• Title/Summary/Keyword: 안정성도

Search Result 24,172, Processing Time 0.051 seconds

Experimental Study of Flip-Bucket Type Hydraulic Energy Dissipator on Steep slope Channel (긴구배수로 감세공의 Filp Bucket형 이용연구)

  • 김영배
    • Magazine of the Korean Society of Agricultural Engineers
    • /
    • v.13 no.1
    • /
    • pp.2206-2217
    • /
    • 1971
  • Spillway and discharge channel of reservoirs require the Control of Large volume of water under high pressure. The energies at the downstream end of spillway or discharge channel are tremendous. Therefore, Some means of expending the energy of the high-velocity flow is required to prevent scour of the riverbed, minimize erosion, and prevent undermining structures or dam it self. This may be accomplished by Constructing an energy dissipator at the downstream end of spillway or discharge channel disigned to dissipated the excessive energy and establish safe flow Condition in the outlet channel. There are many types of energy dissipators, stilling basins are the most familar energy dissipator. In the stilling basin, most energies are dissipated by hydraulic jump. stilling basins have some length to cover hydraulic jump length. So stilling basins require much concrete works and high construction cost. Flip bucket type energy dissipators require less construction cost. If the streambed is composed of firm rock and it is certain that the scour will not progress upstream to the extent that the safety of the structure might be endangered, flip backet type energy dissipators are the most recommendable one. Following items are tested and studied with bucket radius, $R=7h_2$,(medium of $4h_2{\geqq}R{\geqq}10h_2$). 1. Allowable upstream channel slop of bucket. 2. Adequate bucket lip angle for good performance of flip bucket. Also followings are reviwed. 1. Scour by jet flow. 2. Negative pressure distribution and air movement below nappe flow. From the test and study, following results were obtained. 1. Upstream channel slope of bucket (S=H/L) should be 0.25<H/L<0.75 for good performance of flip bucket. 2. Adequated lip angle $30^{\circ}{\sim}40^{\circ}$ are more reliable than $20^{\circ}{\sim}30^{\circ}$ for the safety of structures.

  • PDF

Purification and Characterization of Lactate Dehydrogenase Isozymes in Channa argus (가물치(Channa argus) 젖산탈수소효소 동위효소들의 정제 및 특성)

  • Park, Eun-Mi;Yum, Jung-Joo
    • Journal of Life Science
    • /
    • v.20 no.2
    • /
    • pp.260-268
    • /
    • 2010
  • The lactate dehydrogenase (EC 1.1.1.27, LDH) isozymes in tissues from Channa argus were purified and characterized by biochemical, immunochemical and kinetic methods. The activity of LDH in skeletal muscle was the highest at 380.4 units and those in heart, eye and brain tissues were 13.4, 3,5 and 5.4 units, respectively. Citrate synthase (EC 4.1.3.7, CS) activity in heart tissue was the highest at 20.7 units. LDH/CS in skeletal muscle, heart, eye and brain tissues were 172.9, 0.6, 0.32 and 0.47. Protein concentration in skeletal muscle tissue was 14.7 mg/g and specific activities of LDH in skeletal muscle, heart, eye and brain tissues were 25.88, 0.79, 0.31 and 1.38 units/mg, respectively. Therefore, skeletal muscle tissue was anaerobic and heart tissue was aerobic. The LDH isozymes in tissues were identified by polyacrylamide gel electrophoresis, immunoprecipitation and Western blot with antiserum against $A_4$, $B_4$, and eye-specific $C_4$. LDH $A_4$, $A_3B$, $A_2B_2$. $AB_3$ and $B_4$ isozymes were detected in every tissue, $C_4$, $AC_3$, $A_2C_2$ and $A_3C$ were detected in eye tissue, and $A_3C$ was found in brain tissue. LDH $A_4$, $A_3B$, $A_2B_2$, $AB_3$, $B_4$, eye-specific $C_4$ isozymes were purified by affinity chromatography and Preparative PAGE Cells. The LDH $A_4$ isozyme was purified in the fraction from elution with $NAD^+$ containing buffer of affinity chromatography. Eye-specific $C_4$ isozyme was eluted right after $A_4$, after which $B_4$ isozyme was eluted with plain buffer. As a result, one part of molecular structures in $A_4$, $B_4$ and eye-specific $C_4$ were similar, but were different from each other in $B_4$ and $C_4$. Therefore the subunit A may be conservative in evolution, and the evolution of subunit B seems to be faster than that of subunit A. The activity of LDH $A_4$, $A_2B_2$, $B_4$, and eye-specific $C_4$ isozymes remained at 39.98, 21.28, 19.67 and 16.87% as a result of the inhibition by 10 mM of pyruvate, so the degree of inhibition was very high. The $Km^{PYR}$ values were 0.17, 0.27 and 0.133 mM in $A_4$, $B_4$ and eye-specific $C_4$ isozymes, respectively. The optimum pH of LDH $A_4$, $B_4$, eye-specific $C_4$, $A_2B_2$, $A_3B$, and $AB_3$ were pH 6.5, pH 8.5, pH 5.5, pH 6.0-6.5, pH 5.0 and pH 7.5. The $A_4$ and heterotetramer isozymes stabilized a broad range of pH. Especially, LDH activities in skeletal muscle tissue were high, resulting in a high degree of muscle activity.LDH metabolism in eye tissue seems to be converted faster from pyruvate to lactate by eye-specific $C_4$ isozyme as eye-specific $C_4$ have the highest affinity for pyruvate, and right after the conversion, oxidation of lactate was induced by $A_4$ isozyme. It was found that expression of Ldh-C, affinity to substrate and reaction time of $C_4$ isozyme were different according to the ecological environmental and feeding capturing patterns.

