• Title/Summary/Keyword: AIR 모델

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A Study on Developing a Model for Cancer Damage Cost Due to Risk from Benzene in Ulsan Metropolitan City (울산 지역에서 대기중 벤젠으로 인한 암 사망 손실비용 추정 모형에 관한 연구)

  • Lee, Yong-Jin;Kim, Ye-Shin;Shin, Dong-Chun;Shin, Young-Chul
    • Environmental and Resource Economics Review
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    • v.13 no.1
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    • pp.49-82
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    • 2004
  • The study aimed to evaluate cancer damage cost due to risk from benzene inhalation. We performed health risk assessment based on US EPA guideline to estimate annual population risk in Ulsan metropolitan city. Also, we estimated a willingness-to-pay amount for reducing a cancer mortality rate to evaluate a value of statistical life. We combined the annual population risk and the value of statistical life to calculate the cancer damage cost. In the health risk assessment, we applied the benzene unit risk ($2.2{\times}10^{-6}{\sim}7.8{\times}10^{-6}$) in the US EPA'S Integrated Risk Information System to assess the annual population risk. Average concentration of benzene in ambient air is $7.88{\mu}g/m^3$(min: 1.16~max: $23.32{\mu}g/m^3$). We targeted an exposure population of 516,641 persons who aged over 30 years old. Using a Monte-Carlo simulation for uncertainty analysis, we evaluated that the population risk of benzene during ten years in Ulsan city is 2.90 persons (5 percentile: 0.32~95 percentile: 9.11persons). And the monthly average WTP for 5/1,000 cancer mortality reduction during ten years is 14,852 Won(95% C.I: 13,135~16,794 Won) and the implied VSL is 36 million Won(95% C.I: 30~40 million Won). Cancer damage cost due to risk from benzene inhalation during 10 years in Ulsan city is about 104 million Won(5 percentile: 13~95 percentile: 328 million Won). Health benefit cost to reduce a cancer mortality risk of benzene is about 50 million Won is Ulsan metropolitann city. But, it is very important that this cost is not for all health damage cost of cancer mortality in some area. We just recommended a model for evaluating a cancer risk reduction, so we must re-evaluate an integrated application of total VOCs damage cost including benzene.

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Effects of Matrix Metalloproteinase Inhibitor on Ventilator-Induced Lung Injury in Rats (기계환기로 인한 백서의 급성 폐손상에서 Matrix Metalloproteinase Inhibitor의 효과)

  • Kim, Je-Hyeong;Park, Soo-Yeon;Hur, Gyu-Young;Lee, Seung-Heon;Lee, Sang-Yeub;Park, Sang-Myeon;Suh, In-Bum;Shin, Chol;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.619-634
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    • 2002
  • Background : Many inflammatory mediators and collagenases are involved in the pathogenesis of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The increase of matrix metalloproteinase-9 (MMP-9, gelatinase-B) produced mainly by inflammatory cells was reported in many ALI models and connective tissue cells. In this study, the expression of MMP-9 in ventilator-induced lung injury (VILI) model and the effects of matrix metalloproteinase inhibitor (MMPI) on VILI were investigated. Methods : Eighteen Sprague-Dawley rats were divided into three groups: low tidal Volume (LVT, 7mL/Kg tidal volume, 3 $cmH_2O$ PEEP, 40/min), high tidal volume (HVT, 30mL/Kg tidal volume, no PEEP, 40/min) and high tidal volume with MMPI (HVT+MMPI) groups. Mechanical ventilation was performed in room air for 2 hours. The 20 mg/Kg of CMT-3 (chemically modified tetracycline-3, 6-demethyl 6-deoxy 4-dedimethylamino tetracycline) was gavaged as MMPI from three days before mechanical ventilation. The degree of lung injury was measured with wet-to-dry weight ratio and acute lung injury score. Expression of MMP-9 was studied by immunohistochemical stain with a mouse monoclonal anti-rat MMP-9 $IgG_1$. Results : In the LVT, HVT and HVT+MMPI groups, the wet-to-dry weight ratio was $4.70{\pm}0.14$, $6.82{\pm}1.28$ and $4.92{\pm}0.98$, respectively. In the HVT group, the ratio was significantly higher than other groups (p<0.05). Acute lung injury score measured by five-point scale was $3.25{\pm}1.17$, $12.83{\pm}1.17$ and $4.67{\pm}0.52$, respectively. The HVT group was significantly damaged by VILI and MMPI protects injuries by mechanical ventilation (p<0.05). Expression of MMP-9 measured by four-point scale was $3.33{\pm}2.07$, $12.17{\pm}2.79$ and $3.60{\pm}1.95$, respectively, which were significantly higher in the HVT group (p<0.05). Conclusion : VILI increases significantly the expression of MMP-9 and MMPI prevents lung injury induced by mechanical ventilation through the inhibition of MMP-9.

