• Title/Summary/Keyword: Heart rates

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Comparison of Veno-arterial Extracorporeal Membrane Oxygenation Configurations for Patients Listed for Heart Transplantation

  • Jung Ae Hong;Ah-Ram Kim;Min-Ju Kim;Dayoung Pack;Junho Hyun;Sang Eun Lee;Jae-Joong Kim;Pil Je Kang;Sung-Ho Jung;Min-Seok Kim
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.535-547
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    • 2023
  • Background and Objectives: Veno-arterial extracorporeal membrane oxygenation (VAECMO) as a bridge to eventual heart transplantation (HT) is increasingly used worldwide. However, the effect of different VA-ECMO types on HT outcomes remains unclear. Methods: This was a retrospective observational study of 111 patients receiving VA-ECMO and awaiting HT. We assessed 3 ECMO configuration groups: peripheral (n=76), central (n=12), and peripheral to central ECMO conversion (n=23). Cox proportional hazards regression and landmark analysis were conducted to analyze the effect of the ECMO configuration on HT and in-hospital mortality rates. We also evaluated adverse events during ECMO support. Results: HT was performed in the peripheral (n=48, 63.2%), central (n=10, 83.3%), and conversion (n=11, 47.8%) ECMO groups (p=0.133) with a median interval of 10.5, 16, and 30 days, respectively (p<0.001). The cumulative incidence of HT was significantly lower in the conversion group (hazard ratio, 0.292, 95% confidence interval, 0.145-0.586, p=0.001). However, there was no difference in in-hospital mortality (log-rank p=0.433). In the landmark analysis, in-hospital mortality did not differ significantly among the 3 groups. Although we did note a trend toward lower HT in the conversion group, the difference was not statistically significant. Surgical site bleeding occurred mainly in the central, while limb ischemia occurred mainly in the peripheral groups. Conclusions: We suggest that if patients are being stably supported with their initial ECMO configuration, whether it is central or peripheral, it should be maintained, and ECMO conversion should only be cautiously performed when necessary.

Changes of Body Fat Contents, Cardiopulmonary Functions and Some Blood Constituents by Long-Term Physical Training (장기간의 신체 단련에 따른 체지방, 심폐기능 및 혈액화학상의 변화)

  • Hwang, Sang-Ik
    • The Korean Journal of Physiology
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    • v.20 no.2
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    • pp.279-288
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    • 1986
  • In an attempt to observe the to long-term training effects, the exercise of rope-skipping was regularly loaded to nine soldiers for nine weeks. And some physical characteristics, cardiopulinonary functions. some blood constituents were measured before, during and after the load of test exercise. treadmill running, and were compared with the pre-trained values. The results obtained were as follows: 1) Body weight, body surface area, skinfold thickness and total body fat decreased sifnificantly after the training. 2) The post-trained values of MVV and $FEF_{25%}$, increased significantly. 3) By the training, heart rates decreased very significantly in the resting, exercising and recovery periods. 4) After the training, the systolic blood pressures of the resting and recovery periods decreased meaningfully, while diastolic blood pressures increased significantly through the recovery stages. 5) In spite of the training, the respiration rates never change in both the resting and the recovery periods. 6) After the training, total cholesterol concentration of the venous blood decreased significantly in the resting the early recovery phases while the blood levels of glucose and HDL-cholesterol decreased very slightly. 7) Blood lactate concentration decreased through the recovery periods and the value of the recovery 20 and 60 minutes decreased obviously, in comparison with the pre-trained values. The above results suggest that the 9 week-training of the rope-skipping brings about the decrease of the body fat contents, the enhancement of cardiopulmonary functions and some changes in the blood constituents.

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The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity

  • Han, Hyejin;Park, Bomi;Park, Bohyun;Park, Namsoo;Park, Ju Ok;Ahn, Ki Ok;Tak, Yang Ju;Lee, Hye Ah;Park, Hyesook
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.163-168
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    • 2018
  • Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

Preliminary Study of a New Extracorporeal Membrane Oxygenator Development When Using Pulsatile Flow

