• Journal of Chest Surgery
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• v.49 no.5
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• pp.366-373
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• 2016

Background: The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods: In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (${\geq}$3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results: Follow-up was 100% complete (mean $85{\pm}24months$). CWPM was inversely correlated with single lung VC (Spearman R=-0.72, p=0.0003), global VC (R=-0.51, p=0.02) and diaphragm excursion (R=-0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion: Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.732-745
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• 2009

Objectives : This study analyzed the contents of research papers of complementary and alternative medicine (CAM) concerning chronic obstructive pulmonary disease (COPD) published in PubMed during the last 5 years. This study was conducted to help clinical studies for treating COPD with Oriental medicine. Materials and Methods : We inspected 31 theses and scrutinized their objectives, periods, participants, materials and methods, methods of assessment, results and Jadad score. Results : The treatments in the studies were supplements, physical training, acupuncture, acu-TENS, Bojungikgi-tang (Buzhongyiqi-tang), counseling, breathing training, osteopathic manipulative treatment, reflexology, and distractive auditory stimuli. The aims of treatment were improvement of exercise capacity, lung function, quality of life, oxidative status, nutrient status, systemic inflammation, and cessation of smoking. The median for treatment period of study was 8 weeks, the median number of participants was 35 and the differences between mean $FEV_1$ from groups were less than 10% in 22 studies. The methods of assessment were lung function test, exercise capacity test, muscle strength test, questionnaire of QoL, laboratory studies, and measurement of nutrient state. The mean of Jadad score was $2.4\;{\pm}\;1.03$, and 24 treatment were assessed as effective. Conclusion : Recent CAM studies of COPD have focused on various topics in alternative and complementary medicine, and it is necessary to provide objective studies for treatment of this disease with Oriental medicines.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.1-7
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• 2005

Purpose: The purpose of this study was to identify the quality of sleep in hospitalized patients with lung cancer. Methods: The data were collected from January to April 2001. Study subjects were 50 lung cancer patients hospitalized at K University and G hospital in Busan, Korea. Quality of sleep was measured using the Quality of Sleep Scale (range $15{\sim}60$) developed by Oh et al (1999). The data were analyzed with the SPSS 10.0 program using frequency and percentage, mean, standard deviation, t-test, ANOV4 and Post-hoc test (Scheffe's test). Results: The results of this study were as follow; 1) The mean quality of sleep score was $35.64{\pm}7.59$ (range: $21{\sim}52$). 2) There was 3 Significant difference in 'ongoing pain' (t=-1.943, P=.046), 'major caregiver' (F=B863, P=.047), 'change of weight' (F=5.906, P=.019), according to general characteristics in the quality of sleep in hospitalized patients with lung cancer. Conclusion: As a results, the level of the quality of sleep in hospitalized patients with lung cancer was moderate. And, the study results indicate that ongoing pain, major caregiver, change of weight impact the quality of sleep of lung cancer patients. Therefore, nurses should consider those factors in providing nursing care for hospitalized patient with lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• Neonatal Medicine
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• v.25 no.1
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• pp.7-15
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• 2018

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6289-6294
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• 2012

Background: Research evidence suggests a debilitating impact of the diagnosis of cancer on the quality of life of the afflicted individuals, their spouses and their families. However, relatively few studies have been carried out on the impact on the QOL of adolescents living with parents diagnosed with cancer. This paper presents a sub-analysis on the impact of parental cancer (colorectal, breast and lung) on adolescents. Materials and Methods: This is a cross-sectional study on adolescents aged 13-18 years old. Upon ethical clearance obtained from UMMC Medical Ethics Committee, patients with colorectal, breast or lung cancer and their adolescent children were recruited from the Clinical Oncology Unit of University of Malaya Medical Centre. Respondents who gave consent completed a demographic questionnaire and the Pediatric Quality of Life Inventory, via the post, email, home visit or meetings at the clinics. Results: 95 adolescents from 50 families responded, giving a response rate of 88 percent. The adolescent's mean age was 16 years (ranging between 13-18 years). Adolescents with parental cancer had the lowest mean score in emotional functioning (p<0.05). Male adolescents had significantly higher quality of life overall and in physical functioning compared to female adolescents. Adolescents with a father with cancer had better school functioning compared to adolescents whose mothers had cancer. Families with household income of RM 5000 and above have significantly better quality of life compared to families with lower household income. Conclusions: Adolescent sons and daughters of parents with a cancer diagnosis show lowered QOL, particularly with reference to emotional functioning and school performance. Addressing the needs of this young group has been slow and warrants special attention. Revisiting the risk and resilience factors of adolescents might also inform tailored programs to address the needs of this neglected adolescent population.

