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Surgical Correction of Total Anomalous Pulmonary Venous Connection in Early Infancy (조기 영아에서 전폐정맥연결이상의 외과적 교정)

  • 성시찬;방정희;전희재;조광조;최필조;우종수;이인규;이형두
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.510-517
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    • 1999
  • Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

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Expiration-Day Effects: The Korean Evidence (주가지수 선물과 옵션의 만기일이 주식시장에 미치는 영향: 개별 종목 분석을 중심으로)

  • Choe, Hyuk;Eom, Yun-Sung
    • The Korean Journal of Financial Management
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    • v.24 no.2
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    • pp.41-79
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    • 2007
  • This study examines the expiration-day effects of stock index futures and options in the Korean stock market. The so-called 'expiration-day effects', which are the abnormal stock price movements on derivatives expiration days, arise mainly from cash settlement. Index arbitragers have to bear the risk of their positions unless they liquidate their index stocks on the expiration day. If many arbitragers execute large buy or sell orders on the expiration day, abnormal trading volumes are likely to be observed. If a lot of arbitragers unwind positions in the same direction, temporary trading imbalances induce abnormal stock market volatility. By contrast, if some information arrives at market, the abnormal trading activity must be considered a normal process of price discovery. Stoll and Whaley(1987) investigated the aggregate price and volume effects of the S&P 500 index on the expiration day. In a related study, Stoll and Whaley(1990) found a similarity between the price behavior of stocks that are subject to program trading and of the stocks that are not. Thus far, there have been few studies about the expiration-day effects in the Korean stock market. While previous Korean studies use the KOSPI 200 index data, we analyze the price and trading volume behavior of individual stocks as well as the index. Analyzing individual stocks is important for two reasons. First, stock index is a market average. Consequently, it cannot reflect the behavior of many individual stocks. For example, if the expiration-day effects are mainly related to a specific group, it cannot be said that the expiration of derivatives itself destabilizes the stock market. Analyzing individual stocks enables us to investigate the scope of the expiration-day effects. Second, we can find the relationship between the firm characteristics and the expiration-day effects. For example, if the expiration-day effects exist in large stocks not belonging to the KOSPI 200 index, program trading may not be related to the expiration-day effects. The examination of individual stocks has led us to the cause of the expiration-day effects. Using the intraday data during the period May 3, 1996 through December 30, 2003, we first examine the price and volume effects of the KOSPI 200 and NON-KOSPI 200 index following the Stoll and Whaley(1987) methodology. We calculate the NON-KOSPI 200 index by using the returns and market capitalization of the KOSPI and KOSPI 200 index. In individual stocks, we divide KOSPI 200 stocks by size into three groups and match NON-KOSPI 200 stocks with KOSPI 200 stocks having the closest firm characteristics. We compare KOSPI 200 stocks with NON-KOSPI 200 stocks. To test whether the expiration-day effects are related to order imbalances or new information, we check price reversals on the next day. Finally, we perform a cross-sectional regression analysis to elaborate on the impact of the firm characteristics on price reversals. The main results seem to support the expiration-day effects, especially on stock index futures expiration days. The price behavior of stocks that are subject to program trading is shown to have price effects, abnormal return volatility, and large volumes during the last half hour of trading on the expiration day. Return reversals are also found in the KOSPI 200 index and stocks. However, there is no evidence of abnormal trading volume, or price reversals in the NON-KOSPI 200 index and stocks. The expiration-day effects are proportional to the size of stocks and the nearness to the settlement time. Since program trading is often said to be concentrated in high capitalization stocks, these results imply that the expiration-day effects seem to be associated with program trading and the settlement price determination procedure. In summary, the expiration-day effects in the Korean stock market do not exist in all stocks, but in large capitalization stocks belonging to the KOSPI 200 index. Additionally, the expiration-day effects in the Korean stock market are generally due, not to information, but to trading imbalances.