  • Lee, Sa-Ram;Lee, Kyung-Soo;Jung, Jae-Hoon;Mun, Cho-Hay;Min, Byoug-Goo
    • Journal of Biomedical Engineering Research
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    • v.28 no.3
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    • pp.387-391
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    • 2007
  • An oxygenator is a very important artificial organ and widely used for patients with lung failure or during open heart surgery. Although an oxygenator has been widely studied worldwide to enhance its efficiency, studies on oxygenators, in particular when using a pulsatile blood flow, are domestically limited. Therefore, a new oxygenator was developed in the lab and animal experimental results are described in the paper. The oxygenator is composed of polycarbonate housing and polypropylene hollow fibers. It has a total length of 400 mm and a surface area of $1.7 m^2$. The animal experiment lasted for 4 hours. The blood flow rate was set to 2 L/min and a pulsatile blood pump, T-PLS (Twin-Pulse Life Support), was used. Samples were drawn at the oxygenator's inlet and outlet. The total hemoglobin (Hb), saturation oxygen ($sO_2$), and partial oxygen pressure ($pO_2$), partial $CO_2$ pressure ($pCO_2$), and plasma bicarbonate ion concentration ($HCO_3^-$) were measured. The oxygen and carbon dioxide transfer rates were also calculated based on the experimental data in order to estimate the oxygenator's gas transfer efficiency. The oxygen and carbon dioxide transfer rates were $16.4{\pm}1.58$ and $165.7{\pm}10.96 mL/min$, respectively. The results showed a higher carbon dioxide transfer rate was achieved with the oxygenator. Also, the mean inlet and outlet blood pressures were 162.79 and 137.92 mmHg, respectively. The oxygenator has a low pressure drop between its inlet and outlet. The aim of own preliminary study was to make a new oxygenator and review its performance when applying a pulsatile blood pump thus, confirming the possibility of a new oxygenator suitable for pulsatile flow.

Effect on Smoking Quit Rate of Telling Smokers their Health Risk Appraisal in Terms of Health Age: A Randomized Control Trial

  • Paek, Yu-Jin;Lee, Sungkyu;Kim, Yun-Hee;Lee, Kang-Sook;Yim, Hyeon-Woo;Kim, Myung-Shig;Kim, Cheol-Hwan;Jeung, Ok
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4963-4968
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    • 2014
  • Background: We evaluated whether providing health risk appraisal for Koreans (KHRA) in terms of 'health age' during smoking cessation program would effectively help smokers quit smoking or not. Materials and Methods: A total of 332 male smokers aged between 30-65 years old, registered for a smoking cessation program in a public health center in a city, were recruited and underwent a baseline survey from January 2010 to February 2011. They were then prospectively randomized to a conventional counseling group (n=165) or a KHRA group (n=167), and received conventional counseling or KHRA-based counseling for six months. Abstinence rates were identified through carbon monoxide measurement (at the $4^{th}$ and $24^{th}$ weeks) or urinary cotinine level (at the $12^th$ week). Results: The abstinence rate confirmed by exhaled carbon monoxide was significantly higher in the KHRA group (61.1%) than the control group (49.1%) at the $4^{th}$ week (absolute difference 12.0%, 95% CI: 1.4%-22.6%). However, there was no difference in abstinence rates between the two groups at the 12th and 24th weeks. The predicting factors of 24 week's smoking cessation success were age, older than 50 years old (OR 2.02, 95% CI: 1.16-3.52), lower Fagerstr$\ddot{o}$m Test for Nicotine Dependence score less than 4 (OR 1.84, 95% CI: 1.03-3.29), and higher Self Efficacy/Temptation score (OR 1.79, 95% CI: 1.05-3.06). Conclusions: Smoking cessation counseling with KHRA could be effective compared to conventional counseling in the short period of smoking cessation. Further study is needed to evaluate the long-term efficacy of KHRA in tobacco dependence treatment and to establish the indication and target population of this tool.

Analysis of the Characteristics of Ambulatory Care Sensitive Conditions in Patients Visiting the Emergency Departments: Focused on Health-care Delivery System (외래의료 민감 질환으로 응급실을 내원한 환자의 특성 분석: 의료전달체계 중심으로)

  • Huh, Young-Jin;Kim, Ji-Yeon;Lee, Myoung-Hwa;Lee, Sung-Min;Oh, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.10 no.10
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    • pp.253-258
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    • 2020
  • This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

Long Term Experience of Mitral Valve Replacement (승모판치환수술의 장기 임상성적)

