• Title/Summary/Keyword: Ventilation Rate

Search Result 829, Processing Time 0.038 seconds

Clinical Characteristics of Intensive Care Unit Patients with Carbapenem Resistant Acinetobacter Baumannii Isolated from Sputum (객담에서 Carbapenem 내성 Acinetobacter baumannii가 동정된 중환자실 환자의 임상적 특징)

  • Lee, Sung Won;Jo, Heui Sug;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
    • /
    • v.60 no.2
    • /
    • pp.228-234
    • /
    • 2006
  • Background : Acinetobacter baumannii is an important pathogen associated with nosocomial infections in intensive care units, and is responsible for nosocomial pneumonia, UTI, bacteremia, etc. The main concern is that this pathogen is often resistant to many antimicrobial agents, particularly to carbapenem. This study compared the clinical those of ICU admitted patients with the carbapenem resistant A. baumannii isolated from the sputum with characteristics of patients with carbapenem sensitive A. baumannii. Methods : A total of 49 patients with A. baumannii from a sputum culture who were admitted to the ICU from January to December 2003 were enrolled in this study. This study evaluated the demographic variables, mortality, APACHE II score, comorbidity, antibiotics used, hospital and ICU stay, Clinical Pulmonary Infection Score, and mechanical ventilation. A retrospective analysis was made by a review of the patients' medical records. Results : Carbapenem sensitive and resistant A. baumannii was isolated from 23 patients and 26 patients respectively. Univariate analysis revealed renal disease, the use of carbapenem and aminoglycoside to be statistically significant factors for carbapenem resistance. Multivariate analysis revealed carbapenem use(p=0.024; OR, 8.17; CI 1.32 to 50.68) to be positively associated with carbapenem resistance, and aminoglycoside use(p=0.026; OR, 0.18; CI, 0.04 to 0.82) to be negatively associated with carbapenem resistance. There was no significant difference in mortality between the carbapenem sensitive and resistant group(30 vs 42%. P=0.39). Conclusion : The occurrence of carbapenem resistant A. baumannii is positively associated with carbapenem use and negatively associated with aminoglycoside use. Carbapenem resistance in the sputum culture did not affect the mortality rate.

Implication of Quantitative Culture of Bronchoalveolar Lavage Fluid in the Diagnosis of Ventilator Associated Pneumonia in Patients with Antimicrobial Therapy (항생제 사용 중 발생한 기계 호흡기 관련 폐렴에서 기관지 세포 세척술의 진단적 의미)

  • Chang, Yoon-Soo;Ahn, Chul-Min;Chung, Byung-Chun;Kim, Hyung-Jung;Kim, Seong-Kyu;Lee, Won-Yong;Shin, Jeung-Su
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.1
    • /
    • pp.72-81
    • /
    • 2000
  • Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

  • PDF

Investigation into Air Pollution in Car Shipping Workshop in Pyeongtaek Port (자동차 선적작업장의 공기오염 실태조사)

  • Kim, Ji-Ho;Won, Jong-Uk;Kim, Chi-Nyon;Roh, Jaehoon
    • Journal of Korean Society of Occupational and Environmental Hygiene
    • /
    • v.16 no.1
    • /
    • pp.44-53
    • /
    • 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.

Early Response of Cardiopulmonary Exercise Test(CPET) in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Radiation (방사선 치료 후 폐암환자의 운동부하 심.폐 기능의 초기변화)

  • Shin, Kyeong-Cheol;Lee, Deok-Hee;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.4
    • /
    • pp.466-473
    • /
    • 2000
  • Background : Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. Method : Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. Results : The forces vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$ and maximal voluntary ventilation (MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity (DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption ($VO_2$max), carbon dioxide production ($VCO_2$), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. Conclusion : Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.

  • PDF

Pigment Stability of Lavers Porhyra tenera Kjellman during Processing and Storage (김의 가공 저장중에 있어서의 색소의 안정도)