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Pericentric Inversion of the X Chromosome in a Male with Azoospermia and in the Family of a Pregnant Female Carrier (무정자증을 보이는 남성과 정상 생식력을 가진 여성의 가계에서 관찰된 X 염색체의 Pericentric Inversion)

  • Lee, Bom-Yi;Ryu, Hyun-Mee;Lee, Moon-Hee;Park, Ju-Yeon;Kim, Jin-Woo;Lee, Joong-Shik;Kim, Hye-Ok;Kim, Min-Hyung;Park, So-Yeon
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.139-144
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    • 2008
  • We report on two cases of pericentric inversion of X chromosome. The cases were found in a 40-year-old man with azoospermia and in a family of a 38-year-old pregnant woman. The first case with 46,Y,inv(X)(p22.1q27) had concentrations of LH, prolactin, estradiol, and testosterone that were within normal ranges; however, FSH levels were elevated. Testis biopsy revealed maturation arrest at the primary and secondary spermatocytes without spermatozoa. There were no microdeletions in the 6 loci of chromosome Y. For the second case, the cytogenetic study of thepregnant woman referring for advanced maternal age and a family history of inversion X chromosome was 46,X,inv(X)(p22.11q27.2). The karyotype of her fetus was 46,X,inv(X)(p22.1q27). Among other family members, the karyotypes of an older sister in pregnancy and her fetus were 46,X,inv(X)(p22.11q27.2), and 46,Y,?inv(X), respectively. The proband's father was 46,Y,inv(X)(p22.11q27.2). All carriers in the family discussed above were fertile and phenotypically normal. In addition, the ratio of inactivation of inv(X) by RBG-banding was discordant between the two sisters, with the older sister having only 4.1% of cells carrying inactivated inv(X) while the proband had a 69.5% incidence of late replicating inv(X). Therefore, we suggest that the cause of azoospermia in the first case might be related to inversion X chromosome with positional effect. Also, the family of the second case showing normal phenotype of the balanced inv(X) might be not affected any positional effect of genes.

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A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination (골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰)

  • Park, Jin A;Park, Joo Young;Park, Ji Min;Park, Seat Byoul;Kim, Heung Sik;Jeon, Dong Seok
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1007-1015
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    • 2002
  • Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

The Correlation between Concepts on Chemical Reaction Rates and Concepts on Chemical Equilibrium in High School Students (고등학생들의 화학반응속도 개념과 화학평형 개념간의 상관관계)

  • Park, Guk-Tae;Kim, Gyeong-Su;Park, Gwang-Seo;Kim, Eun-Suk;Kim, Dong-Jin
    • Journal of the Korean Chemical Society
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    • v.50 no.3
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    • pp.247-255
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    • 2006
  • The purpose of this study was to investigate the correlation between concepts on chemical reaction rates and concepts on chemical equilibrium in high school students. The subjects of the investigation consisted of 120 third grade students attending high school in K city of Kyunggi province. For this study, questionnaire relevant to the subject of chemical reaction rates and chemical equilibrium was developed and the answers were analyzed. As a result of the study, a large percentage of high school students answered questions on reaction rates correctly, but only a small percentage of the students could give explanations. Many high school students answered questions on the rates of forward reactions correctly, but not the questions on the rates of reverse reactions. For the concepts on chemical equilibrium, many high school students gave correct answers when faced with equilibrium questions that only required the understanding of one side of the reaction. But the students could not answer the questions requiring understanding of both forward and reverse reactions as well. Overall, there was a little high correlation between concepts on chemical reaction rates and concepts on chemical equilibrium in high school students. Especially, high school students with little understanding of reverse reaction rates did not understand that chemical equilibrium is a dynamic equilibrium. Also, high school students with little understanding of the collision mechanism regarding chemical reaction rates did not understand the effect of concentration and catalyst factors on chemical equilibrium. And the correlation between concepts on chemical reaction rates and concepts on chemical equilibrium related to concentration and catalyst factors was low. In conclusion, the formation of scientific concepts on chemical reactions rates can decrease misconceptions on chemical equilibrium. Also the teaching-learning method limited to one side of a reaction can cause difficulty in forming the concepts on chemical dynamic equilibrium. Therefore, the development of a teaching-learning method which covers both the forward and reverse reactions can be effective in helping students form the concepts on chemical equilibrium.

