Why should we switch chest compression providers every 2 minutes during cardiopulmonary resuscitation?

Objective. Tis study was conducted to determine whether trained male rescuers could maintain adequate chest compression depth (CCD) for longer than the current recommended guidelines of 2 minutes. Methods. Forty male medical doctors administered a 5-minute single rescuer cardiopulmonary resuscitation (CPR) to a manikin on the foor with conventional CPR or randomly administered continuous chest compressions (CCC). Te ratio of compression to ventilation was set to 30:2 with mouth-to-mouth technique during conventional CPR. Chest compression data were recorded with an accelerometer device and divided into 1-minute segments for analysis. Results. Although average CCD maintained the recommended depths throughout 5 minutes in conventional CPR, it decreased signifcantly with CCC (1 minute: 55.4 ± 4.5 mm; 2 minutes: 54.2 ± 5.4 mm; 3 minutes: 52.6 ± 5.6 mm; 4 minutes: 51.6 ± 5.5 mm; 5 minutes: 49.9 ± 5.8 mm, p < 0.001). Te average chest compression numbers (ACCN) per minute were maintained over 80/min and have not been changed signifcantly within 5 minutes in the CCC. However, it didn’t reach to the 80/min and decreased signifcantly afer 3minutes compared to the baseline ACCN during frst 1-minute segment in the conventional CPR. Conclusions. Despite the chest compression providers being limited to trained male medical doctors, the average CCD decreased signifcantly within 5minutes with CCC. Although maintaining adequate CCD, ACCN in each minute decreased signifcantly afer 3minutes in the conventional CPR. Terefore, we should rotate chest compression providers every 2minutes regardless of the rescuer’s qualifcations and CPR methods

Diosgenin Induces Apoptosis in HepG2 Cells through Generation of Reactive Oxygen Species and Mitochondrial Pathway

Diosgenin, a naturally occurring steroid saponin found abundantly in legumes and yams, is a precursor of various synthetic steroidal drugs. Diosgenin is studied for the mechanism of its action in apoptotic pathway in human hepatocellular carcinoma cells. Based on DAPI staining, diosgenin-treated cells manifested nuclear shrinkage, condensation, and fragmentation. Treatment of HepG2 cells with 40 μM diosgenin resulted in activation of the caspase-3, -8, -9 and cleavage of poly-ADP-ribose polymerase (PARP) and the release of cytochrome c. In the upstream, diosgenin increased the expression of Bax, decreased the expression of Bid and Bcl-2, and augmented the Bax/Bcl-2 ratio. Diosgenin-induced, dose-dependent induction of apoptosis was accompanied by sustained phosphorylation of JNK, p38 MAPK and apoptosis signal-regulating kinase (ASK)-1, as well as generation of the ROS. NAC administration, a scavenger of ROS, reversed diosgene-induced cell death. These results suggest that diosgenin-induced apoptosis in HepG2 cells through Bcl-2 protein family-mediated mitochndria/caspase-3-dependent pathway. Also, diosgenin strongly generated ROS and this oxidative stress might induce apoptosis through activation of ASK1, which are critical upstream signals for JNK/p38 MAPK activation in HepG2 cancer cells

Effect of Information Disclosure Policy on Control of Infectious Disease:MERS-CoV Outbreak in South Korea

This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean Ministry of Health & Welfare website and analyzed using segmented linear autoregressive error models for interrupted time series. This study showed that the number of laboratory-confirmed cases was increased by 14.629 on June 5 (p < 0.001). However, this number was significantly decreased following disclosure of a list of hospitals with MERS-CoV cases (Estimate = −0.948; p < 0.001). Disclosing the list of hospitals exposed to MERS-CoV was critical to the prevention of further infection. It reduced the number of confirmed MERS-CoV cases. Thus, providing accurate and timely information is a key to critical care response

Whole-liver radiotherapy for end-stage colorectal cancer patients with massive liver metastases and advanced hepatic dysfunction

