• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.228-232
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• 2018

Background: Chronic bronchitis (CB) is an important phenotype in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate different pattern of COPD assessment test (CAT) score between CB and non-CB patients. Methods: Patients were recruited from 45 centers in Korea, as part of the Korean COPD Subgroup Study cohort. CB was defined when sputum continued for at least 3 months. Results: Total 958 patients with COPD were eligible for analysis. Among enrolled patients, 328 (34.2%) were compatible with CB. The CAT score was significantly higher in patients with CB than non-CB, and each component of CAT score showed a similar result. CB was significantly associated with CAT score when adjusted with age, sex, modified Medical Research Council, and post-bronchodilator forced expiratory volume in 1 second. Each component of CAT score between patients with CB and non-CB showed different pattern according to Global Initiative for Chronic Obstructive Lung Disease grade. Conclusion: CAT score is significantly higher in patients with CB than non-CB. Each component of CAT score was significantly different between two groups.

• Korean Journal of Veterinary Service
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• v.37 no.1
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• pp.1-9
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• 2014

Although it has been generally accepted that porcine reproductive and respiratory syndrome virus (PRRSV) induces weak and delayed protective immunity after infection, it is unclear that the same immunological features can be applicable to all PRRS viruses because huge genetic variation exists even among the same genotypes of PRRSV (Type 1 and 2). In the current study, two genetically distinct type 2 PRRSV strains (VR-2332 and JA142) which showed approximately 90% nucleotide homology based on ORF5 sequences were characterized by both in vitro and in vivo assessments to determine the immunological features of the viruses. For in vitro assessment, porcine alveolar macrophages (PAM) were infected with the viruses at $10^{-3}$ multiplicity of infection (MOI) and then supernatants and cells were collected separately at 36 hrs post infection to determine the relative expression levels of IL-$1{\alpha}$, IL-12, TNF-${\alpha}$ and INF-${\alpha}/{\beta}$ by quantitative RT-PCR. In addition, five PRRSV-free pigs were inoculated with either of JA142 or VR2332 for in vivo assessment. Serum samples were collected every week until 6 weeks post challenge. The serum samples were analyzed for the levels of viremia, PRRSV nucleocapsid-specific antibody and virus neutralizing antibody. Based on those assessments, the two viruses showed different patterns of cytokine expression in PAM and immune responses in pigs after infection. These results indicate that genetically distinct PRRSV strains have different immunological features, which might be criteria for virus classification and selection of candidate virus strains for vaccine development in the future.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.47-55
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• 2022

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.80-90
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• 2024

Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

• Toxicological Research
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• v.18 no.1
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• pp.23-29
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• 2002

Disodium disulphite, the HPV chemical, was assigned to Korea in order to implement OECD SIDS program in 1999. It was produced about 3,200 ton/year in 1998. This report evaluates the toxic potency of disodium disulphite based on the environmental and mammalian effects as well as human exposure. Oral $LD_{50}$ in rats is 1,540 mg/kg b.w. and effects was observed to the stomach, liver and the GI track that was filled with blood. For repeated dose toxicity, the predominant effect was the induction of stomach lesion due to local irritation. The no observed adverse effect lever for local (stomach irritation) was about 217 mg/kg bw/day. There is no evidence that disodium disulphite is genotoxic in vivo. No reproductive or developmental toxicty of disodium disulphite was observed for the period up to 2 yr and over three generation. In humans, urticaria and asthma with itching, edema, rhinitis, and nasal congestion were reported. Disodium disulphite is unlikely to induce respiratory sensitization but may enhance symptom of asthma in sensitive individuals. This chemical would be mainly transported to water compartment when released to environmental compartments since it is highly water soluble (470 g/l at 20). Low K oc (2.447) indicates disodium disulphite is so mobile in soil that it may not stay in the terrestrial compartment. The chemical has been tested in a limited number of aquatic species. hem acute toxicity test to fish, 96 hr-$LC_{50}$ was > 100 mg/1. For algae, 72 hr-$XC_{50}$ was 48.1 mg/1. For daphnid, the acute toxicity value of 48 hr-$EC_{50}$ was 88.76 mg/1, and chronic value of 21day-NOEC was > 10 mg/1. Therefore, PNEC of 0.1 mg/l for the aquatic organism was obtained from the chronic value of daphnid using the assessment factor of 100. Based on these data the disodium disulphite was recommended as low priority for further post-SIDS work in OECD.

• Journal of Environmental Health Sciences
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• v.45 no.4
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• pp.370-380
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• 2019

Objective: This study was performed to investigate the distribution of individual exposure characteristics according to an exposure assessment classification for humidifier disinfectant and to identify the factors that influence assessment classification. Methods: We examined the exposure characteristics of 4,482 subjects who applied for the 4-1 and 4-2 assessments of environmental exposure to humidifier disinfectant conducted by the Korea Environmental Industry & Technology Institute (KEITI). Environmental exposure assessment classification was assessed using the following seven criteria: 1) Distance from humidifier to face; 2) Spray direction; 3) Time used, daytime 4) Time used, during sleep; 5) Time used, cumulative; 6) Exposure intensity; and 7) Cumulative exposure level. Each criteria was then classified as 'high' or low'. When participants answered for more than four criteria, exposure assessment was determined as 'definite,' 'probable,' or 'possible' depending on the ratio of 'high' responses. If participants' responses were inconsistent, exposure assessment was listed as 'unlikely.' If participants answered for less than four criteria, exposure assessment was considered 'indeterminate.' Results: For the exposure assessment classes, definite was assigned to 38.5% (1,725 subjects), probable assigned to 32.9% (1,474 subjects), 25.0% (1,122 subjects) were assigned to as possible, unlikely assigned to 0.1% (3 subjects), and indeterminate assigned to 3.5% (158 subjects). Overall, participants who used 'Oxy Ssakssak New Gaseupgi Dangbun,' 'Aekyung Gaseupgi Mate,' 'Homeplus Gaseupgi Chungjungje,' and 'E-Mart Gaseupgi Salgyunje' totaled 2,996, 557, 176, and 162 subjects, respectively. There was a statistical difference in the type of humidifier disinfectant products between high-exposed and low-exposed participants. Based on the assessment criteria of humidifier disinfectant exposure, subjects were likely to be in the highly exposed classes (definite and probable) when the subjects were exposed 1) for more than ten hours per day and 2) for more than four hours at night 3) when the total cumulative exposure time was higher than the average, 4) when the direction of humidifier spray was toward the face, 5) when the respiratory position was less than 1 meter of distance from the humidifier, 6) when the concentration of indoor contaminants (ug/m3) was higher than the average exposure intensity, and 7) when overall exposure level ($ug/m3^*hr$) was higher than the average exposure level. Conclusion: This study suggests that each exposure assessment criteria was able to appropriately estimate cumulative exposure levels.