The study examined characteristics of 20 patients who visitied Kongju (비만환자(肥滿患者) 20명(名)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Park, Tae Gyun;Lee, Byung Ryul
    • Journal of Haehwa Medicine
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    • v.11 no.1
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    • pp.137-149
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    • 2002
  • Dong-Eui-Bo-Gham Oriental medicine clinic on the purpose of losing their weight, from March 1, 2001 to March 1, 2002. The characteristics studied were gender, average weight, average height, distribution of body fat rate, base body metabolism rate, distribution of bmi, purpose of losing weight, treatment history, cause of gaining weight, clinical symptoms, distribution of Sahsang constitution, and change of body constituent. The conclusions drawn from this study were: 1. Among patients who came to the clinic for weight loss, there were 16 females (80%), and 4 males (20%). The ratio of gener was 1 to 4 (male to female) The distribution of their ages were 1 in one's teens (5%), 6 in their 20s (30%), 7 in their 30s (35%), and 6 in their 40s (30%). 2. The average weight of the patients was 72.155kg, and their average height was 163.2 cm. 3. The body fat rates of patients were distributed as: 2 were below 25 (10%), 3 were 25 to 30 (15%), 8 were 30 to 35 (40%), 5 were 35 to 40 (25%), and 2 were 40 to 45 (10%). 4. The base body metabolism rates of the patients were distributed as: 1 was below 1000Kcal (5%), 6 were 1100 to 1200Kcal (30%), 5 were 1200 to 1300Kcal (25%), 6 were 1300 to 1400Kcal (30%), and 2 were 1400 to 1500Kcal (10%). 5. The distribution of the patients bmi was: 4 were below 20 (20%), 5 were 20 to 25 (5%), 11 were 25 to 30 (55%), and 4 were 30 to 35 (20%). 6. The patients visited the clinic to lose their weight for the follwoing purposes: 5 were related to health concerns (25%), and 15 were to imprve their physical apprearnce (75%). Among patients who wanted to lose their weight becase of health concerns, 4 were married (20%) and 1 was single (5%). Among patiens who wanted to lose their weight to improve their physical appearance, 6 were married (30%) and 9 were single (45%). 7. As for the past treatment methods, physical exercises were most frequently used (19 patiens, 43%). 14 tried diet (32%), 8 used food substitues (19%), 1 was treated through Western medicine, and 1 was not related to any of these (2%). 8. Main reasons for weight gains were: 12 were related to overeating (40%), 10 were stress (33%), and 8 were lack of physical exercise (27%). 9. Physical symptoms included: 15 were fatigue (29%), 14 were constipation (26%), 13 were body swelling (25%), 3 were headache (5%), menstruation pain (4%), one was stomach upset (2%), 2 were related to physical structure, and 2 were related to other (4%). 10. As for the distribution of Sahsang constitution, 10 were Taeum (50%), 9 were Sohyang (45%), and 1 was Sohum (5%). 11. The average muscle weight was 44.87kg, average abdomen fat rate was 0.8999, and average base body metabolism rate was1369.2Kcal. 12. For the 5-week period, The body fat rate changes were 35.93 1.56% to 30.40 1.98% for A group, and 34.27 1.19% to 31.73 1.38% for B group. The abomen fat rate changes were 0.90 0.02% to 0.86 0.03 for A group, and 0.89 0.02% to 0.83 0.02% for B group. The body fat weight changes were 26.92 2.04kg to 20.74 1.98kg for A group, and 27.86 3.37kg to 24.58 3.02kg for B group. The body weight chages were 72.36 3.18kg to 64.54 2.55kg for A group, and 72.48 3.14kg to 67.74 3.11kg for B group. The muscle rate changes were 43.86 1.63kg to 43.10 1.76kg for A group, and 42.72 1.22kg to 41.60 1.86kg for B group. Overall, A group was superior to B group. 13. After being treated for obesity, 13 patients used exercise treatment (65%), 5 continued to receive obesity treatment (25%), and 2 used diet (10%). Based on these results, we could conclude that the importande of setting a criterion of obesity and weight control have changed according to changes in social and cultural values, and that treatment of obesity through Oriental medicine and research should keep up with changes in esthetic and psychological values.

