• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.28 no.4
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• pp.382-392
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• 2018

Objective: Allergic diseases such as asthma due to fungal exposure in houses have increased, and proper management is urgent. Mold can grow in the air, floor, walls, and other areas according to environmental conditions, and there are many limitations to the conventional methodology for examining fungal exposure. For this reason, the degree of fungal contamination is being evaluated by ERMI (Environmental Relative Moldiness Index), a quantitative analysis method proposed by the EPA. In this study, we compared ERMI values between water-damaged dwellings and non-damaged ones to evaluate the effectiveness of Korean ERMI values. We also explored the association of ERMI values with the level of airborne mold and characteristics of dwellings. Methods: Floor dust was collected after installing a Dustream collector on the suction port of a vacuum cleaner. The collected samples were filtered to remove only 5 mg of dust, and DNA was extracted using the FastDNA SPIN KIT protocol. Results: The ERMI values were found to be 19.6 (-6.9-58.8) for flooded houses, 7.5 (-29.2-48.3) for leaks/condensation, and 0.8 (-29.2-37.9) for non-damaged dwellings. The airborne concentration of mold for flooded, leakage or condensed, and non-damaged houses were $684CFU/m^3$, $566CFU/m^3$, and $378CFU/m^3$, respectively. The correlation between ERMI values and the levels of airborne mold was low (R = 0.038), but a weakly significant association of the ERMI values with the concentration of particulate matter ($PM_{10}$) was observed as well(R=0.231,P<0.05). Conclusions: Our findings show that the reference value using ERMI can be used to distinguish water-damaged and non-damaged dwellings. It is believed that ERMI values could be a promising tool for assessing long-term fungal exposure in dwellings.

• 한국노년학
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• v.31 no.3
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• pp.607-621
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• 2011

Purpose The purpose of this study was to examine the relationship between physical activities, sleep disturbance, and health related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). Methods A descriptive survey design used pretest dataset of COPD symptom management intervention study (N=245). Measures included the international physical activity questionnaire, the COPD and asthma sleep impact scale, and the St. George's respiratory questionnaire of HRQOL. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and simultaneous multiple regression by the SPSS WIN 18.0 program. Results The mean scores (SD) of HRQOL and sleep disturbance were 36.04 (19.43) and 14.33 (6.20), respectively. About 32% of participants were physically inactive. The multivariate approach showed the patients who have more sleep disturbance (β=.27), lower levels of FEV1 % predicted (β=-.23), lower physical activities (β=-.19), lower household income (β=-.16), and diagnosed longer than 5 years (β=.14) reported lower HRQOL (R²=.34). Conclusion The findings of this study suggest that improving the quality of sleep and physical activities can be efficient strategies for HRQOL in patients with COPD. Future research in enhancing HRQOL through improving sleep quality and physical activities is needed.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.407-416
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• 1992

Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.

• Applied Microscopy
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• v.38 no.3
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• pp.167-174
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• 2008

Atopic dermatitis (AD) is a chronically relapsing inflammatory skin disease that often has asthma and allergic rhinitis. Magnesium salts, the important component of minerals in Dead Sea water, are known to exhibit beneficial effects in inflammatory disease. Favorable effects of magnesium ions and sea water treated to the skin of patients with contact dermatitis have been reported. But histological and immunological investigations are insufficient. This study was performed to examine the inhibitory effect of magnesium-rich sea mineral water on the development of AD-like skin lesions in hairless mice. AD-like skin lesions are induced by the repeated application of 2,4-dinitrochlorobenzene (DNCB). Local application of magnesium-rich sea mineral water on hairless mice skin applied with DNCB inhibited the development of AD-like skin lesions as exemplified by a significant increase in skin hydration (p<0.01), and a decrease in epidermal water loss (p<0.01). Serum IgE level was also significantly decreased (p<0.01). These results suggest that magnesium-rich sea mineral water inhibits the development of DNCB-induced AD-like skin lesions in hairless mice. These observations indicate that magnesium-rich sea mineral water may be alternative and assistant substances for the management of AD.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.1
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• pp.44-53
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• 2006

