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Problems of Environmental Pollution (환경오염의 세계적인 경향)

  • 송인현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.3.4-5
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    • 1972
  • 생활수준이 낮은 단계에 있어서는 우선 식량에 대한 수요가 강하다. 인간의 욕구가 만족스럽게 먹는다는 것에 대하여 제일 강하게 발동하는 것이다 그러나 점차 과학기술과 산업과 경제가 발전하여 성장과정에 오르게 되고 소득수준도 향상하게 되면 시장기구를 통해서 구입 할 수 있는 개인의 물적 소비재에 대해서는 점차 충족하게 되며 식량이외에도 의복, 전기기구 및 일용생활용품, 자동차 등에 이르기까지 더욱 고차원의 소비재가 보급하게 되는 것이다. 이렇게 되며는 사람의 욕구는 사적 재물이나 물적 수요에서 점진적으로 공공재나 또는 질적 수요(주택, 생활환경 등)의 방향으로 움직이게 되는 것으로써 여기에 환경오염 또는 공해문제에 대하여 의식하게 된다. 그러나 여기에서 더욱이 문제점이 되는 것은 소득 수준의 향상 과정이란 그 자체가 환경오염의 커다란 요인이라는 점이며 자동차의 급격한 보급과 생활의 편의성을 구하여 집중되는 도시인구의 집적, 높은 소득을 보장하기 위한 생산성 높은 중화학공업의 발전 등등은 그 자체가 환경권이란 사람이 요구하는 고차원의 권리를 침해하는 직접적인 요인이 된다는 것이다. 이와 같은 환경오염이나 공해문제에 대한 세계적인 논의는 이미 시작된 지 오래이지만 현재는 우리의 건강보호를 위해서나 생활환경의 보전을 위해서라는 점에서는 그치는 것이 아니고, 더욱 넓혀서 자연의 보호, 자원의 보호라는 견지로 확대되고 있다. 이와 같은 세계적인 확대된 이해와 이에 대한 대책강구의 제안은 1968년 국제연합의 경제사회이사회에서 스웨덴 정부대표에 의하여 제시되었으며 1969년의 우- 탄트 사무총장의 인간환경에 관한 보고서, 1970년 Nixon 미대통령의 연두일반교서 그리고 1972년 5월 6일 스웨덴의 스톡홀롬에서 개최되는 인간환경회의의 주제 등을 통해서 알 수 있고, 종래의 공해나 생활환경의 오염문제라는 좁은 개념에서가 아니고 인간환경전체의 문제로 다루고 있는 것이다. 즉 환경개발(도시, 산업, 지역개발에 수반된 문제), 환경오염(인위적 행위에 의하여 환경의 대인간조건이 악화하는 문제) 자연ㆍ자원의 보호관리(지하, 해양자원, 동식물, 풍경경치의 문제)란 3개 측면에서 다루고 있는 것이다. 환경오염이란 문제를 중 심하여 보면 환경을 구성하는 기본적인 요소로서 대기, 물, 토지 또는 지각. 그리고 공간의 사대요소로 집약하여 생각할 수 있음으로 이 4요소의 오염이 문제가 되는 것이다. 대기의 오염은 환경의 오염중 가장 널리 알려진, 또 가장 오랜 역사를 가진 오염의 문제로써 이에 속하는 오염인자는 분진, 매연, 유해가스(유황산화물, 불화수소, 염화수소, 질소산화물, 일산 화염소 등) 등 대기의 1차 오염과 1차 존재한 물질이 자외선의 작용으로 변화발생 하는 오존, PAN등 광화학물질이 형성되는 2차적인 오염을 들 수 있다. 기외 카도미움, 연등 유해중금속이나 방사선물질이 대기로부터 토지를 오염시켜서 토지에 서식하는 생물의 오염을 야기케 한다는 점등이 명백하여지고 있으며 대기의 오염은 이런 오염물질이 대기중에서 이동하여 강우에 의한 침강물질의 변화를 일으키게 되며 소위 광역오염문제를 발생케하며 동시에 토지의 토질저하등을 가져오게 한다. 물의 오염은 크게 내육수의 오염과 해양의 오염의 양면으로 나누어 볼 수 있다. 하천의 오염을 방지하고 하천을 보호하기 위한 움직임 역시 환경오염의 역사상 오래된 문제이며 시초에는 인분뇨와의 연결에서 오는 세균에 의한 오염이나 양수 기타 일반하수와의 연결에서 오는 오염에 대비하는 것부터 시작하였지만 근래에는 산업공장폐수에 의한 각종 화학적유해물질과 염료 그리고 석유화학의 발달에 의한 폐유등으로 인한 수질오탁문제가 점차 크게 대두되고 있다. 이것은 측 오염이란 시초에 우리에게 주는 불쾌감이 크므로 이것을 피하자는 것부터 시작하여 인간의 건강을 지키고 각종 사용수를 보존하자는 용수보존으로 그리고 이제는 건강과 용수보존뿐만 아니라 이것이 농림 수산물에 대한 큰 피해를 주게됨으로써 오는 자연환경의 생태계보전의 문제로 확대전환하고 있는 것이다. ?