The Neuroprotective Effects of 6-cyano-7-nitroquinoxalin-2,3-dione (CNQX) Via Mediation of Nitric Oxide Synthase on Hypoxic-ischemic Brain Injury in Neonatal Rats

  • Jung, Ji-Eun;Keum, Kyung-Hae;Choi, Eun-Jin;Kim, Jin-Kyung;Chung, Hai-Lee;Kim, Woo-Taek
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.59-69
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    • 2011
  • Purpose: Current studies have demonstrated the neuroprotective effects of 6-cyano-7-nitroquinoxalin-2,3-dione (CNQX) in many animal models of brain injury, including hypoxic-ischemic (HI) encephlopathy, trauma and excitotoxicity, but limited data are available for those during the neonatal periods. Here we investigated whether CNQX can protect the developing rat brain from HI injury via mediation of nitric oxide synthase. Methods: In an in vivo model, left carotid artery ligation was done in 7-day-old Sprague-Dawley (SD) rat pups. The animals were divided into six groups; normoxia (N), hypoxia (H), hypoxia with sham-operation (HS), hypoxia with operation (HO), HO treated with vehicle (HV), and HO treated with CNQX at a dose of 10 mg/kg (HC). Hypoxia was made by exposure to a 2 hr period in the hypoxic chamber (92% $N_2$, 8% $O_2$). In an in vitro model, embryonic cortical neuronal cell culture of SD rats at 18-day gestation was done. The cultured cells were divided into three groups: normoxia (N), hypoxia (H), and hypoxia treated with CNQX (HC). The N group was prepared in 5% $CO_2$ incubators and the other groups were placed in 1% $O_2$) incubators (94% $N_2$, 5% $CO_2$) for 16 hr. Results: In the in vitvo and in vivo models, the expressions of iNOS and eNOS were reduced in the hypoxia group when compared to the normoxia group, whereas they were increased in the CNQX-treated group compared to the hypoxia group. In contrast, the expression of nNOS was showed reversely. Conclusion: CNQX has neuroprotective property over perinatal HI brain injury via mediation of nitric oxide synthase.

A Study for the Evaluation of Container Modules; The Technology of Korean Container Tree Production Model (한국형 컨테이너 조경수 생산기술로서 컨테이너 모듈의 성능 평가)

  • Jung, Yong-Jo;Lim, Byung-Eul;Oh, Jang-keun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.5
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    • pp.59-67
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    • 2016
  • In landscape design by public institutions, although the costs and species of landscape trees stipulated by the Korean Public Procurement Service(PPS) are generally adhered to, the PPS regulations about planting trees with well-developed rootlets are almost entirely neglected. This study aimed to evaluate the performance of buried container modules, which are a new technology and product in landscape production that is able to reduce the defect rate while complying with regulations. To this end, this study measured rootlet density, rootlet development length, rootlet survival rate on excavation, and impairments of tree growth for 3 months after root pruning, and compared these variables for the container modules with those for trees that underwent root pruning in bare ground, and those that were cultivated in a container above ground. The results were as follows: First, the rootlet density was 88% for the trees in container modules, which was very high. Trees that underwent standard root pruning in bare ground had a somewhat lower density of 64%. Meanwhile, the trees that were cultivated in pots above ground died, invalidating measurement. Second, in terms of rootlet development and rootlet survival rate, the trees in container modules showed a mean length of 10.4cm, and 100% survival rate, indicating that there was no rootlet damage caused by excavation. For the trees that only underwent root pruning in bare ground, the mean length was 25.6cm and the rootlet survival rate was only half that of the trees in container modules, at 56%, demonstrating considerable damage. Rootlet development did not occur at all in the trees grown in pots. Third, the trees in container modules and those that underwent root pruning in bare ground did not show any deaths during the root pruning process, or any impairments such as stunted leaf growth. Conversely, the trees grown in pots nearly all died, and severe impairments of tree growth were observed. As shown by the results above, when we evaluated the performance of buried container modules, they showed the most outstanding performance of the three models tested in this study. The container modules prevent defects by stimulating early rooting in environments that with poor conditions for growth, or in trees that are not suited to the summer environment Therefore, it is expected that they would be an optimal means by which to enable compliance with rules such as the regulation presented by the PPS.

