Objective : Cardiopulmonary exercise test is a useful tool to evaluate the operative risk and to plan exercise treatment for the patients with chronic obstructive pulmonary disease(COPD). In cardiopulmonary exercise test, most of the measured parameters are recorded at the time of peak exercise, which are hard to attain in COPD patients. So we evaluated the usefulness of the parameter, breathing reserve index(BRI=minute ventilation [$V_E$]/maximal voluntary ventilation[MVV]) at the time of anaerobic threshold($BRI_{AT}$) for the differentiation of COPD patients with normal controls. Methods : Thirty-six COPD patients and forty-two healthy subjects underwent progressive, incremental exercise test with bicycle ergometer upto possible maximal exercise. All the parameters was measured by breath by breath method. Results : The maximal oxygen uptake in COPD patients (mean$\pm$SE) was $1061.2{\pm}65.6ml/min$ which was significantly lower than $2137.6{\pm}91.4ml/min$ of normal subjects(p<0.01). Percent predicted maximal oxygen uptake was 54.3% in COPD patients and 86.0% in normal subjects(p<0.01). Maximal exercise(respiratory quotient; $VCO_2/VO_2{\geq}1.09$) was accomplished in 7 of 36 COPD patients(19.4%) and in 18 of 42 normal subjects(42.9%). The $BRI_{AT}$ of COPD patients was higher($0.50{\pm}0.03$) than that of control subject($028{\pm}0.02$, p<0.01), reflecting early hyperventilation in COPD patient during exercise. The correlation between $BRI_{AT}$ and BRI at maximal exercise in COPD patients was good(r=0.9687, p<0.01). Conclusion : The $BRI_{AT}$ could be a useful parameter for the differentiation of COPD patients with normal controls in the submaximal cardiopulmonary exercise test.
Kim, Dong Kyun;Chun, Kang Il;Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki Up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Park, No Jin;Choi, Tae Youn
Tuberculosis and Respiratory Diseases
/
v.59
no.6
/
pp.651-655
/
2005
Background : Diagnosing a pulmonary embolism is difficult because its presenting symptoms are nonspecific and there are limitations with all of the objective tests. The D-dimer is known to be a marker of the lysis of intravascular cross-linked fibrin as a result of the activation of the endogenous fibrinolytic pathways, and the D-dimer assay is these an objective method for diagnosing a pulmonary embolism. This study assessed the benefits of the D-dimer test for diagnosing a pulmonary embolism using semiquantitative latex agglutination. Methods : The latex agglutination results of 185 patients were retrospectively reviewed. The D-dimer test was performed at the time a pulmonary embolism was suspected. Ninety patients(group I) were diagnosis with PE through spiral chest CT or a chest CT angiogram, perfusion/ventilation scans, and/or pulmonary angiogram. Ninety-five patients (group II) were found not to have a pulmonary embolism through the above tests. Results : The male to female ratio and mean age in groups I and II was 37:55, and 57 years old to 50:45 and 52 years old, respectively. When the cut off value for a positive D-dimer assay was set to $500{\mu}g$, the sensitivity, positive predictive value, negative predictive value and specificity was 86.7%, 61.4%, 79.3%, and 48.4%, respectively. Conclusion : The semiquantitative latex agglutination method in the D-dimer test has a lower sensitivity and negative predictive value than the well known ELISA test particularly for small emboli. Therefore, this test is not a suitable screening test for excluding a pulmonary embolism.
Pleurotus ostreatus, the oyster mushroom, is one of the most widely cultivated and important edible mushrooms in the world. In order to study the developmental process of P. ostreatus and its regulatory mechanism, a new culturing method needs to be established for inducing the fruiting body and sporulation in the laboratory. In this study, we have examined whether the fruiting body of P. ostreatus can be formed on the plastic petri dish which are commonly used for cell culture in the laboratory. The strain was cultured on $60{\times}15mm$ plastic petri dish with potato dextrose agar media at $28^{\circ}C$ for mycelial growth and then at $18^{\circ}C$ for the formation of primordia and fruiting bodies within plant growth chamber. The development of primordia into fruiting bodies was achieved on cultured dishes under air ventilation. At the primordia stage, the normal formation of fruiting body was blocked by sealing the plastic dish with parafilm. The periods requiring for the formation of primordia and fruiting bodies were examined on the dish culture. About 96% and 76% of cultured samples formed primordia and fruiting bodies under the optimal conditions during ten weeks of culture, respectively. These culturing periods, however, were changed by the mechanical injury treatment to mycelia. As other factors affecting the fruiting body formation, the effects of light and cold shock have been tested. No fruiting formation was observed on the cultured dishes under the dark. The cold shock treatment by storing cultured dishes for one day at $4^{\circ}C$ did not have any significant effects in the fruiting body formation. Spores of fruiting bodies acquired from the petri dishes could be germinated on culture media at $28^{\circ}C$. These results suggest that the fruiting bodies of P. ostreatus can be formed on the experimental petri dish and this dish-culturing method is useful for understanding of the developmental process of P. ostreatus in the laboratory. Furthermore, the dish-culturing method is able to shorten the life cycle of P. ostreatus without requiring large area and expensive device.
