리적 모델링 합성법에 기반을 둔 줄 없는 기타 구현)

  • Kang, Myeong-Su;Cho, Sang-Jin;Chong, Ui-Pil
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.2
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    • pp.119-126
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    • 2009
  • This paper describes the non-stringed guitar composed of laser strings, frets, sound synthesis algorithm and a processor. The laser strings that can depict stroke and playing arpeggios comprise laser modules and photo diodes. Frets are implemented by voltage divider. The guitar body does not need to implement physically because commuted waveguide synthesis is used. The proposed frets enable; players to represent all of chords by the chord glove as well as guitar solo. Sliding, hammering-on and pulling-off sounds are synthesized by using parameters from the voltage divider. Because the pitch shifting corresponds to the time-varying propagation speed in the digital waveguide model, the proposed model can synthesize vibrato as well. After transformation of signals from the laser strings and frets into parameters for synthesis algorithm, the digital signal processor, TMS320F2812, performs the real-time synthesis algorithm and communicates with the DAC. The demonstration movieclip available via the Internet shows one to play a song, 'Arirang', synthesized by proposed algorithm and interfaces in real-time. Consequently, we can conclude that the proposed synthesis algorithm is efficient in guitar solo and there is no problem to play the non-stringed guitar in real-time.

Human Risk Assessment for Exposure to Heavy Metals within Finishing Materials of Playground Facilities for Children in Gwangju (광주지역 어린이 놀이시설 마감재의 중금속 노출에 의한 인체 위해성평가)

  • Sang-Hoon Yoon;So-Young Kim;Eun Cho;Tae-Hui Nam;Jin-Hwan Park;Hwa-Jin Kong;Ki-Won Lee;Gwang-Yeob Seo;Jeong-Hun Park;Kyoung-Woo Min
    • Journal of Environmental Health Sciences
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    • v.50 no.2
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    • pp.146-156
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    • 2024
  • Background: Children who use playground facilities are exposed to potential risks due to the high concentration of heavy metals contained in the finishing materials of facilities in children's playgrounds. Objectives: The purpose of this study was to investigate the concentration of heavy metals in the finishing materials of outdoor children's playgrounds where harmful heavy metals exist in Gwangju and to conduct human risk assessment for children and adults by age to find the risks and limitations. Methods: The bottom and top layers of double-painted paint were peeled off and collected together from the finishing materials of children's play facilities such as slides, swings, and seesaws in 147 children's parks in Gwangju. Heavy metals were analyzed using ICP-OES, etc., and human risk assessment was performed using the concentrations of heavy metals. Results: Based on 1.0E-04, which requires legal regulation, CTE was found to pose a carcinogenic risk for preschool children and no carcinogenic risk for the rest of the age groups. However, RME showed that both men and women of all ages had a carcinogenic risk. For reference, when the carcinogenic risk was based on 1.0E-06, CTE was found to pose a carcinogenic risk from infants to elementary school students, and RME was found to have a carcinogenic risk in all age groups. It was judged that there is a non-carcinogenic risk if the non-carcinogenic risk exceeds 1 based on the hazard index (HI) 1. In CTE, there was no non-carcinogenic risk, and RME for preschooler males (1.49E+00) and females (1.56E+00) were found to have non-carcinogenic risk. Conclusions: This study was meaningful in that it examines the differences in the current management of heavy metals concentration standards and potential carcinogenic and non-carcinogenic risks to the human body and discusses the relationship between heavy metals and human health effects.

Sports Biomechanical Analysis of Physical Movements on the Basis of the Patterns of the Ready Poses (준비동작의 형태 변화에 따른 신체 움직임의 운동역학적 분석)