A Influence Effect of Mid-life Religious Life and Faith Maturity on the Couples' Life Satisfaction (중년기 종교 활동과 신앙성숙도가 부부생활만족도에 미치는 영향분석연구)

  • Jeong, Jin-O;Byeon, Sang-Hae;Kim, Jong-Su
    • 한국벤처창업학회:학술대회논문집
    • /
    • 2009.10a
    • /
    • pp.265-288
    • /
    • 2009
  • The study has found that the main reasons affecting to the mature conjugal relations of middle-aged persons are closely related with sede factors brought about after marriage. Comparatively the factors before marriage have more or less weak power on the conjugal relations. They are mature relations wp between husbands and wives, stable and enough incede, and religious activities, which have deep relations with the satisfactory conjugal relations. C. G. Jung divided the whole life span as self-assuredness period in the first half and self-convergence period in the second half. The first is the period when one does his or her best to get external and physical self. On the contrary, the second is the middle-aged period one finds his or her meaning of life in the religious, philosophical, intuitional, and spiritual world, which lead life into harmony and integration. Therefore if one overcomes some psychological crisis related with middle-aged development he or she can enjoy happy senescence(old age). The study has suggested through literature investigation the definition of middle age and the developmental traits of middle age, and the relations between religions and conjugal relations of middle-aged husbands and wives. Futhermore, it has analyzed the theories which religions have close relations with the life satisfaction of middle-aged conjugal relations. In order to give an analysis the influence of the variable of religious activities and religious maturity, with the degree of conjugal satisfaction, 400 middle age are selected as the object of the study whose ages are ranging from 35 years to 60 years, and who reside in Seoul or near Seoul. They were asked to fill out the questionnaires asking about religious activities, religious maturity, and the conjugal satisfaction from March 25th to April 30th, 2009. The results of the survey have been statistically processed and analyzed. First, the higher religious maturity gives positive influence on the general religious activities including public service, human relations, and spiritual stability. That is, this result indicates that the individual, spiritual, and formal religious activities give to a degree influence on the religious maturity. Second, the maturity of religious life resulting from religious activities has a causation with the satisfaction of conjugal life. In more details, religious activities has a positive influence on the satisfaction of conjugal life(T=31.36, p<.001) In more details, religious activities has a positive influence on the religious maturity(T=31.36, p<.001), and religious activities has a positive influence on the satisfaction of conjugal life(T=33.81, p<.001), and the religious maturity has a positive influence on the satisfaction of conjugal life(T=28.64, p<.001) Third, as we analyze the main effects which religious activities and the religious maturity could give influence on the satisfaction of conjugal life, it is found that both religious activities(F=15.95, p<.001) and the religious maturity(F=23.94, p<.001) give a positive influence on the satisfaction of conjugal life. In conclusion, it is sure that religious activities and the religious maturity have a close relations with the satisfaction of conjugal life. Therefore it can be said that religious activities at the protestant religion, buddhism, and catholic religion can give an important influence on the satisfaction of middle-aged conjugal life.

