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

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

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.536-542
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• 2007

Purpose : We investigated the effects of restricted fluid in the first 7 days of life on the risk of bronchopulmonary dysplasia (BPD) or patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. Methods : Eighty three VLBW infants who lived more than 28 days were selected. The amount of daily maintenance fluid was determined by calculation of insensible water loss (IWL) and urine output (UO). Seventy to 80 percent of calculated amount was given to the ventilated infants. Subjects were grouped into low (<25th%), moderate (25-75th%), and high (>75th%) fluid groups for the first 24 hours, 3 days and 7 days. Chi square tests analyzed proportions of subjects with or without morbidities across fluid groups. Multivariate logistic regression was used to analyze the effect of fluid intake on BPD or PDA, controlling for factors that are significantly associated with BPD or PDA by univariate analysis. Results : Rates of BPD and PDA were not significantly associated with fluid groups on each time period. The result was the same after controlling for factors that are significantly associated with BPD or PDA by univariate analysis. For the first 3 and 7 days, fluid intakes were positively related with maximal weight loss, urine output and mechanical ventilation duration. Conclusion : In VLBW infants, when given based on needs reflected from IWL and UO versus intake, relatively low fluid intakes in the first week of life do not decrease the risk of BPD or PDA, and vice versa. We suggest that calculation of daily fluid based on IWL and UO is appropriate for VLBW infants.

• Korean Journal of Environmental Biology
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• v.27 no.3
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• pp.285-291
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• 2009

The effects of water temperature on oxygen consumption (OC) of starry flounder Platichthys stellatus reared in seawater (SW) and freshwater (FW) was performed in closed water-recirculating system containing respiratory chamber. Fish acclimated in separate indoor tanks with SW (nine of fish used, $263.0{\pm}40.4$ g) or FW (nine of fish used, $265.8{\pm}34.8$ g) were sampled. The OC of starry flounder at $15^{\circ}C,\;20^{\circ}C$ and $25^{\circ}C$ were $74.4{\pm}17.0,\;85.9{\pm}15.8,\;98.3{\pm}11.4\;mg\;O_2\;kg^{-1}hr^{-1}$ in SW and $46.7{\pm}12.0,\;63.3{\pm}7.5,\;82.6{\pm}5.3\;mg\;O_2\;kg^{-1}hr^{-1}$ in FW, respectively, showing a linear increase in OC with water temperature. The OC of fish reared in both SW and FW clear diel rhythm, with lower values at daytime and higher values in the night, in accordance with light (09:00~21:00 hr) and dark (21:00~09:00 hr) phases of the diel cycle (12L : 12D) in water temperature at $15^{\circ}C$ and $20^{\circ}C$. However OC of fish reared in both SW and FW showed unclear diel rhythm with light and dark phases of the diel cycle in water temperature at $25^{\circ}C$. Starry flounder reared in FW had higher ventilation rates than those in SW, but SW had higher OC per breath than those in FW.

• 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.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.149-161
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• 1995

The first national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preoperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea Association of Pediatric Surgeons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 institutions and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of anorectal malformations in Korea and the distribution of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majority of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(46%) prefers to perform echocardiography as a part of preoperative management to identify congenital heart disease and lateralize the aorta. Esophageal atresia with distal TEF(87.5%) was by far the most common and there were pure esophageal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in addition to tracheoesophageal anomalies. Congenital heart disease was associated in 46 cases(31%), anorectral malfomations in 19 cases(13%), musculoskeletal anomalies in 15 cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, parenteral nutrition and assisted ventilation were given in 66% and 52% of patients respectively. Ninety three(74%) of 126 cases who underwent sugical procedure, experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The survival rates related to the Waterston risk categories were 90.2% in group A, 71.4-75% in $B_1$, $B_2$, and $C_1$, groups, and 28% in group $C_2$, and the overall survival rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratory failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morbidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricture.

• Proceedings of the Korean Society of Postharvest Science and Technology of Agricultural Products Conference
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• 2004.10a
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• pp.67-72
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• 2004

