• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.329-337
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• 1997

Background : Since endotracheal tube is the most important factor involved in the imposed work of breathing during mechanical ventilation, extubation of endotracheal tube is supposed to reduce respiratory work of patient. However, some patients show labored breathing after extubation despite acceptable blood gases. We investigated the changes of work of breathing before and after extubation and the factors involved in the change of WOB after extubation. Methods : The subjects were 34 patients(M : F = 20 : 14, mean age = $61{\pm}17yre$) who recovered from respiratory failure after ventilatory support and were considered to be ready for extubation. The patients with clinical or radiologic evidences of upper airway obstruction before endotracheal intubation for mechanical ventilation were excluded. Vital sign, physical examination, chest X-ray, work of breathing and other respiratory mechanic indices were measured prior to, immediately, 6, 24 and 48 hours after extubation serially. Definition of weaning failure after extubation was resumption of ventilatory support or reintubation of endotracheal tube within 48 hour after extubation because of respiratory failure. The patients were classified into group 1(decreased work of breathing), group 2(unchanged work of breathing) and group 3(increased work of breathing) depending on the statistical difference in the change of work of breathing before and after extubation. Results : Work of breathing decreased in 33%(11/34, group 1), unchanged in 41%(14/34, group 2) and increased in 26%(9/34, group 3) of patients after extubation compared with before extubation. Weaning failure occurred 9%(1/11) of group, 1, 28.6%(4/14) of group 2 and 44%(4/9) of group 3 after extubation(p = 0.07). The change of work of breathing after extubation was positively correlated with change of mean airway resistance(mRaw). (r = 0.794, p > 0.01). In three cases of group 3 whose respiratory indices could be measured until 48 hr after extubation, the change in work of breathing paralleled with the sequential change of mRaw. The work of breathing was peaked at 6 hr after extubation, which showed a tendency to decrease thereafter. Conclusions : Reversible increase of work of breathing after extubation may occur in the patients who underwent extubation, and the increase in mRaw could be responsible for the increase in work of breathing. In addition, the risk of weaning failure after extubation may increase in the patients who have increased WOB immediately after extubation.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.8-14
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• 2012

Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.15 no.5
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• pp.208-215
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• 2005

The 10mm diameter aggregates made of clay, carbon and $Fe_2O_3$ were prepared to investigate the mechanism of black core formation. The specific gravity, absorption rate, percent of black core area, fracture strength, total Fe analysis, and XRF were measured at various compositions, sintering temperatures, sintering times, sintering atmospheres, and sintering methods. Small addition of $Fe_2O_3$ did not affect physical properties of the aggregates; however, the percent of black core area increased with increasing carbon contents and increasing sintering temperature. Specific gravity of the aggregates decreased and the water absorption ratio increased with increasing percent of black core area. The aggregates sintered at oxidation atmosphere showed clear border between shell and black core area. Hence, the aggregates sintered at reduction atmosphere showed only black core area in the cross-section of the aggregates. The specific gravity of the aggregates sintered at reduction atmosphere increased with increasing carbon contents and that was the lowest of all comparing other aggregates sintered at different atmospheres. Adsorption rate increased with increasing carbon contents at all atmospheres. The fast sintered aggregates showed lower specific gravity, higher absorption rate, and more black core area than the normally sintered aggregates. It was turned out that the aggregates having more black core area showed higher fracture strength than that of aggregates with no black core area. From the total Fe analysis, the concentration of Fe and FeO was higher at black core area than at shell. Because the concentration of $Fe_2O_3$ in the shell was higher than other area, the color of the shell appeared red. It was also turned out from the XRF analysis that carbon was exist only at black core area.

• KSBB Journal
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• v.25 no.6
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• pp.572-576
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• 2010