간 특히 해양오염에 대한 문제는 국지적인 것에만 끝이는 것이 아니고 전세계의 해양에 곧 연결되는 것이므로 세계각국의 공통관심사로 등장케 되었으며 이것은 특히 폐유가 유류수송 도중에 해양에 투기되는 유류에 의한 해양의 유막성형에서 오는 기상의 변화와 물피해등이 막심함으로 심각화 되고 있다. 각국이 자국의 해안과 해양을 보호하기 위하여 조치를 서두르고 있는 현시점에서 볼 때에는 이는 국제문제화하고 있으며 세계적인 국제적 협력과 협조의 필요성이 강조되는 좋은 예라 하겠다. 토양의 오염에 있어서는 대기나 수질의 오염이 구국적으로 토양과 관련되고 토양으로 환원되는 것이지만 근래에 많이 보급사용되는 농약과 화학비료의 문제는 토양자체의 오염에만 그치는 것이 아니고 농작물을 식품으로 하여 섭취함으로써 발생되는 인체나 기타생물체의 피해를 고려할 때 더욱 중요한 것이며, 또 토질의 저하를 가져오게 하여 농림생산에 미치는 영향이 적지 않을 것이다. 지반강하는 지각 에 주는 인공적 영향의 대표적인 것으로써 지하수나 지하 천연가스를 채취이용하기 위하여 파들어 감으로써 지반이 침하 하는 것이며 건축물에 대한 영향 특히 풍수해시의 재해를 크게 할 우려가 있는 것이다. 공간에 있어서의 환경오염에는 소음, 진동, 광선, 악취 등이 있다. 이들은 특수한 작업환경의 경우를 제외하고는 건강에 직접적인 큰 피해를 준다고 생각할 수 없으나 소음, 진동, 관선, 악취 등은 일반 일상시민생활에 불쾌나 불안을 줌으로써 안정된 생활을 방해하는 요인이 되는 것이다. 공간의 오염물로써 새로운 주목을 끌게된 것은 도시산업폐기물로써 이들은 대기나 물 또는 토지를 오염시킬 뿐만 아니라 공간을 점령함으로써 도시의 미관이나 기능을 손상케 하는 것이다. 즉 노배폐차의 잔해, 냉장고등고형폐기물등의 재생불가능한 것이나 비니루등 합성물질로 된 용기나 포장 등으로 연소분해 되지 않은 내구소비재가 이에 해당하는 것으로 이는 maker의 양식에 호소하여 그 책임 하에 해결되어야 할 문제로 본다. 이렇듯 환경오염은 각양각색으로 그 오염물질의 주요 발생원인 산업장이나 기타 기관에서의 발생요인을 살펴보며는 다음과 같은 것으로 요약할 수 있다. A. 제도적 요인 1. 관리체재의 미비 2. 관리법규의 미비 3. 책임소재의 불명확 B. 자재적 요인 1. 사용자재의 선택부적 2. 개량대책급 연구의 미흡 C. 기술적 요인 1. 시설의 설계불량, 공정의 결함 2. 시설의 점검, 보전의 불충분 3. 도출물의 취급에 대한 검사부족 4. 발생방지 시설의 미설치, 결함 D. 교육적 요인 1. 오염물질 방제지식의 결여 2. 법규의 오해, 미숙지 E. 경제적 요인 1. 자금부족 2. 융자상의 문제 3. 경제성의 문제 F. 정신적 요인 1. 사회적 도의심의 결여(이기주의) 2. 태만 3. 무지, 무관심 등이다. 따라서 환경오염의 방지란 상기한 문제의 해결에 기대하지 않을 수 없으나 이를 해결하기 위하여는 국내적 국제적 상호협조에 의한 사회각층의 총력적 대책이 시급한 것이다. 이와 같은 환경오염이 단속된다 하며는 미구에 인류의 건강은 물론 그 존립마저 기대하기 어려울 것이며, 현재는 점진적으로 급성피해에 대하여는 그 흥미가 집중되어 그 대비책도 많이 논의되고 있지만 미량의 단속접촉에 의한 만성축적에 관한 문제나 이와 같은 환경오염이 앞으로 태어날 신생률에 대한 영향이나 유전정보에 관한 연구는 장차에 대비하는 문제로써 중요한 것이라 생각된다. 기외에 우려되는 점은 오염방지책을 적극 추진함으로써 올 수 있는 파생적인 문제이다. 즉 오염을 방지하기 위하여 생산기업체가 투자를 하게 되며는 그만큼 생산원가가 상승할 것이며 소비가격도 오를 것이다. 반면 이런 시책에 뒤떨어진 후진국의 값싼 생산국은 자연 수입이 억제 당할 것이며, 이렇게되면 후진국은 무역경쟁에서 큰 상처를 입게될 것이고 뿐만 아니라 선진국에 필요한 오염물질의 발생이 높은 생산기기를 자연후진국에 양도하게 될 것임으로 후진국의 환경오염은 배가할 우려가 있는 것이다. 또 해양오염을 방지할 목적에서와 같이 자국의 해안보호를 위하여 마련된 법의 규제는 타국의 선박운항에 많은 제약을 가하게 될 것이며 이것 역시 시설이 미약한 약소후진국의 선박에 크게 영향을 미치게 될 것임으로 교통, 해운, 무역등을 통한 약소후진국의 경제성장에 제동을 거는 것이 될 것이다. 이렇듯 환경오염의 문제는 환경자체에 대해서만 아니라 부산물적으로 특히 후진국에는 의외 문제를 던져주게 되는 것임으로 환경오염에 대해서는 물론, 전술한 바와 같이 인간환경전체의 문제로써 Nixon 대통령이 말한 결의와 창의와 그리고 자금을 가지고 과감하게 대처해 나가야 할 것이다.

