• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.101-108
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• 2011

Purpose: Cardiopulmonary resuscitation (CPR) prevents tissue necrosis of the brain and cardiac muscle in the cardiac arrest patient and requires exact skills in order to increase survival rate. Through comparison of the training effects of feedback manikin and non-feedback manikin, this study present the effective CPR device to CPR instructors. Method: This CPR course for 80 students by using Resusci Anne $SkillReporter^{TM}$ (RASR; Laerdal Medical, Stavanger, Norway) and Actar 911 $Squadron^{TM}$ (A911; Vital Signs, New Jersey, USA) held on December 22, 2009. Thirty seven students and two assistants were placed in one laboratory, there were five RASR manikins which provide the LED performance indicator, not the metronome. Forty two students and two assistants were placed in the other laboratory, there were 20 A911 manikins which don't provide any feedback indicator. Chest compression scores and ventilation compression scores obtaining from two groups were analysed statistically by using independent t-test. Results: Chest compression scores, average depth (mm) was 37.5 in RASR and 41.80 A911 (p=.004), too depth (#) was 2.8 in RASR and 19.4 A911 (p=.005), average number per min (#/min) was 64.4 in RASR and 68.2 A911 (p=.038), wrong hand position (#/min) was 10.9 in RASR and 30.8 A911 (p=.040). Four items that showed better scores in group RASR had statistically significant difference. Ventilation compression scores, percent correct (%) was 40.6 in RASR and 20.6 A911 (p<.001), number correct (#) was 4.7 in RASR and 2.1 A911 (p=.002), too fast (#) was 0.9 in RASR and 2.9 A911 (p=.003), average volume (ml) was 536.5 in RASR and 707.1 A911 (p=.011). Also, three items that showed better scores in group RASR had statistically significant difference. Conclusions: Regarding the positive effect of CPR training feedback, comparison between the real-time visual feedback manikin (RASR) and the non-feedback manikin (A911) showed that RASR had better results than A911 in chest compression except average number per min (it means that we need harder chest manikin) and ventilation. Verification of the training effect in the real world such as CPR outcomes is also necessary. A proper application of manikin in training circumstances and research on retention of CPR skills will be needed.

• Fire Science and Engineering
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• v.30 no.6
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• pp.137-141
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• 2016

Cross contamination between a patient and rescuer or CPR trainees can occur when performing mouth to mouth ventilation during cardiopulmonary resuscitation (CPR). On the other hand, there has been a lack of research on the filtration efficacy of face shields that are designed to protect people from cross-contamination. This study aims to secure the safety of rescuers from communicable diseases in pre-hospital emergency settings and CPR trainees by verifying the protective effects of face shields. The FA shield and CM Shield were used to verify the safety. The bacteria collected from filters used by CPR trainees were incubated. These incubated bacteria were smeared onto the new filters, and were then blown out through the filters using a Bag Valve Mask (BVM) and the pathogens at the front and the back of the filters were checked. While the FA shield was effective in preventing the transmission of pathogens, the CM shield did not prevent the transmission of pathogens. Therefore, some of face shields that received national certification are ineffective in preventing cross-contamination. Accordingly, it is necessary to verify the safety of other face shields used domestically.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.44-47
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• 2006

Symptoms of aspirin overdose may vary from acid-base disturbance, electrolyte abnormality, non-cardiogenic pulmonary edema, chemical hepatitis, seizure to cardiac toxicity. Cardiac adverse effects from aspirin are uncommon but there are reports of arrhythmia, cardiopulmonary arrest, and myocardial infarction. We report 2 cases of young women with aspirin overdose who exhibited ischemic changes on their ECGs a few hours after the ingestion with spontaneous recovery in a few days. First case, a 29 year old woman, presented to the emergency department 6 hours after ingesting 250 tablets of aspirin (325 mg/T). On examination, the temperature was $36.3^{\circ}C$: blood pressure, 105/72mmHg; Pulse, 111/min and respiratory rate, 24/min. Second case, a 27 year old woman, an hour after ingesting 60 tablets (325mg/T). On examination, the temperature was $36.0^{\circ}C$: blood pressure, 102/72 mmHg; pulse, 89/min and respiratory rate, 25/min. In both cases, ECG after 6 hours of ingestion had sinus tachycardia and developed T wave inversion on the anterior leads in the following ECGs. Their initial serum salicylate levels after 6 hours of ingestion were 71.2 mg/dL and 28.4 mg/dL respectively. These salicylate levels were resolving when these ECGs were observed. The ECG changes resolved in the following days and they were discharged without any further symptoms. Further studies are needed, but for the time being, when dealing with salicylate overdose, transient cardiac depression should be kept in mind to avoid adverse ischemic cardiac events.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.283-291
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• 2014