  • 조용길;류지윤
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1102-1110
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    • 1996
  • Between Oct. 1985 and July 1995, 230 patients underwent mitral valve replacement. There were 77 men and 153 women whose mean age was 35.7 years, range 9 to 62 The concomitant operations were 40 aortic valve replacements(17.4%), 25 tricuspid annuloplasties(10.4%), 8 aortic valve replacements & tricuspid annuloplasties(3.5%), 2 tricuspid valve replacements(0.9%) and others, We used 139 mechanical (76 51. Jude medical, 33 CarboMedics, 30 Sorin) and 91 tissue 386 Carpentier-Edwards, 5 lonescu-Shiley) valves. The early postoperative complications occurred in 28 cases. There were 8 low cardiac output syndrome, 5 pleural effusion, 3 significant arrhythmia, 2 cardiac rupture and others. There were 6 early hospital deaths (2.6%) due to low cardiac output syndrome(2), arrhythmia(2) and ventricul r rupture(2). The cuAmulative notal follow-up period was 764. 4 patient-years with a mean of 4).9 months. The long term follow-up information was available for 212 patients(94.6%). There were 21 cases of valve-related complications. Prosthetic valve failure(10), anti-coagulation related bleeding (5), prosthetic valve endocarditis (4), and thromboembolism (2) occurred at rates of 1.3, 0.7, 0.5, and 0.3%Ipt-yr respectively. Late death occurred In 5 cases (0.7%/pt-yr) associated with prosthetic valve endocarditis (2), heart failure (2) and anti-coagulation related bleeding (1). There was no difference in the rate of freedom from prosthetic valve failure between the mechanical and tissue valve group at 6 years (100%), but there was significant difference at 9 years between the tissue (34.4%) and mechanical valve (100%) group (p=0.032). Actuarial survival rates were 98. 8% in tissue valve. 9).7% in mechanical valve group and 96.6% in total patients at 9 years.

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Characteristics of Individuals Seeking Comprehensive Health Check-ups (종합 건강검진을 원하는 피검진자의 건강특성에 관한 연구)

  • 성미혜
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.563-576
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    • 1997
  • This study was carried out to identify basic data for more efficient operation of comprehensive health check-up centers in the national health care system. The researcher reviewed and analyzed the main symptoms of the subjects according to sex, age, occupation and positive rate in the screening tests of a comprehensive health check-up, performed at one comprehensive health check-up center in located in a hospital. The subjects were 512 persons who had a check-up at the comprehensive health check-up, center in K university hospital in Seoul from October 2, 1996 to March 30, 1997. A questionaire developed by the researcher to obtain subject's general characteristics, main symptoms, medical examination, diagnosed disease was used as the tool for the study. The researcher analyzed the data with SPSS PC/sup +/ program. : the distribution of the subject's general characteristics and main symptoms was described with percentages and the difference between main symptoms and screening tests analyzed with X²-test, t-test, ANOVA. The result of this study are as follows : 1. For the distribution of diagnosis in males. liver disease was most frequent and hypertension was second : in females, hypertention and liver disease were not common in that order. 2. The most common complaints were indigestion in the digestive system, sputum in the respiratory system, irregular heart beat in the cardiovascular system, frequent urine in the urinary system vertigo in the hematologic system. 3. The main symptoms according to sex were for females, a statistically siguificant higher rate of complaints in the digestive system, cardiovascular system, urinary system, hematologic system, musculoskeletal, mental & nervous system as compared to males. 4. The main symptoms according to age were that in the the second decade there wara higher rate of complaints in the digestive system, and cardiovascular system than in the older age groups : and in the fifth decade more in the musculoskeletal system. 5. The main symptoms according to occupation were that formers and fishers had a higher rate of complaints in the mental and nervous system as compared to other occupation groups : and office workers, in gynecology. 6. The main symptoms according to diagnosis, were symptoms of the digestive system, frequent in liver disease : symptoms of the cardiovascular system in allergic disease. 7. The screening tests which showed the highest rates were UGI /FGS, PFT : In males a higher rate of abnormality was seen in abdominal ultrasono- graphy and in, females, in mammography. 8. In screening tests according to sex, males showed a higher positive rate for chest X-rays, and LFT, and females, in mammography, pap smear, CBC. 9. In screening tests according to age, higher positive rates of obesity, high blood pressure, chest X-ray, mammography, pap smear, FBS, CBC, urine test were seen in the fifth decade : PFT and abdominal ultrasonography in the third decade. The subjects who wanted comprehensive health check-up were not asymptomatic but had an illness with several symptoms. It is found that the most frequent diagnosed diseases were hypertention and liver disease. So proper observations must be done for them. Comprehensive health check-ups should be changed to a comprehensive examination including treatment beyond examination for those subjects with positive results.