Quality of fresh-cut tomato slices was compared during cold storage under various modified atmosphere packaging conditions. Chilling injury of slices in containers sealed with Film A was higher than with Film B; these films had oxygen transmission rates of 87.4 and 60.0 ml $h^{-1}\;m^{-2}\;atm^{-1}$ at $5^{\circ}C\;and\;99\%$ RH, respectively. While slices in containers with an initial atmospheric composition of air, $4\%\;CO_2+1\;or\;20\%\;O_2,\;8\%\;CO_2+1\;or\;20\%\;O_2,\;or\;12\%\;CO_2+20\%\;O_2$ showed fungal growth, slices in containers with $12\%\;CO_2+1\%\;O_2$ did not. Low ethylene in containers enhanced chilling injury. Modified atmosphere packaging provided good quality tomato slices with a shelf-life of 2 weeks or more at $5^{\circ}C$. Experiments were conducted to compare changes in quality of slices of red tomato (Lycopersicon esculentum Mill. 'Sunbeam') fruit from plants grown using black polyethylene or hairy vetch mulches under various foliar disease management systems including: no fungicide applications (NF), a disease forecasting model (Tom-Cast), and weekly fungicide applications (WF), during storage at $5^{\circ}C$ under a modified atmosphere. Slices were analyzed for firmness, soluble solids content (SSC), titratable acidity (TA), pH, electrolyte leakage, fungi, yeasts, and chilling injury. With both NF and Tom-Cast fungicide treatments, slices from tomato fruit grown with hairy vetch (Vicia villosa Roth) mulch were firmer than those from tomato fruit grown with black polyethylene mulch after 12 days storage. Ethylene production of slices from fruit grown using hairy vetch mulch under Tom-Cast was about 1.5- and 5-fold higher than that of slices from WF and NF fungicide treatments after 12 days, respectively. The percentage of water-soaked areas (chilling injury) for slices from tomato fruit grown using black polyethylene mulch under NF was over 7-fold that of slices from tomato fruit grown using hairy vetch under Tom-Cast. When stored at $20^{\circ}C$, slices from light-red tomato fruit grown with black polyethylene or hairy vetch mulches both showed a rapid increase in electrolyte leakage beginning 6 hours after slicing. However, slices from tomato fruit grown using the hairy vetch mulch tended to have lower electrolyte leakage than those grown with black polyethylene mulch. These results suggest that tomato fruit from plants grown using hairy vetch mulch may be more suitable for fresh-cut slices than those grown using black polyethylene mulch. Also, use of the disease forecasting model Tom-Cast, which can result in lower fungicide application than is currently used commercially, resulted in high quality fruit for fresh-cut processing. Experiments were conducted to determine if ethylene influences chilling injury, as measured by percentage of slices exhibiting water-soaked areas in fresh-cut tomato slices of 'Mountain Pride' and 'Sunbeam' tomato (Lycopersicon esculentum Mill.). Ethylene concentration in containers without ventilation significantly increased during storage at $5^{\circ}C$, whereas little or no accumulation of ethylene occurred in containers with one or six perforations. Chilling injury was greatest for slices in containers with six perforations, compared to slices in containers with one perforation, and was over 13-fold greater than that of slices in control containers with no perforations. An experiment was also performed to investigate the effectiveness of including an ethylene absorbent pad in containers on subsequent ethylene accumulation and chilling injury. While ethylene in the no-pad controls increased continually during storage of both 'Mountain Pride' and 'Sunbeam' tomatoes at $5^{\circ}C$ under modified atmosphere conditions, no increase in accumulation of ethylene was observed in containers containing ethylene absorbent pads throughout storage. The ethylene absorbent pad treatment resulted in a significantly higher percentage of chilling injury compared with the no-pad control. In studies aimed at inhibiting ethylene production using AVG during storage of slices, the concentration of ethylene in control containers (no AVG) remained at elevated levels throughout storage, compared to containers with slices treated with AVG. Chilling injury in slices treated with AVG was 5-fold greater than that of controls. Further, we tested the effect of ethylene pretreatment of slices on subsequent slice shelf-life and quality. In slices treated with ethylene (0, 0.1, 1, or $10\;{mu}L\;L^{-1}$) immediately after slicing, ethylene production in non-treated controls was greater than that of all other ethylene pre-treatments. However, pretreatment of slices 3 days after slicing resulted in a different pattern of ethylene production during storage. Ihe rate of ethylene production by slices treated with 1 L $L^{-1}$ ethylene 3 days after slicing was greater during storage than any of the other ethylene treatments. With slices pre-treated with ethylene, both immediately and 3 days after slicing, the rate of ethylene production tended to show an negative correlation with chilling injury. Chemical name used: 1-aminoethoxyvinylglycine (AVG).

• 아동간호학회:학술대회논문집
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• 1997.11a
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• pp.61-74
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• 1997

