• Tuberculosis and Respiratory Diseases
• /
• v.46 no.3
• /
• pp.350-362
• /
• 1999

Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

• Korean Journal of Plant Taxonomy
• /
• v.49 no.2
• /
• pp.179-197
• /
• 2019

This study presents the flora of vascular plants on Oenarodo Island, located in Goheung-gun, Jeollanam-do, Korea. A list of vascular plants was created based on the herbarium of the National Biological Resource Center (NIBR) and the Daejeon University Biology Department herbarium (TUT) collected from field surveys. Based on specimens collected in the field during 21 separate field trips amounting to a total of 21 days conducted between March of 2015 and October of 2017, there are 587 taxa on Oenarodo Island, consisting of 122 families, 364 genera, 538 species, six subspecies, 41 varieties, and two forms. Among the collected plants, those endangered were four taxa, those endemic were 14 taxa, floristic regional indicator plants specially designated by the Ministry of the Environment amounted to 137 taxa, and those naturalized amounted to 46 taxa.

• The Journal of the Korea Contents Association
• /
• v.15 no.6
• /
• pp.303-313
• /
• 2015

Purpose: The purpose of this study was to investigate the effect of education and counselling-based cardiac rehabilitation program on cardiovascular risk, health behavior and quality of life in elderly with coronary artery disease. Methods: A quasi-experimental study used a non-equivalent control group pre-post test design. A five week education and counselling-based cardiac rehabilitation program for the elderly with coronary artery disease was developed and offered to the experimental group. Participants were drawn from hospital in Busan. Twenty two were selected for the experimental group while 22 were assigned to a control group. Cardiovascular risk, health behavior and quality of life were measured. Results: There was a statistically significant difference in the cardiovascular risk(U=118.5, p=.002), health behaviors(t=5.200, p=<.001) and quality of life(t=2.431, p=.001) between the experimental group and the control group. Conclusion: Education and counselling-based cardiac rehabilitation program can be not only an effective nursing intervention for old patients having coronary artery disease, but also the very basis of further research on aged people who have the same symptom.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.46 no.2
• /
• pp.153-160
• /
• 2017

Data are limited on biological mechanisms underlying the associations of sleep insufficiency with obesity and dyslipidemia. To explore these mechanisms, we investigated appetite-regulating hormones, stress-related hormones, and cardiometabolic indicators in association with sleep fragmentation, which is a type of sleep disorder. In an experimental study, we randomly allocated 40 Wistar male rats aged 7 weeks into four groups; rats with ad libitum sleep and ad libitum intake (Control), those exposed to sleep fragmentation (SF), those with diet restriction (DR), and those exposed to sleep fragmentation and diet restriction (SF+DR). Amongst them, 13-day chronic sleep fragmentation was applied to the SF and SF+DR groups while 50% reduction in chow intake was applied to the DR and SF+DR groups for 13 days. After these experiments, blood lipid and lipoprotein profiles, leptin, ghrelin, adiponectin, cortisol, epinephrine, and norepinephrine levels were compared among the four groups. In the results, the SF group showed the highest levels of serum ghrelin (P<0.001) and the lowest levels of serum adiponectin (P<0.01). All experimental groups showed higher levels of low density lipoprotein-cholesterol (LDL-C) than the Control (P<0.001). LDL-C levels and the ratio of LDL-C and high density lipoprotein-cholesterol were positively correlated with ghrelin levels (P<0.05) in the SF group, but not in the DR and SF+DR groups. In the SF group, the highest levels of serum free fatty acids were also observed and correlated with lower levels of serum adiponectin, which reflects insulin resistance (P<0.05). Based on these findings, we suggest that chronic sleep fragmentation may induce disturbances in lipid metabolism and appetite-regulating hormones independent of food intake, and these metabolic disturbances may be worse due to insulin resistance related to overeating, which is indicated by elevated ghrelin levels in sleep fragmentation. For persons with sleep insufficiency, anti-atherogenic dietary interventions may be recommended to prevent cardiovascular disease.

• Journal of Korean Society of Spine Surgery
• /
• v.25 no.4
• /
• pp.160-168
• /
• 2018

Study Design: Retrospective study of prospectively-collected data. Objectives: To determine the factors associated with conversion from conservative to surgical treatment in single-level lumbar spinal stenosis patients. Summary of Literature Review: Various reports have presented clinical outcomes after the surgical and nonsurgical treatment of spinal stenosis. However, few reports have investigated factors predicting conversion to surgery during the course of conservative treatment. Materials and Methods: We analyzed 40 patients who visited our hospital from May 2010 to May 2015 and were traceable for at least 3 years after being advised to undergo surgery following 3 months of conservative treatment. Of these patients, 20 underwent surgery and 20 did not. We then investigated the factors associated with conversion to surgical treatment. Clinical assessments were conducted using a questionnaire, and the overall area of the spinal canal and the muscle area within the spinal canal were measured using magnetic resonance imaging. Results: The average area of the spinal canal was $81.40{\pm}53.61mm^2$ in the surgical group, compared to $127.75{\pm}82.55mm^2$ in the nonsurgical group (p=0.042). The muscle area in the spinal canal was $5.17{\pm}1.30cm^2$ in the surgical group, whereas it was $6.40{\pm}1.56cm^2$ in the nonsurgical group (p=0.010). The patients in the surgical group were more likely to have experienced repetitive strain and to have frequently visited health clubs (p=0.047, p=0.037, respectively). However, regular stretching was more common in the nonsurgical group (p=0.028). Conclusions: The factors associated with conversion to surgical treatment were a narrow spinal canal, a small muscle area within the spinal canal, visiting health clubs, repetitive sprain, and not stretching. A small muscle area within the spinal canal can be considered as a key factor related to surgical conversion.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.2
• /
• pp.130-141
• /
• 2002