Patients with extreme anxiety who are unable to cope with dental treatment under non-pharmacological behavioral management method may require sedation, or other forms pharmacological behavioral management method. The aim of this retrospective study was to investigate the effect of concomitant administration of 0.1 mg/kg intramuscular midazolam with or without sevoflurane insufflation sedation on sedation depth and cardiopulmonary function in pediatric patients. We analysed the records of anesthesia on patients who received dental treatment under deep sedation using sevoflurane insufflation from January 2013 to March 2014. Thirty-six children, aged 3 to 6 years, undergoing dental treatment were sedated using either sevoflurane insufflation alone (Group S, n = 18) or a combination of intramuscular injection of 0.1 mg/kg midazolam plus sevoflurane insufflation (Group SM, n = 18). Upon comparison, the average entropy value of group SM was lower than that of group S, but there were no statistically significant difference between the two groups (p > 0.05). The average heart rate and mean arterial pressure of group SM were higher than those of group S (p < 0.05). Concomitant intramuscular injection of 0.1 mg/kg midazolam with sevoflurane insufflation sedation is not sufficient to enhance the quality of sedation.

• Journal of Digital Convergence
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• v.18 no.2
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• pp.175-182
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• 2020

The study aims to verify the effects of volleyball programs on the fitness and attention-intensive abilities of students with intellectual disabilities in middle school. Physical strength and attention concentration were analyzed to verify the effectiveness of the volleyball program. The volleyball program was applied to the experimental group three times a week, 90 minutes a week, a total of 36 times for 12 weeks. To verify the effectiveness of physical strength and attention concentration, the PPS-D intellectual disability student test and ATA concentration test were used to verify the effectiveness of attention concentration The six-minute walking figure related to cardiopulmonary functions was improved compared to those with intellectual disabilities who did not participate in the volleyball program, the report showed. We can see improvements in muscular function-related sit-ups and flexibility-related sit-ups compared to those with intellectual disabilities who did not participate, and significant changes have been seen in the distance of the place-wide jump related to net worth. We could also confirm that it had a positive effect on the improvement of selective attention concentration, and that the change in self-control, continuous attention, and selective attention among middle school students had a positive effect on the improvement.

• Journal of Life Science
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• v.19 no.6
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• pp.818-824
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• 2009

The mechanisms responsible for ischemia/reperfusion (I/R) injury have direct or indirect relevance to clinical lung injury after severe shock, cardiopulmonary bypass, and transplantation. This study investigated the effects of aspirin on intestinal I/R-induced acute lung injury (ALI) in rats. Lipopolysaccharide (LPS) induced cyclooxygenase-2 (COX-2) expression in A549 and RAW264.7 cells. RAW264.7 macrophages had shown greater expression of COX-2 than A549 cells. In addition, the NADPH oxidase inhibitor apocynin and p38 MAPK inhibitor SB203580 attenuated LPS-stimulated COX-2 expression. To induce ALI, intestinal ischemia was performed for 60 min prior to the 4 hr reperfusion by clamping the superior mesenteric artery in Sprague-Dawley rats. In order to test and compare the effect of non-specific COX inhibitor aspirin with the effect of mepacrine, a well known phospholipase$A_{2}$ inhibitor, rats were divided into 4 groups: Sham, I/R, Mepa+I/R (mepacrine, 60 mg/kg, i.p.), ASA+I/R (aspirin, 10 mg/kg, i.p.). In the present investigation, myeloperoxidase activities in the lung and intestinal tissues were increased by I/R. These changes were reduced by single pretreatment of mepacrine (60 mg/kg, i.p.) or aspirin (10 mg/kg, i.p.) 30 min before I/R. Structural studies demonstrated that the tissue injuries in the lung and intestine after I/R were also attenuated by the pretreatment of mepacrine or aspirin. These results suggest that I/R-induced ALI is mediated, in part, by the activation of COX. In addition, pretreatment of aspirin might be helpful for the prevention of ALI in ARDS-prone patients. In addition, the p38 MAPK inhibitor and apocynin also might be helpful to ALI through the inhibition of COX-2 expression.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.28-31
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• 1998

