• Journal of Chest Surgery
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• v.31 no.9
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• pp.827-836
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• 1998

Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.319-328
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• 2013

Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.29-40
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• 2009

Objective : This study is an experimental study which is designed to examine the differences between knowledge and self-confidence before and after theory education(CPR PPT material) based on guidelines of CPR and emergency cardiac treatment of American Heart Association(AHA, 2005) and video self-instruction program for the general public by Korean Association of Cardiopulmonary Resuscitation(KACPR), trace CPR performance ability after CPR and AED education and investigate the accuracy of artificial respiration and chest compression, and know the difference in CPR performance abilities including AED. Methods : Subjects of this study include ground crews and staffs at M airport in G province equipped with emergency equipments for CPR according to Art. 47, Sec. 2 of Emergency Medical Law, airport police, rent-a-cops, security guard, quarantine officer, custom officer, and communication, electricity, civil engineering, facility management staff, airport fire fighting staff, air mechanic, traffic controller, and airport management team among airport facility management staffs. They were given explanation of necessity of research and 147 of 220 subjects who gave consent to this research but 73 who were absent from survey were excluded were used as subjects of this study. of 147 subjects, there were 102 men and 45 women. Results : 1) Knowledge score of CPR was $6.18{\pm}0.87$ before instruction and it was increased to $15.12{\pm}1.78$ after instruction, and there was statistically significant difference. 2) Self-confidence score in CPR was $3.16{\pm}0.96$ before instruction and it was increased to $7.05{\pm}0.75$ after instruction, and there was statistically significant difference. 3) Total average score in CPR performance ability after instruction was 7.46 out of 9, performance ability was highest in confirmation of response as 144(97.95%), follwed by request of help as 140(95.25%) and confirmation of respiration as 135(91.83%), and lowest in performing artificial respiration twice(gross elevation of chest) as 97(65.98%). Accuracy of artificial respiration(%) was $28.60{\pm}16.88$ and that of chest compression(%) was $73.10{\pm}22.16$. 4) Performance ability of AED after instruction showed proper performance in power on by 141(95.91%) and attaching pad by 135(91.83%), hand-off for analyzing rhythm showed 'accuracy' in 115(78.23%) and 'non-performance' in 32(21.77%), delivery of shock and hand-off confirmation showed 'accuracy' in 109(74.14%) and 'inaccuracy' in 38(25.86%), and beginning chest compression immediately after AED was done by 105(71.42%).

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.892-900
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• 2010

Objectives : To save the lives of patients with cardiac arrests, CPR must be performed rapidly and precisely. Regarding its critical necessity, there is a growing tendency to encourage whomever witnesses the cardiac arrest to perform basic CPR. However, the attitude toward basic CPR nor its current state of education in Korean Oriental Medical arena, which is one of the dual axes unique to Korean medical system, are not known. This is a kind of pilot study to research attitudes toward and the educative effect of basic CPR among oriental medical doctors in Korea. Methods : We carried out surveys and tests targeting nineteen apprentice doctors working in Dongguk University Ilsan Oriental Hospital, who were receiving training for 'AHA BLS course for healthcare providers', on the attitude toward and educative effect of basic CPR before and after the education. Results : The pre-educational survey showed that most of the participants felt the necessity to be trained in the BLS course, were not confident about performing CPR, and not well-acquainted with the whole process of performing CPR. After education, however, none of them responded with a lack of confidence to perform basic CPR, and the score of the confidence to perform basic CPR was significantly increased, too (from $2.05{\pm}0.71$ to $4.05{\pm}0.40$, n=19, p<0.001). Moreover, all of them answered they were satisfied with this BLS course, and it aroused their sense of responsibility as oriental medical doctors. All the participants passed the exam, and their average score for BLS scheme performance was $28.2{\pm}1.3$. Conclusions : It is necessary, in the future, to set up a management system for intensive, regular and continuous reeducation and expand the research on the perception and attitude targeting larger numbers and more multilevel groups of oriental medical doctors.