• Korean Journal of Veterinary Service
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• v.24 no.1
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• pp.1-8
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• 2001

This study was carried out to investigate and analyze the gross lesions of lungs in slaughtered pigs. Pigs were collected from the areas of Kyounggj, Chungbuk, Chungnam and Kangwon provinces from November to December 1999. One hundred-eleven pigs(17.4%) had lung lesions with various degrees among 639 pigs tested. By the standard scoring system, mean score of the lung lesion was 25.6+13.2. Regional prevalence of lung lesions were 23.5%(8/34)) in Kangwon, 17.3%(61/352) in Kyunggi, 15.7%(32/204) in Chungnam and 20.4%(10/49) in Chungbuk. Mean number of pulmonary lesions per pig were 2.87. Most frequent region with pulmonary lesions was right cranial lobe(30.1%) and the decreasing prevalence rates were followed by 23.8% in right middle lobe, 21.05 in right accessory lobe, 15.0% in left cranial lobe, and 5.0% in left middle and accessory lobe(5.0%) and also there was the same prevalent tendency on pulmonary lesions in each lobes of 111 pigs with gross lesion. Isolation rate of bacteria from the affected lungs was 72.1% and main pathogen was Pasteurella multocida. Gross and histological examination of pulmonary lesions in some pigs suggested that there were no marked changes regarded as the correlation with specific diseases except fibropurulent bronchopneumonia which was suspective of some respiratory bacteria including Pasteurella multocida and peribronchiolar lymphoid hyperplasia in varying degrees which was strongly associated with mycoplasmal infection. Consequently, the results in the study were suggested that there was consistently exposed against many causative factors including bacteria in the considerable number of pig herds rearing in the middle area in Korea.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.217-224
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• 2000

Background : It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-$\alpha$ and IL-1$\beta$. However, there is an alteration in the macrophages' responsiveness when they are challenged with repeated bouts of endotoxin, termed "endotoxin tolerance" which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. Methods : Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE II score. Peripheral blood monocytes were isolated from the patients and diluted to $1{\times}10^5$ well. After stimulation with endotoxin (LPS of E. coli O114 : B4, 100 ng/ml), they were incubated at $37^{\circ}C$ in 5% $CO_2$ incubator for 24 hours. Supernatant was collected for the measurement of TNF-$\alpha$ and IL-1$\beta$ with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. Results : The APACHE II score (mean$\pm$SD) of the patients at the time of blood sampling was 12.2$\pm$5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods (10 cases), gram positive cocci (6 cases) with two cases of mixed infection. Serum TNF-$\alpha$ could be measured in 4 cases with 29.9$\pm$27.7 pg/ml. Serum IL-1$\beta$was measurable in only one patient. The TNF-$\alpha$ level of supernatant of cultured peripheral blood monocytes was 2,703$\pm$2,066 pg/ml in patients and 2,102$\pm$1914 pg/ml in controls. The IL-1$\beta$level of supernatant was 884$\pm$1,050 pg/ml in patients and 575$\pm$558 pg/ml in controls. There was no difference of TNF-$\alpha$ and IL-1$\beta$ level between patients and controls. Conclusion : We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.1
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• pp.308-317
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• 2007

This study was investigated to know the correlation of complete blood count(CBC), biochemical examination and DSOM fluents(Diagnosis System of Oriental Medicine, (C)2005-01-122-004154). There are 5 fluents in DSOM such as DSOM score(病機點數), mean of the index for pathogenic factor(病機指標 平均), 5-division of DSOM score(病機點數 五點尺度), 5-division of the index for pathogenic factor(病機點數 五點尺度), weighted pathogenic factor(病機加重値).We have carried out clinical trials who volunteered for Sasang constitutional medicine and Oriental OB & GY, Oriental Medical hospital of Dong-Eui University, from May 2005 to June 2006. Volunteers were 245 persons. Because 7 persons didn't checkup DSOM, so we analyzed the results statistically for 238 persons. In the relation of CBC and DSOM, the scores(病機點數, zp) and mean of the index for Pathogenic factor(病機指標 平均, zps) showed correlation more frequently, and correlation with results of RBC, hemoglobin, hematocrit was more significant. Correlation with fluents of pathogenic factor(病機) were more significant and high in deficiency of blood(血虛), insufficiency of Yang(陽虛), coldness(寒), damp(濕), dryness(燥), kidney(腎), phlegm(痰), heat syndrom(熱), lung(肺), and was very low in spleen(脾). There was no correlation with deficiency of Yin(陰虛). If volunteers have DSOM fluents, results of RBC and RBC index was decreased(- derection), and results of RDW, ESR was increased(+ direction). But increase and decrease direction in heat syndrom(熱), lung(肺) was contrary to the others. Correlation with fluents of Pathogenic factor(病機) of WBC, platlet, PDW, MPV was not many. In the relation of biochemical examination and DSOM fluents, correlation with results of albumin, uric acid, triglyceride was more significant. If volunteers have fluents of pathogenic factor(病機), result of examination was usually decreased. Especially result of examination was decreased(- derection) highly in deficiency of blood(血虛), stagnation of (氣滯) coldness(寒), dryness(燥), and was increased(+ direction) highly in heat syndrom(熱), lung(肺). But there was a tendency to show high correlation with specific pathogenic factor (病機) and specific examination in biochemical examination.

• Journal of Korean Biological Nursing Science
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• v.23 no.2
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• pp.138-150
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• 2021

Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.