• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.1-10
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• 1994

Background: Patients with mitral stenosis(MS) have been demonstrated to have a variable degree of pulmonary dysfunction and exercise impairment. The hemodynamic changes of MS can be reversed after percutaneous mitral balloon valvuloplasty(PMV), but the extent and time course of the imporvement in pulmonary function and exercise capacity are not defined. Methods: In order to investigate the early(3 weeks or less)and late(3 months or more) effects of PMV on pulmonary function and determine if the pulmonary dysfunction is reversible even in patients with moderate to severe pulmonary hypertension, we performed the spirometry, measurements of diffusing capacity and lung volumes, and incremental exercise tests in patients with MS before and after PMV. Results: In 46 patients with MS(age: $40{\pm}12$years, male to female ratio: 1:2, mitral valve area: $0.8{\pm}0.2cm^2$) there was a significant increase in FVC(P<0.0025), $FEV_1$(P<0.001), $FEF_{25-75%}$(P<0.001, $FEF_{50%}$(P<0.001), PEF(P<0.0005), MVV(P<0.005), $\dot{V}O_2$max (P<0.0001), and AT(P<0.0001) after average 10 days of PMV. Also there was a significant decrease in DLco(P<0.0001) and DL/VA(P<0.0001). At later($5{\pm}2$months) follow-up in 11 patients, there was no further improvement in any parameters of pulmonary function and exercise test. Twenty nine patients with sinus rhythm were divided into 16 patients with pulmonary arterial pressure(PAP) more than 35mmHg and/or tricuspid regurgitation grade n or more(group A) and 13 patients with PAP less than 35mmHg(group B). Group A Patients had significantly lower FVC(P<0.001), $FEV_1$(P<0.001), DLco(P<0.05), $\dot{V}O_2$ max(P<0.025) and mitral valve area(P<0.025) than group B patients. Group A patients after PMV, showed significant increase in FVC(P<0.001), maximum $O_2$ pulse(P<0.00001) and $\dot{V}O_2$ max(P<0.00025). Both group showed an increase in AT(P<0.0001, P<0.005), but group A showed greater decrease in $\dot{V}E/\dot{V}O_2$ and $\dot{V}E/\dot{V}CO_2$ both at AT(P<0.001, P<0.001) and $\dot{V}O_2$ max(P<0.0001, P<0.0001) after PMV compared with group B. Conclusion: These data suggest that patients with MS can show increased pulmonary function and exercise performance within 1 month after PMV. Patients with moderate to severe pulmonary hypertension had a significant increase in exercise performance compared with those with mild to no pulmonary hypertension and it is thought to be related to a significat decrease of ventilation for a given oxygen consumption at maximum exercise.

• Journal of The Korean Society of Grassland and Forage Science
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• v.3 no.2
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• pp.100-111
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• 1983

The research results reported herein had the objectives to understand and analyze the present problems of saemaeul woodland joint cattle grazing system in Kang Won Do and to take steps of improvement. The study results on actual management conditions, problems analyzed and improvement plan of total 208 joint cattle grazing area which was established 105 area in 1981 and 103 area in 1982 were summarized as follows: 1. the effectiveness of joint cattle grazing projects 1) Average daily weight gain of cattle during joint cattle grazing period was 0.4kg, showing higher daily than the conventional feeding of 0.33kg. 2) Increase of total farm income over the conventional feeding system were \1,031,357,320 during the grazing period from May to October in 1982 by adapting the 208 joint cattle grazing system, of which effectiveness of weight gain was \293,075,300 and labor saving was \543,838,750. 3) According to the results of questionaire investigation from 208 joint cattle grazing area, effectiveness of joint cattle grazing system over the conventional system were (1) labor saving, (2) feed cost saving, (3) reduced diseases, (4) increase of number of feeding, (5) inspiration of joint endeavor, (6) effect of more gain, (7) easiness of feeding and feed cost savings. 2. Problems of joint cattle grazing system. 1) Shortages of grass were a problem at second year of joint cattle grazing period due to the low regrowth rate of wild grass. 2) Proper land for woodland joint cattle grazing is belonging to land of Government ownership and it is very hard to get the permission from office of forestry for cattle grazing purpose. 3) It is also difficult to find a proper time of breeding in grazing area by the difficulty of estrus detection. 4) There are a difficulty to give a proper vaccination and medical examination for the grazing cattle. 3. Improvement plans for woodland joint cattle grazing projects. 1) Obtain sufficient roughages by hoof cultivation and oversowing pasture from the second year of joint cattle grazing period. 2) In order to increase the beef production and to use for a calf production area, Government should arrange that all proper grazing land of Government owned in Kang Won Do convert into woodland joint cattle grazing area. 3) Make a good reproductive record by mixed grazing with a excellent breeding cow in a remote area. And carry out the collective artificial insemination with synchronous puberty induced by injection of puberty stimulation hormone. 4) Make a preventive injection for blackleg, twice medication of fasciola hepatica in a year, and spray and medication of tick insecticide. 4. A policy towards upbringing of woodland joint cattle grazing area. 1) Government should thoroughly investigate about a proper land for woodland joint cattle grazing from all forests. 2) When the area is suitable for the woodland joint cattle grazing, though it is national forest or restricted area, government should make it possible to establish a grazing area. 3) On the proper land foe joint cattle grazing in the remote place, Government should support for the road construction and electric fence equipments by using of national funds. 4) There should be an administrative consideration for well promotion of the project that make woodland joint cattle grazing suitable to the characteristics of Kang Won Do. 5) In order to improve the reproduction record, Government should reform the insufficiency of artificial insemination in the joint cattle grazing area. 6) In order to maintain a proper price of cow, Government should carry out the price plan. 7) When there is any request for grassland formation in the woodland joint cattle grazing area, Government should permit it with preference.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.6
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• pp.729-737
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• 2008