• Korean Journal of Cognitive Science
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• v.26 no.2
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• pp.167-207
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• 2015

This study focused on the awareness and coping methods of psychological trauma and human suffering in the contemporary era after the development of posttraumatic stress disorder(PTSD) including the situations in the Korean society, and proposed principles for an alternative paradigm of trauma recovery. Trauma is defined as an 'external' stress causing chronic suffering mediated by memory, and the American Psychiatric Association approved PTSD in the Diagnostic and Statistical Manual of Mental Disorders in 1980. The development of PTSD empowered moral legitimacy to the victims, opened a successful way to treatment, and accomplished explosive amount of research in the area of neurobiology and cognitive neuroscience. However, this also narrowed the understanding of human suffering, and the importance of an alternative coping method which overcomes the limitations of technical intervention became overlooked. Moreover, the Korean society has an underlying mechanism of replacing the matter of trauma to a problem of an individual. This is shown among the historical context of splitting and denial, and among medicalized bureaucracy. Trauma should be acknowledged as a social suffering, and searching for an alternative paradigm is in need. This study suggested the following principles; seeking for truth and justice, survivor as the agent of recovery emphasizing the responsibility of the community, ecological adaptations of recent bio-psychological achievements, and finally putting emphasis on continuous discussions about the definition of recovery.

• Journal of radiological science and technology
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• v.32 no.2
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• pp.161-168
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• 2009

The carotid intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and is the only non-invasive test that is currently recommended by the American Heart Association for evaluation of the risk. However, use of this parameter has a limitation because it assumes uniform thickness throughout the blood vessel, whereas atherosclerosis is a focal phenomenon that is confined to intima. In fact, plaque can be found along the atherosclerotic blood vessels even though its value is unknown. The aim of this study is to analyze the carotid plaque and IMT in the stroke patients. We investigated the patients with ischemic stroke, who were admitted to the department of neurology at the Stroke Special Hospital from January to March 2008. After the carotid IMT and plaque were assessed by B-mode ultrasonography, IMT and carotid plaque to risk variables (age, sex) were analyzed. The distribution of CCA IMT was significantly different in terms of age (p = 0.004). Likewise, the distribution of carotid plaque was also significantly different in terms of age (p = 0.006). Carotid plaque was 69 and 92% in normal and abnormal CCA IMTs respectively. The results showed that the CCA IMT was closely associated with carotid plaque.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.47-53
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• 2006

Purpose: Recently, the American Heart Association recommended that routine cervical spine protection in submerged patients was not necessary, except in high-energy injury situations. However, until now, this recommendation has few supportive studies and literatures. This retrospective study was performed to demonstrate the risk of cervical spine injury in patients who had been submerged in a river. Methods: Seventy-nine submerged patients who visited St. Mary's Hospital between January 2000 and December 2005 were included in this retrospective study. We investigated and analyzed the victim's age, sex, activity on submersion, mental status and level of severity at admission, prognosis at discharge, associated injuries, and risk group by using the medical records and cervical spine lateral images. According to the activity on submersion, victims were classified into three groups: high risk, low risk, and unknown risk. The reports of radiologic studies were classified into unstable fracture, stable fracture, sprain, degenerative change, and normal. Results: The patients' mean age was 36.8 yrs, and 54% were males. Of the 79 patients, adult and adolescent populations (80%) were dominant. Jumping from a high bridge (48%) was the most common activity on submersion and accounted for 52% of the high-risk group. The Glasgow coma scale at admission and the cerebral performance scale at discharge showed bimodal patterns. The results of the radiologic studies showed one stable fracture, one suspicious stable fracture, and 18 sprains. The incidence of cervical spine fracture in submerged patients was 2.5% in our study. The incidence of cervical spine injury was higher in the high-risk group than it was in the low-risk group, especially in the jumping-from-high-bridge subgroup; however this observation was not statistically significant. No other factors had any significant effect on the incidence of cervical spine injury. Conclusion: Our study showed that even submerged patients in the high risk group had a low incidence of cervical spine fracture and that the prognosis of a patient did not seem to be influenced by the cervical spine fracture itself.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.493-506
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• 1999