Lee, Jong Goo;Jeong, Young Kyun;Yun, Sung Wook;Choi, Man Kwon;Kim, Hyeon Tae;Yoon, Yong Cheol
Journal of Bio-Environment Control
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v.27
no.2
/
pp.166-172
/
2018
This study set out to conduct a field survey with smart greenhouse-based farms in seven types to figure out the actual state of smart greenhouses distributed across the nation before selecting a system to implement an optimal greenhouse environment and doing a research on higher productivity based on data related to crop growth, development, and environment. The findings show that the farms were close to an intelligent or advanced smart farm, given the main purposes of leading cases across the smart farm types found in the field. As for the age of farmers, those who were in their forties and sixties accounted for the biggest percentage, but those who were in their fifties or younger ran 21 farms that accounted for approximately 70.0%. The biggest number of farmers had a cultivation career of ten years or less. As for the greenhouse type, the 1-2W type accounted for 50.0%, and the multispan type accounted for 80.0% at 24 farms. As for crops they cultivated, only three farms cultivated flowers with the remaining farms growing only fruit vegetables, of which the tomato and paprika accounted for approximately 63.6%. As for control systems, approximately 77.4% (24 farms) used a domestic control system. As for the control method of a control system, three farms regulated temperature and humidity only with a control panel with the remaining farms adopting a digital control method to combine a panel with a computer. There were total nine environmental factors to measure and control including temperature. While all the surveyed farms measured temperature, the number of farms installing a ventilation or air flow fan or measuring the concentration of carbon dioxide was relatively small. As for a heating system, 46.7% of the farms used an electric boiler. In addition, hot water boilers, heat pumps, and lamp oil boilers were used. As for investment into a control system, there was a difference in the investment scale among the farms from 10 million won to 100 million won. As for difficulties with greenhouse management, the farmers complained about difficulties with using a smart phone and digital control system due to their old age and the utter absence of education and materials about smart greenhouse management. Those difficulties were followed by high fees paid to a consultant and system malfunction in the order.
Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.
Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
Journal of Chest Surgery
/
v.32
no.4
/
pp.373-378
/
1999
Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
Journal of Korean Tunnelling and Underground Space Association
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v.24
no.4
/
pp.327-339
/
2022
The purpose of this study is to present the effective smoke control flow rate and mode for securing safety through quantitative risk assessment according to the smoke control flow rate and mode (supply or exhaust) of the platform when a train fire occurs at the subway platform. To this end, a fire outbreak scenario was created using a side platform with a central staircase as a model and fire analysis was performed for each scenario to compare and analyze fire propagation characteristics and ASET, evacuation analysis was performed to predict the number of deaths. In addition, a fire accident rate (F)/number of deaths (N) diagram (F/N diagram) was prepared for each scenario to compare and evaluate the risk according to the smoke control flow rate and mode. In the ASET analysis of harmful factors, carbon monoxide, temperature, and visible distance determined by performance-oriented design methods and standards for firefighting facilities, the effect of visible distance is the largest, In the case where the delay in entering the platform of the fire train was not taken into account, the ASET was analyzed to be about 800 seconds when the air flow rate was 4 × 833 m3/min. The estimated number of deaths varies greatly depending on the location of the vehicle of fire train, In the case of a fire occurring in a vehicle adjacent to the stairs, it is shown that the increase is up to three times that of the vehicle in the lead. In addition, when the smoke control flow rate increases, the number of fatalities decreases, and the reduction rate of the air supply method rather than the exhaust method increases. When the supply flow rate is 4 × 833 m3/min, the expected number of deaths is reduced to 13% compared to the case where ventilation is not performed. As a result of the risk assessment, it is found that the current social risk assessment criteria are satisfied when smoke control is performed, and the number of deaths is the flow rate 4 × 833 m3/min when smoke control is performed at 29.9 people in 10,000 year, It was analyzed that it decreased to 4.36 people.