• Environmental Analysis Health and Toxicology
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• v.31
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• pp.11.1-11.6
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• 2016

Objectives A hazard assessment of di(2-ethylhexyl) phthalate (DEHP), a commonly used workplace chemical, was conducted in order to protect the occupational health of workers. A literature review, consisting of both domestic and international references, examined the chemical management system, working environment, level of exposure, and possible associated risks. This information may be utilized in the future to determine appropriate exposure levels in working environments. Methods Hazard assessment was performed using chemical hazard information obtained from international agencies, such as Organization for Economic Cooperation and Development-generated Screening Information Data Set and International Program on Chemical Safety. Information was obtained from surveys conducted by the Minister of Employment and Labor ("Survey on the work environment") and by the Ministry of Environment ("Survey on the circulation amount of chemicals"). Risk was determined according to exposure in workplaces and chemical hazard. Results In 229 workplaces over the country, 831 tons of DEHP have been used as plasticizers, insecticides, and ink solvent. Calculated 50% lethal dose values ranged from 14.2 to 50 g/kg, as determined via acute toxicity testing in rodents. Chronic carcinogenicity tests revealed cases of lung and liver degeneration, shrinkage of the testes, and liver cancer. The no-observed-adverse-effect level and the lowest-observed-adverse-effect level were determined to be 28.9 g/kg and 146.6 g/kg, respectively. The working environment assessment revealed the maximum exposure level to be $0.990mg/m^3$, as compared to the threshold exposure level of $5mg/m^3$. The relative risk of chronic toxicity and reproductive toxicity were 0.264 and 0.330, respectively, while the risk of carcinogenicity was 1.3, which is higher than the accepted safety value of one. Conclusions DEHP was identified as a carcinogen, and may be dangerous even at concentrations lower than the occupational exposure limit. Therefore, we suggest management of working environments, with exposure levels below $5mg/m^3$ and all workers utilizing local exhaust ventilation and respiratory protection when handling DEHP.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.3
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• pp.235-243
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• 2012

Objectives: The purpose of this study is the work environment management method through risk assessment and investigation of the work place that deals with Ammonium nitrate, based on information in and outside the country. Methods: This study suggests method of work environment management through risk assessment and investigation of the work place that deals with Ammonium nitrate, and finds out cases of Ammonium nitrate causing hazard, danger and health risk, based on literature investigation. Results: Rats exposed repeatedly to $LD_{50}$ 2,217 mg/kg(rat), $LC_{50}$ 88.8 mg/L(rat, skin) which cause high level of skin irritation, reported 1 $mg/m^3$ of NOAEL, while LOAEL was less than 100 mg/kg for the rats orally administered with the $LD_{50}$ 2,217 mg/kg(rat), $LC_{50}$ 88.8 mg/L(rat, skin), for 13 weeks. Domestically 31,640 ton/y of ammonium nitrate has been used in 22 workplace and the result of workplace assessment was 0.0171-0.9983 $mg/m^3$. ADD was 8.77-59.63 ${\mu}g/kg-day$ according to the exposure scenario. In other words the result of the risk assessment goes beyond the 'standard 1'. Conclusions: Ammonium nitrate creates a high level of irritation and toxicity when coming in breathe it or contact with skin, and is classified as category3 of GHS and specific target organ toxicant (irritating respiratory system). Exposure level at work places needs to be maintained under $1mg/m^3$, to prevent workers from being damaged.

• Asian Journal of Atmospheric Environment
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• v.11 no.2
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• pp.61-70
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• 2017

This study evaluated the human health risk in terms of the excess number of mortality and morbidity in the megacity Mumbai, India due to air pollution. AirQ software was used to enumerate the various health impacts of critical pollutants in Mumbai in past 22 years during 1992-2013. A relationship concept based on concentration-response relative risk and population attributable-risk proportion was employed by adopting World Health Organization (WHO) guideline for concentrations of air pollutants like $PM_{10}$, $SO_2$ and $NO_2$. For the year 1992 in Mumbai, it was observed that excess number of cases of total mortality, cardiovascular mortality, respiratory mortality, hospital admission due to COPD, respiratory disease and cardiovascular disease were 8420, 4914, 889, 149, 10568 and 4081 respectively. However, after 22 years these figures increased to 15872, 9962, 1628, 580, 20527 and 7905 respectively, but all of these reached maximum in the year 2006. From the result, it is also noted that except COPD morbidity the excess number of cases from 1992-2002 to 2003-2013 increased almost by 30%; and the excess number of mortality and morbidity is basically due to particulate matter ($PM_{10}$) than due to gaseous pollutants.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.197-200
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• 2004

A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.