  • Lee, Joong-Sook
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.179-195
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    • 2002
  • The purpose of this research is to provide a proper model by analyzing the sports biomechanical of physical movements on the basis of the two patterns(open-stance and cross-stance) at the ready-to-start pose. The subjects for this study are composed of five male handball players from P university and five female shooting players from S university. Three-way moving actions at start(right, left, and forward) are recorded with two high-speed video cameras and measured with two Force platforms and a EMG system. Three-dimensional action analyzer, GRF system, and Whole body reaction movement system are used to figure out the moving mechanisms at the start pose. The analytic results of the moving mechanism at the start pose were as follows. 1. Through examining the three-way moving actions at start, I have found the cross-stance pose is better for the moving speed of body weight balance than the open-stance one. 175 degree of knee joint angle at "take-off" and 172 degree of hip joint angle were best for the start pose. 2. The Support time and GRF data shows that the quickest center of gravity shift was occurred when cross-stanced male subjects started to move toward his lefthand side. The quickest male's average supporting time of left and right foot is 0.19${\pm}$0.07 sec., 0.26${\pm}$0.06sec. respectively. The supporting time difference between two feet is 0.07sec. 3. Through analyzing GRF of moving actions at start pose, I have concluded that more than 1550N are overloaded on one foot at the open-stance start, and the overloaded force may cause physical injury. However, at the cross-stance pose, The GRF are properly dispersed on both feet, and maximum 1350N are loaded on one foot.

Studies on Energy Metabolism of Growing Chicken (닭의 에너지 대사(代謝)에 관(關)한 연구(硏究))

  • Kwon, Soon Ki;Oh, Hong Rock
    • Korean Journal of Agricultural Science
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    • v.9 no.2
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    • pp.540-545
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    • 1982
  • An energy metabolism study was conducted with two commercial strains of meat-type chickens, Hubbard and Cobb, and two egg strains, Hy Line and Korean-bred Hanhyup 325. The heat production of growing chickens from each strain were measured by the use of an open-circuit gravimetric respiration calorimeter. The data obtained from this study were summarized as fallows. 1. The average body weight of 9-wk-old Hubbard broilers reared in battery cages was 2,570g/bird. The average body weights of 9-wk-old Hy Line chicks and Hanhyup 325 were 777 and 748g/bird, respectively. 2. At 3 weeks of age, the Hubbard broiler chicks consumed two times the feed consumed by Hy Line chicks (54.6g VS. 26.7g/bird/day). These values increased to 151g and 57.2g/bird/day, respectively, at 8 weeks of age, indicating that the difference in feed intake between meat and egg-type chicks tends to increase as they grow older. In terms of water consumption, the 5-wk-old Hubbard broiler chicks drank $226m{\ell}/bird/day$ as compared with $58m{\ell}$ by Hy Line chicks. These values increased to 282 and $70m{\ell}$, respectively, at 8 weeks of age. 3. The excreta outputs of Hubbard broilers and Hy Line chicks were 18.7 and 6.1g DM/bird/day at 4 weeks of age, and 41.5 and 10.0g DM/bird/day at 8 weeks of age, respectively. 4. The energy metabolizability of broiler chicks were 75.4~77.1% compared to 75.0~83.5% by egg-type chicks. 5. The respiratory quotient (RQ) was between 0.78 and 0.97. There seems to be no difference in RQ between meat and egg-type chicks. The RQ tended to decrease when feed intake was low and vice versa. 6. Both meat and egg-type chicks produced $83.1{\sim}123.1Kcal/kg^{\frac{3}{4}}B.W./day$. The considerably low value of $83Kcal/kg^{\frac{3}{4}}B.W./day$ was obtained when the chicks were off the feed under the stressful conditions. The high value of 123.1Kcal was obtained when the chicken chamber temperature rose to $27{\sim}34^{\circ}C$.

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A Comparative Study on the Method of Internal Alchemy in Southern and Northern Schools of Taoism - Centering on Zhang Bo-duan and Wang Chung-yang (내단도교 남·북종의 단법 비교 -장백단과 왕중양을 중심으로 -)