<p>Abstract</p> <p>Background</p> <p>To investigate whether whole-liver radiotherapy (RT) is beneficial in end-stage colorectal cancer with massive liver metastases and severe hepatic dysfunction.</p> <p>Methods</p> <p>Between June 2004 and July 2008, 10 colorectal cancer patients, who exhibited a replacement of over three quarters of their normal liver by metastatic tumors and were of Child-Pugh class B or C in liver function with progressive disease after undergoing chemotherapy, underwent whole-liver RT. RT was administered using computed tomography-based three-dimensional planning and the median dose was 21 Gy (range, 21-30) in seven fractions. Improvement in liver function tests, defined as a decrease in the levels within 1 month after RT, symptom palliation, toxicity, and overall survival were analyzed retrospectively.</p> <p>Results</p> <p>Levels of alkaline phosphatase, total bilirubin, aspartate transaminase, and alanine transaminase improved in 8, 6, 9, and all 10 patients, respectively, and the median reduction rates were 42%, 68%, 50%, and 57%, respectively. Serum carcinoembryonic antigen level decreased after RT in three of four assessable patients. For all patients, pain levels decreased and acute toxicity consisted of nausea/vomiting of grade ≤ 2. Further chemotherapy became possible in four of 10 patients. Mean survival after RT was 80 ± 80 days (range, 20-289); mean survival for four patients who received post-RT chemotherapy was 143 ± 100 days (range, 65-289), versus 38 ± 16 days (range, 20-64) for the six patients who did not receive post-RT chemotherapy (<it>p </it>= 0.127).</p> <p>Conclusions</p> <p>Although limited by small case number, this study demonstrated a possible role of whole-liver RT in improving hepatic dysfunction and delaying mortality from hepatic failure for end-stage colorectal cancer patients with massive liver metastases. Further studies should be followed to confirm these findings.</p

Cigarette smoke exacerbates mouse allergic asthma through Smad proteins expressed in mast cells

<p>Abstract</p> <p>Background</p> <p>Many studies have found that smoking reduces lung function, but the relationship between cigarette smoke and allergic asthma has not been clearly elucidated, particularly the role of mast cells. This study aimed to investigate the effects of smoke exposure on allergic asthma and its association with mast cells.</p> <p>Methods</p> <p>BALB/c mice were sensitized and challenged by OVA to induce asthma, and bone marrow-derived mast cells (BMMCs) were stimulated with antigen/antibody reaction. Mice or BMMCs were exposed to cigarette smoke or CSE solution for 1 mo or 6 h, respectively. The recruitment of inflammatory cells into BAL fluid or lung tissues was determined by Diff-Quik or H&E staining, collagen deposition by Sircol assay, penh values by a whole-body plethysmography, co-localization of tryptase and Smad3 by immunohistochemistry, IgE and TGF-β level by ELISA, expressions of Smads proteins, activities of signaling molecules, or TGF-β mRNA by immunoblotting and RT-PCR.</p> <p>Results</p> <p>Cigarette smoke enhanced OVA-specific IgE levels, penh values, recruitment of inflammatory cells including mast cells, expressions of smad family, TGF-β mRNA and proteins, and cytokines, phosphorylations of Smad2 and 3, and MAP kinases, co-localization of tryptase and Smad3, and collagen deposition more than those of BAL cells and lung tissues of OVA-induced allergic mice. CSE solution pretreatment enhanced expressions of TGF-β, Smad3, activities of MAP kinases, NF-κB/AP-1 or PAI-1 more than those of activated-BMMCs.</p> <p>Conclusions</p> <p>The data suggest that smoke exposure enhances antigen-induced mast cell activation via TGF-β/Smad signaling pathways in mouse allergic asthma, and that it exacerbates airway inflammation and remodeling.</p

Effects of a dianion compound as a surface modifier on the back reaction of photogenerated electrons in TiO2-based solar cells

