• Title/Summary/Keyword: Ventilation impairment

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Study on the Pulmonary Function in Welding Fume Exposed Workers (용접흄 폭로 근로자들의 폐기능에 관한 연구)

  • Hong, Young-Seoub;Kim, Byoung-Gwon;Kim, Sung-Ryul;Dam, Do-Won;Kim, Jung-Man;Jung, Kap-Yull;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.43-57
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    • 1995
  • In order to study the effect of welding fume exposure upon the pulmonary function test, we examined 131 shielded arc welding workers, and 152 $CO_2$ arc welding workers as cases and 177 control workers for their general characteristics, and forced vital capacity (FVC), forced expiratory volume in one second $(FEV_{1.0})$, forced expiratory volume in one second as a percent of FVC $(FEV_{1.0}%)$, and maximal mid-expiratory flow (MMF) were obtained from the spirogram. In shielded arc welding group and $CO_2$ arc welding group, FVC, $FEV_{1.0},\;FEV_{1.0}%$, and MMF were significantly decreased than control group, especially marked in the MMF finding. The distribution of workers below normal range was as follows. in the shielded arc welding group, 2 workers(1.5%) for FVC, 17 workers(13.0%) for $FEV_{1.0}$, 5 workers(3.8%) for $FEV_{1.0}%$, 28 workers(21.4%) for MMF, and in the $CO_2$ arc welding group, 3 workers(2.0%) for FVC, 25 workers(16.4%) for $FEV_{1.0}$, 8 workers(5.3%) for $FEV_{1.0}%$, and 37 workers(24.3%) for MMF, and significant increase by exposure duration was found in MMF. The distribution of workers who had ventilation impairment was as follows: 5 workers(3.8%) for obstructive type, 2 workers(1.5%) for restrictive type in the shielded arc welding group, and 7 workers(4.6%) for obstructive type, 2 workers(1.3%) for restrictive type, and 1 worker(0.6%) was combined type of the $CO_2$ arc welding group. In the respect of these results, the significant pulmonary function and ventilatory impairment were observed in welding fume exposed workers who had not abnormal finding in chest X-ray, and MMF considered as the most sensitive pulmonary function index by welding fume exposure. Therefore even if it is hard to doing pulmonary function test in the first health examination of workers according to the Industrial Safety Health Act in the welding fume exposure workers, it is desirable to consider doing PFT. Also evaluating the ventilation impairment, it is necessary, to observe the change of MMF that marker of effort-independent portion.

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Experimental Study of Homotransplantation of Lung in Dogs (폐장이식에 관한 실험적 연구)

  • 김진식
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.25-40
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    • 1969
  • Lung homotransplantation was performed in 15 pairs of dog. Methotrexate and R.E.S. blocking were used to prolong the survival time. Details of handling the transplant, operative technique and management of the recipient were discussed and following results were obtained: 1]. 7 dogs out of 15 dogs of homotransplantation of lung were survived beyond 3 days. In the group of dogs treated with methotrexate, the average survival was 8.5 days, and in the group of dogs treated with R.E.S. blocking, the average survial was 9.7 days with longest survival of 17 days. 2]. The causes of immediate postoperative death in homotransplantation of dogs were lung edema and disruption of bronchial anastomosis. 3]. The main causes of death in successful homotransplantation dogs which were survived beyond 3 days were infection of lung parenchyma and bronchial necrosis rather than the occurence of graft rejection. 4]. Graft rejection was not revealed even after 7 days of operation in the group treated with methotrexate as well as in the group treated with R. E.S. blocking. This finding made it suggest that the R. E.S. blocking may be effective to control the rejection reaction. 5]. Even though the pulmonary function of transplanted lung was revealed the evidence of severe impairment immediate after operation by bronchospirometry, it was increased gradually and 10 days after operation the minute ventilation and oxygen uptake were decreased 8%, 13% respectively less than pre-operative one.

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Respiratory syncytial virus infection in children with congenital heart disease: global data and interim results of Korean RSV-CHD survey