The purposes of this study were to investigate supporting status and subsidy for school food service and to analyze the perception of school food service officials at the educational board on using rice bread to the school food service menu. The questionnaire was developed by content analysis, situation analysis, in-depth interview and checked by the school food service officials at the educational board. The questionnaires were responded by 33 officials (respondent rate: 86.8%) during September 1 to October 26 in 2007. The major findings of this study were as follows: First, most of the respondents were women (93.9%), and worked an average of 104.36 months at school-related work. The metropolitan & provincial office of education had prevalently jurisdiction over 272.3 rural and self-operation type of elementary schools, 115.50 rural and self-operation type of middle schools and 73.0 rural and self-operation type of high schools. In the case of the district office of education, 23.3 urban and self-operation type of elementary schools, 11.6 urban and self-operation type of middle schools and 5.3 urban and contracted type of high schools were averagely managed. Second, all the respondents supported meal cost for low-income group and 50.5% provided reimbursement for organic environmental agricultural products. The highest subsidy was 16.8 billion won as meal cost for low-income group in metropolitan & provincial office and 1,050 million won as labor cost in district office. Third, the experience of performing policies for using rice was relatively lower than perception of rice bread application to school food service menu. Fourth, the advantages of using rice bread were acceleration of consuming rice (32.0%), excellence of nutrition (24.0%) and promotion of healthy image (22.7%). On the other hand, the difficulties of using rice bread were lack of facilities (72.7%), higher cost compared to wheat bread (54.5%), limitation of menu application and cooking method (15.7% each). Fifth, the opinion of utilizing rice and that of applying rice bread were significantly correlated (p<0.001). Desirability and willingness were correlated with reality for applying rice bread to the school food service menu (p<0.001). Also, comparative analysis between divided groups by perception of utilizing rice showed that willingness and experience were significantly different.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.2
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• pp.403-425
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• 2015