  • PDF

The Effect of PET/CT Images on SUV with the Correction of CT Image by Using Contrast Media (PET/CT 영상에서 조영제를 이용한 CT 영상의 보정(Correction)에 따른 표준화섭취계수(SUV)의 영향)

  • Ahn, Sha-Ron;Park, Hoon-Hee;Park, Min-Soo;Lee, Seung-Jae;Oh, Shin-Hyun;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.13 no.1
    • /
    • pp.77-81
    • /
    • 2009
  • Purpose: The PET of the PET/CT (Positron Emission Tomography/Computed Tomography) quantitatively shows the biological and chemical information of the body, but has limitation of presenting the clear anatomic structure. Thus combining the PET with CT, it is not only possible to offer the higher resolution but also effectively shorten the scanning time and reduce the noises by using CT data in attenuation correction. And because, at the CT scanning, the contrast media makes it easy to determine a exact range of the lesion and distinguish the normal organs, there is a certain increase in the use of it. However, in the case of using the contrast media, it affects semi-quantitative measures of the PET/CT images. In this study, therefore, we will be to establish the reliability of the SUV (Standardized Uptake Value) with CT data correction so that it can help more accurate diagnosis. Materials and Methods: In this experiment, a total of 30 people are targeted - age range: from 27 to 72, average age : 49.6 - and DSTe (General Electric Healthcare, Milwaukee, MI, USA) is used for equipment. $^{18}F$- FDG 370~555 MBq is injected into the subjects depending on their weight and, after about 60 minutes of their stable position, a whole-body scan is taken. The CT scan is set to 140 kV and 210 mA, and the injected amount of the contrast media is 2 cc per 1 kg of the patients' weight. With the raw data from the scan, we obtain a image showing the effect of the contrast media through the attenuation correction by both of the corrected and uncorrected CT data. Then we mark out ROI (Region of Interest) in each area to measure SUV and analyze the difference. Results: According to the analysis, the SUV is decreased in the liver and heart which have more bloodstream than the others, because of the contrast media correction. On the other hand, there is no difference in the lungs. Conclusions: Whereas the CT scan images with the contrast media from the PET/CT increase the contrast of the targeted region for the test so that it can improve efficiency of diagnosis, there occurred an increase of SUV, a semi-quantitative analytical method. In this research, we measure the variation of SUV through the correction of the influence of contrast media and compare the differences. As we revise the SUV which is increasing in the image with attenuation correction by using contrast media, we can expect anatomical images of high-resolution. Furthermore, it is considered that through this trusted semi-quantitative method, it will definitely enhance the diagnostic value.

  • PDF

Prospective Study of the Immunologic Factors Affecting the Prognosis of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴환자의 예후에 영향을 미치는 면역지표에 대한 연구)

  • Hwang, Jae-Kyung;Lee, Ho-Moeng;Song, Kwang-Sik;Park, Gye-Young;Park, Jeong-Woong;Park, Jae-Kyung;Jeong, Seong-Hwan;Ahn, Jeong-Yeal;Seo, Yiel-Hea;Nam, Gui-Hyun
    • Tuberculosis and Respiratory Diseases
    • /
    • v.50 no.4
    • /
    • pp.437-449
    • /
    • 2001
  • Background : In the severe community-acquired pneumonia, it has been known that the immune status is occasionally suppressed. This study was performed to identify the immunologic markers related with the prognostic factors in severe community-acquired pneumonia. Methods : 23 patients with severe community-acquired pneumonia were involved in this study, and divided into survivor (16) and nonsurvivor (7) groups. In this study, the medical history, laboratory tests(complete blood counts, routine chemistry profile, immunoglobulins, complements, lymphocyte subsets, cytokines, sputum and blood culture, urine analysis), and chest radiographs were scrutinized. Results : 1) Both groups had lymphopenia(total lymphocyte count $995.6{\pm}505.7/mm^3$ in the survivor and $624.0{\pm}287.6/mm^3$ in the nonsurvivor group). 2) The T-lymphocyte count of the nonsurvivor group($295.9{\pm}203.0/mm^3$) was lower than the survivor group($723.6{\pm}406.5/mm^3$) (p<0.05). 3) The total serum protein(albumin) was $6.0{\pm}1.0(2.7{\pm}0.7)\;g/d{\ell}$ in the survivor and $5.2{\pm}1.5(2.3{\pm}0.8)g/d{\ell}$ in the nonsurvivor group. The BUN of the nonsurvivor group($41.7{\pm}30.0mg/d{\ell}$) was higher than that of the survivor group($18.9{\pm}9.8mg/d{\ell}$)(p<0.05). The creatinine concentration was higher in the nonsurvivor group($1.8{\pm}1.0mg/d{\ell}$) than that in the survivor group($1.0{\pm}0.3mg/d{\ell}$)(p<0.05). 4) The immunoglobulin G level was higher in the survivor group($1433.0{\pm}729.5mg/d{\ell}$) than in the nonsurvivor group($849.1{\pm}373.1mg/d{\ell}$) (p<0.05). 5) The complement $C_3$ level was $108.0{\pm}37.9mg/d{\ell}$ in the survivor group and $88.0{\pm}32.1mg/d{\ell}$ in the nonsurvivor group. 6) A cytokine study showed an insignificant difference in both groups. 7) Chronic liver disease, DM, and COPD were major underlying diseases in both groups. Conclusion : These results suggest that decreased a T-lymphocyte count and immunoglobulin G level, and an increased BUN and creatinine level may be associated with the poor prognosis of severe community-acquired pneumonia.