  • LEE Kang-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
    • /
    • v.2 no.2
    • /
    • pp.105-133
    • /
    • 1969
  • The stability of three major pigments in lavers, namely chlorophylls, carotenoids, and phy-cobilins, during processing and storage was studied. The results of the pigment retention in fresh lavers during storage at low temperatures, of heat lability during heat treatment, and of the pigment loss during storage are summarized as follows: 1. The contents of chlorophyll a, xanthophyll (lutein+zeaxanthin), and carotene ($\alpha-+\beta-carotene$) averaged 1,525, 627, and $409{\mu}g/g$ of dry samples respectively The comparative composition of four carotenoids, lutein, $\beta-carotene$, zeaxanthin, and $\alpha-carotene$, was 35.9, 33.7, 12.2, and $5.8\%$ respectively. 2. In storage of fresh lavers at room ternperature ($20-25^{\circ}C$), 2 to $5^{\circ}C$, and $-15^{\circ}C$, the pigments generally were retained more at 2 to $5^{\circ}C$ than others while carotene only showed more retention at $-15^{\circ}C$ than at 2 to $5^{\circ}C$. Phycocyanin tended to decrease more rapidly than phyco-erythrin at low temperatures. 3. In regard to heat treatment of both dried and wet materials at 40, 60, 80, $100^{\circ}C$ respectively, the pigments were more stable at lower temperatures than at higher temperatures in both cases of materials. Carotenoids were retained more in wet materials than in the sun dried. Xanthophylls showed higher heat stability than carotenes. Phycoerythrin was considered more heat labile than phycocyanin, particularly at higher temperatures. 4. In storage of heat treated lavers for 50 days at room temperature, the retention of pigments appeared differently in accordance with the temperatures of treatment The materials treated at $60^{\circ}C$ showed better relention of pigments than those treated at the other temperatures. Degradation rate of xanthopllylls, carotenes, and phycobilins was decreased in the materials treated at higher temperatures, showing a tendency of great pigment retention even for a long period storage. Chlorophyll il was retained more in sun dried materials whereas xanthophyll and carotene were retained more in the wet. 5. In order to maintain a higher pigment stability during storage, the materials must be treated at $60^{\circ}C$ in a dryer with rapid ventilation until the moisture level reaches about $6.0\%$. In case of treatment at a higher temperature than $60^{\circ}C$, they must be treated for a short period of time to minimize pigment degradation by heat. 6. The lavers treated with the solutions of pH around 7.8 showed a higher retention of chlorophyll a. When treated with the solutions of algal extracts such as agar and alginic acid, uniform layer of laver sheets and better surface gloss of dried layers were obtained.

  • PDF

Fluconazole prophylaxis in high-risk, very low birth weight infants (고위험 극소저체중 출생아에서 fluconazole 예방요법)

  • Kim, Soo Young;Lee, Soon Joo;Kim, Mi Jeong;Song, Eun Song;Choi, Young Youn
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.7
    • /
    • pp.636-642
    • /
    • 2007
  • Purpose : Fluconazole prophylaxis for very low birth weight (VLBW) infants has been shown to reduce invasive fungal infection and its mortality. This study aims to evaluate the effect of fluconazole prophylaxis in VLBW infants on the incidence and mortality of fungal infection. Methods : VLBW infants with endotracheal intubation and central vascular access admitted to the Neonatal Intensive Care Unit (NICU) at Chonnam University Hospital were enrolled. Twenty eight infants of 7-month baseline period from January to July 2005 ('non-fluconazole group') were compared with 29 infants of a 7-month fluconazole period from January to July 2006 ('fluconazole group'). Results : Gestational age, birth weight, sex, mode of delivery, frequency of twin pregnancy, chorioamnionitis, antenatal steroid and rupture of membranes were similar between the fluconazole and non-fluconazole groups. The rate of extremely low birth weight (ELBW) infants, frequency and duration of prophylactic antibiotics, total parenteral nutrition and umbilical catheters, duration of intralipid, mechanical ventilation and nasal continuous positive airway pressure (CPAP) were also not significant. However, frequency of percutaneous central venous catheterization (PCVC) and intralipid administration, and duration of PCVC were significant between the two groups. The overall incidence and mortality of fungal infection were not different between the two groups. Although the Malassezia infection was increased in the fluconazole group (P<0.05), candida was significantly decreased compared to the non-fluconazole group (P<0.05). Conclusion : Fluconazole prophylaxis in high risk VLBW infants decreased the candida infection significantly. Antifungal prophylaxis is recommended in terms of cost effectiveness, but further study is needed to clarify the reason for the increase of Malassezia infection.

Study on the Indoor Environment and Status of Facilities and Equipments of Home Economics Practice Rooms of Middle Schools in Jeju Special Self-Governing Province (제주특별자치도 중학교 가정실의 실내환경 및 시설.설비 현황에 관한 연구)