The Chicago Convention and Annexes have become the basis of aviation safety regulations for every contracting state. Generally, the State's aviation safety regulations refer to the Standards and Recommended Practices(SARPs) provided in the Annexes of the Chicago Convention. In order to properly reflect international aviation safety regulations, constant studies of the aviation fields are of paramount importance. This Paper is intended to identify the main differences between korean and foreign regulation and suggest a few amendment proposals on Mixed-fleet Flying(at or more two aircraft type operation) of flight crew. Comparing with these regulations, the korean regulations and implementations have some insufficiency points. I suggest some amendment proposals of korean regulations concerning Mixed-fleet Flying that flight crew operate aircraft of different types. Basically an operator shall not assign a pilot-in-command or a co-pilot to operate at the flight controls of a type of airplane during take-off and landing unless that pilot has operated the flight controls during at least three take-offs and landings within the preceding 90 days on the same type of airplane or in a flight simulator. Also, flight crew members are familiarized with the significant differences in equipment and/or procedures between concurrently operated types. An operator shall ensure that piloting technique and the ability to execute emergency procedures is checked in such a way as to demonstrate the pilot's competence on each type or variant of a type of airplane. Proficiency check shall be performed periodically. When an operator schedules flight crew on different types of airplanes with similar characteristics in terms of operating procedures, systems and handling, the State shall decide the requirements for each type of airplane can be combined. In conclusion, it is necessary for flight crew members to remain concurrently qualified to operate multiple types. The operator shall have a program to include, as a minimum, required differences training between types and qualification to maintain currency on each type. If the Operator utilizes flight crew members to concurrently operate aircraft of different types, the operator shall have qualification processes approved or accepted by the State. If applicable, the qualification curriculum as defined in the operator's Advanced Qualification Program could be applied. Flight crew members are familiarized with the significant differences in equipment and/or procedures between concurrently operated types. The difference among different types of airpcrafts decrease and standards for these airpcrafts can be applied increasingly because function and performance have been improved by aircraft manufacture company in accordance to basic aircraft system in terms of developing new aircrafts for flight standard procedure and safety of flight. Also, it becomes more necessary for flight crews to control multi aircraft types due to various aviation business and activation of leisure business. Nevertheless, in terms of flight crew training and qualification program, there are no regulations in Korea to be applied to new aircraft types differently in accordance with different levels. In addition, it has no choice different programs based on different levels because there are not provisions to restrict or limit and specific standards to operate at or more than two aircraft types for flight safety. Therefore the aviation authority introduce Flight Standardization and/or Operational Evaluation Board in order to analysis differences among aircraft types. In addition to that, the aviation authority should also improve standard flight evaluation and qualification system among different aircraft types for flight crews to apply reasonable training and qualification efficiently. For all the issue mentioned above, I have studied the ICAO SARPs and some state's regulation concerning operating aircraft of different types(Mixed-fleet flying), and suggested some proposals on the different aircraft type operation as an example of comprehensive problem solving. I hope that this paper is 1) to help understanding about the international issue, 2) to help the improvement of korean aviation regulations, 3) to help compliance with international standards and to contribute to the promotion of aviation safety, in addition.

• Advances in pediatric surgery
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• v.8 no.2
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• pp.143-155
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• 2002

A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

• The Korean Journal of Air & Space Law and Policy
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• v.28 no.2
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• pp.223-258
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• 2013

1967 Outer Space Treaty(Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space, including the Moon and Other Celestial Bodies; OST) is a treaty that forms the basis of international space law. OST is based on the 1963 Declaration of Legal Principles Governing the Activities of States in the Exploration and Use of Outer Space announced by UNGA resolution. As of May 2013, 102 countries are states parties to OST, while another 27 have signed the treaty but have not completed ratification. OST explicitly claimed that the Moon and Other Celestial Bodies are the province of all mankind. Art. II of OST states that "outer space, including the Moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means", thereby establishing res extra commercium in outer space like high seas. However 1979 Moon Agreement stipulates that "the moon and its natural resources are the Common Heritage of Mankind(CHM)." Because of the number of the parties to the Moon Agreement(13 parties) it does not affect OST. OST also established its specific treaties as a complementary means such as 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention. OST bars states party to the treaty from placing nuclear weapons or any other weapons of mass destruction in orbit of Earth, installing them on the Moon or any other celestial body, or to otherwise station them in outer space. It exclusively limits the use of the Moon and other celestial bodies to peaceful purposes and expressly prohibits their use for testing weapons of any kind, conducting military maneuvers, or establishing military bases, installations, and fortifications. However OST does not prohibit the placement of conventional weapons in orbit. China and Russia submitted Draft Treaty on the Prevention of the Placement of Weapon in Outer Space and of the Threat or Use of Force against Outer Space Objects(PPWT) on the Conference on Disarmament in 2008. USA disregarded PPWT on the ground that there are no arms race in outer space. OST does not have some articles in relation to current problems such as space debris, mechanisms of the settlement of dispute arising from state activities in outer space in specific way. COPUOS established "UN Space Debris Mitigation Guidelines" based on "IADC Space Debris Mitigation Guidelines" and ILA proposed "International Instrument on the Protection of the Environment from Damage Caused by Space Debris" for space debris problems and Permanent Court of Arbitration(PCA) established "Optional Rules for Arbitration of Disputes Relating to Outer Space Activities" and ILA proposed "1998 Taipei Draft Convention on the Settlement of Space Law Dispute" for the settlement of dispute problems. Although OST has shortcomings in some articles, it is very meaningful in international law in considering the establishment of basic principles governing the activities of States in the exploration and use of outer space, including the Moon and Other Celestial Bodies. OST established the principles governing the activities of states in the exploration and use of outer space as customary law and jus cogens in international law as follows; the exploration and use of outer space shall be carried out for the benefit and in the interests of all countries and shall be the province of all mankind; outer space shall be free for exploration and use by all States; outer space is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means. The principles of global public interest in outer space imposes international obligations erga omnes applicable to all States. This principles find significant support in legal norms dealing with following points: space activities as the "province of all mankind"; obligation to cooperate; astronauts as envoys of mankind; avoidance of harmful contamination; space activities by States, private entities and intergovernmental organisations; absolute liability for damage cauesd by certain space objects; prohibition of weapons in space and militarization of the celestial bodies; duty of openness and transparency; universal application of the international space regime.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.6
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• pp.84-97
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• 2016

