• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1040-1050
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• 1997

Pulmonary rehabilitation has been known to improve dyspnea and exercise tolerance in patients with chronic lung disease, although it does not improve pulmonary function. The mechanism of this improvement is not clearly explained till now; however some authors suggested that the improvement in the skeletal muscle metabolism after the rehabilitation could be a possible mechanism. The metabolc changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation which causes early activation of anaerobic glycolysis and excess lactate production with exercise. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the improvement in the exercise tolerance after the rehabilitation, noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) of the forearm flexor muscle was performed before and after the exercise training in nine patients with chronic lung disease who have undertaken intensive pulmonary rehabilitation for 6 weeks. 31p MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and then 30% of MVC force was constantly loaded to each patient during the isometric exercise. After the exercise training, exercise endurance of upper and lower extremities and 6 minute walking distance were significantly increased(p<0.05). There were no differences of baseline intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr). After rehabilitation pHi at the exercise and the exhaustion state showed a significant increase($6.91{\pm}0.1$ to $6.99{\pm}0.1$ and $6.76{\pm}0.2$ to $6.84{\pm}0.2$ respectively, p<0.05). Pi/PCr at the exercise and the recovery rate of pHi and Pi/PCr did not show significant differences. These results suggest that the delayed intracellular acidosis of skeletal muscle may contribute to the improvement of exercise endurance after pulmonary rehabilitation.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.861-870
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• 1997

Background : Though acute respiratory distress(ARDS) often occurs in the early stage of severe acute pancreatitis and significantly contributed to the mortality of the condition, the characteristics of the group who develops ARDS in the patients with acute pancreatitis have not been fully found. The objective of this investigation was to identify predictable factors which distinguish a group who would develop ARDS in the patients with acute pancreatitis. Method : A retrospective analysis of 94 cases in 86 patients who were admitted the Medical Intensive Care Unit with acute pancreatitis was done. ARDS were developed in 13 cases among them (13.8%). The possible clinical factors related to the development were analyzed using univariate analysis and $x^2$-test. Results : The risk of ARDS development was increased in the patients with abonormal findings of chest X-ray at admission compared to the patients with normal chest X-ray (p<0.05). The risk was also increased according to the sevecrity index score in abdominal computed tomography at the time of admission (p<0.05). The higher APACHE III score of the first day of admission, the more risk increment of ARDS development was observed (p<0.01). Patients with more than one points of Murray's lung injury score showed higher risk of ARDS compared to the patients with 0 points of that. The patients with sepsis and the patients with more than three organ dysfunction at admission had 3.5 times and 23.3 times higher risk of the development of ARDS compared to the patients without sepsis and without organ failure in each (p<0.05, p<0.01). Conclusion : The risk of ARDS development would be higher in the acute pancreatitis patients with abnormal chest X-ray, higher CT severity index, higher APACHE III or Murray's lung injury score, accompanying sepsis, and more than three organ failure at admission.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.210-222
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• 2000

Background: Endothelin(ET) is the most potent vasoconstrictor and bronchoconstrictor. The plasma ET-1 level is elevated in patients with acute pulmonary thromboembolism(APTE). This finding suggest that ET-1 may be an important mediator in the cardiopulmonary derangement of APTE. But whether ET-1 is a pathogenic mediator or a simple marker of APTE is not known. The role of ET-1 in the pathogenesis of cardiopulmonary dysfunction in APTE(delete) was investigated through an evaluation of the effects of $ET_A$-receptor antagonist on APTE. The increase in local levels of preproET-1 mRNA and ET-1 peptide in the embolized lung was also demonstrated. Methods: In a canine autologous blood clot pulmonary embolism model, $ET_A$-receptor antagonist(10 mg/kg intravenously, n=6) was administered one hour after the onset of the embolism. Hemodynamic measurements, blood gas tensions and plasma levels of ET-1 immunoreactivity in this treatment group were compared with those in the control group(n=5). After the experiment., preproET-1 mRNA expression(using Northern blot analysis) and the distribution of ET-1(by immunohistochemical analysis) in the lung tissues were examined. Results: The increases in pulmonary arterial pressure and pulmonary vascular resistance of the treatment group were less than those of the control group. Decrease in cardiac output was also less in the treatment group. Complications such as systemic arterial hypotension and hypoxemia did not occur with the administration of $ET_A$-receptor antagonist The plasma level of ET-1 like(ED: what does 'like' mean?) immunoreactivity was increased after embolization in both groups but was significantly higher in the treatment group. The preproET-1 mRNA and ET-1 peptide expressions were increased in the embolized lung. Conclusion: ET-1 synthesis increases with embolization in the lung and may plays play an important role in the pathophysiology of cardiopulmonary derangement of APTE. Furthermore, $ET_A$-receptor antagonist attenuates cardiopulmonary alterations seen in APTE, suggesting a potential benefit of this therapy.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.236-245
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• 2000

