• Title/Summary/Keyword: 쇼크

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The Usefulness of a Percutaneous Cardiopulmonary Support Device for the Treatment of Fulminant Myocarditis (전격성 심근염의 치료에 있어 경피적 순환 보조 장치의 유용성)

  • Lim, Juyoug;Jung, Sung Ho;Je, Hyoung-Gon;Lee, Taek Yeon;Choo, Suk Jung;Lee, Jae Won;Chung, Cheol Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.20-24
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    • 2010
  • Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.

Effects of Ginseng and Its Saponins on Experimental Amnesia in Mice and on Cell Cultures of Neurons (인삼 및 인삼 사포닌이 쥐의 건망증 및 신경세포배양에 미치는 영향)

  • Saito Hiroshi;Nishiyama Nobuyoshi;Iwai Akihiko;Kawajiri Shinichi;Himi Toshiyuki;Sakai Toshimi;Fukunaka Chizu
    • Proceedings of the Ginseng society Conference
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    • 1988.08a
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    • pp.92-98
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    • 1988
  • The present study was performed to find the effects of ginseng and its saponins. which is written in Chung Yao Ta Tsu Tien as anti-amnesia in its chief indication. on experimental amnesia in mice. In the step through test. ginsenoside $Rb_1\;(GRb_1)\;and\;GRg_1$ facilitated the registration of memory and antagonized the electroconvulsive shock (ECS)-induced inhibition of the retention of memory. Moreover. $GRg_1$ antagonized the EtOH-induced inhibition of the retrieval of memory. In the step down test. $GRb_1\;GRb_2\;and\;GRg_1$ antagonized the ECS-induced inhibition of the retention of memory. Moreover. $GRg_1$ antagonized the EtOH-induced inhibition of the retrieval of memory and facilitated the acquisition of short term memory. In the shuttle hox and lever press tests. they have no effects on acquisition and retrieval of memory. except $GRb_1\;GRb_1$ depressed the retrieval of conditioned avoidance response in the shuttle box test. After the end of four tests. the effects of these orally administered drugs on sedative. analgesic. antipyretic and anticonvulsant actions. and on spontaneous and exploratory movements were tested in doses of less than 500mg/kg. but they had none of these effects. Present study may indicate that $GRg_1$ had effects on the retrieval of memory and on the acquisition process of learning response. The recent research on the role of NGF for the survival. regeneration and regulation of brain in adult animals. indicated the importance of NGF on dementia and amnesia. During our research on the specificity of the neurite out growth induced by NGF. we found that the effect of NGF was potentiated by $GRb_1$ in organ cultures of chick embryonic dorsal root ganglia. Then. the effect of $GRb_1$ on neuronal cell survivalin cell culture system was studied. $GRb_1$ potentiated the NGF-mediated increase of neurofilaments in cell cultures of chick embryonic sensory and sympathetic neurons. NGF with $GRb_1$ also showed a tendency to increase the number of surviving neurons of rat embryonic cerebral cortex. NGF increased choline acetyl transferase activity in cell cultures of rat embryonic septum area neurons. but $GRb_1$ did not potentiate NGF activity in cell cultures of rat embryonic septum area neurons. Present study may indicate that $GRb_1$ plays an important role for the survival or regeneration of neurons in the brain.

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The Present State of Domestic Acceptance of Various International Conventions for the Prevention of Marine Pollution (해양오염방지를 위한 각종 국제협약의 국내 수용 현황)

