• Title/Summary/Keyword: End Effects

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The Effect of External PEEP on Work of Breathing in Patients with Auto-PEEP (Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과)

  • Chin, Jae-Yong;Lim, Chae-Man;Koh, Youn-Suck;Park, Pyung-Whan;Choi, Jong-Moo;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.201-209
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    • 1996
  • Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

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Evaluation of Parameters of Gas Exchange During Partial Liquid Ventilation in Normal Rabbit Lung (토끼의 정상 폐 모델에서 부분액체환기 시 가스교환에 영향을 주는 인자들에 대한 연구)

  • An, Chang-Hyeok;Koh, Young-Min;Park, Chong-Wung;Suh, Gee-Young;Koh, Won-Jung;Lim, Sung-Yong;Kim, Cheol-Hong;Ahn, Young-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.14-23
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    • 2002
  • Background: The opitmal ventilator setting during partial liquid ventilation(PLV) is controversial. This study investigated the effects of various gas exchange parameters during PLV in normal rabbit lungs in order to aid in the development of an optimal ventilator setting during PLV. Methods: Seven New-Zealand white rabbits were ventilated in pressure-controlled mode with the following settings; tidal volume($V_T$) 8 mL/kg, positive end-expiratory pressure(PEEP) 4 $cmH_2O$, inspiratory-to-expiratory ratio(I:E ratio) 1:2, fraction of inspired oxygen($F_TO_2$) 1.0. The respiration rate(RR) was adjusted to keep $PaCO_2$ between 35~45 mmHg. The ventilator settings were changed every 30 min in the following sequence : (1) Baseline, as the basal ventilator setting, (2) Inverse ratio, I:E ratio 2:1, (3) high PEEP, adjust PEEP to achieve the same mean inspiratory pressure (MIP) as in the inverse ratio, (4) High $V_T$, $V_T$ 15 mL/kg, (5) high RR, the same minute ventilation (MV) as in the High $V_T$. Subsequently, the same protocol was repeated after instilling 18 mL/kg of perfluorodecalin for PLV. The parameters of gas exchange, lung mechanics, and hemodynamics were examined. Results: (1) The gas ventilation(GV) group showed no significant changes in the $PaO_2$ at all phases. The $PaCO_2$ was lower and the pH was higher at the high $V_T$ and high RR phases(p<0.05). No significant changes in the lung mechanics and hemodynamics parameters were observed. (2) The baseline $PaO_2$ for the PLV was $312{\pm}$ mmHg. This was significantly lower when decreased compared to the baseline $PaO_2$ for GV which was $504{\pm}81$ mmHg(p=0.001). During PLV, the $PaO_2$, was significantly higher at the high PEEP($452{\pm}38$ mmHg) and high $V_T$ ($461{\pm}53$ mmHg) phases compared with the baseline phase. However, it did not change significantly during the inverse I:E ratio or the high RR phases. (3) The $PaCO_2$ was significantly lower at high $V_T$ and RR phases for both the GV and PLV. During the PLV, $PaCO_2$ were significantly higher compared to the GV (p<0.05). (4) There were no important or significant changes in of baseline and high RR phases lung mechanics and hemodynamics parameters during the PLV. Conclusion: During PLV in the normal lung, adequate $V_T$ and PEEP are important for optimal oxygenation.

Construction of Consumer Confidence index based on Sentiment analysis using News articles (뉴스기사를 이용한 소비자의 경기심리지수 생성)