Homologous blood transfusion entails substantial risks, including allergic reactions, transmission diseases such as hepatitis, acquired immunodeficiency syndrome. Autotransfusion system is a common method of reducing the need for homologous blood transfusion during cardiac operation. Between July 1993 and July 1995, a series of 40 patients undergoing open heart surgery was selected to an autotransfusion group(n=20) or a control group(n=20). The cell saver system(AT1000, Electromedics, Englewood, CO, USA) was employed for autotransfusion. With this system, shed blood in operative field during cardiopulmonary bypass(CPB) and remained blood in cardiotomy reservior after CPB was aspirated by means of a locally heparinized collecting system. After centrifuge salvaged blood, the resulting red cell concentrate reinfused subsequently. The amounts of blood loss were 766.5$\pm$121.3 ml in cell saver group, 770.1$\pm$113.6 ml in control group, and there were no significant differences between two groups(P=NS). The amounts of blood transfused were 2.91$\pm$1.72 units in cell saver group, 4.82$\pm$1.72 units in control group. Composition of processed blood by cell saver was hemoglobin 17.4 gm%, hematocrit 56.4%, RBC 5,780,000/ul, WBC 9,900/ul, and platelet 33,000/ul. There was no complication related to cell saver. Conclusively, cell saver autotransfusion system is safe, effective method for reducing the homologous blood trasfusion in cardiac surgery.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.874-882
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• 1999