  • Jung, Jo-Won
    • Clinical and Experimental Pediatrics
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    • v.54 no.5
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    • pp.192-196
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    • 2011
  • Respiratory syncytial virus (RSV) is a main cause of hospitalization for bronchiolitis and pneumonia in infants worldwide. Children with hemodynamically significant congenital heart disease (HS-CHD), as well as premature infants are at high risk for severe RSV diseases. Mortality rates for CHD patients hospitalized with RSV have been reported as about 24 times higher compared with those without RSV infection. Recently with advances in intensive care, mortality rates in CHD patients combined with RSV have decreased below 2%. The requirements of intensive care and mechanical ventilation for CHD patients with RSV infection were still higher than those without RSV infection or with non-CHD children. RSV infection has frequently threatened CHD infants with congestive heart failure, cyanosis, or with pulmonary hypertension. As a progressive RSV pneumonitis in those infants develops, the impairment of oxygen uptake, the breathing workload gradually increases and eventually causes to significant pulmonary hypertension, even after the operation. Preventing RSV infection as much as possible is very important, especially in infants with HS-CHD. A humanized monoclonal antibody, palivizumab, has effective in preventing severe RSV disease in high-risk infants, and progressive advances in supportive care including pulmonary vasodilator have dramatically decreased the mortality (<1%). Depending on the global trend, Korean Health Insurance guidelines have approved the use of palivizumab in children <1 year of age with HS-CHD since 2009. Korean data are collected for RSV prophylaxis in infants with CHD.

A Case of Acute Respiratory Failure After Trichloroethylene Inhalation (트리클로로에틸렌 흡입으로 인한 호흡부전 1례)

  • Park, Jae-Seok;Jeon, Young-Woo;Kim, Young-Il;Gil, Hyo-Wook;Yang, Jong-Oh;Lee, Eun-Young;Hong, Sae-Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.30-33
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    • 2011
  • Trichloroethylene (TCE, $C_2HCl_3$), which was introduced as a gas for general anesthesia and analgesia in early 1900's has been widely used in industry as an organic solvent. Occupational exposure to TCE is an important medical problem. Manifestations of acute exposure to TCE include mucocutaneous irritation, hepatotoxicity, cognitive impairment, sleep, headache, respiratory insufficiency and death. We report a 38-year-old man who was admitted to a department of emergency medicine after occupational inhalation exposure to TCE. He rapidly developed semicoma and respiratory depression. After mechanical ventilation, hypercapnea and hypoxemia disappeared and his mental state again became alert. Careful evaluation and proper respiratory support are important for respiratory failure after occupational TCE inhalation.

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Design of Rule-based Inference Engine for the Monitoring of Harmful Environments in Workplace

  • Ahn, Yoon-Ae
    • Journal of Korea Society of Industrial Information Systems
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    • v.14 no.4
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    • pp.65-74
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    • 2009
  • The risk of health impairment due to poor ventilation, fire and explosion by inflammable materials, and other unintended occurrences is always present in dangerous workplaces such as manholes, underground septic tanks, storage tanks and confined areas. Therefore, it a system which can monitor harmful working environment through sensors in workplace on a realtime basis and keep workers safe from the risk is needed. This paper has attempted to design an inference engine to monitor harmful environments in the workplace. The proposed inference engine has a rule-based system structure using JESS. This system is not confined to a particular computing platform and is easily interlocked with OSGi-based middleware.

POST-EXTUBATION ACUTE RESPIRATORY DISTRESS SYNDROME OCCURRED IN THE ORTHOGNATHIC SURGERY PATIENT : A CASE REPORT (악교정 수술 환자에서 발관 후 발생된 급성 호흡곤란 증후군 : 증례보고)

  • Park, Ji-Young;Lee, Jung-A;Yun, Sung-Hun;Park, Min-Kyou;Kim, Chang-Hyun;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.79-84
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    • 2007
  • Acute respiratory distress syndrome(ARDS) is severe acute hypoxic respiratory failure state with dynamic impairment in oxygen and carbon dioxide transfer with the need for high levels of supplementary oxygen and a high minute ventilation. This syndrome is caused by pulmonary edema due to increased permeability of the alveolar capillary barrier by various factors. ARDS is an uncommon, but a potentially life-threatening complication. Therefore, immediate diagnosis and appropriate therapy must be performed. The present case is post-extubation ARDS immediately occurred in an orthognathic surgery patient who are healthy 19-year-old man. He rapidly recovered from ARDS without complication by early diagnosis and proper treatment. This case report was aimed to describe the process of the development, possible causes and the management of ARDS occurred in an orthognathic surgery patient

Thyroid dysfunction in very low birth weight preterm infants

  • Lee, Ji Hoon;Kim, Sung Woo;Jeon, Ga Won;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.224-229
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    • 2015
  • Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

Incidence of hearing loss and importance of risk factors in the neonatal intensive care unit (신생아 중환자실에서 난청의 발생빈도 및 위험요소의 중요성)