Background: Transbronchial lung biopsy(TBLB) has known to yield useful information for pulmonary infiltrates of uncertain etiology, However, its safety and usefulness have not been conclusive in the critically ill patients with respiratory failure. Moreover, TBLB has not been recommended for patients with mechanical ventilation. This study was conducted to investigate the diagnostic values and risks of Will performed on critically ill patients at bedside to obtain information on the pulmonary infiltrate of unknown etiology. Methods: Twenty patients(21 admissions with 23 cases) with diffuse pulmonary infiltrates who were treated in a medical intensive care unit of a tertiary referral hospital from January 1994 to May 1998, were enrolled for the study. Their medical records were retrospectively reviewed. TBLB was opted when a noninvasive diagnostic work-up failed to reveal the cause for the pulmonary infiltrate. The procedure was performed at patients' bedside without assistance of fluoroscopy. Bronchial washing or bronchoalveolar lavage was performed on the same pulmonary segment before performing TBLB. Results: Adequate specimens were obtained in 18 cases(78%). TBLB provided a specific diagnosis in two cases. The results of TBLB suggested the underlying etiology in 9 cases; bacterial pneumonitis(4), hypersensitivity pneumonitis(1), polymyositis(1), radiation fibrosis(1), idiopathic pulmonary fibrosis(1), and BOOP(1). Therapeutic decisions were altered in 11 cases(47.8%) based on the TBLB results. Pneumocystis carinii was found in the BAL fluid of another case. Ten patients with a therapeutic change and ten patients without a management change had mortality rates of 40% and 80%, respectively. The APACHE III scores were significantly higher in patients with complications($72.8{\pm}21.8$) compared with those without complications ($48.3{\pm}18.9$)(p<0.05). The complication rates were higher in those with mechanical ventilation(50%) than in those without Mechanical ventilation(33%), but the difference was not statistically significant(p=0.3). Conclusions: TBLB may be a useful diagnostic option for critically ill patients with unknown cause of pulmonary infiltrates. However, it should be cautious be used with care for patients with mechanical ventilation or for severely ill patients.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.419-424
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• 2004

Background : Although bronchodilator reversibility testing is widely performed to diagnose asthma or COPD, there is debate upon its usefulness and methods to differentiate asthma from COPD. The purpose of this study is to elucidate the role of bronchodilator reversibility testing in differentiating asthma from COPD and to confirm which method is better at evaluating bronchodilator reversibility. Methods : 26 asthma patients and 31 COPD patients were reviewed retrospectively. Spirometry was performed before and after bronchodilator inhalation to get $FEV_1$, FVC. To evaluate bronchodilator reversibility, the increase in $FEV_1$ or FVC was expressed as three methods, 'percentage of the baseline value', 'percentage of the predicted value', or 'absolute value'. Area under the ROC curve was measured to compare the three methods. In addition, the criteria of American Thoracic Society (ATS) for bronchodilator reversibility were compared to those of European Respiratory Society (ERS). Results : 1. In differentiating asthma from COPD, 'percentage of the predicted value', or 'absolute value' method was useful but 'percentage of the baseline value' was not. However, the ability to differentiate was weak because areas under the ROC curves by all methods were less than 0.75. 2. The criteria of ERS were superior to those of ATS for bronchodilator reversibility to differentiate asthma from COPD because likelihood ratio (LR) of a positive test by ERS criteria was greater than ATS criteria and because LR of a negative test by ERS criteria was less than ATS criteria. Conclusion : In differentiating asthma from COPD, bronchodilator reversibility testing has a weak role and should be considered as an adjunctive test.

• Journal of Environmental Policy
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• v.5 no.1
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• pp.45-70
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• 2006

China has achieved great economic growth above 9% annual since it changed to more of a market economy system by its reform and open-door policy. At the same time, China has experienced severe ecological deterioration, such as air and water pollutions caused by its rapid urbanization and industrialization. China is now confronted with environmental pollution and ecological deterioration at a critical point, at which economic development in China is limited. Moreover, environmental problems in China have become a lit fuse for social fluctuation beyond pollution problems. The root and background of environmental problems in China, firstly, are its government's lack of understanding of these problems and incorrect economic policies affected by political and ideological prejudice. Secondly, the plundering of resources, 'the principle of development first' which didn't consider environmental sustainability is another source of environmental deterioration in China. In addition, a huge population and poverty in China have increased the difficulty in solving its environmental problems, and in fact have accelerated them. The Chinese government has established many environmental laws and institutions, increased environmental investments, and is enlarging the participation of NGOs and the general public in some limited scale to solve its environmental problems. However, it has not obtained effective results because of the lack of environmental investments owing to the government's limit of the development phase, a structural limit of law enforcement and local protectionism, and the limit of political independency in NGOs and the lack of public participation in China. It seems that China remains in the stage of 'economic development first, environmental protection second', contrary to its catch-phrase of 'the harmony between economic development and environmental protection'. China is now confronted with dual pressure both domestically and abroad because of deepening environmental problems. There are growing public's protests and demonstrations in China in response to the spread of damage owing to environmental pollution and ecological deterioration. On the other hand, international society, in particular neighboring countries, regard China as a principal cause of ecological disaster. In the face of this dual pressure, China is presently contemplating a 'recycling economy' that helps sustainable development through the structural reform of industries using too much energy and through more severe law enforcement than now. Therefore, it is desirable to promote regional cooperation more progressively and practically in the direction of building China's ability to solve environmental problems.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

