• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.75-80
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• 2010

The year of 2009~2010 brought a number of concepts and new ideas were evaluated with promising results. However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS. Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation was associated with an increase in days without ventilation. Although this single center study has some limitations, the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves, and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection. Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice in ICU, we should take into consideration of individual hospital situation including human and material resources.

• Safety and Health at Work
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• v.3 no.1
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• pp.17-21
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• 2012

Objectives: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs. Methods: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared. Results: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01). Conclusion: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.2
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• pp.110-122
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• 2006

Objective : This study was conducted to quantify chronic lead exposure from various media(ie. working environment, food, ambient air), and to certify the usefulness of exposure assessment using Monte-Carlo simulation in the fields of occupational health. Methods : Data were obtained from Korean Industrial Health Association, Korea Food and Drug Administration, and the Ministry of Environment. Then lead worker's exposure was estimated indirectly from various media and parameters (ie. volume inhaled, body weight, dietary intake, etc.). Uncertainty was analyzed by Monte Carlo simulation with Crystal Ball software. Exposure doses and hazard indices were simulated with various hypothetical scenarios including weekly working hours and respiratory protective equipment. Results : Without respiratory protective equipment, the total exposure dose per kilogram of body weight of lead workers was estimated as $5.45{\times}10^{-3}mg/kg/day$, and hazard index was estimated as 2.26, and exposure contributions were calculated as follows : working environment(82.42 %); foods(17.57 %); and ambient air(0.01 %). But, if working condition has changed - reduction of working hours and using respiratory protective equipment, the total exposure dose per kilogram of body weight was estimated between $1.34{\times}10^{-3}-1.49{\times}10^{-3}mg/kg/day$, and hazard index was estimated between 0.56 - 0.62. Conclusions : This study suggested that occurrence of hazardous impact(ie. increased blood pressure) through lifetime lead exposure would be expected, and that the Monte-Carlo simulation was useful for the fields of occupational health.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.281-288
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• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.19-28
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• 2009

Objectives: This study was conducted to help clinical studies for treating Functional Dyspepsia with acupuncture. We inspected tendency of studies of acupuncture treatment for functional dyspepsia and analyzed the assessing instrument for it by scrutinizing Pubmed recent publications. Materials and Methods: We inspected 8 theses and scrutinized their objectives, periods, participants, materials and methods, the instrument of assessment for the studies, and criteria and symptom score for questionaire, results and JADAD score. Results: 1. Most studies were published by oriental doctors except one which was published by an American doctor. More and more studies are being published in America and written in English recently. So it is considered that western doctors think that the acupuncture treatment is useful as unorthodox medicine for functional dyspepsia. 2. Among the 4 clinical studies, 2 studies were RCT and 1 study was not RCT and 1 study with vagueness. All 4 clinical studies were not double-blinded because they were about comparison between acupuncture treatment and medicine. 3. ST36, PC6, CV12, BL21 were chiefly used, and auricular point, ST40, SP6 were also used. Manual acupuncture were used in 2 studies, and low frequency pulse and electroacupuncture were used in other studies respectively. 4. 4 clinical studies used 0~3 points symptom score as the instrument of assessment. Additional assessments were on gastric emptying time, EGG and plasma level of motilin. All thesis were not verified of validity and reliability. 5. Among the 4 reviewed thesis, 2 theses were about acupuncture as one of the various treatment of functional dyspepsia, and the other 2 theses were about efficacy of acupuncture treatment. And the result generally showed effectivity of acupuncture treatment. Conclusion: Acupuncture treatment for functional dyspepsia is considered useful as in unorthodox medicine by western doctors, and it is necessary to provide objective instrument for assessing acupuncture treatment for functional dyspepsia.

• Journal of Environmental Health Sciences
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• v.35 no.4
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• pp.239-248
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• 2009

The Institute of Medicine of the National Academies of Science in the United States concluded in its 2004 report that excessive indoor dampness is a public health hazard and that its prevention should be a public health goal. Water damage in buildings, such as leaks from roofs, walls, or windows, may increase indoor moisture levels. Excessive dampness may promote microbial proliferation in indoor environments, increase occupants' exposure to microbial agents, and eventually produce adverse health effects in building occupants. Epidemiological studies to demonstrate the causal association between exposure to indoor microbial agents and health effects require reliable exposure assessment tools. In this review, I discuss various sampling and analytical methods to assess human exposure to biological agents in indoor environments, their strengths and weaknesses, and recent trends in research and practice in the USA.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.1-6
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• 2023

The aging population, particularly those aged 65 and above, is on the rise, with projections indicating a substantial increase in the elderly demographic. This demographic shift brings challenges in managing age-related diseases, including head and neck cancers (HNCs). Frailty, often characterized by physiological decline and vulnerability to stressors, is a crucial factor affecting treatment outcomes of elderly cancer patients. Accordingly, the significance of assessing frailty in elderly HNC patients before their treatment should be emphasized, but current frailty assessment tools may not fully capture the unique challenges faced by HNC patients. Specific indicators, including respiratory and swallowing functions, are proposed for a more tailored assessment. This comprehensive review explores the impact of frailty on various treatment modalities, including surgery, radiation, and chemotherapy, highlighting the need for personalized interventions. Furthermore, it suggests avenues for future research to enhance frailty assessment tools and investigate interventions aimed at improving treatment outcomes in elderly HNC patients.