  • Song, Minchae;Shin, Kyung-shik
    • Journal of Intelligence and Information Systems
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    • v.23 no.3
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    • pp.1-27
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    • 2017
  • It is known that the economic sentiment index and macroeconomic indicators are closely related because economic agent's judgment and forecast of the business conditions affect economic fluctuations. For this reason, consumer sentiment or confidence provides steady fodder for business and is treated as an important piece of economic information. In Korea, private consumption accounts and consumer sentiment index highly relevant for both, which is a very important economic indicator for evaluating and forecasting the domestic economic situation. However, despite offering relevant insights into private consumption and GDP, the traditional approach to measuring the consumer confidence based on the survey has several limits. One possible weakness is that it takes considerable time to research, collect, and aggregate the data. If certain urgent issues arise, timely information will not be announced until the end of each month. In addition, the survey only contains information derived from questionnaire items, which means it can be difficult to catch up to the direct effects of newly arising issues. The survey also faces potential declines in response rates and erroneous responses. Therefore, it is necessary to find a way to complement it. For this purpose, we construct and assess an index designed to measure consumer economic sentiment index using sentiment analysis. Unlike the survey-based measures, our index relies on textual analysis to extract sentiment from economic and financial news articles. In particular, text data such as news articles and SNS are timely and cover a wide range of issues; because such sources can quickly capture the economic impact of specific economic issues, they have great potential as economic indicators. There exist two main approaches to the automatic extraction of sentiment from a text, we apply the lexicon-based approach, using sentiment lexicon dictionaries of words annotated with the semantic orientations. In creating the sentiment lexicon dictionaries, we enter the semantic orientation of individual words manually, though we do not attempt a full linguistic analysis (one that involves analysis of word senses or argument structure); this is the limitation of our research and further work in that direction remains possible. In this study, we generate a time series index of economic sentiment in the news. The construction of the index consists of three broad steps: (1) Collecting a large corpus of economic news articles on the web, (2) Applying lexicon-based methods for sentiment analysis of each article to score the article in terms of sentiment orientation (positive, negative and neutral), and (3) Constructing an economic sentiment index of consumers by aggregating monthly time series for each sentiment word. In line with existing scholarly assessments of the relationship between the consumer confidence index and macroeconomic indicators, any new index should be assessed for its usefulness. We examine the new index's usefulness by comparing other economic indicators to the CSI. To check the usefulness of the newly index based on sentiment analysis, trend and cross - correlation analysis are carried out to analyze the relations and lagged structure. Finally, we analyze the forecasting power using the one step ahead of out of sample prediction. As a result, the news sentiment index correlates strongly with related contemporaneous key indicators in almost all experiments. We also find that news sentiment shocks predict future economic activity in most cases. In almost all experiments, the news sentiment index strongly correlates with related contemporaneous key indicators. Furthermore, in most cases, news sentiment shocks predict future economic activity; in head-to-head comparisons, the news sentiment measures outperform survey-based sentiment index as CSI. Policy makers want to understand consumer or public opinions about existing or proposed policies. Such opinions enable relevant government decision-makers to respond quickly to monitor various web media, SNS, or news articles. Textual data, such as news articles and social networks (Twitter, Facebook and blogs) are generated at high-speeds and cover a wide range of issues; because such sources can quickly capture the economic impact of specific economic issues, they have great potential as economic indicators. Although research using unstructured data in economic analysis is in its early stages, but the utilization of data is expected to greatly increase once its usefulness is confirmed.

The Effects of Proinflammatory Cytokines and TGF-beta, on The Fibroblast Proliferation (Proinflammatory Cytokines과 TGF-beta가 섬유모세포의 증식에 미치는 영향)

  • Kim, Chul;Park, Choon-Sik;Kim, Mi-Ho;Chang, Hun-Soo;Chung, Il-Yup;Ki, Shin-Young;Uh, Soo-Taek;Moon, Seung-Hyuk;Kim, Yong-Hoon;Lee, Hi-Bal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.861-869
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    • 1998
  • Backgrounds: The injury of a tissue results in the infalmmation, and the imflammed tissue is replaced by the normal parenchymal cells during the process of repair. But, constitutional or repetitive damage of a tissue causes the deposition of collagen resulting in the loss of its function. These lesions are found in the lung of patients with idiopathic pulmonary fibrosis, complicated fibrosis after diffuse alveolar damage (DAD) and inorganic dust-induced lung fibrosis. The tissue from lungs of patients undergoing episodes of active and/or end-stage pulmonary fibrosis shows the accumulation of inflammatory cells, such as mononuclear cells, neutrophils, mast cells and eosinophils, and fibroblast hyperplasia. In this regard, it appears that the inflammation triggers fibroblast activation and proliferation with enhanced matrix synthesis, stimulated by inflammatory mediators such as interleukin-1 (IL-1) and/or tumor necrosis factor (TNF). It has been well known that TGF-$\beta$ enhance the proliferation of fibroblasts and the production of collagen and fibronectin, and inhibit the degradation of collagen. In this regard, It is likely that TGF-$\beta$ undergoes important roles in the pathogenesis of pulmonary fibrosis. Nevertheless, this single cytokine is not the sole regulator of the pulmonary fibrotic response. It is likely that the balance of many cytokines including TGF-$\beta$, IL-1, IL-6 and TNF-$\alpha$ regulates the pathogenesis of pulmonary fibrosis. In this study, we investigate the interaction of TGF-$\beta$, IL-1$\beta$, IL-6 and TNF-$\alpha$ and their effect on the proliferation of fibroblasts. Methods: We used a human fibroblast cell line, MRC-5 (ATCC). The culture of MRC-5 was confirmed by immunofluorecent staining. First, we determined the concentration of serum in cuture medium, in which the proliferation of MRC-5 is supressed but the survival of MRC-5 is retained. Second, we measured optical density after staining the cytokine-stimulated cells with 0.5% naphthol blue black in order to detect the effect of cytokines on the proliferation of MRC-5. Result: In the medium containing 0.5% fetal calf serum, the proliferation of MRC-5 increased by 50%, and it was maintained for 6 days. IL-1$\beta$, TNF-$\alpha$ and IL-6 induced the proliferation of MRC-5 by 45%, 160% and 120%, respectively. IL-1$\beta$ and TNF-$\alpha$ enhanced TGF-$\beta$-induced proliferation of MRC-5 by 64% and 159%, but IL-6 did not affect the TGF-$\beta$-induced proliferation. And lNF-$\alpha$-induced proliferation of MRC-5 was reduced by IL-1$\beta$ in 50%. TGF-$\beta$, TNF-$\alpha$ and both induced the proliferation of MRC-5 to 89%, 135% and 222%, respectively. Conclusions: TNF-$\alpha$, TGF-$\beta$ and IL-1$\beta$, in the order of the effectiveness, showed the induction of MRC-5 proliferation of MRC-5. TNF-$\alpha$ and IL-1$\beta$ enhance the TGF-$\beta$-induced proliferation of MRC-5, but IL-6 did not have any effect TNF-$\alpha$-induced proliferation of MRC-5 is diminished by IL-1, and TNF-$\alpha$ and TGF-$\beta$ showed a additive effect.

