• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.292-300
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• 2008

Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.205-211
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• 2009

Background: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. Methods: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (${\geq}10^4$ cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. Results: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5${\pm}$6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ${\geq}$0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level ${\geq}$0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level ${\geq}$0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. Conclusion: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.

• Korean Journal of Agricultural Science
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• v.32 no.1
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• pp.71-80
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• 2005

Phytic acid chelates excellently the metallic ions and the positive ions, especially has high affinity with $Fe^{2+}$ and $Ca^{2+}$. Merits of phytic acid can be taked in easily, edibile and harmless to body, so it was investigated that phytic acid can be substituted for EDTA in this study. 1. The Intensificative effect of chelating agent and disinfective osmotic shock of Vibrio vulnificus The number of initial existent fungi measured $1.7{\times}10^6$. The percentages of the survival fungi against the osmotic shock by distillated water were calculated at 1 minute, 3 minute and 5 minute after inoculation. The percentages of the survival fungi in $Mg^{2+}$ were 92.5%, 91.8% and 79.8% at each time, the average percentage was 88%. Also the sudden extinction was observed around 1 minute after inoculation and the survival fungi were not observed from 3 through 5 minute in spite of repeated experimentation. 2. Influence of Vibrio vulnificus on the survival of the mice. The first mouse started to die in 180 minute after inoculation in case that the inoculating number was $2.3{\times}10^7cfu/ml$. All died within 4.5 hour. The average of survival time was 226 minute. The first mouse started to die in 228 minute after inoculation in case that the inoculating number was $0.8{\times}10^6cfu/ml$. All died within 5 hour. The average of survival time was 300 minute and the survival time was 1.3 times high. The tendencies of death in two cases were similar, but the fatal rate were largely dependent on inoculating number.