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Interaction Contents for Reconsidering Visually Disabled Parents

  • Hong, Joo-Bong;Lee, Chan-Kyu;Lim, Chan
    • International journal of advanced smart convergence
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    • v.9 no.1
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    • pp.54-62
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    • 2020
  • According to the Ministry of Health and Welfare, "Status of Registered Persons with Disabilities", the number of people with disabilities is 2,494,460 as of 2015. The lowest rates of children with disabilities were intellectual disabilities (23%) and mental disorders (33.3%). The highest rates of screening were blindness (97%), heart failure (94.4%), and hearing impairment (92.7%). 65.2% of visually impaired people who have already had a disability at the time of marriage, and the remaining 34.8% can be thought to be the cause of high incidence of disability after marriage. 'SID (Seed in the Dark)' project was designed to recapture the visually impaired parent's desire for attachment and the space difficulties of the blind who want to be a normal parent to their children through a visual impairment of a father with 7-year-old daughter. Using Gear VR(Virtual Reality), the general public was able to feel the surroundings as if they had no vision and focused on the hearing. Especially, We expressed the sound wave visually and added the hilarious game element which grasps the terrain of the maze by sound wave like a 'blind person who perceives the surroundings by sound' and catches up with daughter. People with disabilities who are far from mental illness often have a form of family with children. The fact that the rate of childbirth is high means that there is relatively little problem in daily life. It is wondered that the rate of blindness among the visually impaired, which accounts for 10% of the total disabled, is the highest at 97%. This is because, in the case of the visually impaired, the obstacle is often caused by aging, accidents, or diseases due to inherited causes rather than the visual disorder. In particular, However, the fact that there is an obstacle in vision that accounts for 83% of the body's sensory organs causes other difficulties in the nursing process of children who are non-disabled. Parents do not know the face of child when their visual impairment is severe. Parents are extremely anxious about worry that they will be lost or abducted if their children are not by their side. And that the child recognizes the disability of his or her parents other than the other parents easily and takes it as a deficiency. Since visually impaired parents are mentally mature parents with non-disabled people, they may want their children not to feel deprived of their disability. The number of people with visual impairments has been increasing since 2001, and people with impairments often become disabled. In addition, there is much research on the problem of nondisabled parents who have children with disabilities, while there is relatively little interest and research on the problem of nondisabled child rearing of parents with disabilities.

Effects of Different Exercise Training Mode on Exercise Specificity and Transability (트레이닝 형태의 차이가 운동 특이성(exercise specificity)과 전사효과(transability)에 미치는 영향)

  • Kim, Young-Il;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.19 no.7
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    • pp.968-975
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    • 2009
  • The purpose of the present study was to examine effects of different exercise training modes (Aerobic Training, Resistance Training) on exercise specificity and transability. The tested subjects, composed of 10 healthy males without known family history or medical illnesses, were divided into two groups: Aerobic Training Group (ATG; n=5) and Resistance Training Group (RTG; n=5). An aerobic training program, based on maximum oxygen consumption rates taken during standard testing, was conducted in 60 minute sessions 3 times a week, and the Heart Rate Reserve (HRR) at 70% of maximum oxygen consumption rate was measured the using Polar. In the weight training program, based on repetition maximum rate (1-RM) taken during standard testing, the weight at 70% of such rates was measured during 60 minute sessions of 7 categories of exercise (Bench press, Leg press, Squat, Shoulder press, Arm curt Lat pull down, Triceps pull down), conducted 3 times a week. The data collected from this research were calculated to obtain average and differences compared to standards using an SPSS 11.0 statistics package. In conclusion, increase in V0$_{2max}$ and production of NO$_x$ (NO$_2$/NO$_3$), reduction of %fat, MAPwere shown effective in aerobic training and in different exercise tests, and aerobic testing within the aerobic training group (ATG) was shown to be more effective. In contrast, resistance training was shown to be more effective for the reduction of CK and LDH, and even in different tests, the resistance test within the resistance training group (RTG) showed to be more effective. Exercise specificity also significantly increased in both groups (ATG, RTG). but there was no significant difference in transability in both groups (ATG, RTG).