Endotracheal suctioning is a routine procedure used for clearing secretions from the airway of the intubated infant. This procedure is not without complications. Endotracheal suctioning has been associated with decreases in $PaO_2$, decreases in systemic venous oxygenation, alterations in mean arterial Pressure, disturbances in cardiac rhythm and development of nosocomial pneumonia. So several endotracheal suctioning techniques have been developed to prevent these blown complications. Another method of Endotracheal suctioning eliminates the risk associated with disconnecting the infant from the ventilatior to perform the suctioning procedure. Studies examining closed endotracheal suctioning methods reported that the closed method results in less arterial oxygen saturation, and less systemic venous oxygen desaturation. However those studies have focused on adult patients, and there have been no published studies for newborn infants. The specific purpose of this study is to investigate the two methods and to make a comparison in terms of (1)variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning; (2)difference in occurrence of nosocomial infection; (3)difference in recovery time to arrive at pre-suction baseline after suctioning and in nursing time taken for the suctioning. The present study is based on the data obtained from two groups of newborn infants : one group comprises 8 infants with closed suctioning (a total of 304 suctions) among 17 infants treated with ventilator and the other group 9 infants with open method (a total of 629 suctions). The data were analyzed using the SPSS statistical program package. As the distribution test on dependent variables with the Skewnesser Shapiro Wilk test showed an asymmetric distribution, the Wilcoxon Matched-pairs Singled- Ranks test was used for the test of variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning. The difference in $SaO_2$ recovery time and nursing time was analyzed with the Mann-Whitney U-Test. The difference in physiologic consequences and occurrence of nosocomial infection between the two groups was analyzed with the Fisher's Exact Test. The results of the study are summarized as follows. For the hypothesis 1 (There would be a difference in $SaO_2$, heart rate, and respiration rate before and after suctioning between the two suctioning methods), the difference in $SaO_2$ turns out to be statistically significant (P=0.015), but heart rate and respiration rate do not procedure a notable difference (P=0.630). The hypothesis 2 (There would be a difference in rates at which a complication arises after suctioning between the two groups) does not prove to be statistically valid (P=0.246). For the hypothesis 3(There would be a difference in $SaO_2$ recovery time and nursing time between the two groups), the average $SaO_2$ recovery time after suctioning turned out to have somewhat significant difference (P=0.064), however the difference in nursing time taken for the suctioning was not statistically significant (P=0.610). The analyses indicate that the closed endotracheal suctioning is more efficient as compared with the open method, in maintaining pre-suction baseline $SaO_2$ and a rapid recovery of newborn infants. Based on these results we suggust to apply the closed method to newborn infants in the ventilation treatment. We also suggest to extend the investigation to include the comparison of suction cost taking into account the case in which a complication arises after endotracheal suctioning between the two groups.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.4
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• pp.613-623
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• 2010

The purpose of this study was to examine parents' perceptions towards the importance and performance levels of foodservices quality at kindergartens. The questionnaire was developed to measure the thirty-one quality attributes of foodservice operations. A questionnaire survey was conducted to 500 parents and the return rates were 62.4%. The survey period was from July 15 to August 8, 2008. The parents had a high level of perception toward the need for foodservice, earning 4.46 points out of 5 point. Their perceptions of foodservice quality were examined by six dimensions of importance and performance level. While the parents gave 4 points or greater of 5 points to most quality attributes of importance level, they gave 4 points or less out of 5 points to most quality attributes of performance level. As for the importance and performance level of the quality dimensions of foodservice, parents regarded sanitation as the most important dimension. IPA showed that 'ventilation', 'sanitation of tableware' and 'sanitation of dining tables and chairs' were included as 'focus' areas. The overall satisfaction level for foodservice was 3.74 out of 5 points A higher level of satisfaction was shown at self-operated foodservice system of kindergartens. According to multiple regression analysis, 46.3% of the variance in the respondents' overall satisfaction scores was explained by factors such as food, menu and price, facilities, sanitation, atmosphere and foodservice effects.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.503-509
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• 2010

Purpose : Although neonatal pulmonary hemorrhage is rare, it is associated with high mortality. We aimed to evaluate the risk factors associated with pulmonary hemorrhage in preterm infants and to describe the clinical course, including neonatal morbidity, of infants who developed pulmonary hemorrhage. Methods : We performed a retrospective case-control study of 117 newborn infants aged less than 37 gestational weeks admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 1995 and December 2008. Control group infants without pulmonary hemorrhage were matched according to the gestational age, duration of mechanical ventilation, and birth weight range (${\leq}100g$). Pulmonary hemorrhage was defined as the presence of hemorrhagic fluid in the trachea and severe respiratory decompensation. Results : Pulmonary hemorrhage occurred in 17 cases of very low birth weight infants (VLBW; birth weight < 1,500 g; median age, 3 days) and 22 cases of low birth weight infants (LBW; $1,500g{\leq}$ birth weight < 2,500 g; median age, 1 day). Antenatal maternal glucocorticoid treatment significantly reduced the incidence of pulmonary hemorrhage in VLBW infants. Low APGAR score (${\leq}3$ at 1 min) and acidosis at birth were associated with significantly high incidence of pulmonary hemorrhage in LBW infants. Conclusion : Antecedent factors and timing of pulmonary hemorrhage of LBW infants were different from those of VLBW infants. The mortality rates of VLBW and LBW infants were 88.2% and 45.5%, respectively. Pulmonary hemorrhage was the principal cause of death in 66.6% VLBW infants and 40.0% LBW infants.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1252-1264
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• 1998

Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.