This study purposed to investigate air pollution in car shipping yards and, for this purpose, we selected an outdoor open-air yard and an indoor ramp into the ship and measured the concentrations of sulfur dioxide, nitrogen dioxide, carbon monoxide, PM10, PM2.5 and heavy metals in the air. The results of this study are as follows. No significant difference was observed in temperature and humidity between the outdoor and indoor workshop, and the average air flow was 0.52 m/s in the indoor workshop, which is higher than 0.19 m/s in the outdoor workshop(p<0.01). The average concentrations of sulfur dioxide, nitrogen dioxide, carbon monoxide, PM10 and PM2.5 according to workplace were 0.03 ppm(${\pm}0.01$), 0.03 ppm(${\pm}0.01$), 0.46 ppm(${\pm}0.22$), $39.44{\mu}g/m^3$(${\pm}2.45$) and $5.45{\mu}g/m^3$(${\pm}1.15$) respectively in the outdoor workshop, and 0.15 ppm(${\pm}0.05$), 0.22 ppm(${\pm}0.06$), 8.85 ppm(${\pm}3.35$), $236.39{\mu}g/m^3$(${\pm}58.21$) and $152.43{\mu}g/m^3$(${\pm}35.42$) respectively in the indoor workshop. Thus, the concentrations of gaseous substances in the indoor workshop were 4.9-19.2 times higher than those in the outdoor workshop, and the concentrations of fine dusts were 5.9-27.9 times higher(p<0.01). In addition, according to the result of investigating pollutant concentrations according to displacement and the number of car loaded when shipping gasoline cars into the ship, no significant relation between the number of cars loaded and pollutants was observed in shipping passenger cars, but the concentrations of nitrogen dioxide and carbon monoxide got somewhat higher with the increase of the number of cars loaded(p<0.05). In addition, the concentrations of nitrogen dioxide, carbon monoxide, PM10 and PM2.5 in the air were significantly higher when shipping recreational vehicles, the displacement of which is larger than passenger cars, than when shipping passenger cars(p<0.01). On the other hand, the average heavy metal concentrations of the air in indoor workshop were: lead $-0.05{\mu}g/m^3$(${\pm}0.10$); chromium $-0.90{\mu}g/m^3$(${\pm}0.18$); zinc $-0.38{\mu}g/m^3$(${\pm}0.24$); copper $-0.18{\mu}g/m^3$(${\pm}0.22$); and manganese and cadmium not detected. In addition, the complaining rates of 'asthma,' a major symptom of chronic respiratory diseases, were 18.5% and 22.5% respectively in indoor workers and outdoor workers. Thus the rate was somewhat higher in indoor workers but the difference was not statistically significant. The complaining rates of 'chronic cough' and 'chronic phlegm' were very low and little different between indoor and outdoor workers. The results of this study show that the reason for the higher air pollution in indoor than in outdoor workshop is incomplete combustion of fuel due to sudden start and over-speed when cars are driven inside the ship. In order to prevent high air pollution, efficient management measures should be taken including the observance of the optimal speed, the improvement of old ships and the installation of efficient ventilation system.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.622-628
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• 2007

Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.298-308
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• 1997

Background : Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. Methods : The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. Results : The PEFR measured with MPFM was significantly related to the PEFR and $FEV_1$ measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r = 0.92 ; p < 0.001 ; for $FEV_1$, r = 0.78 ; p < 0.001). The accuracy of MPFM was within 100(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being 16.5L/min(percentage of difference being 2.90%) or 10.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or 20.49~+9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p > 0.05) and the coefficient of variation($2.4{\pm}1.2%$) of PEFR measured with MPFM was significantly lower than that($5.2{\pm}3.5%$) with standard pneumotachygraph in normal (p < 0.05). Conclusion : This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.220-225
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• 2006

Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.37-46
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• 2022

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.