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

Gap Analysis Between the Level of Heat Wave Adaptation Policy and Heat Wave Effects in South Korean Municipalities

This study aims to analyze the gap between the level of heat wave adaptation policies and heat wave effects in South Korean municipalities. First, the types of industries in municipalities were classified using factor analysis and cluster analysis. Second, the level of heat wave adaptation policy in the municipalities was assessed using a fuzzy analytic hierarchy process analysis. Third, the gap between the level of heat wave adaptation policy and the heat wave effect was analyzed. The results show that the heat wave adaptation policies were established in accordance with the heat wave effects to at least some degree. However, closer to the long-term future (2095), the policies have not sufficiently matched the level of heat wave effects. The proportion of municipalities with insufficient levels of heat wave adaptation policies against the heat wave effects was higher among urban-type municipalities. The analysis results suggest two policy implications. First, the heat wave adaptation policies of municipalities should be established through continuous feedback on the predictions of future heat wave effects. Second, urban-type municipalities should strengthen their planning authority and competence by securing a professional workforce and budgets for the establishment of heat wave adaptation policies

Nationwide Multicenter Survey for Current Status of Endoscopic Thyroidectomy in Korea

ObjectivesWe evaluated the current status of endoscopic thyroidectomy procedures in Korea in terms of indications, contraindications, advantages, disadvantages, complications, and limitations of each approach.MethodsAn email survey, consisting of 15 questions, was sent to 29 experienced endoscopic thyroidectomy surgeons.ResultsThe most commonly used approach was the gasless transaxillary approach (66.7%), followed by the bilateral axillo-breast approach with gas insufflation (23.8%). The most common indication was less than 1 cm, single papillary thyroid cancer. The role of endoscopic thyroidectomy is not still established; some consider it a novel procedure (34.8%), others a transition to robotic thyroidectomy (34.8%).ConclusionOur results shed light on the general consensus of opinions about endoscopic thyroidectomy, such as the advantages, disadvantages, complications, limitations, and even its future role

Histological confinement of transglutaminase-mediated nit sheath crosslinking is essential for proper oviposition and egg coating in the human head louse, Pediculus humanus capitis

Background Head louse females secrete liquid gel, which is mainly composed of the louse nit sheath protein 1 (LNSP1) and LNSP2, when they lay eggs. The gel is crosslinked by transglutaminase (TG) to form the nit sheath, which covers most of the egg except the top operculum area where breathing holes are located. Knowledge on the selective mechanism of nit sheath solidification to avoid uncontrolled crosslinking could lead to designing a novel method of louse control, but no information is available yet. Methods To elucidate the crosslinking mechanisms of nit sheath gel inside the reproductive system of head louse females, in situ hybridization in conjunction with microscopic observation of the oviposition process was conducted. Results Histochemical analysis revealed that LNSP1 and LNSP2 are expressed over the entire area of the accessory gland and uterus, whereas TG expression site is confined to a highly localized area around the opening of posterior oviduct. Detailed microscopic observations of oviposition process uncovered that a mature egg is positioned in the uterus after ovulation. Once aligned inside the uterus, the mature egg is redirected so that its operculum side is tightly held by the ventral end of the uterus being positioned toward the head again and its pointed bottom end being positioned toward the dorsal end of the uterus, which functions as a reservoir for the nit sheath gel. Conclusions Physical separation of the TG-mediated crosslinking site from the ventral end of the uterus is necessary to avoid uncontrolled crosslinking inside the uterus and to ensure selective crosslinking over only the lower part of egg without any unwanted crosslinking over the operculum during oviposition. Graphical Abstrac

MRI Findings of Pericardial Fat Necrosis: Case Report

Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum

Specific Radius Change of Quantum Dot inside the Lipid Bilayer by Charge Effect of Lipid Head-Group

We studied the quantum dot-liposome complex (QLC), which is the giant unilamellar vesicle with quantum dots (QDs) incorporated in its lipid bilayer. A spin coating method in conjunction with the electroformation technique yielded vesicles with highly homogeneous unilamellar structure. We observed QD size dependence of the QLC formation: QLCs form with blue, green and yellow-emission QD (core radius ~1.05 nm, 1.25 nm and 1.65 nm) but not with red-emission QD (core radius ~2.5 nm). In order to explain this size dependence, we made a simple model explaining the QD size effect on QLC formation in terms of the molecular packing parameter and the lipid conformational change. This model predicts that QDs below a certain critical size (radius &amp;#8776; 1.8 nm) can stably reside in a lipid bilayer of 4 - 5 nm in thickness for Egg-PC lipids. This is consistent with our previous experimental results. In the case of red-emission QD, QD-aggregations are only observed on the fluorescent microscopy instead of QLC. We expected that the reduction of packing parameter (P) would lead to the change of specific QD radius. This prediction could be verified by our experimental observation of the shift of the specific QD size by mixing DOPG

Complete Atrioventricular Block Secondary to Bortezomib Use in Multiple Myeloma

Bortezomib is an inhibitor of 26S proteasome, which is an effective treatment for multiple myeloma. The common adverse effects of bortezomib are asthenic conditions, gastrointestinal disturbances, and peripheral neuropathy. Here we describe a patient with dyspnea and general weakness because of complete atrioventricular block while receiving bortezomib. We immediately stopped bortezomib, and after inserting a permanent VDD pacemaker, the patients' symptoms disappeared

Transcatheter Arterial Embolization as Treatment for a Life-Threatening Retroperitoneal Hemorrhage Complicating Heparin Therapy

Spontaneous retroperitoneal hemorrhage is a distinct clinical entity that can present in the absence of specific underlying pathology or trauma and is typically associated with anticoagulation therapy. We report a case of a 74-year-old female patient with a cerebral infarction related to atrial fibrillation who developed a spontaneous lumbar arterial hemorrhage complicating heparin therapy. The diagnosis was suggested by a computed tomography scan and confirmed by angiography. She was treated successfully with transcatheter embolization