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Non-radiologic Methods for Predicting Vesicoureteral Reflux in Childhood Urinary Tract Infection (요로감염 환아에서 비방사선학적 방법에 의한 방광요관역류의 조기 예측에 관한 연구)

  • Jeon Seong-Hoi;Lee K.C.;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.38-45
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    • 1997
  • Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

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Trends of hospitalized tuberculosis at a children's hospital during a 20-year period (1988-2007) (20년간(1988-2007) 1개 대학병원에 입원한 소아결핵 환자의 동향)

  • Yang, Mi Ae;Sung, Ji Yeon;Kim, So Hee;Eun, Byung Wook;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.59-67
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    • 2008
  • Purpose : According to the 2008 WHO report, incidence, prevalence, and mortality of tuberculosis are decreasing globally. The 7th National Tuberculosis Survey of 1995 in Korea showed that the prevalence of tuberculosis was also decreasing. This study was performed to review the hospitalized childhood tuberculosis in a children's hospital over a 20 year period. Methods : Medical records of children <16 years of age hospitalized with the diagnosis of tuberculosis at the Seoul National University Children's Hospital between 1988 and 2007 were reviewed retrospectively. Changes in number of patients and involved sites were also analyzed by four 5-year periods. Results : Out of the 186 hospitalized patients, 59.1% were male. Median age at diagnosis was 5.5 years old (range, 10 days-15 years). The main involved sites included the lung (n=54, 29%) or pleura (n=12, 6.5%), central nervous system (n=49, 26.3%), lymph node (n=15, 8.1 %), bone and joint (n=9, 4.8%), gastrointestinal tract (n=5, 2.7%) or peritoneum (n=5, 2.7%), pericardium (n=2, 1.1%) and others (n=3, 1.6%). Total 32 patients (17.2%) showed miliary pattern. The proportion of hospitalization with newly diagnosed tuberculosis among all cause hospitalization decreased from 0.61% to 0.09%, comparing the period of 1988-1992 and 2003-2007 (P<0.001) and the incidence of hospitalized tuberculosis of any involved organs also decreased with a statistical significance. Conclusion : The data from a single children's hospital suggest that the number of hospitalized childhood patients with tuberculosis has decreased over a 20 year period in Korea.

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Molecular Epidemiology of Bacillus cereus in a Pediatric Cancer Center (소아 암 환자에서 발생한 Bacillus cereus 균혈증의 분자역학 분석에 관한 연구)

  • Kim, Jong Min;Park, Ki-Sup;Lee, Byung-Kee;Kim, Soo Jin;Kang, Ji-Man;Kim, Yanghyun;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Lee, Nam Yong;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.172-179
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    • 2016
  • Purpose: Bacillus cereus has been reported as the cause of nosocomial infections in cancer patients. In our pediatric cancer ward, a sudden rise in the number of patients with B. cereus bacteremia was observed in 2013 to 2014. This study was performed to investigate the molecular epidemiology of increased B. cereus bacteremia cases in our center. Methods: Pediatric cancer patients who developed B. cereus bacteremia were identified from January 2001 to June 2014. The B. cereus bacteremia in this study was defined as a case in which at least one B. cereus identified in blood cultures, regardless of true bacteremia. Available isolates were further tested by multilocus sequence typing (MLST) analysis. A retrospective chart review was performed. Results: Nineteen patients developed B. cereus bacteremia during the study period. However, in 2013, a sudden increase in the number of patients with B. cereus bacteremia was observed. In addition, three patients developed B. cereus bacteremia within 1 week in July and the other three patients within 1 week in October, respectively, during emergency room renovation. However, MLST analysis revealed different sequence types without consistent patterns. Before 2013, five tested isolates were ST18, ST26, ST177, and ST147-like type, and ST219-like type. Isolates from 2013 were ST18, ST73, ST90, ST427, ST784, ST34-like type, and ST130-like type. Conclusions: MLST analyses showed variable ST distribution of B. cereus isolates. Based on this study, there was no significant evidence suggesting a true outbreak caused by a single ST among patients who developed B. cereus bacteremia.

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

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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