  • PDF

Lymphocyte Proportion and Cytokines from the Bone Marrow of Patients with Far-Advanced Pulmonary Tuberculosis with Peripheral Lymphocytopenia (말초혈액의 림프구감소증을 동반한 중증폐결핵 환자들에서 골수 내의 림프구 분획과 사이토카인 소견)

  • An, Chang Hyeok;Kyung, Sun Yong;Lim, Young Hee;Park, Gye Young;Park, Jung Woong;Jeong, Sung Hwan;Ahn, Jeong Yeal
    • Tuberculosis and Respiratory Diseases
    • /
    • v.55 no.5
    • /
    • pp.449-458
    • /
    • 2003
  • Background : The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)(< $1,000/mm^3$) and $T_4$-cell count ${\leq}500/mm^3$. However, the cause of PB lymphocytopenia in FAPTB is unclear. The aim of this study was to analyze the lymphocyte proportion and cytokines of the bone marrow(BM) in FAPTB patients with peripheral lymphocytopenia in order to clarify whether the limiting step of the lymphocytopenia occurs in production, differentiation, or circulation. Methods : This study included patients with FAPTB between August 1999 and August 2002 who visited Gachon Medical School Gil Medical Center. The exclusion criteria were old age(${\geq}65years$), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-${\alpha}$, Interferon-${\gamma}$, and TGF-${\beta}$ levels in the BM were measured by ELISA. Result : Thirteen patients(male : female=9:4) were included and the mean age was $42{\pm}12$years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group ($7.4{\pm}3.0%$, $694{\pm}255/mm^3$ vs. $17.5{\pm}5.8%$, $1,377{\pm}436/mm^3$, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group($9{\pm}4%$ vs. $12{\pm}3%$, p=0.138). The IL-2($26.0{\pm}29.1$ vs. $112.2{\pm}42.4pg/mL$, p=0.001) and IL-10($3.4{\pm}4.7$ vs. $12.0{\pm}8.0pg/mL$, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. Conclusion : These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.

The Usefulness of Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure after Extubation (기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성)

  • Na, Joo-Ock;Lim, Chae-Man;Shim, Tae-Sun;Park, Joo-Hun;Lee, Ki-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.3
    • /
    • pp.350-362
    • /
    • 1999
  • Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

  • PDF

Prospective Study on Preoperative Evaluation for the Prediction of Mortality and Morbidity after Lung Cancer Resection (폐암절제술후 발생하는 사망 및 합병증의 예측인자 평가에 관한 전향적 연구)

  • Park, Jeong-Woong;Suh, Gee-Young;Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Kim, Kwan-Min;Kim, Jin-Kook;Shim, Young-Mok;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
    • /
    • v.45 no.1
    • /
    • pp.57-67
    • /
    • 1998
  • Purpose : This study was undertaken to determine the preoperative predictors of mortality and morbidity after lung cancer resection. Method: During the period from October 1, 1995 to August 31, 1996, a prospective study was conducted in 92 lung resection candidates diagnosed as lung cancer. For preoperative predictors of nonpulmonary factors, we considered age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness, and for those of pulmonary factors, smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test. And predicted postoperative(ppo) pulmonary factors such as PPO-$FEV_1$, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}ppo$-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also considered. Results: There were 78 men and 14 women with a median age of 62 years(range 42 to 82) and a mean $FEV_1$ of $2.37\pm0.06L$. Twenty nine patients had a decreased $FEV_1$ less than 2.0L. Pneumonectomy was performed in 26 patients, bilobectomy in 12, lobectomy in 54. Pulmonary complications developed in 10 patients, cardiac complications in 9, other complications(empyema, air leak, bleeding) in 11, and 16 patients were managed in intensive care unit for more than 48hours. Three patients died within 30 days after operation. The ppo-$VO_2$max was less than 10ml/kg/min in these three patients, but its statistical significance could not be determined due to small number of patients. In multivariate analysis, the predictor related to postoperative death was weight loss(p<0.05), and as for pulmonary complications, weight loss, dyspnea scale, ppo-DLco and extent of resection(p<0.05). Conclusions: Based on this study, preoperative nonpulmonary factors such as weight loss and dyspnea scale are more important than the pulmonary factors in the prediction of postoperative mortality and/or morbodity in lung resection candidates, but exercise pulmonary fuction test may be useful Our study suggests that ppo-$VO_2$max value less than 10ml/kg/min is associated with death after lung cancer resection but further studies are needed to validate this result.

