• Title/Summary/Keyword: Pressure support

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Clinical Experiences of High-Risk Pulmonary Thromboembolism Receiving Extracorporeal Membrane Oxygenation in Single Institution

  • Jang, Joonyong;Koo, So-My;Kim, Ki-Up;Kim, Yang-Ki;Uh, Soo-Taek;Jang, Gae-Eil;Chang, Wonho;Lee, Bo Young
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.3
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    • pp.249-255
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    • 2022
  • Background: The main cause of death in pulmonary embolism (PE) is right-heart failure due to acute pressure overload. In this sense, extracorporeal membrane oxygenation (ECMO) might be useful in maintaining hemodynamic stability and improving organ perfusion. Some previous studies have reported ECMO as a bridge to reperfusion therapy of PE. However, little is known about the patients that benefit from ECMO. Methods: Patients who underwent ECMO due to pulmonary thromboembolism at a single university-affiliated hospital between January 2010 and December 2018 were retrospectively reviewed. Results: During the study period, nine patients received ECMO in high-risk PE. The median age of the patients was 60 years (range, 22-76 years), and six (66.7%) were male. All nine patients had cardiac arrests, of which three occurred outside the hospital. All the patients received mechanical support with veno-arterial ECMO, and the median ECMO duration was 1.1 days (range, 0.2-14.0 days). ECMO with anticoagulation alone was performed in six (66.7%), and ECMO with reperfusion therapy was done in three (33.3%). The 30-day mortality rate was 77.8%. The median time taken from the first cardiac arrest to initiation of ECMO was 31 minutes (range, 30-32 minutes) in survivors (n=2) and 65 minutes (range, 33-482 minutes) in non-survivors (n=7). Conclusion: High-risk PE with cardiac arrest has a high mortality rate despite aggressive management with ECMO and reperfusion therapy. Early decision to start ECMO and its rapid initiation might help save those with cardiac arrest in high-risk PE.

Effects of Acupuncture with a Combination of GV20 and EX-HN1 Acupoints on CO2 Reactivity in the Anterior and Middle Cerebral Arteries during Hypercapnia in Normal Subjects: A Randomized Crossover Trial

  • Park, Hojung;Moon, Sang-Kwan;Lee, Han-Gyul;Kwon, Seungwon;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-sang;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.582-595
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    • 2022
  • Objectives: To investigate the effects of acupuncture at GV20 and EX-HN1 on cerebral blood flow (CBF) velocity and cerebrovascular reactivity (CVR) in the middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) and to compare the effects to acupuncture at GV20. Methods: The study was a randomized, crossover trial that included 10 healthy men aged 20 to 29 years who underwent acupuncture treatment four times with a washout period of one week. The CBF velocity and CVR were measured by transcranial Doppler sonography (TCD) on both MCAs at the first and second visits, and both ACAs at the third and fourth visits. Participants were randomly assigned to one of two groups (A and B) before the first and third visits. Group A received two phases of acupuncture intervention at a single GV20 point and a combination of GV20 and EX-HN1 acupoints. Group B received the same interventions, but in the reverse order. Results: The increase in CO2 reactivity was significantly higher for the combination acupoints of GV20 and EX-HN1 than for the GV20 single acupoint in both MCAs (Right: 136 to 178, p=0.017; Left: 127 to 191, p=0.017) and ACAs (Right: 133 to 158, p=0.013; Left: 122 to 168, p=0.025). No significant change was noted in the corrected velocity at PETCO2 40 mmHg, blood pressure, or heart rate. Conclusions: The findings suggest that improvement of the CBF in the MCA and ACA after GV20 acupuncture increases when acupuncture is also performed at EX-HN1. These results clinically support the combined use of EX-HN1 and GV20 to treat disorders of MCA and ACA circulation.

The Effects of Coordinative Locomotor Training Program for Life-Care Promotion on Balance of Obese Elderly Women (라이프케어 증진을 위한 협응적 이동훈련 프로그램이 비만 여성노인의 균형에 미치는 영향)

  • Lee, Dong-Ryul
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.1
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    • pp.17-25
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    • 2020
  • The purpose of this study was to examine the effects of coordinative locomotor training (CLT) program on the balance for the promotion of life care of elderly obese women. Ten participants of elderly obese women who were able to walk independently without surgery experience of lumbar, hip or knee joint within the past year were recruited and under went the pretest, CLT (20 sessions), followed by the post-test. The test included BMI test using In-body, joint kinematics using myoVIDEO, muscle activation using surface EMG test (erector spinae (ER), external oblique abdominalis (EO), quadriceps femoris (Quad), hamstring muscle (Ham)) and balance tests including dynamic balance test using forced treadmill, Berg balance scale (BBS) and timed up go (TUG). The CLT program was conducted 60 minutes a day, 5 days a week, over 4 weeks period. As a result of this study, The the trunk and hip joints kinematics during the stance and swing phases of gait were a statistical significance levels were set at p <0.05. The ER and EO muscle activation were significantly improved after intervention (p <0.05). The length of gait line and single support line of change of center of pressure (COP) were significantly increased after intervention (p <0.05). The BBS and TUG were also significantly enhanced after intervention (p <0.05). The results of this study showed that CLT program for the improvement of life care had significant effects on improving postural instability, muscle weakness, reduced balance ability and falling risk of obese elderly women. Therefore, it is recommended to apply CLT program to improve life-care through improving balance ability and preventing fall of obese elderly women.