  • Kim, Kwang-Soo
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.12 no.4 s.27
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    • pp.293-300
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    • 2006
  • Domestic laws such as Korea Marine Pollution Prevention Law (KMPPL) which has been mae and amended according to the conclusions and amendments of various international conventions for the prevention a marine pollution such as MARPOL 73/78 were reviewed and compared with the major contents of the relevant international conventions. Alternative measures for legislating new laws or amending existing laws such as KMPPL for the acceptance of major contents of existing international conventions were proposed. Annex VI of MARPOL 73/78 into which the regulations for the prevention of air pollution from ship have been adopted has been recently accepted in KMPPL which should be applied to ships which are the moving sources of air pollution at sea rather tlnn in Korea Air Environment Conservation Law which should be applied to automobiles and industrial installations in land. The major contents of LC 72/95 have been accepted in KMPPL However, a few of substances requiring special care in Annex II of 72LC, a few of items in characteristics and composition for the matter in relation to criteria governing the issue of permits for the dumping of matter at sea in Annex III of 72LC, and a few of items in wastes or other matter that may be considered for dumping in Annex I of 96 Protocol have not been accepted in KMPPL yet. The major contents of OPRC 90 have been accepted in KMPPL. However, oil pollution emergency plans for sea ports and oil handling facilities, and national contingency plan for preparedness and response have not been accepted in KMPPL yet. The waste oil related articles if Basel Convention, which shall regulate and prohibit transboundary movement of hazardous waste, should be accepted in KMPPL in order to prevent the transfer if scrap-purpose tanker ships containing oil/water mixtures and chemicals remained on beard from advanced countries to developing and/or underdeveloped countries. International Convention for the Control if Harmful Anti-Fouling Systems on the Ships should be accepted in KMPPL rather tlnn in Korea Noxious Chemicals Management Law. International Convention for Ship's Ballast Water/Sediment Management should be accepted in KMPPL or by a new law in order to prevent domestic marine ecosystem and costal environment from the invasion of harmful exotic species through the discharge of ship's ballast water.

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Studies of Exercise-Induced Allergy Anaphylaxis Mechanisms and the Effects of Vitamin C and Catalase Supplementation in Exercise-Induced Allergy Anaphylaxis Models (운동 유발성 알레르기 질환분석 및 비타민 C와 catalase 투여 효과 분석)

  • Kwak, Yi-Sub
    • Journal of Life Science
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    • v.20 no.4
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    • pp.511-518
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    • 2010
  • Exercise-induced anaphylaxis (EIA) is defined as the onset of allergic symptoms during, or immediately after, exercise, the clinical signs being various degrees of urticaria, angioedema, respiratory and gastrointestinal signs, and even anaphylactic shock. Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods within the preceding several hours. To describe the physiopathologic mechanism, etiologic factors, and clinical manifestations, we evaluated the supplementation of vitamin C and catalase on spleen index, proliferation assay, ROS, and ASAS in sensitized and exercise trained mice. The results were as follows: Spleen index showed the highest level in the ST12 group compared to other groups; this level increased in a time dependent manner and in significant amounts. In proliferation assay of Med and OVA, the ST12 group showed the highest level compared to other groups; this level also increased in a time dependent manner. On the other hand, spleen ROS did not show a statistically significant difference, and peritoneal ROS showed the highest level in the ST12 group. ASAS showed the highest level in the ST12 compared to the S; this was also in a time dependent manner and in significant amounts. From the results, we chose the ST9 and ST12 groups to evaluate allergy anaphylaxis with supplementation of Vitamin C and catalase. In both the ST9 and ST12 groups, peritoneal ROS and ASAS were lower in vitamin C treatment group than in the catalase treatment group. This was a statistically significant difference. From the results, allergy anaphylaxis showed a higher level in the long trained group than in the short trained group. Also, treatment with vitamin C was more effective in lowering allergy anaphylaxis than catalase treatment.

Clinical Significance of Repeated Delayed Air Reduction in Unsuccessful Initial Reduction of Intussusception (초기 정복에 실패한 장중첩증 환자에서 반복 지연 정복술의 임상적 의의)

  • Shin, Song-Heui;Rho, Young-Il;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.175-180
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    • 2001
  • Purpose: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. Methods: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. Results: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. Conclusion: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.