  • Kim, Kyeong-soo
    • The Journal of Korean Philosophical History
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    • no.42
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    • pp.197-232
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    • 2014
  • Taoism is very political orientation from the start have. Internal alchemy has several factions, but southern school and northern school of taoism is typical of this. southern school begun from Zhang Bo-duan in north Song dynasty. Northern school is under Jin dynasty rule by Wang Chung-yang been established. Southern school did not create the platform, but northern school is developed mainly by the denomination from the first. Taoism is basically seek eternal life. Internal alchemy was created a unique discipline to reach the such stage with only Internal alchemy. Southern school's training methods were an elaborate series of logical structure with a counterpart, but northern school's methods is somewhat lacking logically. Southern school claim a training methods from the physical to mental through how to achieve it's ultimate goals, northern school took from mental to spiritual retreat methods that the way to achieve objectives. But northern school's theory of ascetic Practice is difficult to see that the contents are pure. Also, the labours of penance during his training process is the other way with Southern school. These differences are they closely associated with Confucianism and Buddhism, to understand the point of view. Southern school put a primary objective in the personal Practice, while northern school is fundamental to the relief of the people. This can see that has how long life times in southern school and northern school's main members. Because the members of southern school enjoyed great longevity, but northern school's main members was not enjoyed longevity. As a result, the southern school's flow is cut off and northern school became the center form a major organization in the history of china taoism. The southern school assimilated to the northern school. In a pure sense, host and guest's changed.

Resarch on Manufacturing Technology of Red-Burnished Pottery Excavated from Samdeok-ri, Goseong, Korea (고성 삼덕리유적 출토 적색마연토기의 제작 특성 연구)

  • Han, Leehyeon;Kim, Sukyoung;Jin, Hongju;Jang, Sungyoon
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.170-187
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    • 2020
  • Dolmens bearing the burial layout and stone coffin tombs of the late Bronze Age were excavated from Samdeok-ri, Goseong, Gyeonsangnsamdo, and grave items such as red-burnished pottery, arrowheads, and stone swords were also discovered. In the case of the red-burnished pottery that was found, it retains a pigment layer with a thickness of about 50 to 160㎛, but with most of the other items, exfoliation and peeling-off of pigment layers can be observed on the surface. The raw materials of the red-burnished pottery contained moderately sorted minerals such as quartz, feldspar, and hornblende, and partly opaque iron oxide minerals were also identified. In particular, the raw materials of the red-burnished pottery from stone coffin tomb #6 were different from those of the other pottery, containing large amounts of hornblende and feldspar. The pottery's red pigment was identified as hematite and showed similar mineral content of raw materials such as fine grained quartz, feldspar, and hornblende. The firing temperature is estimated to have been approximately 900℃, based on their mineral phase. The possibility exists that the raw materials had been collected from the Samdeok-ri area, because diorite and granite diorite with dominant feldspar and hornblende have been identified within 3km of that area. During the pottery manufacturing process, it is estimated that the pigment was painted on the entire surface of the red-burnished pottery after it had been molded and then finished using the abrasion technique. In other words, the red-burnished pottery was made by the process of vessel forming - semi drying - coloring - polishing. The surface and cross-section of the pottery appears differently depending on the concentration of the pigment and the coloring method used after vessels were formed. Most of the excavated pottery features a distinct boundary between pigment and body fabric. However, in the case of pottery in which fine-grained pigments penetrate the body fabric so that layers cannot be distinguished, there is the possibility that the fine-grained pigment layer was applied at a low concentration or immediately after vessel forming. Many cracks can be seen on the surface pigments in thickly painted pottery items, and in many cases, only a small portion of the pigment layers remain due to surface exfoliation and abrasion in the burial environment. It is reported that pottery items may be more easily damaged by abrasion if coated with pigment and polished, so it is believed that the red-burnished pottery of the Samdeok-ri site suffered from weathering in the burial environment. This damage was more extensive in the potsherds that were scattered outside the tomb.

The Interpretation of a Korean Folk Tale from the Perspective of Analytical Psychology (민담 <외쪽이>의 분석심리학적 해석)