• Journal of Environmental Health Sciences
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• v.46 no.6
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• pp.667-675
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• 2020

Objectives: Exposure to fine dust (PM10) could contribute to the occurrence of cardiovascular disease or respiratory abnormalities. Since garlic is known to possess an anti-oxidative stress effect, the present study was performed to evaluate the effect of garlic intake on fine dust-mediated pulmonary toxicity. Methods: Rats were intratracheally instilled with fine dust at 15 mg/kg body weight (BW)/day for five days following five-day intragastric intubation of garlic at 0.7 or 1.4 g/kgBW/day, or 13.1 mg/kgBW/day S-allyl-cysteine (SAC) as a reference component in garlic. Blood and bronchoalveolar lavage fluid (BALF) were collected. Results: Deposit of fine dust was visually and histopathologically observed in the lungs. Body weight gain during the instillation period was significantly lowered in all the groups instilled with fine dust. Neutrophil numbers in blood were significantly elevated in the fine dust alone group, but this alteration was diminished in the groups administered with garlic. Levels of serum glutathione were lower in the rats instilled with fine dust alone, and this decrease in the glutathione level seems dose-dependently compensated among the groups administered with garlic. Similar findings were observed in the BALF with statistical significance. Typical pulmonary histopathological observation related with inflammation was demonstrated in the lungs of the rats exposed to fine dust alone, whereas such histopathologic findings were not improved in the groups administered with garlic. Conclusion: The present study suggests that garlic intake could alleviate fine dust-mediated pulmonary or systemic toxicities. Further investigation is necessary to delineate the mechanism of garlic-mediated effects on pulmonary function.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.104-107
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• 2015

Purpose: Nitric oxide (NO) is a vasodilator and inhaled NO (iNO) is used in acute respiratory distress syndrome (ARDS) to improve alveolocapillary gas exchange. The mechanism to improve oxygenation is likely to redistribute blood flow from unventilated areas to ventilated areas. Though improvement of oxygenation, iNO therapy has not been shown to improve mortality and considered as only rescue therapy in severe hypoxemia. We conducted the study to investigate an efficacy of iNO in trauma patients with severe hypoxemia. Methods: We reviewed the trauma patients who underwent iNO therapy retrospectively from 2010 to 2014. Degree of hypoxemia was represented as $PaO_2/FiO_2$ ratio (PFR) and the severity of patient was represented with sequential organ failure assessment (SOFA) score. Patients were divided into the survivor group and non-survivor group according to the 28-day mortality. Results: A total of 20 patients were enrolled. The mortality of 28-day was 40%. There were no significant differences between survivor and non-survivor group in age, sex, severity of injury, PFR and SOFA score. There was significant difference in initiation time of iNO after injury (p=0.047). Maximum combinations of sensitivity and specificity for timing of iNO therapy were observed using cut-off of 3-day after injury with a sensitivity of 88% and specificity of 75%. Conclusion: Though iNO therapy does not influence the mortality, iNO therapy may decrease the mortality caused by respiratory failure in the early phase of trauma.

• The Journal of Korean Medicine
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• v.41 no.3
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• pp.162-172
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• 2020

Objectives: The purpose of study was to report the clinical improvement of Chronic Obstructive Pulmonary Disease (COPD) patients treated with Korean medicine pulmonary rehabilitation. Methods: The patients were treated with Lung-conduction exercise, Chuna manual therapy, Exercise therapy. To assess the treatment outcomes, we used the pulmonary function test (PFT), modified medical research council scale (mMRC), 6-minute walk distance (6MWD), peak expiratory flow rate (PEFR), COPD assessment test (CAT), St. George respiratory questionnaire (SGRQ). Results: After treatments, the patient's clinical symptoms were improved with CAT, SGRQ's significant decrease and PFT, mMRC, 6MWD and PEFR were maintained or improved slightly. Conclusions: The Korean medicine pulmonary rehabilitation was effective in the treatment of COPD patients. This study suggested the possibility of Korean Medicine pulmonary rehabilitation program in the clinic.