• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.813-822
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• 1998

Background: Extubation is recommended to be performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. Methods: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventilation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate $\times$ total ventilatory system resistance) at the 15cm $H_2O$ of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at PSmin). The measurements were repeated at PSmm, during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extubation. In intervention group, failure to continue weaning process was also considered as weaning failure. Results: Thirty-six patients with 42 times weaning trial were satisfied to the protocol. Mean PSmin level was 7.6 (${\pm}1.9$)cm $H_2O$. There were no differences in total ventilation times (TVT), APACHE III score, nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, and tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group ($10.4{\pm}1.25$ and $1.66{\pm}1.08$ J/L in work of breathing) ($191{\pm}232$ and $287{\pm}217$cm $H_2O$ s/m in pressure time product) ($0.33{\pm}0.09$ and $0.29{\pm}0.09$ L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success ($246{\pm}195$ hr, $0.43{\pm}0.11$ L) and the those with weaning failure ($407{\pm}248$ hr, $0.35{\pm}0.10$L) (P<0.05 in each). Conclusion : There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PS min.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.4
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• pp.435-448
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• 2022

Objectives: As the time spent wearing masks has increased with spread of COVID-19, various research related to masks have been reported. However, there are still few experiments on the physiological response of the body to wearing industrial dust masks in South Korea. Considering the actual working hours at the work site, it is necessary to investigate the comfort of industrial dust masks. Therefore, this study aims to confirm the change in subjective discomfort level according to the wearing time for industrial dust masks in South Korea that have been certified for safety by KCS. Methods: This study evaluated subjective discomfort level over four hours. The experimental conditions were five types: not worn (control group), special grade, first grade, second grade (with valve), and second grade (without valve). The subjective discomfort levels were classified for breathing, warmth (body and face) and wetness (body and face). Subjects recorded their discomfort level on a checklist every one hour. Results: In special grade and second grade (without valve), the discomfort level in terms of breathing, warmth (face), and wetness (face) was significantly higher than that of the control group. However, the effects of all kinds of industrial dust masks on the discomfort level in the body were low. Conclusions: Since this study was conducted on subjects working in an office with a comfortable working environment, it is difficult to apply it to workers at actual industrial sites. However, it is considered meaningful as the first clinical study to evaluate the subjective level of discomfort over a long time for domestic industrial dust masks that have been certified for safety by KCS.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.380-387
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• 1998

Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.803-810
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• 1999

Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.20 no.4
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• pp.225-235
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• 2010

This study was aimed to assess the status of working environment, health care management status and cause of exposure in manufactories using dimethylformamide (DMF). For the purpose, airborne concentration of DMF in the workplaces and N-methylformamide (NMF) in worker's urine were measured with job type and process. In addition, management of local exhaust ventilation system (LEV) and personal protective equipment (PPE) was evaluated at 35 work places (107 workers) located in Busan and Gimhae area. Mean DMF concentrations in work places by job type and process were of high level measured in printing and record media reproduction (5.23 ppm) and flaking process (2.48 ppm). Workers in adhesive job were measured a large amount of urine NMF (21.59 mg/${\ell}$). 98.1% of DMF handling workers were provided respirators, but 67.3% of those workers used them. The main reasons for not using respirators were inconvenience and difficulty of breathing. Airborne concentrations of DMF were higher in the workplaces in which LEVs were working abnormally, but there was not statistically significant. In addition, the urine NMF levels were correlated with management of LEV within the workers who did not use the respirators (p<0.048). These results implied that LEV should be installed and maintained properly to protect the workers from the exposure to DMF. Management of PPE should be also necessary to protect the workers from chemical hazards.

• International Journal of Advanced Culture Technology
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• v.5 no.3
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• pp.24-34
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• 2017

Nail art is a kind of nail painting or decoration that adds to the beauty. Throughout making nail art, the worker was on a dusty operation with the smoothing of chemicals and nails. People working at nail shops not only use a variety of chemicals, but also experience a lot of fine powder during the process of nail trimmings. While drying the chemical adhesive, the workers often complain of eye, nose and throat discomfort. In addition, the acrylic brush is characterized by a lot of smell when washed with washing solution. Also nail art workers directly influence the worker's breathing through the work done by placing the guest's hands in a work space called a nail table. Chemical ingredients used in nail art procedures include acetone, ethyl acetic acid, toluene, butyl acetic acid, glue, and top coating of nail varnishes. Prolonged inhalation of these substances may cause dizziness, vomiting, as well as impaired respiratory system. The purpose of this study is to investigate the respiratory symptoms of nail shop workers who are likely to be affected by work in nail shop and to find out which factors have the greatest influence if they have respiratory symptoms. Therefore this study is to provide basic data on the health management system of people engaged in nail shop and to develop health education program. For this study, the data collection was collected on July 7, 2017 for the nail shop workers attending the nail art trend seminar held in Gwangju, in Korea. The data were all 236. However, except for the poor data, 208 data were used for the final analysis. The questionnaire consisted of 30 in general questions, questions about self-efficacy in 24 questions. elf-efficacy measuring tool developed by A.Y, Kim, I. Y, Park(2001). The self-efficacy questionnaire consists of 24 items and is self-reported 7-point Likert scale. The reliability of this tool was cronbach alpha = .934.The collected data were analyzed using spss 18.0. Information of Research participant performed frequency analysis. To examine the effects of personal characteristics on self-efficacy, $X^2$ analysis was conducted. And also $X^2$ analysis was conducted to analyze the coughing symptom appearance according to individual and environmental factors. A hierarchical regression analysis was used to determine which of the personal and environmental factors influenced cough symptoms.

