• Title/Summary/Keyword: 쇼크

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Electric Kickboard Safety Environment Systemfor Neuromuscular Disease Patients (신경근육질환 환자를 위한 전동킥보드 안전 환경 시스템)

  • DongYeon Ha;JooYong Song;ChangRyeol Lee;TaeHwa Ha;JoonYong Park
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.11a
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    • pp.986-987
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    • 2023
  • 본 논문은 신경근육질환 환자의 이동 문제를 해결하고, 기존 전동킥보드 시스템의 한계와 문제점도 해결하는 '신경근육질환 환자를 위한 전동킥보드 안전 환경 시스템'을 제안한다. 주요 특징은 다음과 같다. 첫째, 헬멧 착용 검사를 통과해야만전동킥보드를 이용할 수 있다. 휴대폰 전면 카메라를 통해 사용자의 모습을 촬영하면 딥러닝 모델을 통해 헬멧 착용 여부를 판단한다. 둘째, 주행 금지구역에서는 이용자 추적 모드를 활성화하여 OpenCV를 통해 이용자를 검출및 추적하고이에 따라 모터 PWM을 조절해서 방향 및 속력을 조절함으로써 이용자를 추적한다. 셋째, 헬멧 내 자이로 센서와 쇼크 센서를 통해 주행 사고를 감지하고 SMS를 이용해 해당 보호자에게 자동으로 사고 정보를 전달한다.

Middle and Long Term Results of 34 Cases of Emergency Coronary Artery Bypass Graft Surgery (응급 관상동맥 우회술 34예의 중장기 성적)

  • 손정환;김응중;지현근;신윤철;김건일;최광민;이원진;이원용
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.741-747
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    • 2003
  • Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

A Study on the Comovements and Structural Changes of Global Business Cycles using MS-VAR models (MS-VAR 모형을 이용한 글로벌 경기변동의 동조화 및 구조적 변화에 대한 연구)

  • Lee, Kyung-Hee;Kim, Kyung-Soo
    • Management & Information Systems Review
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    • v.35 no.3
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    • pp.1-22
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    • 2016
  • We analyzed the international comovements and structural changes in the quarterly real GDP by the Markov-switching vector autoregressive model (MS-VAR) from 1971(1) to 2016(1). The main results of this study were as follows. First, the business cycle phenomenon that occurs in the models or individual time series in real GDP has been grasped through the MS-VAR models. Unlike previous studies, this study showed the significant comovements, asymmetry and structural changes in the MS-VAR model using a real GDP across countries. Second, even if there was a partial difference, there were remarkable structural changes in the economy contraction regime(recession), such as 1988(2) ending the global oil shock crisis and 2007(3) starting the global financial crisis by the MS-VAR model. Third, large-scale structural changes were generated in the economic expansion and/or contraction regime simultaneously among countries. We found that the second world oil shocks that occurred after the first global oil shocks of 1973 and 1974 were the main reasons that caused the large-scale comovements of the international real GDP among countries. In addition, the spillover between Korea and 5 countries has been weak during the Asian currency crisis from 1997 to 1999, but there was strong transmission between Korea and 5 countries at the end of 2007 including the period of the global financial crisis. Fourth, it showed characteristics that simultaneous correlation appeared to be high due to the country-specific shocks generated for each country with the regime switching using real GDP since 1973. Thus, we confirmed that conclusions were consistent with a number of theoretical and empirical evidence available, and the macro-economic changes were mainly caused by the global shocks for the past 30 years. This study found that the global business cycles were due to large-scale asymmetric shocks in addition to the general changes, and then showed the main international comovements and/or structural changes through country-specific shocks.

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Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.465-473
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    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

The Effects of Slide-Covered of Slide-Covered Contemporary Charging Automated External Defibrillator on Rapidity and Convenience of Defibrillation (슬라이드 커버 동시충전 자동심장충격기가 제세동의 신속성과 편의성에 미치는 효과)

