• Title/Summary/Keyword: Restrictive

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Long-term Prognosis and Physiologic Status of Patients Requiring Ventilatory Support Secondary to Chest wall Disorders (흉벽질환에 의한 급성호흡부전 환자의 생리적 특성과 장기적인 예후)

  • Yoon, Seok Jin;Jun, Hee Jung;Kim, Yong Joo;Lee, Seung Jun;Kim, Eun Jin;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.265-272
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    • 2006
  • Background: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. Methods: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. Results: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean $PaCO_{2}$ of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the $PaCO_{2}$ level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. Conclusion: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.

Probability-based Pre-fetching Method for Multi-level Abstracted Data in Web GIS (웹 지리정보시스템에서 다단계 추상화 데이터의 확률기반 프리페칭 기법)

  • 황병연;박연원;김유성
    • Spatial Information Research
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    • v.11 no.3
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    • pp.261-274
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    • 2003
  • The effective probability-based tile pre-fetching algorithm and the collaborative cache replacement algorithm are able to reduce the response time for user's requests by transferring tiles which will be used in advance and determining tiles which should be removed from the restrictive cache space of a client based on the future access probabilities in Web GISs(Geographical Information Systems). The Web GISs have multi-level abstracted data for the quick response time when zoom-in and zoom-out queries are requested. But, the previous pre-fetching algorithm is applied on only two-dimensional pre-fetching space, and doesn't consider expanded pre-fetching space for multi-level abstracted data in Web GISs. In this thesis, a probability-based pre-fetching algorithm for multi-level abstracted in Web GISs was proposed. This algorithm expanded the previous two-dimensional pre-fetching space into three-dimensional one for pre-fetching tiles of the upper levels or lower levels. Moreover, we evaluated the effect of the proposed pre-fetching algorithm by using a simulation method. Through the experimental results, the response time for user requests was improved 1.8%∼21.6% on the average. Consequently, in Web GISs with multi-level abstracted data, the proposed pre-fetching algorithm and the collaborative cache replacement algorithm can reduce the response time for user requests substantially.

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Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis (비결핵성 기관지탄분섬유화증의 임상 양상)

  • Lee, Hee-Seub;Maeng, Joo-Hee;Park, Pae-Gun;Jang, Jin-Gun;Park, Wan;Ryu, Dae-Sik;Kang, Gil-Hyun;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.510-518
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    • 2002
  • Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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A Study on the Liability for Third Party's Damage on the Time Charter-parties (정기용선계약에서 제3자 화물손해 책임에 관한 연구)

  • Shin, Hak-Sung
    • International Commerce and Information Review
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    • v.15 no.2
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    • pp.285-313
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    • 2013
  • By the revision of the Commercial Code of Korea in 1991 and 2007, some provisions for the regulation of Time Charterparty have been introduced into our own maritime law system. But, those provisions are in their nature mainly the reproduction of the provisions prescribed in the standard forms of time charterparty which are widely used, such as BALTIME Charter and NYPE Form, and the subject matters of their regulation are restrictive, so that the applicability of the provisions is not desirable. The cargo is lost or damaged, the cargo owner should seek compensation form, or sue, the carrier as, traditionally, under the COGSA, the cargo carrier is responsible for loss of damage of cargo. However, it is difficult to determine who is the responsible carrier under charters. There is no test to determine the carrier, but the courts in every country generally consider the bill of lading. Although the master has general authority to sign bills of lading on behalf of the shipowner, he can also sign bills of lading for, and on behalf of, the charterer. In this case, the charter is considered the carrier. Furthermore, the charterer is authorized to contract with third parties on behalf of the shipowner and, as such, the responsible carrier is the shipowner. Therefore, when determining the carrier we should examine carefully the all factors and the circumstances surrounding the case. Also, negligence of a captain of a time-chartered ship causing damages to a third party. It will analyze the legal character of a time-charter contract, review judicial precedents on time-charter. The Inter-Club Agreement was drawn up and is intended to be a somewhat easier way of allocating liability for cargo claims between owners and charterers and, although there is still scope for disputes to arise, the Inter-Club Agreement does in fact to some extent make the allocation of liabilities for cargo claims easier. Finally, it will also make legislative suggestions to resolve complex issues involving maritime transportation contracts under the current Commercial Code.