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The Correlation between Toxin Genotype and Antibiotic Resistance in Methicillin Resistant Staphylococcus aureus Isolated from Clinical Specimen of Intensive Care Unit (중환자실의 임상검체로부터 분리된 Methicillin 내성 Staphylococcus aureus의 독소유전자형과 항생제내성의 상관관계)

  • Park, Chul;Seong, Chi Nam
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.3
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    • pp.202-209
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    • 2016
  • This study is aimed to determine the correlation between the toxin gene types and antibiotic resistance from MRSA (methicillin-resistant Staphylococcus aureus). Fifty-two strains of MRSA, between January 2014, and December 2014, were isolated from clinical specimens obtained from 2,664 cases in the intensive care unit of a hospital in Suncheon, Jeonnam, Korea. Genes encoding mecA, enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), exfoliative toxin (ET), and Panton-Valentine leukocidin (PVL) were detected by multiplex PCR-mediated amplification using specific primers. Toxin genes (seg and sei) were present in 40 strains (76.9%), followed by tst in 34 strains (65.4%). Other genes (eta, etb, sea, sed, see, seh, sej, and pvl) were not detected. Forty strains (76.9%) of MRSA had 2 or more toxin genes simultaneously; 5 coexistent toxin-genes (seb, sec, seg, sei, tst) were the most common in 28 strains (53.8%), and 6 strains (11.5%) had seg and sei genes. The coexistence of genes were 72.5~100%, showing a high correlation among genes (seb, sec, seg, sei and tst). As strains (seb, sec, tst) that had particular toxin genes (seb, sec, seg, sei, tst) in multiple showed 100% resistance to ciprofloxacin, clindamycin, erythromycin, we were able to find that seb, sec, and tst genes have a close relationship to the aforementioned antibiotics. It showed a higher resistance to ciprofloxacin, clindamycin, erythromycin, and tetracycline compared with strains that had toxin genes independent from multiple toxin genes.

Effects of Hypovolemic Hypotension on Cardiopulmonary Functions and Acid-Base Balance (출혈성 쇼크가 심폐기능 및 산.염기평형에 미치는 영향)

  • Sou, Won-Young;Lee, Sung-Haing
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.131-142
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    • 1973
  • Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

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A Study on the Characteristic Analysis and Manufacture of Electrostatic Dissipation PU Foaming Film (정전방전 PU 발포필름의 제조와 특성분석)

  • Kim, Seung-Jin;Park, Jun-Hyeong;Choi, La-Hee;Park, Mi-Ra;Ma, Hye-Young;Kwon, Oh-Kyung
    • Proceedings of the Korean Society of Dyers and Finishers Conference
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    • 2011.03a
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    • pp.58-58
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    • 2011
  • CNT 나노기술을 응용한 IT산업용 적층간지용 ESD(정전방전, Electrostatic Dissipation)PU 발포필름의 제조 가공기술 및 상품화 개발은 전자제품 패키지에 요구되는 쿠션성과 정전방전 기능을 갖는 폴리우레탄 발포 필름의 제조기술을 확립함으로써 가능 할 수 있다. 특히 IT산업용 필름제품이 개발되면 ESD 성능을 발휘하게 됨으로서 정전기 쇼크에 의한 각종 전자제품의 오작동이나 파손 방지가 가능하게 되어 포장재, 자동차, 전자제품의 하우징 등으로 사용될 수 있게 된다. 현재까지 ESD 기능을 부여하기 위해서 사용되는 충전재로는 금속섬유, 금속플레이크, 탄소섬유, 카본블랙 등이 있으며, 최근 탄소나노튜브를 응용한 연구가 많이 진행되고 있는데 탄소나노튜브는 직경이 수십nm, 종횡비 1000이상의 나노섬유형태로 서 전기전도성이 구리수준으로 알려져 있고 소량을 충전할 시 기계적 특성도 오히려 증대하는 장점을 가지고 있으며 전기적 특성으로는 상대적으로 낮은 나노튜브 함량에서는 ESD를 들 수 있고 높은 함량에서는 전자파 차폐성까지 기대되고 있다. 본 연구에서는 우수한 인장강도, 기계적 강도, 열적 안정성, 내약품성을 가지면서 습식 또는 용융공정을 통해 용이하게 시트, 필름, 코팅제를 제조할 수 있는 방수, 투습방수성을 가지는 유연재료인 폴리우레탄(PU) 1액형 PU에 MWNT 함량이 3wt%인 IPA/MWNT 분산용액을 PU 함량 대비 20, 30, 40파트로 함유시켜 $120^{\circ}C$에서 2분 건조시켜 제조한 그라운드 필름에 2액형 PU와 IPA/MWNT 분산용액에 발포제를 첨가하여 발포온도 140, 150, $160^{\circ}C$에서 5분간 건조시켜 시료 필름을 제조하였다. 제조된 필름의 전기전도성 측정은 부피저항과, 표면저항을 각각 측정하여 확인하였으며, 필름의 마찰 대전압은 E.S.T-7 마찰 대전압 시험기를 이용하여 표면 마찰 대전압과 반감기를 측정하여 확인하고, 필름의 물리적 특성은 인장시험기를 이용하여 breaking stress, breaking strain을 구하였다. 필름의 표면 특성은 영상 현미경 시스템을 사용하여 ${\times}1000$ 배율로 측정하여 분산특성과의 연관성을 확인하였다.