Journal of the Korean Institute of Landscape Architecture
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v.48
no.5
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pp.80-88
/
2020
With the issuance of one-week fine dust emergency reduction measures in March 2019, the public's anxiety about fine dust is increasingly growing. In order to assess the application of air purifying plant-based bio-filters to public facilities, this study presented a method for measuring pollutant reduction effects by creating an indoor environment for continuous discharge of particle pollutants and conducted basic studies to verify whether indoor air quality has improved through the system. In this study conducted in a lecture room in spring, the background concentration was created by using mosquito repellent incense as a pollutant one hour before monitoring. Then, according to the schedule, the fine dust reduction capacity was monitored by irrigating for two hours and venting air for one hour. PM10, PM2.5, and temperature & humidity sensors were installed two meters front of the bio-filters, and velocity probes were installed at the center of the three air vents to conduct time-series monitoring. The average face velocity of three air vents set up in the bio-filter was 0.38±0.16 m/s. Total air-conditioning air volume was calculated at 776.89±320.16㎥/h by applying an air vent area of 0.29m×0.65m after deducing damper area. With the system in operation, average temperature and average relative humidity were maintained at 21.5-22.3℃, and 63.79-73.6%, respectively, which indicates that it satisfies temperature and humidity range of various conditions of preceding studies. When the effects of raising relatively humidity rapidly by operating system's air-conditioning function are used efficiently, it would be possible to reduce indoor fine dust and maintain appropriate relative humidity seasonally. Concentration of fine dust increased the same in all cycles before operating the bio-filter system. After operating the system, in cycle 1 blast section (C-1, β=-3.83, β=-2.45), particulate matters (PM10) were lowered by up to 28.8% or 560.3㎍/㎥ and fine particulate matters (PM2.5) were reduced by up to 28.0% or 350.0㎍/㎥. Then, the concentration of find dust (PM10, PM2.5) was reduced by up to 32.6% or 647.0㎍/㎥ and 32.4% or 401.3㎍/㎥ respectively through reduction in cycle 2 blast section (C-2, β=-5.50, β=-3.30) and up to 30.8% or 732.7㎍/㎥ and 31.0% or 459.3㎍/㎥ respectively through reduction in cycle 3 blast section (C-3, β=5.48, β=-3.51). By referring to standards and regulations related to the installation of vegetation bio-filters in public facilities, this study provided plans on how to set up objective performance evaluation environment. By doing so, it was possible to create monitoring infrastructure more objective than a regular lecture room environment and secure relatively reliable data.
Park Kuhn;Lee Jong Ho;Kim Jin Ho;Jin Ung;Kwon Jong Bum;Kim Chi Kyeong;Wang Young Pil
Journal of Chest Surgery
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v.38
no.12
s.257
/
pp.807-814
/
2005
Background: Cardiopulmonary bypass is an essential process to maintain circulation for saving life during the cardiac surgery, But it is a process in which systemic inflammation was evoked inevitably because of the exposure of blood to foreign surface. The injuries to distal organs during the cardiopulmonary bypass were resulted from systemic inflammation and the disturbances of micro-circulations in the organs. We designed this study to research the effects of leukocyte depletion from pump-oxygenator priming solution on the systemic inflammation, and the micro-circulation of gastric mucosa that is suggested by the gastric mucosal $CO_{2}$ partial pressure and acidity. Material and Method: The dogs were divided into three groups according to the different pump-oxygenator priming solutions; non-hemic crystalloid solution; leukocyte-depleted homologous blood; and non leukocyte-depleted homo-logous blood. Each priming solution group contained five dogs. In all three groups, 2 hours of cardiopulmonary bypass, and 4 consecutive hours of general anesthesia was maintained on the mechanical ventilation. Each dog was evaluated for the gastric mucosal pH, $CO_{2}$ partial Pressure, arterial pH, $CO_{2}$ partial pressure, the exhaled air $CO_{2}$ partial pressure and the level of IL-8 on before the cardiopulmonary bypass, 1 hour after the cardiopulmonary bypass, 2 hours after the cardiopulmonary bypass, 2 hours after the restoration of normal circulation, and 4 hours after the restoration of normal circulation after the cardiopulmonary bypass. The levels of IL-8 were measured with ELISA (enzyme linked immunosorbent assay) technique. Result: 1. There were significant differences of gastric mucosal $CO_{2}$ partial pressure between the leukocyte-depleted homologous blood group and other two groups(vs non leukocyte-depleted homologous blood group; P=0.02, vs non-hemic crystalloid solution group; P=0,01). 2. The gastric mucosal pH of leukocyte-depleted homologous blood group was significantly different from non leukocyte-depleted homologous blood group (p=0.01). 3. The levels of IL-8, which examine the systemic inflammation, showed signi- ficantly better results in leukocyte-depleted homologous blood group and non-hemic crystalloid solution group than non leukocyte-depleted homologous blood group (p=0.01, 0.01). Conclusion: Based upon these results, we concluded that the leukocyte depletion from the pump-oxygenator priming solution has a beneficial effects in reducing systemic inflammation and the preserving of gastric mucosal micro-circulation.
Lee, Kwang Ha;Lee, Sae Hwan;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Koh, Yoonsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang Bum
Tuberculosis and Respiratory Diseases
/
v.60
no.5
/
pp.548-553
/
2006
Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.
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