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Study on the Salt Tolerance of Rice and Other Crops in Reclaimed Soil Areas. -6. On the Effects of Increased N. P. K. Applications for Rice Plant in Reclaimed Salty Areas (간척지(干拓地)에서 수도(水稻) 및 기타작물(其他作物)의 내염성(耐鹽性)에 관(關)한 연구(硏究) -6. 염분간척지(鹽分干拓地)에서 수도(水稻)에 대한 N, P, K,의 증비효과에 관(關)하여)

  • Im, H.B.
    • Korean Journal of Soil Science and Fertilizer
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    • v.3 no.1
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    • pp.35-41
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    • 1970
  • The experiment was conducted at the salt concentration of 0.5% and 1% end of April, respectively, in low and high-salty and the non-salty areas of silt loam with the Nongkwang, rice variety. The factorial design with confounding blocks of 3 levels each of 10, 15 and 20 kg of N, 8, 12 and 16kg of phosphate and potash, respectively, per 10a was applied. 1. N applications increased by 1.5 and 2 times with the fixed amount of $P_2O_5$ and $K_2O$ (8kg/10a each) increased the proportion absorbed to the applications of N in both non salty and low-salty areas. It was observed that the absorption of Ca and Si was inhibited by either an increased treatment of N alone or combination with the other nutrients in the salty area. 2. In the non-salty area, an increased applications of standard amount of N, $P_2O_5$ and $K_2O$ respectively did not increased the yields. Doubling the application of $K_2O$ resulted in a decreased yield. 3. Applications of additional of 1.5 and 2 times the 10 kg of N per 10a increased the rice yields 12% and 21% respectively, in the low-salty area. An increased application of $P_2O_5$ and $K_2O$ failed to bring about an increased yield. 4. Increasing the application of N gave a significant increased in the yield of rice grain and 1.5 times of N applications were seemed profitable on the high-salty area. Although an increased applications $P_2O_5$ and $K_2O$ seemed to increase the yields of grain, no significant increase was observed. 5. An increased application of N increased the number of panicles up to 1.5 times the standard amount in the non-salty area, but no further increase resulted by doubling the application. The number of panicles was increased in proportion to the increased application of N in both low and high-salty areas. An increased application of $P_2O_5$ increase the number of panicles per unit area in each experimental plot while that of $K_2O$ had no effect but rather decreased the number. 6. The effect of an increased application of N decreased the weight of panicle in the non-salty area, but when the application was increased to 1.5 times or more an increased weight of panicle resulted in both salty areas. Doubling the application had approximately the same effect as 1.5 times the application. Increasing the applications of $P_2O_5$ and $K_2O$ had no effect on the panicle weight in the experimental plots. Increasing the applications of N, $P_2O_5$ and $K_2O$ did not effect the weight of 1,000 grains produced in the non-salty and salty areas. Increasing the application of N decreased the number of grains per panicle in the non-salty area but increased the number of grains per panicle in either salty areas. 7. The ratio of matured grains was highest in the low-salty area and the lowest in the high-salty area. An increased N applications decreased the ratio of matured grains in the non-salty area. No effect was observed in both low and high-salty areas. Increased the $P_2O_5$ and $K_2O$ application showed no effect on the ratio of matured grains in the experimental plots. 8. Increased applications of N, $P_2O_5$ and $K_2O$ was observed not to change the percentage of milling recovery in any experimental plots. Broken rice was increased equally by an increased application of N in the non-salty and salty areas but more remarkably so in the former. 9. Increased applications of N increased the straw production equally in the non-salty, low and high-salty areas. However, no increased production was observed from heavier applications of $P_2O_5$ and $K_2O$. Additional N applications reduced the rate of rough grain weight v.s. straw weight in the non-salty area but increased the ratios in both low and high-salty areas. Additional $P_2O_5$ and $K_2O$ had no effect with the ratio.

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