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Clinical Analysis of Spontaneous Hemopneumothorax (자연성 혈기흉에 관한 임상적 고찰)

  • 이양행;박동욱;조광현
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1076-1080
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    • 1998
  • Background: Spontaneous hemopneumothorax, occurring in 1% to 12% of patients with spontaneous pneumothorax, is a rare disorder that can potentially lead to life-threatening complications. Materials and methods: We have experienced 15 cases (2.28%) with spontaneous hemopneumothorax among 659 episodes of spontaneous pneumothorax for eight years, from 1990 to 1997, at our hospital. We studied our previously treated patients by retrospective case studies to determine the nature of optimal management. Results: There were 14 male and 1 female patients whose mean age was 27.5 years, ranging from 19 to 58. The sides with disorder were as following: right in 10 cases and left in 5, unilaterally. The amount of initial bleeding ranged from 400 to 1,500 mL and 8 patients received a homologous blood transfusion. Patients exhibited symptoms of chest pain, dyspnea, chest discomfort, and hypovolemic shock. We concluded that causes of this disease in our patients were a torn pleural adhesion (14 cases) and a rupture of vascularized bullae (1 case with an underlying intrinsic lung disease, tuberculosis). All patients underwent closed thoracostomy and had good results except for 3. One patient underwent thoracotomy within 3 days from the onset because of continuous active hemorrhage. Decortication was required in one case because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. Another patient underwent thoracotomy due to a ipsilateral recurrent pneumothorax without blood collection. Conclusions: The goals of treatment include hemostasis and reexpansion of the collapsed lung. Thus, if patients arrive early at hospital, closed thoracostomy and transfusion are thought to be sufficient treatments, although early surgical repair has been considered recently.

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Establishment of the Digital Era Elderly by Lifelong Educational Leisure Sports (평생 교육적 여가스포츠를 통한 디지털 시대의 신노인상 정립)

  • Kim, Myung-Mi
    • The Journal of the Korea institute of electronic communication sciences
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    • v.8 no.6
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    • pp.933-940
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    • 2013
  • Our country is defenseless against the aging population in society that is suddenly and rapidly increasing. This is expressed as the aging shock and aged society earthquake, warning us of the crisis in the future society. Senior citizens of Korea are a group that does not receive proper education due to various social factors, and it is a group that requires lifelong education more than any other group, and therefore, senior citizens have become a priority target for lifelong education. Thus, the need for lifelong education for seniors can be said to be in establishing a new senior citizen image so that they may live a fuller retirement by improving their abilities to appropriately adapt to the rapidly changing modern society due to the digital times. Furthermore, with the enhanced cultural level and personal desire for a fuller life in the modern society, the necessity for leisure activities has been emphasized. Instead of simply relieving stress through leisure activities, it aims at being provided with educational opportunities through leisure activities. Therefore, senior leisure activity education should be an important method for establishing the senior citizen identity of a self-oriented senior, productive senior, volunteering senior, informed senior, and a well-rounded senior, which are all the image of senior citizens in the 21st century. In addition, a specialized leisure activity program that systematically provides education for leisure activities should be performed from the perspective of lifelong education. Hence, the significance of senior citizen leisure activities as lifelong education is in improving health, enhancing sociability and realizing one's self, while improving the quality of life for senior citizens. It will be greatly meaningful for establishing the new senior citizen image in which they independently live their own lives, while not being dependent on others, as required in the 21st century.