  • Park, Min-Hye;Kim, Bong-Ae
    • Journal of Korean Home Economics Education Association
    • /
    • v.19 no.3
    • /
    • pp.61-76
    • /
    • 2007
  • The purpose of the study is to identify and understand problems existing in the middle school home economics practice rooms in Jeju Special Self-Governing Province. The findings are based on the examination and the analysis of the indoor environment and the condition of the facilities and equipment. Study method employs on-site research and a survey. The on-site research was conducted about temperature, humidity, intensity of illumination, and status of teaching instrument in 10 out of 41 middle schools in Jeju Special Self-Governing Province from August 16 to September 30, 2006. Meanwhile, the survey was implemented by mail for 95 teachers in charge of manual training and home economics education in 41 middle schools in Jeju from November 1 to 23, 2005. 64 questionnaires out of total 95 were collected, including those collected during the period of on-site research. Finally, 61 questionnaires which were effective among the answered ones were used for analysis. Collected materials were analyzed with the SPSS Win.12.0 program for frequency, percentile analysis. In conclusion, the study determines that the condition of the home economics practice rooms of the middle school in JSSGP in terms of temperature, humidity, lighting and ventilation is very inadequate. The structure of the practice room represents an inefficient work flow pattern. Further, the facilities and equipment are in a very poor condition because the facilities are old and the retention rate of teaching tools is low. Therefore, to address these problems, the study suggests that improvements on the facilities and equipment should be made and teaching tools should be replenished in accordance with the industry standard.

  • PDF

COPD Patients with Hypercapnic Respiratory Failure : Response to Therapy and Determinant of Intubation (만성폐쇄성폐질환 환자의 고탄산혈증성 호흡부전 : 치료 반응 및 기도삽관의 결정인자)

  • Song, So-Hyang;Kim, Chi-Hong;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
    • /
    • v.50 no.4
    • /
    • pp.462-472
    • /
    • 2001
  • Background : The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. Methods : This study involved a review of 132 episodes of hypercapnic respiratory failure($PaCO_2\;{\geq}\;50\;mmHg$ and $pH\;{\leq}\;7.35$). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. Results : Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had a greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score ($20{\pm}5$ vs $14{\pm}4$ ; p<0.01), a higher WBC, a higher serum BUN, and greater acidosis (pH, $7.23{\pm}0.11$ vs $7.32{\pm}0.04$ ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation($2{\pm}3\;h$). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation($97{\pm}121\;h$). The patients with a pH 7.21 to 7.25($4.1{\pm}2.9$ day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35($2.2{\pm}3.1$ day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. Conclusion: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This should assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.

  • PDF

Effects of Combination of Air Temperature and Soil Moisture Contents on Growth, Clove Initiation, Physiological Disorders, and Yield of Garlic (기온과 토양수분 함량에 따른 난지형 마늘의 생장, 인편분화, 생리장해 및 수량에 미치는 영향)

  • Lee, Hee Ju;Lee, Sang Gyu;Kim, Sung Kyeom;Mun, Boheum;Lee, Jin Hyoung;Lee, Hee Su;Kwon, Young Seok;Han, Ji Won;Kim, Cheol Woo
    • Journal of Bio-Environment Control
    • /
    • v.27 no.3
    • /
    • pp.191-198
    • /
    • 2018
  • The objective of this study was to determine the effects of combination of air temperature and soil water contents on growth, physiological disorder rate, and yield of garlic. This experiments has been carried out in the typical plastic house (one side open and other side installed ventilation fans) which was maintained gradient air temperature (maximum different value of air temperature : $6^{\circ}C$). The excessive irrigation (EI) set at $0.34m^3/m^3$ soil moisture contents. The significant differences found in the growth parameters of garlics as affected by air temperature and soil moisture conditions. The plant height of garlic with combination of ambient $(A)+6^{\circ}C$ and optimal irrigation (OI; set at $0.22m^3/m^3$ soil moisture contents) treatments represented 47.4 cm/plant, which was the highest among all the tested treatments. The leaf length and width showed the greatest, which were 16.1 and 2.4 cm/plant, respectively, in $A+6^{\circ}C-OI$. The physiological disorder ratio was higher as 12.9% at $A+6^{\circ}C-OI$ and was not occurred at ambient temperature with EI compared with OI treatment. The bulb and clove weight were dramatically decreased at $A+6^{\circ}C$ temperature treatment. The yields were decreased by 51% in OI at $A+6^{\circ}C$ and $A+3^{\circ}C$ temperature treatment. Those results indicated that yields were decreased and ratio of physiological disorders was increased by high temperature treatments.

Comparison of the Reconstruction Routes after Esophagectomy for Esophageal Cancer (식도암 절제후 식도 재건경로의 비교)

  • Lee, Seung-Yeoll;Kim, Kwang-Taik;Choi, Young-Ho;Kim, Il-Hyun;Baik, Man-Jong;Sun, Kyung;Lee, In-Sung;Kim, Hyoung-Mook
    • Journal of Chest Surgery
    • /
    • v.32 no.9
    • /
    • pp.806-812
    • /
    • 1999
  • Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

  • PDF