The purpose of the study is to evaluate the effectiveness and competence level of trainees of Cardiopulmonary resuscitation training targeted for nursing students. 70 nursing students of Y nursing college are recruited as subjects from Dec. 1st, 1998 through Dec. 8th. 1998. For the pre-test. demographic data related to CPR and knowledge of CPR were evaluated. For the post-test, the next week of pre-test, three difference groups of subjects were tested their knowledge of CPR. CPR training was designed by two components which were 90 mins lecture and demonstration by one professor and individual practice using two educational models with two professors. As the tool of measurement estimating pre or post knowledge of CPR. questionnaires were developed based on self-diagnosis questionnaires of American Heart Association(AHA). The questionnaires were multiple choices (50 questions) and open end questions regarding CPR process. Each multiple choices questions valued 2 points (Score varied min. 0 point to max 100 points.). Collected data were computerized and analyzed by SPSS-WIN. Frequency and percentage of each questions analyzed. The differences of the knowledge and competency level of subjects between pre and post test was analyses by paired t-test. The followings are research outcome. 1. In the pre-test, 95% of subjects answered that they already knew what CPR was. but only 82% described correctly what CPR was. 49% learned CPR before, and 80s5 of them learned at high school. 2. 37 questions scores increases, and 10 questions scores decreased. 3 questions didnt change their score. After getting training, ratio of 80% correct score significantly increased 4 times. 3. In post-test. knowledge level of trainees increased compared to that of pre-test. (t=-15.075, p=.000) 4. Competence level also increased (t=-14.86, p=.00). In result, after getting CPR training, most CPR knowledge increased except open the air tract, toddler CPR, and alternative behavior when the air tract is blocked. CPR training needs to extend the educational scope not only CPR lecture but also psychomotor skill practice. CPR trainees are in need of appropriate feedback as well as enough opportunities of skill practice.

• Health Communication
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• v.13 no.2
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• pp.125-132
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• 2018

Purpose: The aim of this study is to investigate the quality of basic life support (BLS) information for primary Korean-speaking individuals on the internet. Methods: Using the $Google^{(C)}$ search engine, we searched for the terms 'CPR', 'cardiopulmonary resuscitation (in Korean)' and 'cardiac arrest (in Korean)'. The accuracy, reliability and accessibility of web pages was evaluated based on the 2015 American heart association(AHA) guidelines for CPR & emergency cardiovascular care, the health on the net foundation code of conduct and Korean web content accessibility guidelines 2.1, respectively. Results: Of the 178 web pages screened, 50 met criteria for inclusion. The overall quality of BLS information was not enough (median 5/7, IQR 4.75-6). 23(36%) pages were created in accordance with 2010 AHA guidelines. Only 24(48%) web pages educated on how to use the automated electrical defibrillator. The attribution and transparency of the reliability of pages was relatively low, 20(40%) and 16(32%). The web accessibility score was relatively high. Conclusion: A small of proportion of internet web pages searched by Google have high quality BLS information for a Korean-speaking population. Web pages based on past guideline were still being searched. The notation of the source of CPR information and the transparency of the author should be improved. The verification and evaluation of the quality of BLS information exposed to the Internet are continuously needed.

• Therapeutic Science for Rehabilitation
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• v.10 no.3
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• pp.57-69
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• 2021

Objective : The purpose of this study was to identify occupational therapy guidelines for patients with stroke according to the clinical guidelines, and to investigate the quality and characteristics of the identified guidelines. Methods : This involved a review of domestic and foreign rehabilitation treatment guidelines from 2008 to 2019. These guidelines were searched using, the search terms: 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', and 'stroke guidelines'. Results : A total of 708 papers were identified from the search. Eight guidelines met the selection criteria and were included in this review. The selected guidelines were developed in Canada, Australia, the United States, the United Kingdom, and Korea. One of the eight guidelines was occupational therapy guidelines, and the other seven were rehabilitation guidelines. The guidelines were categorized into a total of 36 topics, including 28 guidelines for stroke rehabilitation in Australia, 24 guidelines for the British and American Heart Association, and 23 guidelines for stroke rehabilitation developed in Korea. Conclusion : In this study, the guidelines for occupational therapy for existing stroke patients were identified, and the quality and characteristics of the guidelines were compared. The results of this study will provide important basic data for the development of occupational therapy guidelines for stroke in the future.