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A Study on Direct Sowing Culture of Scutellaria baicalensis GEORGE Cultivated after Barley (황금의 맥후작 직파 재배 연구)

  • 권병선;신종섭
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2001.11b
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    • pp.49-61
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    • 2001
  • This study was carried out to determine the effect of various fertilizer levels, sowing time and planting density on the growth and yield of Scuteliaria baicalensis GEORGE cultivated after the barley in the southern coastal areas of Korea under the non- mulching condition by direct sowing culture. The flowering date of medium dressing plot(N : P$_2$O$\sub$5/ : K$_2$O=9 : 13.5 : 9kg/10a) and heavy dression plot(N : P$_2$O$\sub$5/, : K$_2$O=12 :18 : 12kg/10a) were July 23. The flowering date of the medium and the heavy dressing plot was delayed by 3days compared with that of non-fertilizing plot. The growth characteristics such as stem length, diameter of main stem, number of branch per plant, main root length, main root length, main root thickness and dry weight of stem leaves were more increased at medium dressing plot than that of other fertilizer levels, The root dry weight of in Scutellaria baicalensis GEORGE cultivated after barley was hlghest at the fertilizing plot of N : P$_2$O$\sub$5/ : K$_2$O=9 : 13.5 : 9kg/10a. The dried-root yield was 178kg in medium dressing plot, 167kg in standard dressing pot, and 126kg in non-dressing plot, The dried-root yield of medium dressing plot was 7% and 41 cie higher than that of standard dressing pot and non-dressing control plot, respectively. Emergence and flowering dates in the sowing time of June 1 were earlier than those of the other sowing times. In the sowing time of June 1, length and diameter of main stem, number of node per main stem, number of branch per plant and dry weight of stem leaves were greater than those of sowing times of June 10 and June 20. Yield components such as main stem length and diameter, main stem numbers, branches per plant, dry weight of stem leaves, main root length and thickness, number of large root and fine root per plant, and dry weight of root were the highest at the sewing time of June 1 as the yield of 71.3kg/10a. Optimum sowing time of Scuteilaria baicaiensis GEORGE cultivated after barley was June 1 in southern areas of Korea. Stem length was long in dense planting of 20${\times}$10cm and short in spacious planting of 30${\times}$10cm and 40${\times}$10cm by direct sowing cultivated after barley. Stem diameter was thick in spacious planting of 30${\times}$10cm and 40${\times}$10cm and was thin in dense planting of 20${\times}$10cm by direct sowing cultivated after barley. Length and dry weight of root per plant were decreased in dense planting of 20${\times}$10cm and were increased in spacious planting of 30${\times}$10cm and 40${\times}$10cm by direct sowing cultivated after barley. Yield of dry root was highest in optimum planting density(30${\times}$10cm 33 plants/㎡) by direct sowing cultivated after barley. The correlation coefficient between number of planting plant and stem length showed highly positive correlation. These characters of stem diameter, number of branches, main root length and yield of dry root mentioned above showed negative correlations with planting plants.