• Journal of Sericultural and Entomological Science
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• v.26 no.2
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• pp.11-15
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• 1984

To save the labour reguired for separation of copulated moth during egg Production, some of the chemicals available at the market were on screen test for easy separation of copulated moth of silkworm. The obtained results are summarized as following. 1. In a separation ratio of copulated moth along with a treating time, TCTFE(Trichloro-trifluoroethane) completely separated the copulated moth in 10 minutes. The combinations of TCTFE plus Acetone (87.5 : 12.5 V/V) and TCTFE plus Acetic acid (50 : 50 V/V) take 25minutes for the complete separation of copulated moth. Use of Acetic acid solution only makes 100% separation of copulated moth in one hour and foully minutes and non$.$treatment shows only 47.5% of separation in three and half hours. On the other hand. There is no statistical significance between TCTFE Plus Acetone and control in the egg productivity. 2. The combination of TCTFE Plus Acetone (87.5 : 12.5 V/V) does not infuluence the egg productivity of the moth, showing 443 grains for an average number of egg per moth out of which 417 grains are for the number of fertilized eggs while control shows 452 grains for an avarage number of egg/moth and 428 grains for the number of fertilized eggs. However a sing1e use of TCTFE and Acetic acid shows less egg productivity and number of ferilized eggs per moth, respectively as compared to those of the control. In particular, a single use of acetic acid makes an increase of number of non-egg prodncible moth and it seems to be brought due to a chemical damage. 3. In a rearing test of the egg laid by the chemical treated moth, there are no differences among the treatments in all of the useful characters of the larvae; larval duration, survival rate, cocoon yield, single cocoon weight, single cocoon shell weight and cocoon shell ratio. In these regards, it is recognized that TCTFE can be practically used for the separation of copulated moth and the combination of TCTFE and Acetone promote its efiectiveness on the separation of copulated moth.

• Radiation Oncology Journal
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• v.13 no.2
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• pp.149-156
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• 1995

Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

• Korean Journal of Environmental Agriculture
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• v.11 no.1
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• pp.50-58
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• 1992

Studies were conducted to determine the combined effect of uniconazole [(E) -1-(4-chlorophenyl)-4, 4-demethyl 2-(1,2,4 triazol-1-yl)-1-penten-3-ol] and silver thiosulfate $[Ag {(S_2O_3)}^3\;_2-]$ (STS) on reduction of ozone injury in tomato plants(Lycopersicon esculentum Mill. 'Pink Glory'). Plants were given a 50ml soil drench of uniconazole at concentrations of 0, 0.001, 0.01 and 0.1 mg/pot at the stage of emerging 4th leaf. Two days prior to ozone fumigation, STS solution contained 0.05% Tween-20 was also sprayed at concentrations of 0, 0.3 and 0.6 mM. Uniconazole at 0.01 mg/pot and STS at 0.6 mM were effective in providing protection against ozone exposure(20h at 0.2ppm) without severe retardation of plant height and chemical phytotoxicity, respectively. Combined treatment with uniconazole, STS significantly reduced ozone injury at the lower concentration than a single treatment with uniconazole or STS. Uniconazole treatment reduced plant height, stem elongation and transpiration rate on a whole plant level and increased chlorophyll concentration. STS did not give any effect on plant growth and chlorophyll content but increased transpiration rate in non-ozone-fumigated plants. Ethylene production in the leaves of ozone-fumigated plants was decreased by uniconazole and STS pretreatment, but there was no protective effect on epinasty of leaves in uniconazole-treated plants. STS increased ethylene production in non-ozone-fumigated plants, but it significantly reduced the degree of epinasty and defoliation of cotyledons when plants were exposed to ozone. Uniconazole slightly increased superoxide dismutase and peroxidase activities. But STS showed little or no effects on such free radical scavengers. Day of flowering after seeding was shortened and percentages of fruit set were increased by uniconazole treatment. STS was highly effective on protecting reduction of fruit set resulting from ozone fumigation. These results suggest that combined use of uniconazole and STS should provide miximum protection against ozone injury without growth retardation resulting in yield loss.