  • Kong, Seung Hyun;Kang, Jang Hee;Hwang, Kwang Su;Kim, Joong Pyo;Lee, Hyeon Jung;Choi, Hyeon;Mok, Ji Sun;Kim, Jung Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.845-850
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    • 2006
  • Purpose : To assess the incidence of neonatal hearing loss in a neonatal intensive care unit and the relative importance of risk factors for hearing imparement in a neonatal intensive care unit which the Joint Committee on Infant Hearing(JCIH) had recommended. Methods : One thousand, two hundred and one newborns admitted to the Good Moonhwa Intensive Care Unit from May 2003 to December 2005 were assesed using the automated auditory brainstem response(AABR). The screening was performed on those aged more than 36 weeks and weighing more than 2,200 g. We divided the infants into two groups, 'pass' and 'refer'. The 'refer' group were retested one month later, and if classified as 'refer' during the retest, were referred to a hearing impairment clinic. Results : From the 1,201 neonates, 1,187(98.8 percent) passed the test and 14(1.2 percent) failed. 293(24.4 percent) of the 1,201 neonates had a risk factor for hearing impairment; 282(96.2 percent) passed the test and 11(3.8 percent) failed. The group with risk factors were shown to have a higher incidence of hearing loss(P<0.001). The neonates in the refer group were shown to have a higher incidence of ototoxic drugs(P<0.001), low birth weight(<1,500 g)(P<0.001) and craniofacial anomalies(P=0.007). On the other hand, there were no statistical differences between the pass and refer groups in congenital infection, hyperbilirubinemia, bacterial meningitis, low Apgar scores, prolonged mechanical ventilation and syndromes known to include hearing loss. Conclusion : In order to identify hearing-impaired infants within an appropriate period, neonatal hearing screening tests and identification of the risk factors for neonatal hearing loss are important.

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.

Comparision of Chest Radiographs and Pulmonary Function in Coal Workers' Pneumoconiosis and Welders' Lung (탄광부 진폐증과 용접공 폐증에 있어 흉부-X선 소견과 폐기능의 비교)

  • Park, Dong-Youl;Hwang, Joo-Ho;Kang, Byung-Son;Chung, Chan-Su;Kim, Wha-Jo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.713-722
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    • 1995
  • Background: Chest X-ray of coal workers' pneumoconiosis and shipyard welders' lung show similar and regular opacities mostly, it is very difficult that we distinguish the former from the latter by only chest X-ray. so we performed this study to understand the progression of the disease and to provide the disease by considering pulmonary function and other factors in proportion to the profusion of small regular opacities of chest X-ray in both groups. Method: 430 coal workers' pneumoconiosis were compared with 311 shipyard welders' lung by the number, the age, the duration of dust exposure, %vital capacity(%VC), %FEV1.0, the type of ventilatory impairment, the combined pulmonary disease according to the profusion of small regular opacities on the chest radiographs, which were classified into category 0/1, category 1, and category 2. Result: 1) the percent of category 2 in coal workers' pneumoconiosis was 54.4%. the percent of category 1, and category 2 in welders' lung were 60.0%, 7.4%. the progression to the category 2 was higher in coal workers' pneumoconiosis than in welders' lung 2) The mean age was higher in coal workers' pneumoconiosis than in welders' lung, significantly increased in proportion to the progresion of profusion of small regular opacities in both groups 3) There was no difference in the duration of dust exposure by category 1/0, but the duration of dust exposure by category 1, 2 in coal workers' pneumoconiosis more significantly increased than in welders' lung. the duration in the proportion of category 2 to category 0/1, 1 significantly increased in the proportion to small regular opacities in coal workers' pneumoconiosis. but there was no significant difference in the proportion to small regular opacities in duration of dust exposure in welders' lung. 4) There was no significant difference of mean values of %VC(%vital capacity)in both groups except for category 1. the mean values of %VC had no relationship between the progression of small regular opacities in both groups. 5) The mean values of %FEV1.0 decreased more significantly in coal workers' pneumoconiosis than in welders' lung except for category 0/1. and decreased significantly in proportion to the profusion of small regular opacities in coal workers' pneumoconiosis. there was significant difference of %FEV1.0 in the proportion of category 2 to category 011 in welders' lung. 6) there were no significant difference of %FEV1.0, %VC in smoker and nonsmoker in both groups. 7) With regard to the type of ventilation in both groups in coal workers' pneumoconiosis 21.4 percent of patients belonged to the restrictive type, 11.6 percent to the obstructive type, 5.6 percent to the combined type, but in welders' lung 21.8 percent to the restrictive type, 2.9 percent to the obstructive type, 1.9 percent to the combined type. 8. in the pulmonary disease, the incidence of the pulmonary tuberculosis was the most in both groups, was more in coal workers' pneumoconiosis than welders' lung Conclusion: If we compare coal workers' pneumoconiosis with electric arc welders'lung by considering pulmonary function and other factors in proportion to the profusion of chest X-ray, I think that we will have the better result in understanding the progression of the disease and provision of the disease in both groups.

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