Study on the Fire Risk Prediction Assessment due to Deterioration contact of combustible cables in Underground Common Utility Tunnels (지하공동구내 가연성케이블의 열화접촉으로 인한 화재위험성 예측평가)

  • Ko, Jaesun
    • Journal of the Society of Disaster Information
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    • v.11 no.1
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    • pp.135-147
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    • 2015
  • Recent underground common utility tunnels are underground facilities for jointly accommodating more than 2 kinds of air-conditioning and heating facilities, vacuum dust collector, information processing cables as well as electricity, telecommunications, waterworks, city gas, sewerage system required when citizens live their daily lives and facilities responsible for the central function of the country but it is difficult to cope with fire accidents quickly and hard to enter into common utility tunnels to extinguish a fire due to toxic gases and smoke generated when various cables are burnt. Thus, in the event of a fire, not only the nerve center of the country is paralyzed such as significant property damage and loss of communication etc. but citizen inconveniences are caused. Therefore, noticing that most fires break out by a short circuit due to electrical works and degradation contact due to combustible cables as the main causes of fires in domestic and foreign common utility tunnels fire cases that have occurred so far, the purpose of this paper is to scientifically analyze the behavior of a fire by producing the model of actual common utility tunnels and reproducing the fire. A fire experiment was conducted in a state that line type fixed temperature detector, fire door, connection deluge set and ventilation equipment are installed in underground common utility tunnels and transmission power distribution cables are coated with fire proof paints in a certain section and heating pipes are fire proof covered. As a result, in the case of Type II, the maximum temperature was measured as $932^{\circ}C$ and line type fixed temperature detector displayed the fire location exactly in the receiver at a constant temperature. And transmission power distribution cables painted with fire proof paints in a certain section, the case of Type III, were found not to be fire resistant and fire proof covered heating pipes to be fire resistant for about 30 minutes. Also, fire simulation was carried out by entering fire load during a real fire test and as a result, the maximum temperature is $943^{\circ}C$, almost identical with $932^{\circ}C$ during a real fire test. Therefore, it is considered that fire behaviour can be predicted by conducting fire simulation only with common utility tunnels fire load and result values of heat release rate, height of the smoke layer, concentration of O2, CO, CO2 etc. obtained by simulation are determined to be applied as the values during a real fire experiment. In the future, it is expected that more reliable information on domestic underground common utility tunnels fire accidents can be provided and it will contribute to construction and maintenance repair effectively and systematically by analyzing and accumulating experimental data on domestic underground common utility tunnels fire accidents built in this study and fire cases continuously every year and complementing laws and regulations and administration manuals etc.

Neuroprotection of Recombinant Human Erythropoietin Via Modulation of N-methyl-D-aspartate Receptors in Neonatal Rats with Hypoxic-ischemic Brain Injury (신생 백서의 저산소성 허혈성 뇌손상에서 NMDA receptor 조절을 통한 유전자 재조합 인 에리스로포이에틴의 신경보호)