Implementation of Responsive Web-based Vessel Auxiliary Equipment and Pipe Condition Diagnosis Monitoring System (반응형 웹 기반 선박 보조기기 및 배관 상태 진단 모니터링 시스템 구현)

  • Sun-Ho, Park;Woo-Geun, Choi;Kyung-Yeol, Choi;Sang-Hyuk, Kwon
    • Journal of Navigation and Port Research
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    • v.46 no.6
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    • pp.562-569
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    • 2022
  • The alarm monitoring technology applied to existing operating ships manages data items such as temperature and pressure with AMS (Alarm Monitoring System) and provides an alarm to the crew should these sensing data exceed the normal level range. In addition, the maintenance of existing ships follows the Planned Maintenance System (PMS). whereby the sensing data measured from the equipment is monitored and if it surpasses the set range, maintenance is performed through an alarm, or the corresponding part is replaced in advance after being used for a certain period of time regardless of whether the target device has a malfunction or not. To secure the reliability and operational safety of ship engine operation, it is necessary to enable advanced diagnosis and prediction based on real-time condition monitoring data. To do so, comprehensive measurement of actual ship data, creation of a database, and implementation of a condition diagnosis monitoring system for condition-based predictive maintenance of auxiliary equipment and piping must take place. Furthermore, the system should enable management of auxiliary equipment and piping status information based on a responsive web, and be optimized for screen and resolution so that it can be accessed and used by various mobile devices such as smartphones as well as for viewing on a PC on board. This update cost is low, and the management method is easy. In this paper, we propose CBM (Condition Based Management) technology, for autonomous ships. This core technology is used to identify abnormal phenomena through state diagnosis and monitoring of pumps and purifiers among ship auxiliary equipment, and seawater and steam pipes among pipes. It is intended to provide performance diagnosis and failure prediction of ship auxiliary equipment and piping for convergence analysis, and to support preventive maintenance decision-making.

Effects of Dynamic Tubing Gait Training on Postural Alignment, Gait, and Quality of Life in Chronic Patients with Parkinson's Disease : Case Study (동적탄력튜빙 보행훈련 프로그램이 만성 파킨슨병 환자의 자세정렬과 보행능력과 삶의 질에 미치는 영향 : 사례연구)

  • Lee, Dong-Ryul
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.363-377
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    • 2021
  • The present study investigated the effects of dynamic tubing gait training(I and II) on the postural alignment, gait, and quality of life in chronic patients with Parkinson's disease. This study is based on the case study that recruited a total of 3 patients with chronic Parkinson's disease (Hoehn and Yahr Stage of 1 to 3 each one person). Dynamic tubing gait training (I and II) applied to chronic patients with Parkinson's disease for 25 sessions, 30 minutes a day, 5 days a week, over 5 weeks period. To investigate the effects of this study, evaluating using the postural alignment test, muscle activity tests, gait analysis, and quality of life scale for patient with Parkinson's disease. After the intervention of Dynamic tubing gait training (I and II), Trunk flexion was decreased. Also, during walking from initial contact (IC) to mid stance (Mst), muscle activity of Quadriceps, Hamstring, and Tibialis Anterior (TA) was increased and muscle activity of Gastrocnemius was decreased. The muscle activation of Erector Spinae (ES T12, L3) was increased in the H&Y I and III stages and decreased in the H&Y II stage. Length of gait line, single support line, ant/post position and lateral symmetry of center of pressure (COP) parameters improved. The spatio-temporal gait parameters including of step length, stride length, and velocity was increased, and cadence decreased. Further the quality of life of patients with Parkinson's disease was improved. Based on these findings, Dynamic tubing gait training (I and II) could be applied as a new approach to improve posture, gait, quality of life in chronic patients with Parkinson's disease for more than 5 years, whose drug resistance is halved.

Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice

  • Douglas Lobb;Masoud MiriMoghaddam;Don Macalister;David Chrisp;Graham Shaw;Hollis Lai
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.19-28
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    • 2023
  • Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

Performance Evaluation for All-In-One Construction Method of Curbstone and Gutter Using Formwork Rail and Jig (거푸집 레일과 지그를 이용한 경계석 및 측구의 일체형 시공법에 대한 성능평가)

  • Choi, Jae-Jin;Ko, Man-Gi;Kim, Kyoung-Ju;Choi, Khyung-Dong
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.6A
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    • pp.525-534
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    • 2010
  • A road curbstone is a structure installed at the boundary of the sidewalk and the street with the objectives of road drainage, drawing attention and such. The current general construction method of curbstones places foundation concrete for the curbstones first, waits until the concrete reaches the strength to support the curbstones, places the curbstones on top, and then places the gutter and rear filling concrete. Such method has the issues of poor compaction and weakened bond strength of concrete due to split placing of concrete, and causes the curbstones to easily separate due to vehicle impact or earth pressure, in turn creating maintenance costs and spoiling the aesthetics. To improve such conventional construction methods, an all-in-one method was developed using formwork rail and jig where both the curbstones and gutter can be worked at the same time, and to evaluate the structural performance, static tests of lateral loading test, pullout test, and bending test were executed, and dynamic tests such as pendulum test and actual vehicle impact test were executed. In all tests, the all-in-one construction method using formwork rail and jig was shown to be superior to the conventional construction method by the increase of construction quality and bond strength of concrete.