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Association between the Number of Existing Permanent Teeth and Chronic Obstructive Pulmonary Disease (현존자연치아수와 만성폐쇄성폐질환과의 연관성)

  • Shin, Hye-Sun;Ahn, Yong-Soon;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.217-224
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    • 2016
  • The aim of this study was to evaluate whether the number of existing permanent teeth is associated with chronic obstructive pulmonary disease (COPD) in a representative sample of Korean adults. Data from 3,107 subjects who participated in the 2009 Korea National Health and Nutrition Examination Survey were examined. The dependent variable was COPD and the independent variable was the number of existing permanent teeth. Spirometry results were classified into three groups (normal pattern, restrictive pattern, and obstructive pattern) by trained technicians. We used dichotomized COPD variables (no vs. yes). The number of existing permanent teeth was evaluated by oral examination and divided into 3 groups (0~19, 20~27, and 28). Demographic factors (age group and sex group), socioeconomic status (education and income), health behaviors (smoking and drinking), oral health and behavior (frequency of toothbrushing; periodontitis; decayed, missing, filled, permanent teeth index; and denture status), and general health status (body mass index, diabetes mellitus, and hypertension) were included as confounders in the analysis. Bivariate analysis and multivariate logistic regression analyses including confounders were applied, and all analyses considered a complex sampling design. Stratified analysis was performed by smoking status. After controlling for various confounders, there was a significant association between the number of existing permanent teeth and COPD (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.20~3.00 for the 20~27 group; OR, 3.93; 95% CI, 1.75~8.84 for the 0~19 group). The association was more significant in current smokers (OR, 8.90; 95% CI, 2.53~31.33). Our data indicate that the number of existing permanent teeth was independently associated with COPD, especially in current smokers. Further longitudinal research is needed to determine whether oral health promotion plays a role in the improvement of lung function and prevention of COPD.

Clinical Characteristics of Diffuse Panbronchiolitis (미만성 범세기관지염의 임상상에 관한 연구)

  • Kim, Young-Whan;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.28-34
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    • 1992
  • Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.

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Effect of a New Spirometric Reference Equation on the Interpretation of Spirometric Patterns and Disease Severity (폐활량측정법의 새로운 정상예측식이 폐활량측정법 장애 양상 및 질병 중증도 해석에 미치는 영향)

  • Oh, Yeon-Mok;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae-Man;Koh, Younsuck;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Kim, Young Sam;Lee, Sang Do
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.215-220
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    • 2006
  • Background : A spirometric reference equation was recently developed for the general population in Korea. The applicability of the new Korean equation to clinical practice was examined by comparing it with the Morris equation, which is one of the most popular reference equations used for interpreting the spirometric patterns and for grading the disease severity in Korea. Methods : Spirometry was performed on 926 men and 694 women, aged 20 years or older, in November 2004 at the Asan Medical Center, Seoul, Korea. The subjects' age, gender, height, weight, and spirometric values ($FEV_1$ [forced expiratory volume in one second], FVC [forced vital capacity], and $FEV_1/FVC$) were obtained. The spirometric patterns and disease severity were evaluated using both equations, and the results of the Korean equation were compared with the Morris equation. The spirometric patterns were defined as normal, restrictive, obstructive, and undetermined according to the level of $FEV_1/FVC$ and FVC. The disease severity was defined according to the level of $FEV_1$ level for subjects with an airflow limitation, and according to the FVC level for those subjects without an airflow limitation. Results : Spirometric patterns were differently interpreted in 22.5% (208/926) of the men and 24.8% (172/694) of the women after the application of the Korean equation compared with the Morris equation. Of the subjects with airflow limitation, disease severity was differently graded in 30.2% (114/378) of the men and 39.4% (37/94) of the women after the application of the Korean equation. Of the subjects without airflow limitation, disease severity was differently graded in 27.9% (153/548) of the men and 30.2% (181/600) of the women after the application of the Korean equation. Conclusion : Achange in the reference equation for spirometry could have an effect on the interpretation of spirometric patterns and on the grading of disease severity.