  • Jang, Yoon-Jung;Seo, Eok-Su;Kim, Woo-Taek
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.221-233
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    • 2009
  • Purpose: Erythropoietin (EPO) has neuroprotective effects in many animal models of brain injury, including hypoxic-ischemic (HI) encephalopathy, trauma, and excitotoxicity. Current studies have demonstrated the neuroprotective effects of EPO, but limited data are available for the neonatal periods. Here in we investigated whether recombinant human EPO (rHuEPO) can protect the developing rat brain from HI injury via modulation of NMDA receptors. Methods: In an in vitro model, embryonic cortical neuronal cell cultures from Sprague-Dawley (SD) rats at 19-days gestation were established. The cultured cells were divided into five groups: normoxia (N), hypoxia (H), and 1, 10, and 100 IU/mL rHuEPO-treated (H+E1, H+ E10, and H+E100) groups. To estimate cell viability and growth, a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay was done. In an in vivo model, left carotid artery ligation was performed on 7-day-old SD rat pups. The animals were divided into six groups; normoxia control (NC), normoxia Sham-operated (NS), hypoxia-ischemia only (H), hypoxia-ischemia+vehicle (HV), hypoxia-ischemia+rHuEPO before a HI injury (HE-B), and hypoxia-ischemia+rHuEPO after a HI injury (HE-A). The morphologic changes following brain injuries were noted using hematoxylin and eosin (H/E) staining. Real-time PCR using primers of subunits of NMDA receptors (NR1, NR2A, NR2B, NR2C and NR2D) mRNA were performed. Results: Cell viability in the H group was decreased to less than 60% of that in the N group. In the H+E1 and H+E10 groups, cell viability was increased to >80% of the N group, but cell viability in the H+E100 group did not recover. The percentage of the left hemisphere area compared the to the right hemisphere area were 98.9% in the NC group, 99.1% in the NS group, 57.1% in the H group, 57.0% in the HV group, 87.6% in the HE-B group, and 91.6% in the HE-A group. Real-time PCR analysis of the expressions of subunits of NMDA receptors mRNAs in the in vitro and in vivo neonatal HI brain injuries generally revealed that the expression in the H group was decreased compared to the N group and the expressions in the rHuEPO-treated groups was increased compared to the H group. Conclusion: rHuEPO has neuroprotective property in perinatal HI brain injury via modulation of N-methyl-D-aspartate receptors.

Effect of Various Mixing Ratio of Non-glutinous and Glutinous Rice on Physical and Rheological Properties of Extrudate (멥쌀과 찹쌀의 혼합비율별 압출성형물의 물리적 성질 및 유동특성)

  • Kum, Jun-Seok;Kwon, Sang-Oh;Lee, Hyun-Yu;Lee, Sang-Hyo;Jung, Jin-Hyub;Kim, Jun-Pyong
    • Korean Journal of Food Science and Technology
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    • v.26 no.4
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    • pp.442-447
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    • 1994
  • Effect of different mixing ratio of non-glutinous and glutinous rice on physical and rheological properties of extrudate prepared in a single screw extruder were examined. The extrusion conditions in term of screw speeds, moisture content and die temperature were 258 rpm, 18% and $120^{\circ}C$, respectively. The resisdence time distribution of the most of materials were within 30 second and small portion of them went up to 80 second. The expansion ratio was the highest value (2.93) for 70% of glutinous rice in the mixture, while the lowest value for 100% of non-glutinous rice. Breaking strength was in the range between 1,051g and 1,117g for $10{\sim}20%$ of glutinous rice in the mixture, while the lowest value (737g) for 80%r of glutinous rice. As the amount of glutinous rice increased, L and a values were increased and b value was decreased. The uncooked cold paste viscosity had 400 B.U. for 100% non-glutinous rice , while no peak for the 100% glutinous rice. As the amount of glutinous rice increased up to 100%, the water absorption index (WAI) was decreased, while water solubility index (WSI) was increased. The rheological properties of extrudate were accounted by the law of Oswald. The flow behavior index of extrudate was less than 1.0, which showed pseudoplastic behavior. Yield stress was the highest value for 20% of glutinous rice in the mixture and the lowest value for $80{\sim}100%$ of glutinous; rice. Number of air cell was between 128 and 159 for $80{\sim}100%$ of glutinous rice in the mixture, while $81{\sim}84%$ for $0{\sim}20%$ of glutinous rice. The degree of shapefact was increased more when the mixtures of glutinous and non-glutinous rice was used than when glutinous or non-glutinous rice was only used.