The TiO2 films were modified with a dianion compound, 1,2-ethanedisulfonic acid disodium salt (ESD), to give a negative charge (ethane sulfonate anion) on the TiO2 surface, i.e., TiO2-O-SO2-CH2-CH2-SO3 −), and effects of repulsion between the negative charge and ions (I3 −) of the electrolyte on the performance of dye-sensitized solar cells (DSSCs) were investigated. The reference device without any modification showed a power conversion efficiency (PCE) of 9.89%, whereas for the device with ESD(20)-TiO2/FTO, which was prepared by soaking bare TiO2/FTO in an ESD solution for 20 min, the PCE was increased to 10.97%, due to an increase in both short-circuit current (Jsc) and open-circuit voltage(Voc). It was verified from the measurements of electrochemical impedance, open-circuit voltage decay and dark current that the enhancement in the Jsc and Voc values was attributed to the reduced back reaction between photoinjected electrons and I3 − ions, resulting from the presence of the ethane sulfonate anions on the TiO2 surface. © 2018 King Saud University1

Comparison of air pollution and the prevalence of allergy-related diseases in Incheon and Jeju City

PurposeA high level of air pollutants can increase the number of patients with allergy-related diseases such as asthma and allergic rhinitis (AR). To analyze the association between air pollution and allergic disease, we investigated 2 areas in Korea: Incheon, an industrial area, and Jeju, a non-industrialized area.MethodsSecond grade students at elementary schools (11 schools in Incheon and 45 schools in Jeju) were examined in a cross-sectional study. A questionnaire was used and a skin prick test was performed. The levels of NO2, CO2, O3, particulate matter (PM) PM10/2.5, formaldehyde, tVOCs, and dust mites in the classrooms and grounds were determined.ResultsThe levels of outdoor CO, PM10, and PM2.5 were significantly higher in Incheon (P<0.01). The levels of indoor CO, CO2, PM10, PM2.5 were significantly higher in Incheon (P<0.01). The prevalence rates of AR symptoms at any time, AR symptoms during the last 12 months, diagnosis of rhinitis at any time, and AR treatment during the last 12 months were significantly higher in Incheon (P<0.01). The prevalence rate of wheezing or whistling at any time, and wheezing during the last 12 months were significantly higher in Incheon (P<0.01).ConclusionWe found that the children living in Incheon, which was more polluted than Jeju, had a higher rate of AR and asthma symptoms compared to children in Jeju. To determine the effect of air pollution on the development of the AR and asthma, further studies are needed

Relationship between the number of family members and stress by gender:Cross-sectional analysis of the fifth Korea National Health and Nutrition Examination Survey

Background Due to gendered inequalities in the division of domestic work, women with paid employment and family caregiving responsibilities can feel extremely tired with general distress and depression. Therefore, the purpose of this study was to examine the association between the number of family members and stress level by gender among Korean adults using a nationally representative dataset. Methods We used a sample of 6,293 subjects aged 19 or older (3,629 female and 2,264 male) from the fifth Korea National Health and Nutrition Examination Survey. A multivariable logistic regression analysis with sociodemographic and health-related characteristics was conducted. Because there were gender differences, a stratified analysis was performed for each gender. Results Age, number of family members, education level, occupational status, depression, self-rated health status, and chronic diseases were found to have a significant association with stress level in the study subjects (p Conclusion We found that unmarried women are more likely to be stressed as the number of family members increases. Gender expectations giving women the main responsibility for domestic and care work may become a source of stress. Reconciliation of family and work remains women's responsibility in Korea. As family problems are recently becoming a big issue, our study shows the importance of considering gender difference in studies on stress according to family roles and functions

A Case of Minimal Change Disease Treated Successfully with Mycophenolate Mofetil in a Patient with Systemic Lupus Erythematosus

The World Health Organization classifies lupus nephritis as class I to V or VI. However, a few cases of minimal change glomerulopathy have been reported in association with systemic lupus erythematosus (SLE). Mycophenolate mofetil has been shown to be effective for treatment of minimal change disease and lupus nephritis. A 24-year-old woman diagnosed with SLE five years prior to presentation complained of a mild generalized edema. The urinalysis showed microscopic hematuria and proteinuria. The assessed amount of total proteinuria was 1,618 mg/24 hours. A renal biopsy demonstrated diffuse fusion of the foot processes of podocytes on electron microscopy. Mycophenolate mofetil was started in addition to the maintenance medications of prednisolone 10 mg/day and hydroxychloroquine 400 mg/day. After six months of treatment, the microscopic hematuria and proteinuria resolved, and the total urine protein decreased to 100 mg/24 hours