Biological products, such as live varicella vaccine, are composed of biological substances derived from biological organisms. It is very difficult to identify these biologics' characteristics by analysis of simple physical and chemical methods alone. So the reference material is essential in order to evaluate the quality of bilogics. The 1'st national standard for varicella live vaccine was manufactured, established in 2002 and 2003, and have been used for the manufacturer's quality control and national lot release since then. As the lack of its availability and the decrease of its stability, this study was initiated by National Institute of Food and Drug Safety Evaluation (NiFDS) in 2008 to manufacture and establish the 2nd national standard for varicella live vaccine. The candidate material was manufactured from one of domestic manufacterers and the joint research of the NiFDS and manufacturers of varicella live vaccine was conducted to estimate of the reliable virus content. In the collaborative study, 3 laboratories including NiFDS performed the virus content test more than 7 times and all assay results were statistically analyzed. The mean coefficient of variation (CV) was 1.24%, and the geometric mean titre (GMT) variation range of each laboratory was low. On the basis of the results of this study, the candidate material of 2nd national standard for varicella live vaccine was assigned a potency of 4.26 log10 pfu/0.5 mL, when reconstituted in 0.7 mL.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.91-98
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• 2007

Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.515-525
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• 2005

Purpose of study: Lingual nerve damage can be caused by surgery or trauma such as physical irriatation, radiation, chemotherapy, infection and viral infection. Once nerve damage occurred, patients sometimes complain taste change and loss of taste along with serious disturbance of tongue. The purpose of this study was to evaluate the effects of unilateral lingual nerve transection on taste as well as on the maintenance of taste buds. Materials & Methods: Male Sprague-Dawley rats weighing 220-250g received unilateral transection of lingual nerve, subjected to the preference test for various taste solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) with two bottle test paradigm at 2, 4, 6, or 8 weeks after the operation. Tongue was fixed with 8% paraformaldehyde. After fixation, they were observed with scanning electron microscope(JSM-$840A^{(R)}$, JEOL, JAPAN) and counted the number of the dorsal surface of the fungiform papilla for changes of fungiform papilla. And, Fungiform papilla were obtained from coronal sections of the anterior tongue(cryosection). After cryosection, immunostaining with $G{\alpha}gust$(I-20)(Santa Cruz Biotechnology, USA), $PLC{\beta}2$(Q-15)(Santa Cruz Biotechnology, USA), and $T_1R_1$(Alpha Diagnostic International, USA) were done. Immunofluorescence of labeled taste bud cells was examined by confocal microscopy(F92-$300^{(R)}$, Olympus, JAPAN). Results: The preference score for salty and sweet tended to be higher in the operated rats with statistical significance, compared to the sham rats. Fungiform papilla counting were decreased after lingual nerve transaction. In 2 weeks, maximum differences occurred. Gustducin and $T_1R_1$ expressions of taste receptor in 2 and 4 weeks were decreased. $PLC{\beta}2$ were not expressed in both experimental and control group. Conclusion: This study demonstrated that the taste recognition for sweet and salty taste changed by week 2 and 4 after unilateral lingual nerve transection. However, regeneration related taste was occurred in the presence of preserving mesoneurial tissue and the time was 6 weeks. Our results demonstrated that unilateral lingual nerve damage caused morphological and numerical change of fungiform papilla. It should be noted in our study that lingual nerve transection resulted in not only morphological and numerical change but also functional change of fungiform papillae.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.67-77
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• 2003

Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.264-279
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• 2011

Objectives: The aims of this study were to evaluate the effect of a metabolic syndrome management program on participants enrolled in a public health center program in, Seoul, Korea for 6 months and to analyze the changes in their life habits and risk factors for treating their metabolic syndrome. Methods: Participants enrolled in a metabolic syndrome program at a public health center and answered questionnaires. Their waist circumference and, blood pressure were measured and their blood was tested. Based on the results, the participants were classified into 3 groups. Then, the center provided a metabolic syndrome management intervention program for the individual groups and analyzed the changes in participants' life habits and risk factors after 6 months. Results: After the intervention, the active group, showed improved physical activity, increased eating habits by 0.7 points, and decreased drinking and smoking; however, these results were not statistically significant. As for the Participants' overall health status, all groups positively changed a statistically significant result. In regard to the change in risk factors for metabolic syndrome in the active group, systolic and diastolic blood pressure and triglyceride levels were, statistically significantly decreased, meanwhile, an increase was found in HDL cholesterol level, waist measurement, and anteprandial glucose level; but the result were not statistically significant. Their review rate was 19.0%; 29.4% in the active group, 19.0% in motivating group A, and 14.5% in motivating group B. Conclusions: Participants showed changes in some life habits and risk factors, a result still far from the program's goal to improve residents' health status (improved living habits and variations in risk factors); thus, it is necessary to supplement this program for better performance.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.238-250
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• 2011

Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.227-237
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• 2011

Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.