1.Effect of Recovery of Pulmonary Function in Hypothermic Lung Preservation.
Man Bok LEE ; Woo Jong KIM ; Chang Hee KANG ; Khil Rho LEE
The Korean Journal of Thoracic and Cardiovascular Surgery 1997;30(3):253-262
Hypothermia during lung preservation decreases metabolic processes. After the rabbit lung was flushed with modified Euro-Collins solution, heart-lung block was harvested and the left lung was assessed after ligation of the right pulmonary artery and right main-stem bronchus. Heart-lung block was immersed in the same solution for 6 hours. The modified Euro-Collins solution and storage temperature of group 1( 10 cases ) was 4 degrees C, group 2( 10 cases ) was 10 degrees C. On completion of the storage period, the left lung was ventilated and reperfused with blood which used a cross-circulating paracorporeal rabbit as a " biologic deoxygenator " for 60 minutes. Pulmonary artery pressure, airway pressure, difference in oxygen tension between inflow and outflow perfusate and degree of pulmonary edema were assessed at 10-minute intervals while the left lung was ventilated at 0.8 of the inspired oxygen fraction. The mean pulmonary venous oxygen tensions at 10 and 60 minutes after reperfusion were 209.52 +/- 42.46 and 103.48 +/- 15.96 mmHg in group I versus 247.78 +/- 36.19 and 147.91 +/- 11.07 mmHg in group II( p = 0.049, <0.0001 ). The mean alveolar-arterial oxygen differences at 20 and 60 minutes after reperfusion were 357.95 +/- 12.84 and 437.31 +/- 14.26 mmHg in group I versus 310.88 +/- 33.47 and 390.93 +/- 15.86 mmHg in group II( p = 0.0092, <0.0001 ). The mean pulmonary arterial pressures at 10 and 60 minutes after reperfusion were 40.56 +/- 18.66 and 87.22 +/- 17.22 mmHg in group I versus 31.22 +/- 6.84 and 65.78 +/- 11.02 mmHg in group II( p = 0.048, 0.0062 ). The mean pulmonary vascular resistances at 10 and 60 minutes after reperfusion were 2.69 +/- 0.85 and 4.36 +/- 0.86 mmHg/ml/min in group I versus 1.99 +/- 0.39 and 3.29 +/- 0.55 mmHg/ml/min in group II( p = 0.0323, 0.0062 ). There were no difference between groups in peak airway pressure, lung compliance and degree of pulmonary edema. In conclusion that preservation of lung at 10 degrees C was superior to preservation at 4 degrees C.
Arterial Pressure
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Bronchi
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Hypothermia
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Ligation
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Lung Compliance
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Lung Transplantation
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Lung*
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Metabolism
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Organ Preservation
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Oxygen
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Pulmonary Artery
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Pulmonary Edema
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Reperfusion
2.A Study on a current Legal Foundations for Emergency Medical Service in Public Facilities.
Jung Hwan AHN ; Ho Jung KIM ; Mi Seon KIM ; Jong Khil LEE ; Dae Wook LEE ; Joon Pil CHO
Journal of the Korean Society of Emergency Medicine 2008;19(4):366-371
PURPOSE: Our country has seen a rapid increase in economic growth, national land development and planning. As a consequence, cities were enlarged and became densely populated. Public facilities were also increased to adequately serve the increasing population. Within the past 10 years, a lot of accidents in public facilities have occurred but the legal foundations for emergency medical care and systems for these public facilities may be lacking. METHODS: From the current domestic laws, we defined the public facilities and the enrolled laws that govern these facilities. Adequacy of the enrolled laws were then analyzed using 7 reference points: education for all employees, education for security employees, education for customers, arrangement of medical persons, arrangement of security person, equipment for emergency care and penalty. RESULTS: There were 17 enrolled laws and only 'Juvenile Activity Promotion Act' fulfilled most of the reference points except for 2; the arrangement of medical persons and penalty. Fifteen of the enrolled laws fulfilled less than 3 reference points. CONCLUSION: In the current domestic laws governing public facilities, almost all of them practically lacked policies addressing emergency care and systems.
Economic Development
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Emergencies
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Emergency Medical Services
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Foundations
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Humans
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Jurisprudence
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Public Facilities