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Effects of Supplementation of Synbiotic Co-cultures Manufactured with Anaerobic Microbes on In Vitro Fermentation Characteristics and In Situ Degradability of Fermented TMR (혐기성 미생물로 제조한 synbiotics 혼합배양물의 첨가가 발효 TMR의 발효특성과 소실률에 미치는 영향)

  • Lee, Shin-Ja;Shin, Nyeon-Hak;Hyun, Jong-Hwan;Kang, Tae-Won;An, Jung-Jun;Jung, Ho-Sik;Moon, Yea-Hwang;Lee, Sung-Sill
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1538-1546
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    • 2009
  • This study was conducted to estimate the in vitro fermentation characteristics and in situ degradabilities of total mixed rations fermented by the synbiotic co-cultures composed of various anaerobic microorganisms in the rumen of cow. Seventy two TMR bags (4 treatments $\times$ 6 fermentation days $\times$ 3 replications) were manufactured for in vitro and in situ experiments. The experiment was composed of four treatments including the control, the mould and bacteria synbiotics (T1), the mould and yeast synbiotics (T2) and the bacteria and yeast synbiotics (T3). Each treatment had six fermentation days (1, 3, 5, 7, 14, 21 day) with three replications. Two rumen cannulated Holstein cows (550 ㎏ of mean body wt) were used for in situ trial, and a total of 96 nylon bags were retrieved from the rumen according to eight fermentation times (1, 3, 6, 9, 18, 24, 48 and 72 hr). The mean fermentation temperatures of TMRs by supplementation of anaerobic micoorganism co-cultures ranged from $22.97^{\circ}C$ to $26.07^{\circ}C$, and tended to increase steadily during the entire period. pH values of the F-TMRs ranged from 4.39 to 4.98 and tended to decrease with the extension of the fermentation period, and decreased by supplementation of synbiotics (p<0.05). The ammonia concentrations of F-TMRs were not affected by addition of synbiotic co-cultures during the early fermentation period (within 7 days), but was lowest (p<0.05) in T3 during the late fermentation periods (after 14 days). Lactic acid concentration of F-TMR was lowest in T3 at 1 day of fermentation, but was not different from treatments in the other fermentation days. Microbial growth rates of F-TMR reached a peak at 7 days of fermentation, and afterward tended to decrease. In in situ experiment, the DM disappearance rates were higher in T1 than the control during early fermentation times (within 3 hours), but was vice versa at 48 hours of fermentation (p<0.05). There was no significant difference in effective DM degradability among treatments. NDF and ADF disappearance rates in situ were similar to those of DM. From the above results, the supplementation of synbiotics, particularly the mould and bacteria synbiotics, resulted in improving the pH and concentration of lactic acid of F-TMR as parameters of fermentation compare to the control, and also had higher in situ disappearance rates of DM, NDF and ADF than the control at early fermentation time. However, effective DM degradability was not affected by supplementation of synbiotics.