• Journal of Haehwa Medicine
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• v.12 no.1
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• pp.103-121
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• 2003

Human being can't live without nature, then the changes of nature affect human body. It means that human body has corresponding changes to the KI(vital energy) of nature. There is a stream of changes in human body which circulate mysteriously and punctually by the laws of nature. If this stream of changes fits into human's life style, it would be most effective. It has a certain mode continuously. So if a person has a habit fitting into it, he will get the healthiest body. Then the researcher tries to explain the changes in human body by the time, mainly focused on within 24 hours. it is showing not only the oriental view, but also the western's. The researcher can find the coincidence as followings. At In-Si(3-5 am), the body function and the body temperature get to the bottom, therefore it's good for him to wake up and to run the vital energy. At Sa-Si(9-11 am), the patience on pain anxiety and the psychic concentration get to the top, he'd better start the work. At O-Si(11am-1pm), the heart energy has a vital move, then the blood concentration of Hb(hemoglobin) gets to the top. At Mi-Si(1-3 pm), the muscle strength, the squeeze, and the breathing rate increase. The reflex nerve sensitivity gets to the top. Creativity, observation, and working efficiency go high, so it's time to work hard. At Hae-Si(9pm-1am), the body function falls, sleeping is needed. At Chuck-Si(1-3 am), the cell spontaneity gets to the top, immune lymphocyte moves actively, and the blood concentration of growth hormone gets to the top. These are liver's work. In west, there has been active studies on how to reduce the side effect by using a person's bio-rhythm based on the 'time treatment', and how to reorganize the bio-rhythm by using the machine and the age resistance based on the 'bio-watch'. Though the 'time treatment' means something, the artificial resistance on bio-rhythm seems to give bad effects to human body. If a person lives by regimen of oriental medicine, he will maintain the healthiest body. Regimen is that human body follows the laws of nature, and moves its mysterious, Punctual and periodical changes.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.574-582
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• 1997

Background : Normal humans meet the increased ventilatory need during exercise initially by the increase of tidal volume (TV) and later by the increase of respiratory frequency (Rf). And the inspiratory duty cycle (Ti/Ttot) is also increased more than 50% for the compensation of the decrease of respiratory cycle provoked by the increase of respiratory frequency. The patients with chronic airflow obstruction show rapid and shallow breathing pattern during exercise because of the decreased ventilatory capacity and the increased dead space ventilation. However, the studies about the change of inspiratory duty cycle are only a few and there is no literature about the relationship between the change of inspiratory duty cycle and the degree of airflow obstruction. Methods : The subjects were the twelve patients with chronic airflow obstruction (CAO) and ten normal people. The incremental exercise test was done. The increase of work load was 10 W in CAO group and 25 W in normal control group. The analysis of the results was done by the comparison of the parameters such as minute ventilation (VE), TV, Rf, physiologic dead space (Vd/Vt), and inspiratory duty cycle between the two groups. Each parameters were compared after transformation into % control duration base that means dividing the total exercise time into five fractions and % control duration data were obtained at rest, 20%, 40%, 60%, 80%, and max. Statistical analysis was done by repeated measure ANOVA using SAS program. Results : The changes of VE and TV were significantly different between two groups while the change of Rf was not significant. The decrease of Vd/Vt was significantly low in CAO group. Ti/Ttot was markedly increased from 38.4 + 3.0% at rest to 48.6 + 4.5% at max in normal control group while Ti/Ttot showed little change from 40.5 + 2.2% at rest to 42.6 + 3.5% at max. And the change of inspiratory duty cycle showed highly good correlation with the degree of airflow obstruction (FEV1%). (r=0.8151, p < 0.05). Conclusions : The increase of Ti/Ttot during exercise observed in normal humans is absent in the patients with CAO and the change of Ti/Ttot is well correlated with the degree of airflow obstruction.

• Journal of Haehwa Medicine
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• v.22 no.2
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• pp.47-56
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• 2014

Objectives : The purpose of this study is to raise the proper recognition of Qigong and expand the area of Medical Qigong in the korean Medicine by investigating and analyzing the current state of Javaldonggong training which has a high medical value but there has not been little research on. Method : The survey of this study was conducted by doing a search on the internet - Naver(www.naver.com) and Daum(www.daum.net), Nate(www.nate.com), trying question-and-answer on the websites and over the phone, visiting the organizations and reading their publications. Results : None of the teachers of these selected organizations are doctors. One thing all these organizations have in common is that they are, ultimately, aiming to gain the individual enlightenment and to contribute to public welfare although the terms they use are different. As for training contents, most of these organizations use breathing, meditation, gymnastics, circuit training in addition to Javaldonggong training and they work on Javaldonggong training programs to prevent problems that Qigong training can result in. 7 organizations have published the books of the theories, which are based on their own Javaldonggong training experience. Conclusions : Applying Javaldonggong training to the therapy for the diseases is the role of a doctor of Korean medicine. A further study of and a great interest in Javaldonggong training are required for Korean medical doctors to gain a firm foothold in using it as the medical Qigong therapy.

• Clinical and Experimental Pediatrics
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• v.61 no.3
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• pp.78-83
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• 2018

Purpose: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. Methods: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-square (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. Results: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. Conclusion: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.