  • Park, Si-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.325-333
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    • 2020
  • This study compares the rapidity and subjective convenience of T-AED and SC-AED for health care providers and the general public. Subjects were randomly allocated to T-AED (n=77) and SC-AED (n=79) groups. Each group conducted defibrillation, with subsequent measurement of the rapidity of defibrillation in peri-shock pause, pre-shock pause, hesitation pause, and post-shock pause. Defibrillation and chest compression delay times for both equipment were analyzed by t-test. On conclusion of the experiment, subjects answered a questionnaire on the subjective convenience of defibrillation, as measured for confidence, convenience, and clear decision. Comparisons of subjective convenience analyzed by t-test revealed significantly shortened peri-shock pause (11.22s), pre-shock pause (11.04s), and hesitation pause (2.15s) in the SC-AED group, as compared to the T-AED group (p<0.001). However, no significant differences were observed for post-shock pause values. Comparing subjective convenience, confidence (T-AED: 7.62±1.25VAS vs. SC-AED: 7.80±0.98VAS, p=0.358) was not significant, whereas convenience (T-AED: 7.05±1.36VAS vs. SC-AED: 8.95±0.89VAS, p<0.001) and clear decision (T-AED: 6.58±1.73VAS vs. SC-AED: 9.08±0.98VAS, p=0.001) showed statistically significant differences. Our results indicate that compared to T-AED, SC-AED has significantly shortened pauses. Moreover, it is more convenient for the user, and significantly aids in clear decisions.

Pulmonary Embolectomy for Treatment of Pulmonary Embolism (폐색전증의 수술적 치료)

  • Park, Byung-Joon;Park, Pyo-Won;Shim, Young-Mog;Lee, Young-Tak;Park, Kay-Hyun;Kim, Jhin-Gook;Kim, Wook-Sung;Sung, Ki-Ick
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.492-496
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    • 2009
  • Background: The treatment of acute pulmonary embolism is difficult, and it can be lethal when cardiogenic shock is involved with major pulmonary embolism. In the past, pulmonary embolectomy was considered as the last choice for patients with pulmonary embolism. Accordingly, we analyzed our experience with seven cases of pulmonary embolectomy as an alternative option for the early treatment of pulmonary embolism. Material and Method: A retrospective analysis of medical charts of all patients who underwent pulmonary embolectomy at our hospital over the past eight years was performed. The patients were observed during their hospital stay and followed until their last visit to the outpatient department. Result: Among 7 patients (4 men and 3 women), 4 had massive pulmonary embolism, and 3 had sub massive pulmonary embolism. An extracorporeal membrane oxygenator was inserted in 3 patients before surgery. There was no mortality, and postoperative echocardiography showed no pulmonary hypertension in 6 patients. Conclusion: Pulmonary embolectomy can be performed with minimal mortality. We think that the use of an extracorporeal membrane oxygenator in patients with cardiogenic shock before surgery improves survival.

Clinical Significance of Serum Endothelin-1 and Interleukin-8 in Sepsis (패혈증에서 혈중 Endothelin-1 및 Interleukin-8의 임상적 의의)

  • Park, Kwang-Joo;Choi, Young-In;Oh, Yoon-Jung;Choi, Young-Hwa;Hwang, Sung-Chul;Lee, Yi-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.300-309
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    • 2001
  • Background : Sepsis is a clinical syndrome characterized by a systemic inflammatory and hemodynamic response to severe bacterial infections that involve various mediators. Endothelin (ET)-1, a potent vasoconstrictor is associated with mu1tiple organ failure, and interleukin (IL)-8, a proinflammtory cytokine, plays a major role in neurophil activation. Both have been reported to be useful parameters in the clinical assessment of sepsis. The levels of ET-1 and IL-8 in the blood were measured in patients with sepsis, and the correlation of both parameters and their relationship with the clinical data was assessed. Methods : 19 sepsis patients and 17 controls were studied. Blood samples of the sepsis patients were drawn in day 1, 3, 7, and 14. The APACHE III scores were calculated in concurrent days. The ET-1 and IL-8 levels were measured using immunoassay methods. Results : The ET-1 levels of patients with sepsis were significantly higher than in the controls. In patients with sepsis, non-survivors had higher ET-1 levels than survivors on day 1 and 7, and patients with shock also had higher ET-1 levels than normotensive patients on admission. The ET-1 levels were significantly correlated with the creatinine levels on day 1, 7, and 14. The IL-8 levels showed a significant correlation with the ET-1 levels on day 14. Conclusion : ET-1 was found to be closely related with the clinical outcome, shock, and renal failure, and showed a correlation with IL-8. These mediators can be considered not only to play pathophysiologic roles but also as useful parameters in the clinical assessment of sepsis.