한국인으로부터 분리한 비피더스균의 특성과 Bifidobacterium longum A-2의 임상실험에 관한 연구

  • Kim, Yeong-Chan
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1998.10a
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    • pp.83-106
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    • 1998
  • This study was conducted to investigate the probiotics(acid and bile resistance, fermentation properties, viability, cholesterol assimilation, antimicrobial activity, antimutagenicity, and immunoactivation) of the strains of bifidobacteria isolated from healthy Koreans and to investigate the effects of oral administration of Bifidobacterium longum A-2 on the fecal microflora, ${\beta}-glucuronidase$ activity, pH values, Ammonia concentration. The experimental results are summarized as follows: The probiotics were tested for 23 strains including three commer챠al strains as controls. Compared to other strains, strains of A-2 and A-9 showed more acid resistance whereas A-2, A-5, A-13, A-14, A-18 and A-22 showed excellent bile resistances. The properties of bifidobacteria during fermentation were tested. Strains of A-1, A-2, A-3, A-4, A-6, and A-23 resulted in less than pH 4.5 and titratable acidity over 0.90 after 24 hr of fermentation. When the strains of A-2 was grown with glucose, maltose, and fructooligosaccharide, the acetic acid production were higher than with sorbitol and mannitol. The storage stability of the strains of A-2 and A-22 were tesed, indicating the strain A-2 was more stable over 10 days of storage at both $4^{\circ}C$ and $20^{\circ}C$ than A-22. The strains of A-8, A-10, A-11, A-12 and A-20 assimilated more than 30% of cholesterol included in the media. The strains of A-1 and A-2 showed antimicrobial activity against Sta. aureus. The antimutagenicity of the strains were also tested, showing that the mutation was suppressed more by three strains(A-2, A-12, and A-23). In addition, strain A-5 improved immunological activity(phagocytosis, $TNF-{\alpha}$, IL-6) more than other strains. In the effects of oral administration of Bif. longum A-2, the number of fecal bifidobacteria was siginificantly increased(p<0.01) and the level of fecal ${\beta}-glucuronidase$ also was siginificantly reduced(p<0.05). However there were no siginificant differences in the level of Lαctobacilli, Enterobacteriaceae, Clostridium perfringens, pH and ammonia by the administration. The results suggested that Bif. longum A-2 may be met the criteria for probiotics culture.

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Study on Types and Counterplans of Medical Accident Experienced by Dentists in Seoul(2004) (서울특별시 개원 치과의사의 의료사고 및 분쟁의 유형과 대책에 관한 연구(2004년))

  • Yoon, Jeong-Ah;Kang, Jin-Kyu;Ahn, Hyoung-Joon;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.163-199
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    • 2005
  • Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

Clinical Course of Usual Interstitial Pneumonia (통상성 간질성 폐섬유증의 임상경과)

  • Park, Joo-Hun;Kitaichi, M.;Yum, Ho-Kee;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.601-613
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    • 2000
  • Background : Idiopathic pulmonary fibrosis (IPF) is a fatal progressive fibrous disease of the lung of unknown etiology. Recently it has been classified into several distinct entities on the basis of pathologic and clinical characteristics, ie : usual interstitial pneumonia (UIP), desquamative interstitial pneumonia (DIP), acute interstitial pneumonia (AIP), bronchiolitis obliterans with organizing pneumonia (BOOP), and nonspecific interstitial pneumonia (NSIP). IPF is now applied only for UIP, which has the worst prognosis. The previous reports of 3-5 year median survival appears to be overoptimistic because other types with better prognosis like NSIP or BOOP might have been included. Therefore, this study was performed to determine the clinical course and the prognostic factors of UIP as diagnosed by surgical lung biopsy. Methods : The subjects were 72 UIP patients (age $58.2{\pm}11.6$ years, M : F=45 : 27, median follow up period : 18.1 months (0.7-103.6) diagnosed by surgical lung biopsy at the Asan Medical Center (68 patients) and the Paik Hospital in Seoul (4 patients). Clinical scores (level of dyspnea : 1-20 points), radiologic score (honeycombing : HC score 0-5 points, ground glass : GG score 0-5 points), and physiologic scores (FVC : 1-12 points, $FEV_1$ : 0-3 points, TLC : 0-10 points, $D_{LCO)$ : 0-5 points, $AaDO_2$ : 0-10 points) were summed into a total CRP score. Results : 1) The one year survival rate was 78.3%, while the rate for three year survival was 58.1%, and the median survival period was 42.5months. 2) Short term (1 year) prognosis : The patients who died within one year of diagnosis (14 patients) had the higher initial total CRP score ($28.6{\pm}8.3$ vs. $16.6{\pm}9.7$) than those who lived longer than one year (46 patients). The difference in the total CRP score was attributed to the symptom score ($8.4{\pm}2.1$ vs. $5.7{\pm}3.9$) and the physiologic score ($15.7{\pm}7.1$ vs. $6.7{\pm}5.7$) including FVC, $D_{LCO)$ and $AaDO_2$. 3) Long-term (3year) prognosis : The total CRP score ($12.2{\pm}6.7$ vs. $28.7{\pm}7.9$ : including symptom score, FVC, $D_{LCO)$ and $AaDO_2$) at the time of diagnosis were also different for the long-term survivors and those who lived less than 3 years. 4) Cox regression analysis showed $D_{LCO)$ (${\geq}$60%) (Hazard ratio : 4.56, 95% CI : 2.30-16.04) was the independent prognostic factors of UIP (P<0.05). Conclusion : These results suggest that $D_{LCO)$ at the time of diagnosis seem to be a prognostic markers of biopsy-proven UIP.