배경: 체외순환 후의 부종현상 및 이에 따른 여러 장치의 기능 저하를 방지하기 위하여, 최근에 체외 순환 이탈 후 환자의 혈액을 짧은 시간에 관류하여 여과해 주는 변형 초여과법의 사용이 늘고 있다. 이에 대한 긍정적인 임상결과들의 보고도 있으나, 다른 한편 체외 순환 후 염증반응을 포함한 폐손상의 기전에 혈구 성분의 영향이 보고되고 있는 바, 변형 초여과법의 효과, 특히 폐 조직에 대한 영향을 밝혀 보고자 하였다. 대상 및 방법: 몸무게 15에서 22 Kg(평균 16.5$\pm$0.5)의 16 쌍의 잡견을 이용한 정소성 심장이식, 실험에서, 통상적인 인공심폐기 작동군과 인공심폐기 작동 후 변형 초여과 관류를 시행한 군으로 무작위 구분하였다. 변형초여과법은 체외순환 정지 후에 대동맥관에서 나온 혈류를 Roller pump를 거쳐 Amicon Diafilter 초여과 관에 150 mL/m 정도의 속도로 10~15 분 정도 관류시켜 정맥관을 통하여 우심방에 직접 주입하였다. 혈액 채취 및 폐생검은 심폐기 시작 전과 정지 직후, 그리고 변형초여과 시행 군은 초여과 완료 직후에, 대조군은 심폐기 정지 10~15분 후에 각각 시행하였다. 혈류역학 측정요소는 동맥압, 우심방압, 좌심방압 등이었으며, 혈액 검사 항목은 동맥혈 가스분석, 혈색소 농도, 헤마토크릿, 백혈구 수, 혈소판 수, 혈중 단백 성분, 알부민 성분 등이었다. 폐 생검 조직으로는 냉동 건조법을 이용한 수분 함유량을 측정하였고, 광학 및 전자현미경으로 관찰을 하였다. 결과: 변형 초여과 군에서 혈중 혈색소 농도는 수술전 10.3$\pm$1.7 mg/dL, 심폐기 정지 직후 6.3$\pm$1.7 mg/dL, 초여과 직후는 8.3$\pm$2.8 mg/dL의 변화를(p=0.0078, 0.0117), 혈중 총 단백질의 농도 변화는 4.3$\pm$0.9, 3.1$\pm$1.5, 4.1$\pm$1.6 mg/dL, 혈중 알부민의 농도는 1.9$\pm$0.5, 1.4$\pm$0.7, 1.8$\pm$0.8 mg/dL로서, 각각 초여과법의 시행 전후에 유의한 증가를 가져왔고(p=0.0280, 0.0277), 폐조직의 수분 함유량의 변화는 수술전 75.1$\pm$8.6%, 심폐기 정지 직후 82.8$\pm$6.0%, 초여과 직후 77.88%를 보인 반면, 대조군에서는 각각 74.7$\pm$4.9, 82.1$\pm$5.9, 82.3$\pm$5.1%의 변화를 보였다. 미세 구조의 관찰에서, 폐포의 내포세피의 융합 기저막층과 미토콘드리아에서의 부종은 변형 초여과 후에 급격히 감소하였으나, 미토콘드리아내 크리스티의 파괴성 변화와 막성 파괴 성향이 초여과 후에 심화되게 관찰되었고, 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 폐조직 내의 백혈구는 심폐기 작동 후에 그 수에 있어서 증가하였으며 백혈구의 괴변, 탈과립 정도도 심폐기 작동 후 및 초여과 후에 증가한 소견을 보였다. 결론: 변형 초여과법은 인공 심폐기 후의 혈색소 농도 및 혈중 단백질 농도의 복원에 효과가 있었으며 변형 초여과 관류후 폐의 미세 조직내에서 부종의 급격한 감소 등을 관찰할 수 있었다.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.279-285
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• 2005

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

• The Korean Journal of Physiology
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• v.30 no.1
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• pp.105-116
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• 1996

Rendering the brain ischemic would evoke the cerebral ischemic reflex which is characterized by an arterial pressor response, apnea and bradycardia. Since the rostral ventrolateral medulla (RVLM) is known to play a key role in the maintenance of normal cardiopulmonary activity, during the cerebral ischemic reflex some cardiac related cells should be excited and respiration related cells inhibited. In this context, the responses of RVLM neurons to systemie and focal hypoxia were analyzed in the present study. Twenty-five adult cats of either sex were anesthetized with ${\alpha}-chloralose$ and the single neuronal activities were identified from RVLM area. For the induction of focal hypoxia in the recording site, sodium cyanide was applied iontophoretically and for systemic hypoxia the animal was ventilated with nitrogen gas for a twenty-second period. Cellular activities were analyzed in terms of their discharge pattern and responses to the hypoxia by using post-stimulus time and single-pass time histograms. Of eighteen cardiac related cells recorded from the RVLM area, twelve cells were excited by iontophoresed sodium cyanide and of twenty-five respiration related cells, fourteen cells were excited by iontophoresed sodium cyanide. Remaining cells were either inhibited or unaffected. Eight of fifteen cells tested with iontophoresed sodium lactate were excited and remaining seven cells were inhibited. Systemic hypoxia induced by nitrogen gas inhalation elevated the arterial blood pressure, but excited, inhibited or unaffected the single neuronal activities. Some cells showed initial excitation followed by inhibition during the systemic hypoxia. Bilateral vagotomy resulted in a decrease of arterial pressor response to the systemic hypoxia, and a slight decrease in the rhythmicity related to cardiac and/or respiratory rhythms. The single neuronal responses to either systemic or focal hypoxia were not affected qualitatively by vagotomy. From the above results, it was concluded that the majority of the cardiac- and respiration- related neurons in the rostral ventrolateral medulla be excited by hypoxia, not through the mediation of peripheral chemoreceptors, and along with the remaining inhibited cells, all these cells be involved in the mediation of cerebral ischemic reflex.