This study was to investigate the user's thermal environments of the children's parks according to pavements and sunscreen types during periods of heat waves. The measurements were conducted at the sand pits, rubber chip pavement, shelters, and green shade ground of the two children's parks located in Jinju, Korea(Chilam: $N\;35^{\circ}11^{\prime}1.4{^{\prime}^{\prim}}$, $E\;128^{\circ}5^{\prime}31.7{^{\prime}^{\prime}}$, elevation 38m, Gaho: $N\;35^{\circ}09^{\prime}56.8{^{\prime}^{\prime}}$, $E\;128^{\circ}6^{\prime}41.1{^{\prime}^{\prime}}$, elevation 24m) over three days during 11-13, August, 2016. The highest ambient air temperatures at the Jinju Meteorological Office during the three measurement days were $35.9{\sim}36.8^{\circ}C$, which corresponded with the extremely hot weather. A series of experiments measured air temperature, relative humidity, wind velocity, black globe temperature, and long-wave and short-wave radiation of the six directions 0.6 m above ground level. The wet bulb globe temperature(WBGT) and the universal thermal climatic index(UTCI) were used to evaluate thermal stress. Surface temperature images of the play equipment were also taken using infrared thermography. Surface temperatures of the play equipment and grounds were used to evaluate burn risk through contact with playground materials. The results showed the following. The maximum air temperatures averaged over 1-hour period for three days were $36.6{\sim}39.4^{\circ}C$. The sun shades reduced those temperatures by up to $2.8^{\circ}C$(green shade) and $1.0^{\circ}C/2.3^{\circ}C$(shelters). The minimum relative humidity values averaged over 1-hour period for three days were 44~50%. The sun shades increased those humidity values by up to 6%(green shade) and 4%/6%(shelters). The risk of heat related illness at the measurement sites of the children's parks were extreme and high in the daytime hours. The maximum WBGT values averaged over a 30-minute period for three days were $31.2{\sim}33.6^{\circ}C$. The sun shades reduced those WBGT values by up to $2.4^{\circ}C$(green shade) and $0.5^{\circ}C/2.1^{\circ}C$(shelters) compared to sandpits, but would not block the risk of heat related illness in the daytime hours. The category of heat stress at the measurement sites of the children's parks were extreme and very strong in the daytime hours. The maximum UTCI values averaged over a 30-minute period for three days were $39.9{\sim}48.1^{\circ}C$. The sun shades reduced those UTCI values by up to $7.8^{\circ}C$(green shade) and $4.1^{\circ}C/8.2^{\circ}C$(shelters) compared to sandpits, but could not lower heat stress category from extreme and very strong to strong and moderate in the daytime hours. According to the burn threshold criteria when skin was in contact with playground materials, the maximum surface temperature of the stainless steels($70.8^{\circ}C$) surpassed three seconds $60^{\circ}C$ threshold for uncoated steel, that of the rubber chip($76.5^{\circ}C$) surpassed five seconds $74^{\circ}C$ threshold for the plastic, that of the plastic slide($68.5^{\circ}C$) and seats($71.0^{\circ}C$) surpassed the one min $60^{\circ}C$ threshold for plastic, respectively. The surface temperatures of shaded play equipment were lower approximately $20^{\circ}C$ than those of play equipment exposed to the sun. Therefore, sun shades can block the risk of burns in daytime hours. Because of the extreme and high risk of heat related illness and extreme and high heat stress at the children's parks during periods of heat waves, parents and administrators must protect children from the use of playgrounds. The risk of burn when contact with play equipments and grounds at the children's parks during periods of heat waves, was very high. The sun shades are essential to block the risk of burn from play equipments and grounds at the children's parks during heat waves.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.107-126
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• 1991

The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of the urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follows : The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.555-568
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• 1995

Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.631-637
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• 1993

Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.