The Impacts of Smoking Bans on Smoking in Korea (금연법 강화가 흡연에 미치는 영향)

  • Kim, Beomsoo;Kim, Ahram
    • KDI Journal of Economic Policy
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    • v.31 no.2
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    • pp.127-153
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    • 2009
  • There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoking. As a result, smoking bans in workplace become more prevalent worldwide. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was amended. The new law requires all office buildings larger than 3,000 square meters (multi-purpose buildings larger than 2,000 square meters) should be smoke free. Therefore, a lot of indoor office became non smoking area. Previous studies in other counties often found contradicting answers for the effects of workplace smoking ban on smoking behavior. In addition, there was no study in Korea yet that examines the causal impacts of smoking ban on smoking behavior. The situation in Korea might be different from other countries. Using 2001 and 2005 Korea National Health and Nutrition surveys which are representative for population in Korea we try to examine the impacts of law change on current smoker and cigarettes smoked per day. The amended law impacted the whole country at the same time and there was a declining trend in smoking rate even before the legislation update. So, the challenge here is to tease out the true impact only. We compare indoor working occupations which are constrained by the law change with outdoor working occupations which are less impacted. Since the data has been collected before (2001) and after (2005) the law change for treated (indoor working occupations) and control (outdoor working occupations) groups we will use difference in difference method. We restrict our sample to working age (between 20 and 65) since these are the relevant population by the workplace smoking ban policy. We also restrict the sample to indoor occupations (executive or administrative and administrative support) and outdoor occupations (sales and low skilled worker) after dropping unemployed and someone working for military since it is not clear whether these occupations are treated group or control group. This classification was supported when we examined the answers for workplace smoking ban policy existing only in 2005 survey. Sixty eight percent of indoor occupations reported having an office smoking ban policy compared to forty percent of outdoor occupation answering workplace smoking ban policy. The estimated impacts on current smoker are 4.1 percentage point decline and cigarettes per day show statistically significant decline of 2.5 cigarettes per day. Taking into account consumption of average sixteen cigarettes per day among smokers it is sixteen percent decline in smoking rate which is substantial. We tested robustness using the same sample across two surveys and also using tobit model. Our results are robust against both concerns. It is possible that our measure of treated and control group have measurement error which will lead to attenuation bias. However, we are finding statistically significant impacts which might be a lower bound of the true estimates. The magnitude of our finding is not much different from previous finding of significant impacts. For cigarettes per day previous estimates varied from 1.37 to 3.9 and for current smoker it showed between 1%p and 7.8%p.

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Regulatory Reform Proposals for the Korean Deep Sea Fishing Industry (원양어업(遠洋漁業)에 대한 정부규제(政府規制)의 개선방안(改善方案))

  • Kim, Jong-seok
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.93-110
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    • 1990
  • The basic purpose behind the Korean government's policy toward the Korean deep sea fishing industry is to limit growth of the industry. Therefore, the regulations on the industry are generally restrictive and interventionist. The policy is intended to maintain high domestic fish prices in order to protect the domestic coastal fishing industry. Some regulations have also been introduced to maintain "industrial order." Each fishing vessel must obtain a government permit for operation. The permit specifies the kind of fish it can catch, the area of sea in which it can operate, and the port at which it can unload its catches. The number of permits government issues each year is based on the estimates of the demand increase calculated by government officials, and the government traditionally has been fairly conservative in its estimation, reflecting its concern for fish price stabilization, which actually implies a gradual increase of the prices. There is also a restriction on importing vessels from abroad. This regulation is intended to protect the domestic shipbuilding industry. However, this regulation has resulted in an unusually high average age of Korean fishing vessels, causing fishing costs to rise. These regulations and the inflexible response of the regulators to changing circumstances have resulted in many problems: i) high domestic fish prices, which are, to some extent deliberately, inflated to three or four times the level of international prices, resulting in huge consumer welfare losses; ii) over-exploitation of coastal fish resources; iii) provision of a hospitable environment for inefficient firms to survive, which is especially evident from the fact that, despite the high fish prices in Korea, most of the firms in the industry do not enjoy high profitability. It also must be pointed out that the actual beneficiaries of the high fish prices are the large operators, who are protected from competition and provide most of the fish for domestic consumption, rather than the low-income fishing households and small coastal operators whom the policy was originally designed to help. This study proposes a set of regulatory reforms and policy changes which could Promote competition and equity within the industry and allow firms to reduce costs and increase productivity. Such changes can make the industry more efficient and internationally competitive. Major proposals are, among others: minimization of bureaucratic discretion in issuing fishing permits and maintaining transparency in the governments' decision-making processes; reduction of the government permit specifications and simplification of the operational categories within the industry; and removal of the restrictions on importing foreign fishing vessels.

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