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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
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    • v.46 no.3
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    • pp.350-362
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    • 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.

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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
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    • v.45 no.1
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    • pp.57-67
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    • 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.

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The Evaluation of IL-8 in the Serum of Pneumoconiotic patients (진폐증 환자에서의 혈청내 IL-8 농도)

  • Ahn, Hyeong Sook;Kim, Ji Hong;Chang, Hwang Sin;Kim, Kyung Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.945-953
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    • 1996
  • Background : Many acute and chronic lung diseases including pneumoconiosis are characterized by the presence of increased numbers of activated macrophages. These macrophages generate several inflammatory cell chemoattractants, by which neutrophil migrate from vascular compartment to the alveolar space. Recruited neutrophils secrete toxic oxygen radicals or proteolytic enzymes and induce inflammatory response. Continuing inflammatory response results in alteration of the pulmonary structure and irreversible fibrosis. Recently, a polypeptide with specific neutrophil chemotactic activity, interleukin-8(IL-8), has been cloned and isolated from a number of cells including : monocytes, macrophages and fibroblasts. IL-1 and/or TNF-${\alpha}$ preceded for the synthesis of IL-8, and we already observed high level of IL-1 and TNF-${\alpha}$ in the pneumoconioses. So we hypothesized that IL-8 may be a central role in the pathogenesis of pneumoconiosis. In order to evaluate the clinical utility of IL-8 as a biomarker in the early diagnosis of pneumoconiosis, we investigated the increase of IL-8 in the pneumoconiotic patient and the correlation between IL-8 level and progression of pneumoconiosis. Method : We measured IL-8 in the serum of 48 patients with pneumoconiosis and 16 persons without dust exposure history as a control group. Pneumoconiotic cases were divided into 3 groups according to ILO Classification : suspicious group(n=16), small opacity group(n=16) and large opacity group(n=16). IL-8 was measured by a sandwich enzytne immunoassay technique. All data were expressed as the $mean{\pm}standard$ deviation. Results: 1) The mean value of age was higher in the small opacity and large opacity group than comparison group, but smoking history was even. Duration of dust exposure was not different among 3 pneumoconiosis groups. 2) IL-8 level was $70.50{\pm}53.63pg/m{\ell}$ in the suspicious group, $107.50{\pm}45.88pg/m{\ell}$ in the small opacity group, $132.50{\pm}73.47pg/m{\ell}$ in the large opacity group and $17.85{\pm}33.85pg/m{\ell}$ in the comparison group. IL-8 concentration in all pneumoconiosis group was significant higher than that in the comparison group(p<0.001). 3) IL-8 level tended to increase with the progression of pneumoconiosis. Multiple comparison test using Anova/Scheffe analysis showed a significant difference between suspicious group and large opacity group(p<0.05). 4) The level of IL-8 was correlated with the progression of pneumoconiosis(r=0.4199, p<0.05). Conclusion : IL-8 is thought to be a good biomarker for the early diagnosis of pneumoconiosis.