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Effects of Aspirin on the Pathogenesis of Acute Lung Injury in Rats Subjected to Hemorrhage (출혈성 쇼크로 인한 급성 폐손상의 발병기전과 아스피린의 효과)

  • Park, Yoon-yub;Lee, Young Man
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.83-91
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    • 2006
  • Background : For unknown reasons, the serum ferritin concentrations are higher in patients with acute lung injury. A pretreatment with aspirin reduces the acute lung injury in rats subjected severe hemorrhage, and increases the rate of ferritin synthesis in vitro. This study investigated the effect of aspirin on the serum ferritin changes in rats subjected to severe hemorrhage. Methods : Hemorrhagic shock was induced by withdrawing blood (20 ml/kg of B.W.) through the femoral artery for 5 min. The rats were pretreated with aspirin (10 mg/kg, i.v.) 30 min before hemorrhage. Results : The protein content and leukocyte count in the bronchoalveolar lavage fluid, lung tissue myeloperoxidase activities were significantly higher after hemorrhage. The aspirin pretreatment prevented these changes. The serum and lavage fluid ferritin concentrations were elevated higher after hemorrhage. These were also attenuated by the aspirin pretreatment. Conclusion : The changes in the serum and lung lavage ferritin level might be closely related to the severity of hemorrhage-induced acute lung injury. Therefore, the serum and lavage ferritin concentrations can be a useful biomarker for patients with precipitating conditions.

Severe Hemorrhage Induced Expressions of Ferritin and Heme Oxygenase-1 In Leukocytes (출혈로 인한 폐 염증세포에서의 ferritin과 heme oxygenase-1의 발현)

  • Kwon, Jung-Wan;Park, Yoon-Yub
    • Journal of Life Science
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    • v.19 no.7
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    • pp.878-885
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    • 2009
  • Serum ferritin levels are elevated in subjects with acute lung injury (ALI), and abnormalities in plasma and lung iron chemistry have also been demonstrated in ALI and acute respiratory distress syndrome (ARDS). Stress-inducible heme oxygenase-1 (HO-1), as well as ferritin, had shown anti-inflammatory actions. Biomarkers for early detection in patients who are likely to develop ARDS would give several therapeutic chances to the patients. In order to verify the predictability in severe hemorrhage-induced ALI in rats, we measured serum ferritin and HO-1 concentrations before and after hemorrhage. Severe hemorrhages significantly increased the number of leukocytes in bronchoalveolar lavage (BAL) fluid and lung tissue myeloperoxidase activity. Both serum ferritin and HO-1 levels increased following hemorrhage, but ferritin levels were elevated earlier than HO-1. In BAL cell immunohistochemical studies, ferritin and HO-1 expressions increased after hemorrhage and localized in the cytoplasm of leukocytes. These findings suggest that inflammatory leukocytes in BAL fluid can secrete ferritin and HO-1, and serum ferritin levels might be more valid factor in predicting ARDS than HO-1 levels in hemorrhage-induced ALI.

Clinical and Angiographic Features of Secondary Postpartum Hemorrhage and the Outcomes of Transcatheter Arterial Embolization (속발성 분만 후 출혈의 임상 및 혈관 조영술의 특징과 경도관 동맥 색전술의 결과)

  • Baek, Seung Dae;Kang, Ung Rae;Ji, Seung Woo;Kim, Young Hwan;Cha, Jung Guen
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.315-322
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    • 2018
  • Purpose: To analyze the clinical and angiographic features with outcome of transcatheter arterial embolization in patients with secondary postpartum hemorrhage. Materials and Methods: Clinical details and angiographic features with assessment of arterial embolization were reviewed in total 38 patients underwent arterial embolization at single tertiary referral center. Results: Twenty patients (53%) had Cesarean section. The major causes of bleeding were iatrogenic vascular injury, and retained placenta (55%). The patterns of vaginal bleeding were recorded as intermittent (50%), or as persistent (50%). Seven patients (18%) were hemodynamically unstable at presentation. Positive angiographic findings appeared in eighteen patients (47.3%). The frequency of pseudoaneurysm was statistically high in the Cesarean section (p < 0.001). The used embolic agents except gelfoam were N-butyl cyanoacrylate (n = 7), and microcoil (n = 7). Unilateral selective embolization (26.3%) was shown effective in superselective embolization of bleeding focus. Technical and clinical success rate were 100% and 97.4%, respectively with no complication. Sixteen resumed regular menstruation, and one pregnancy were observed in patients with available follow-up of over 6 months. Conclusion: Considerable rate of hemodynamically unstable patients was observed with high rate of positive angiography findings. Given high successful rate and few complications, early angiographic assessment with embolization should be considered.