Objectives : Stress induces alteration of gastrointestinal function in which interleukin (IL) and hypothalamo-pituitary-axis are involved. Depression again is associated with functional gastrointestinal disorders (FGID) and interleukins. The author attempted to look into the role of interleukins in the FGID also the association of depression and stress in this context. Methods : Entered were 20 patients with FGID, diagnosed by Rome IT criteria and 20 healthy controls. Depression was measured by Hamilton Rating Scale for Depression (HAM-D), and stress of the last one year by Schedule of Recent Experience (SRE). Serum levels of IL-$1\beta$, IL-2, IL-6 were measured by Enzyme-linked Immunosorbent Assay and serum cortisol by Fluorescence Polarization Immunoassay. The results were as follows : Results: 1) Serum levels of IL-$1\beta$, IL-2 were significantly lower in the patients with FGID than those in the controls, but level of IL-6 did not differ between two groups. 2) The patient group showed significantly higher level of serum cortisol as well as higher degrees of depression and stress. 3) Positive correlation was noted between depression and serum cortisol, and between depression and IL-2. A trend of negative correlation was seen between depression IL-$1\beta$. Positive correlation was noted between SRE and IL-6 and IL-6 and serum cortisol. Conclusions : It was concluded that FGID might be related to depression and stress. Changes of the interleukins might be involved with elevated cortisol level.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.7 no.1
• /
• pp.54-60
• /
• 2004

Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.47 no.2
• /
• pp.205-212
• /
• 2020

The purpose of this study is to evaluate the validity of primary anterior zirconia crown made with Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) technology by analyzing fracture strength and translucency parameter. Zirconia crown was designed with CAD software, using 3D scanned data of #61 tooth model. Crown fabrication was performed with CAM machine using zirconia block. Zirconia crowns were divided into 3 groups according to thickness(0.3, 0.5, and 0.7 mm), and fracture strength was compared with 1.0 mm thickness of resin strip crown. The compressive force was applied with universal testing machine at 30° along the incisal edge at increments of 1 mm/min. For translucency evaluation, 0.3, 0.5, and 0.7 mm thickness of zirconia specimens were fabricated and translucency was measured with spectrophotometer. Among zirconia groups, there was a significant increase in fracture strength as thickness increased (p < 0.05). The fracture strength of zirconia crown was significantly higher than resin strip crown in all groups (p < 0.05). Translucency parameter was highest in 0.3 mm group, and significantly decreased as thickness increased to 0.5 and 0.7 mm (p < 0.05). Thin primary anterior zirconia crown can be designed and fabricated according to individual needs by using CAD/CAM. Restoration with thin crown would reduce the amount of tooth reduction, risk of pulp exposure, and make more esthetic restoration possible.

• Korean Journal of Plant Taxonomy
• /
• v.51 no.3
• /
• pp.205-249
• /
• 2021

This study was carried out to survey the flora of Hongdo Island in Sinan-gun, Jeollanam-do, South Korea. Specimens collected from previous Hongdo flora studies were reexamined using a relevant biodiversity database, and field surveys were carried out 22 times from April of 2003 to October of 2020. Based on the specimens collected during both previous studies and this study, the identified vascular plants of Hongdo consisted of 472 taxa comprising 102 families, 296 genera, 425 species, 6 subspecies, and 41 varieties. Among them, 111 taxa are newly recorded in this study, and 6 taxa are described in detail in terms of their morphological characteristics and habitat. Also, 29 taxa were reviewed or re-identified with corresponding taxonomic annotations. In Korea, Hongdo represents the northern distributional limit of the 4 taxa of Goodyera biflora, Damnacanthus major, Calanthe aristulifera, and Hemerocallis hongdoensis. Moreover, Hosta yingeri and Saussurea polylepis are endemic to Hongdo and nearby islands in Korea. Distribution maps of these species were prepared. Protected species designated by the Ministry of Environment were 7 taxa consisting of 2 taxa of level I, specifically Sedirea japonica and Neofinetia falcata, and 5 taxa of level II, which were Cymbidium macrorhizon, Woodwardia japonica, Dendrobium moniliforme, Calanthe aristulifera, and Bulbophyllum inconspicuum. Red list plants as designated by the National Institute of Biological Resources numbered 11 taxa. Naturalized plants numbered 40 taxa.

• Journal of the Korean Applied Science and Technology
• /
• v.37 no.4
• /
• pp.659-673
• /
• 2020

The purpose of this study was to identify the effectiveness of the 8-week telephone counseling hypertension self-management program provided through welfare center nurses and nursing student volunteers for hypertensive patients with physical disabilities and brain lesions who use the welfare centers for the disabled. A quasi-experimental with non-equivalent control group pretest-posttest design was implemented. From December 2019 to May 2020, data from 28 controls and 29 experimental groups who completed pre and post-investigation were analyzed using the SPSS program. As a result of the main study, after the intervention, the knowledge of hypertension, seriousness and sensitivity among the health beliefs, and quality of life EQ-VAS indicated significant difference between the experimental group and the control group. Therefore, efforts to improve self-care behaviors and quality of life by applying various self-care programs to hypertensive patients with the disabled which require long-term health care will be needed continuously.