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Effects of ${Zn}^{2+}$ on the Activities of Electron Transport and Photophosphorylation of Barley Chloroplasts (보리 엽록체의 전자전달과 광인산화 활성에 미치는 ${Zn}^{2+}$의 영향)

  • 김지숙;홍영남;권영명
    • Journal of Plant Biology
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    • v.28 no.1
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    • pp.69-77
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    • 1985
  • The degree of The degree of The degree of ${Zn}^{2+}$ effect on the photosynthetic electron transport and photophosphorylation activities in barley chloroplasts has been tested.${Zn}^{2+}$treatment was done in the 2 ways. One was that it was added into the chloroplasts suspensions isolated from the plants grown under the normal ${Zn}^{2+}$level (10$^{-6}$ M). The other was that the different concentrations of ${Zn}^{2+}$was applied in each growth medium. Then, it was not added into the chloroplasts suspensions isolated from the plants. PS II activity in both way of the treatments was more severely inhibited than PS I by the increment of ${Zn}^{2+}$ concentration. The photophosphorylation activity measured by pH measurement was gradually decreased with the increase of ${Zn}^{2+}$concentration in both ways, too. However, it was shown that M $n^{2+}$ could be near fully overcome the inhibitory effect of ${Zn}^{2+}$in PS II, and $Mg^{2+}$ could also reduce the Z $n^{2+}$ inhibition in the photophosphorylation. In the low concentrations of $Mg^{2+}$ (3 to 5$\times$10$^{-3}$ M) in the suspension, ${Zn}^{2+}$(2$\times$10$^{-5}$ M) could increase the activity of photophosphorylation. As compares to other cations, Z $n^{2+}$ caused less inhibitory effect on the photophosphorylation activity than Cu, Cd, but more than Pb and Ni. It may be assumed that a complex from reaction of Z $n^{2+}$ and mercaptoethanol was produced and it could reduce the stability of CPI band during SDS-PAGE.effect on the photosynthetic electron transport and photophosphorylation activities in barley chloroplasts has been tested. Z $n^{2+}$ treatment was done in the 2 ways. One was that it was added into the chloroplasts suspensions isolated from the plants grown under the normal Z $n^{2+}$ level (10$^{-6}$ M). The other was that the different concentrations of Z $n^{2+}$ was applied in each growth medium. Then, it was not added into the chloroplasts suspensions isolated from the plants. PS II activity in both way of the treatments was more severely inhibited than PS I by the increment of Z $n^{2+}$ concentration. The photophosphorylation activity measured by pH measurement was gradually decreased with the increase of Z $n^{2+}$ concentration in both ways, too. However, it was shown that M $n^{2+}$ could be near fully overcome the inhibitory effect of Z $n^{2+}$ in PS II, and $Mg^{2+}$ could also reduce the Z $n^{2+}$ inhibition in the photophosphorylation. In the low concentrations of $Mg^{2+}$ (3 to 5$\times$10$^{-3}$ M) in the suspension, Z $n^{2+}$ (2$\times$10$^{-5}$ M) could increase the activity of photophosphorylation. As compares to other cations, Z $n^{2+}$ caused less inhibitory effect on the photophosphorylation activity than Cu, Cd, but more than Pb and Ni. It may be assumed that a complex from reaction of Z $n^{2+}$ and mercaptoethanol was produced and it could reduce the stability of CPI band during SDS-PAGE.effect on the photosynthetic electron transport and photophosphorylation activities in barley chloroplasts has been tested. Z $n^{2+}$ treatment was done in the 2 ways. One was that it was added into the chloroplasts suspensions isolated from the plants grown under the normal Z $n^{2+}$ level (10$^{-6}$ M). The other was that the different concentrations of Z $n^{2+}$ was applied in each growth medium. Then, it was not added into the chloroplasts suspensions isolated from the plants. PS II activity in both way of the treatments was more severely inhibited than PS I by the increment of Z $n^{2+}$ concentration. The photophosphorylation activity measured by pH measurement was gradually decreased with the increase of Z $n^{2+}$ concentration in both ways, too. However, it was shown that M $n^{2+}$ could be near fully overcome the inhibitory effect of Z $n^{2+}$ in PS II, and $Mg^{2+}$ could also reduce the Z $n^{2+}$ inhibition in the photophosphorylation. In the low concentrations of $Mg^{2+}$ (3 to 5$\times$10$^{-3}$ M) in the suspension, Z $n^{2+}$ (2$\times$10$^{-5}$ M) could increase the activity of photophosphorylation. As compares to other cations, Z $n^{2+}$ caused less inhibitory effect on the photophosphorylation activity than Cu, Cd, but more than Pb and Ni. It may be assumed that a complex from reaction of Z $n^{2+}$ and mercaptoethanol was produced and it could reduce the stability of CPI band during SDS-PAGE.ld reduce the stability of CPI band during SDS-PAGE.

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