Effects of Intermittent Walking for Health Related Physical Fitness and Metabolic Syndrome Risk Factors in Elderly Women (간헐적인 걷기가 고령여성의 건강관련체력과 대사증후군 위험요인에 미치는 영향)

  • Kim, Sang-Hoon
    • 한국노년학
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    • v.29 no.4
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    • pp.1397-1411
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    • 2009
  • This study was aimed to examine the effects of intermittent walking on health related fitness and metabolic syndrome risk factors in elderly women. Forty five elderly women were randomly assigned to three groups: three 10-min walks per day, one 30-min walk per day or no exercise, respectively. Both walking groups exercised three days a week at moderate intensity for 12 weeks. Two-way repeated measures ANOVA was used to test the hypothesis with a significant level of α = .05. The results indicated that body composition(body weight, body mass index, percent body fat), muscle endurance, flexibility and cardiorespiratory fitness significantly increased after 12 weeks for both walking groups. However, it was found that muscle strength significantly increased only in a continuous walking group. Metabolic syndrome risk factors comprised of waist circumference, systolic blood pressure, triglyceride, high-density lipoprotein, and fasting glucose were significantly improved in both walking groups. In addition, there was a difference in these metabolic syndrome risk factors between pre and post exercise. The results of this study support the hypothesis that intermittent walking has a significant impact on health related physical fitness and metabolic syndrome rick factors in elderly women as continuous walking does.

Korean society and educational achievement (V): The contribution of educational achievement for the future of Korean society (한국 사회와 교육적 성취 (V): 교육적 성취를 통한 미래 한국 사회의 모색)

  • Youngshin Park;Uichol Kim
    • Korean Journal of Culture and Social Issue
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    • v.14 no.1_spc
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    • pp.427-468
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    • 2008
  • This article examines the role and influence of educational achievement on Korean society and its future. Four major factors that associated with and influence educational achievement in Korea (i.e., trust, efficacy beliefs, quality of life, and societal transformation) are reviewed. First, the role of educational achievement on establishing a basis for trust in Korean society is examined. By reviewing studies of perception of Korean society, people and institutions, the importance of establishing trust in Korean society is outlined. Second, the role of efficacy belief in promoting educational achievement is examined. The importance of collective efficacy, at the adolescent, adult and political levels is emphasized. In addition, the concept and application of self-efficacy for teachers and parents is reviewed. Third, the role and influence of educational achievement on quality of life is outlined. Studies indicate that educational achievement plays an important role in improving the quality of life. The pressure to achieve, however, can have negative impact on stress and mental health and support systems need to be developed to alleviate their impact. Fourth, the future and prospects for Korean society through educational achievement is discussed. Through education, the importance of bridging the divide with North Korea is an important agenda for the future of Korean society. Finally, the importance of indigenous psychological perspective in understanding Korean society and providing direction for the future is discussed.

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A Study on the Entrepreneurship Experience of Unmarried Mothers Living in Community : Focusing on Maternity Rights and Labor Rights (지역사회거주 비혼모의 기업가정신 (Entrepreneurship) 경험에 관한 연구 : 모성권과 노동권을 중심으로)

  • Kang, Ra Hyeon
    • Journal of Family Resource Management and Policy Review
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    • v.27 no.4
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    • pp.1-17
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    • 2023
  • This study examines the entrepreneurial experiences of unmarried mothers living in a community who have succeeded in starting a business. Attention was given to the maternal and labor rights of five single mothers in a community who gave birth, raised children, and engaged in vocational activities. Data were collected through one-on-one in-depth discussions with the participants and analyzed using Colaizzi's descriptive-phenomenological method. The data analysis revealed 53 themes and 10 clusters of themes. Based on these results, items such as overcoming pregnancy conflict, reasons for starting a business, and successful entrepreneurial experience were identified and described. The key themes of this study include "Pressure to live", "Hold oneself responsible for an unblessed life", "Stigma and deprivation of opportunity", "Maintaining basic life amid anxiety", "Starting from ground zero", "Work and parenting tug-of-war", "Let's rely on my ability rather than external support", "Securing credit capital", "Philosophy for shared growth" and "Infinite possibilities at the edge of a cliff". In the attempt to start a business using positive psychological capital for the well-being of themselves and their children's, the mothers uncovered social capital, which led to mutual growth. Based on the research results, the ethics and resilience of shared growth were discussed.