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Effects Of Environmental Factors And Individual Traits On Work Stress And Ethical Decision Making (간호사의 환경적 요소와 개인적 특성이 직무스트레스와 윤리적 의사결정에 미치는 영향)

  • Kim, Sang Mi L.;Shake ketefian
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.417-430
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    • 1993
  • 이 연구는 환경적 요소(간호사의 자율성, 조직의 표준화)와 개인의 특성(통제위, 나이, 경험. 간호역할개념, 도덕성), 직무 스트레스, 윤리적 의사결정 사이의 관계를 이론적 틀을 구성하여 테스트함으로써 그 인과관계를 탐구하였다. 본 연구를 위해 개발된 모형은 1) Katz와 Kahn의 조직에 대한 개방체계 이론(open systems theory of organization) ; 2) Kahn. Wolfe, Quinn, Snoek의 스트레스 이론 (theory of stress) : 3) Kohlberg의 도덕발달 이론(theory of moral develop-ment): 그리고 4) 여러 문헌고찰을 기초로 하였다. 본 연구의 모형은 2가지의 주요 종속변수(직무 스트레스, 윤리적 간호행위), 2가지 매개변수(간호 역할개념, 도덕성 발달정도) 그리고 여러 독립변수들(조직의 표준화, 자율성, 통제위, 교육, 나이, 경험 등)로 구성되었다. 간단히 말해, 간호사의 스트레스와 윤리적 간호행위 를 개인 자신과 환경이라는 두 요소의 결과로 간주한 것이다. 미국(2개주)의 여러 건강관리기관에 근무하는 224명의 정규 간호사를 대상으로 하였고. 가설 검증을 위하여 1) 변수간의 인과관계를 조사하기 위한 Linear Structural Relationships(LISREL)기법과 2) 나이, 경험, 교육이 변수간의 관계에 미치는 중간역할을 알아보기 위해 상관분석을 이용하였다. LISREL결과를 보면 제시된 모델이 각 내재 변수에 상당한 설명력을 가지면서 자료에 잘 맞는 것으로 나타났다. 이 연구에서 가장 뚜렷한 점으로 나타난 것은 개인의 특성보다 환경적 요소로서의 자율성이 직무스트레스와 윤리적 의사결정을 예견하는데 훨씬 중요한 변수로 부각되었다는 점이다. 또한 간호사의 전문적 역할개념과 봉사적 역할개념이 간호사의 윤리적 의사결정을 예견하는 가장 중요한 요소로 나타났다. 중간영향(moderation effect)을 보면, 젊고 경험이 적은 간호사일수록 나이가 많고 경험있는 간호사보다 환경적 요소(자율성)에 더 큰 영향을 받는다는 것을 암시하고 있다. 또한 4년제 대학 이상을 졸업한 간호사의 윤리 적 간호행 위 는 2, 3년제 를 졸업 한 간호사 보다 환경적 요소에 의해 덜 영향을 받는 것으로 나타났다. 한편 자율성의 부족은 2, 3년제 졸업 간호사보다 4년제 졸업 간호사에게 더 심한 스트레스가 되고 있음을 시사하였다. 이 연구의 결과로부터 적어도 다음과 같은 두 가지 실제적인 제언을 도출할 수 있다. 첫째, 이 연구는 환경적요소로서의 자율성이 다른 어떤 개인적인 요소보다 직무 스트레스를 예견하는 데 중요한 요소라는 것을 제시하였다. 이것은 간호행정가들에게, 간호사의 직무 스트레스를 감소시키기 위해선 “자율성”이 아주 중요히 다루어져야 한다는 것을 의미한다. 만일 간호사들의 직무스트레스가 그 개인의 복지에 큰 해가 되고 환자를 간호하는 데 직접적으로 관계된다면, 간호행정가는 그 조직의 직무체계를 다시 평가해서 일에 대한 새로운 설계가 필요한지를 파악해야 한다. 또한 이 연구는 직무를 다시 설계할 경우, 누구에게 먼저 촛점을 두고 시작해야 하는지를 밝혀주고 있다. 즉, 젊고 경험이 미숙한 간호사들에게 촛점을 두고 시작해야 하며, 작업환경의 가장 중요한 차원중의 하나인 사회적 지원(social support)을 조심스럽게 고려해 보아야 한다. 둘째, 간호사의 윤리적 간호행위를 높히기 위해 전문적 역할개념과 봉사적 역할개념이 재강조될 필요가 있다. 이 두 역할개념 들을 교육을 통하여 효과적으로 가르칠 필요가 있다고 본다. 이 두 개념들이 간호사의 바람직한 간호행 위에 영향을 미치는 가장 중요한 요소로 나타났기 때문이다. 또한, 본 연구결과에 따르면, 경험이 많을수록 일에 싫증을 느껴 바람직한 윤리적 간호행위가 감소되는 경향이 있었다. 따라서, 건강관리체제 (health care system) 안에서의 간호사의 역할이-전문직으로서의, 그리고 환자를 위한 옹호자로서의-학교와 임상에서 효과적으로 교육되어져야 한다고 본다. 간호사들의 역할에 대한 계속적인 교육이 학생은 물론 임상 간호사들에게도 실시되어져야 할 것이다. 미래연구의 방향을 제시해 보면 첫째로 연구의 일반화를 높히기 위해 더 많은 대상자를 포함시켜야 한다. 이는 여러 종류의 표본을 반드시 한번에 전부 포함시켜야 한다는 것을 의미하는 것이 아니고, 특정한 여러 표본들을 연속적으로 연구함으로서 이 목표를 성취할 수 있다고 생각한다. 둘째는 여러 construct들(윤리적 간호행위, 직무 스트레스, 간호 역할개념 등)에 대한 적절한 측정도구를 개발해야 한다. 측정도구를 개발하기 위해서는 풍부하고 세세한 통찰력을 제공하는 질적인 정보를 얻는 것이 선행되어야 한다. 셋째, 윤리적 간호행위와 직무 스트레스에 관한 연구를 증진시키기 위해 실험설계 및 종단적 연구(expel-imental, longitudinal design)가 시도될 필요가 있다. 마지막으로, 윤리적 간호행위와 직무 스트레스를 예견할 수 있는 이론적 탐구(theoretical exploration), 즉 이론정립을 위하여, 환경적 요소와 개인의 특성에 대한 자세한 정보를 제공해 줄 수 있는 질적 연구들이 요구된다.