  • PDF

The Usefulness of Pressure-regulated Volume Control(PRVC) Mode in Mechanically Ventilated Patients with Unstable Respiratory Mechanics (기계 호흡 중 불안정한 호흡역학을 보인 환자에서 압력조절용적조정양식(Pressure-regulated Volume Control Mode)의 효용)

  • Sohn, Jang-Won;Koh, Youn-Suck;Lim, Chae-Man;Shim, Tae-Sun;Lee, Jong-Deog;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.6
    • /
    • pp.1318-1325
    • /
    • 1997
  • Background : Since the late 1960s, mechanical ventilation has been accomplished primarily using volume controlled ventilation(VCV). While VCV allows a set tidal volume to be guaranteed, VCV could bring about excessive airway pressures that may be lead to barotrauma in the patients with acute lung injury. With the increment of knowledge related to ventilator-induced lung injury, pressure controlled ventilation(PCV) has been frequently applied to these patients. But, PCV has a disadvantage of variable tidal volume delivery as pulmonary impedance changes. Since the concept of combining the positive attributes of VCV and PCV(dual control ventilation, DCV) was described firstly in 1992, a few DCV modes were introduced. Pressure-regulated volume control(PRVC) mode, a kind of DCV, is pressure-limited, time-cycled ventilation that uses tidal volume as a feedback control for continuously adjusting the pressure limit However, no clinical studies were published on the efficacy of PRVC until now. 'This investigation studied the efficacy of PRVC in the patients with unstable respiratory mechanics. Methods : The subjects were 8 mechanically ventilated patients(M : F=6 : 2, $56{\pm}26$ years) who showed unstable respiratory mechanics, which was defined by the coefficients of variation of peak inspiratory pressure for 15 minutes greater than 10% under VCV, or the coefficients of variation of tidal volume greater than 10% under PCV. The study was consisited of 3 modes application with VCV, PCV and PRVC for 15 minutes by random order. To obtain same tidal volume, inspiratory pressure setting was adjusted in PCV. Respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Results : 1) Mean tidal volumes($V_T$) in each mode were not different(VCV, $431{\pm}102ml$ ; PCV, $417{\pm}99ml$ ; PRVC, $414{\pm}97ml$) 2) The coefficient of variation(CV) of $V_T$ were $5.2{\pm}3.9%$ in VCV, $15.2{\pm}7.5%$ in PCV and $19.3{\pm}10.0%$ in PRVC. The CV of $V_T$ in PCV and PRVC were significantly greater than that in VCV(p<0.01). 3) Mean peak inspiratory pressure(PIP) in VCV($31.0{\pm}6.9cm$ $H_2O$) was higher than PIP in PCV($26.0{\pm}6.5cm$ $H_2O$) or PRVC($27.0{\pm}6.4cm$ $H_2O$)(p<0.05). 4) The CV of PIP were $13.9{\pm}3.7%$ in VCV, $4.9{\pm}2.6%$ in PVC and $12.2{\pm}7.0%$ in PRVC. The CV of PIP in VCV and PRVC were greater than that in PCV(p<0.01). Conclusions : Because of wide fluctuations of VT and PIP, PRVC mode did not seem to have advantages compared to VCV or PCV in the patients with unstable respiratory mechanics.

  • PDF

Preoperative Evaluation for the Prediction of Postoperative Mortality and Morbidity in Lung Cancer Candidates with Impaired Lung Function (폐기능이 저하된 폐암환자에서 폐절제술후 합병증의 예측 인자 평가에 관한 전향적 연구)

  • Perk, Jeong-Woong;Jeong, Sung-Whan;Nam, Gui-Hyun;Suh, Gee-Young;Kim, Ho-Cheol;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.1
    • /
    • pp.14-23
    • /
    • 2000
  • Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo) pulmonary factors such as ppo-$FEV_1$ ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}$ppo-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.

  • PDF