  • Ji Youn Kim
    • Sim-seong Yeon-gu
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    • v.32 no.2
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    • pp.122-168
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    • 2017
  • I tried to understand a folk tale "The half-boy" in terms of analytical psychology. In the story, a lady without children prayed to the Buddha. The white old man came and gave three fishes, but the cat ate half of it. So, she ate two and a half. She gave birth to two perfect sons. The third son had one arm, one leg, and one eye. They grew well. Brothers went to take the civil service examinations, and the half-boy followed. But two brothers did not like the half-boy coming along. So, brothers tied the half-boy to the rocks and trees, and he picked them up with force and gave them down to the yard of the house. And the half-boy followed his brothers again, and brothers tied him with kudzu and put him in front of the tiger. The half-boy won the tiger by betting with cutting kudzu. The half-boy stripped off the tiger's skin. The host coveted the tiger skin and they played with janggi. The half-boy won the game and was permitted to take host's daughter. The half-boy went with a string, a drum, a flea, and a bedbug. He teased host's people with these. The half-boy brought a virgin and lived well. "The Half-Boy" folktale is an old story spread throughout the country. There are similar stories in India and Africa. Unilateral figures are universally distributed archetypal images. In numerous cultures gods and spirits are being portrayed as unilateral figures. In the creation mythology, half-figure beings have immortality. In Indonesian and African folk tales, the half-born boy goes to heaven and merges with its half and becomes perfect. Some of one-sided spirits are harmful to humans but some of one-sided birds, chickens, and spirits are helpful to people. Sometimes half being is a cultural hero who steals grain from heaven or gets some advice how to use bamboo. There are stories that half body becomes a whole body afterwards. But in this folktale and most of the similar folktales, half-figure does not change and maintains half-figure to the end. And as a half-figure he does various great things and marries a virgin. The half-boy symbolizes a psychic experience born in the unconscious. The unconscious contents may seem strange and weird at first and the collective consciousness does not want to accept them. But the unconscious exerts greater power and brings vitality and creativity to consciousness. This folk tale seems to have compensated for the stubborn collective consciousness of our society, which was a Confucian class society. It also allows people to change their attitude toward disabled people and recognize strengths and creativity of the handicapped.

Anthropometric Measurements and Biochemical Nutritional Status of the Older Residents (50 years and over) in Andong Area (2) (안동주변 농촌지역 50세 이상 주민의 신체계측치 및 생화학적 영양상태에 관한 연구 (2))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.12
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    • pp.1599-1608
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    • 2008
  • This study aimed to assess the health status based on the anthropometric and biochemical measurements of middle-aged and elderly people living in Andong area. The subjects were 1,384 people (532 males, 852 females) aged 50 years and over (average 62.7 years). The mean anthropometric values for males and females were heights of 163.7 and 151.5 cm; weights 63.6 and 57.3 kg; body mass index (BMI) 23.6 and $24.9kg/m^2$; body fat 21.8 and 31.8%, respectively. Height and weight were lower, however, waist circumference (in female) and BMI were higher than those of the 2001 National Health and Nutrition Survey (NHNS). Obesity incidences of male and female subjects were 28.7% and 47.3% by BMI; 25.8% and 50.8% by % body fat; and 15.6% and 80.9% by waist circumference, respectively. Also, abdominal adiposity was very severe in female subjects of 50s. The mean biochemical measurements of male and female were as follows: systolic and diastolic blood pressure 136.9, 83.8 mmHg and 133.6, 82.5 mmHg; hemoglobin (Hb) 14.3 and 13.0 g/dL; hematocrit (Ht) 44.7 and 39.8%; blood albumin 4.15 and 4.04 g/dL; total-cholesterol 170.0 and 183.1 mg/dL; HDL-cholesterol 43.6 and 42.7 mg/dL; fasting blood glucose 96.7 and 93.0 mg/dL, respectively. Also, the prevalence of biochemically abnormal subjects according to each cut-off point of biochemical measurements were analyzed. The results for male and female were; hypertension 58.0% and 47.2%; iron deficient anemia 19.3% and 20.6% by Hb, 7.2% and 11.9% by Ht; hypoalbuminemia 9.8% and 11.7%; diabetes 12.0% and 10.2%; hypercholesterolemia 19.5% and 30.5%, respectively. From those results we found that hypoalbuminemia, hypertension and hypercholesterolemia were prevalent, and obesity in females of 50s, iron-deficient anemia and diabetes in males of 70 years and over were significant health problems in this area. Therefore, it seems to be necessary to examine their health status periodically and provide the appropriate health and nutrition education program, which includes low sodium intake, balanced diet, exercise and weight control, to prevent the occurrence of chronic diseases.