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Site Selection for Geologic Records of Extreme Climate Events based on Environmental Change and Topographic Analyses using Paleo Map for Myeongsanimni Coast, South Korea (고지도 기반 환경변화연구 및 지형분석을 통한 명사십리 해안의 제4기 연안지대 이상기후 퇴적기록 적지선정)

  • Kim, Jieun;Yu, Jaehyung;Yang, Dongyoon
    • Economic and Environmental Geology
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    • v.47 no.6
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    • pp.589-599
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    • 2014
  • This study selected optimal sites in Myeongsasimni located in west coast of Korea for stratigraphic research containing extreme climate event during quaternary period by spatio-temporal analyses of changes in sedimentary environment and land use employing 1918 topographic map, 2000 digital terrain map, 1976 and 2012 air photographies. The study area shows no significant changes in topographic characteristics that hilly areas with relatively large variations in elevation are distributed over north and south part of the study area, and sand dues are developed along the coast line. Moreover, flat low lying areas are located at the back side of the sand dues. The movement of surface run off and sediment loads shows two major trends of inland direction flow from back sides of sand dunes and outland direction flow from high terrains inland, and the two flows merge into the stream located in the center of the study area. Two sink with individual area of $0.2km^2$ are observed in Yongjeong-ri and Jaryong-ri which are located in south central part and south part of the study area, respectively. In addition, sea level change simulation reveals that $3.4km^2$ and $3.64km^2$ are inundated with 3 m of sea level rise in 1918 and 2000, respectively, and it would contribute to chase sea level change records preserved in stratigraphy. The inundated areas overlaps well with sink areas where it indicates the low lying areas located in south cental and south part of the study area are identical for sediment accumulation. The areas with minimal human impact on sediment records over last 100 years are $3.51km^2$ distributed over central and south part of the study area with the land use changes of mud and rice field in 1918 to rice field in 2012. The candidate sites of $0.15km^2$ in central part and $0.09km^2$ in south part are identified for preferable locations of geologic record of extreme climate events during quaternary period based on the overlay analysis of optimal sedimentary environment and land use changes.

Analysis of Surgical Risk Factors in Pulmonary (폐국균종의 수술위험인자 분석)

  • 김용희;이은상;박승일;김동관;김현조;정종필;손광현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.281-286
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    • 1999
  • Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

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