• Title/Summary/Keyword: chronic symptoms

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

  • Kim, Ji-Ho;Won, Jong-Uk;Kim, Chi-Nyon;Roh, Jaehoon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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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.

Prevalence of Combined Bronchial Asthma with COPD in Patients with Moderate to Severe Air flow Limitation (중등증 및 중증의 만성 기류 장애 환자에서 만성폐쇄성폐질환과 기관지 천식의 합병률)

  • Rhee, Yang Keun;In, Byeong Hyun;Lee, Yang Deok;Lee, Yong Chul;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.386-394
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    • 2003
  • Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

Insomnia in Patients with Chronic Renal Failure on Hemodialysis (혈액투석 중인 만성 신부전증 환자에서의 불면증에 대한 연구)

  • Kim, Gyung-Ryul;Yang, Chang-Kook;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.126-132
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    • 1999
  • Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

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Effects of Thermotherapy for Life Care in the Elderly with Chronic Neck Pain (만성 목통증 노인환자의 라이프케어를 위한 온열치료의 효과 연구)

  • Lee, Jong-Min;Shin, Ho-Jin;Kim, Sung-Hyeon;Roh, Young-Chae;Jung, Kyoung-Sim;Hahm, Suk-Chan;Lee, Sung-Jae
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.635-645
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    • 2019
  • Non-specific chronic neck pain (CNP) is a prevalent disorder and often accompany with pain, fatigue, reduced range of motion (ROM), and hand function. Although various types of drug are commonly used to manage the symptoms following CNP, there is a need for therapeutic exercise and alternative medicine interventions that have few side effects or are easy to apply. Present study investigated the effects of salt pack and neck exercise for life care of the elderly with non-specific CNP. Sixteen patients with non-specific CNP were recruited and randomly assigned into two groups: the intervention group (n=8) or the control group (n=8). All patients performed neck self-exercise for 30 min/day, 5 times a week for 1 week. And the subjects in the intervention group additionally received salt hot pack for 20 min per session. Visual analogue scale (VAS) and pain pressure threshold (PPT) using algometer were used to assess pain intensity (primary outcome). ROM of shoulder joint and grip strength were measured to test shoulder and hand function (secondary outcome). There were significant improvements in the intervention group (p<.05), while the subjects in the control group did not show a significant change after intervention (p>.05). Also, the intervention group show significant differences in VAS and PPT compared to the control group (p<.05). Thus, our results demonstrated that salt pack and neck exercise have a positive effect for life care in elderly patients with non-specific CNP.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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A Clinical Review of Primary Tracheal Carcinoma (원발성 악성기관종양의 임상적 고찰)

  • Ryu, Jeong-Seon;Cho, Hyun-Myung;Yang, Dong-Gyoo;Lee, Hong-Lyeol;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Shin, Kye-Chul;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.766-775
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    • 1997
  • Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.

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The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

BTEX Exposure and its Health Effects in Pregnant Women Following the Hebei Spirit Oil Spill (허베이 스피릿호 유류유출사고 지역 산모의 BTEX 노출과 건강영향)

  • Kim, Byung-Mi;Park, Eun-Kyo;LeeAn, So-Young;Ha, Mi-Na;Kim, Eun-Jung;Kwon, Ho-Jang;Hong, Yun-Chul;Jeong, Woo-Chul;Hur, Jong-Il;Cheong, Hae-Kwan;Yi, Jong-Heop;Kim, Jong-Ho;Lee, Bo-Eun;Seo, Ju-Hee;Chang, Moon-Hee;Ha, Eun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.96-103
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    • 2009
  • Objectives : We evaluated the health effects of exposure to BTEX(Benzene, Toluene, Ethylbenzene, m,p-Xylene, o-Xylene) in the Taean area after the Hebei Spirit oil spill. Methods : We used a questionnaire survey to look for health effects among 80 pregnant women 2 to 3 months following the Hebei Spirit oil spill. Their BTEX exposures were estimated using the CALPUFF method. We then used a multiple logistic regression analysis to evaluate the effects of BTEX exposure on the women s health effets. Results : Pregnant women who lived near the accident site reported more symptoms of eye irritation and headache than those who lived farther from the site. There was a trend of decreasing symptoms with an increase in distance from the spill site. Pregnant women exposed to higher ambient cumulative levels of Xylene were significantly more likely to report symptoms of the skin(OR 8.01 95% CI=1.74-36.76) in the first day after the accident and significantly more likely to report abdominal pain(OR 3.86 95% CI=1.02-14.59 for Ethylbenzene, OR 6.70 95% CI=1.82-24.62 for Xylene) during the 1st through 4th days following the accident. Conclusions : This study suggests that exposure to BTEX from an oil spill is correlated with an increased risk of health effects among pregnant women. This implies the need to take proper measures, including the development of a national policy for environmental health emergencies and a plan for studying the short- and long-term chronic health effects associated with such spills.

Clinicopathological Correlation of Intralobar Pulmonary Sequestration (내엽성 폐격리증의 임상적 특성과 조직병리학적 소견의 연관성)

  • Cho, Hyun-Min;Shin, Dong-Hwan;Kim, Kil-Dong;Lee, Sak;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.356-362
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    • 2003
  • Background: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively, uncommon among them. Material and Method: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records wire retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. Result: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not significantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. Conclusion: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.

Reevaluation of Clinical Efficacy of Peripheral Vasodilator: Ethaverine HCl (말초혈관(襪梢血管) 확장제(擴張劑) Ethaverine HCl의 임상효과(臨床效果)의 재평가(再評價))

  • Kim, Yoon-Young;Cho, Young-W.
    • The Korean Journal of Pharmacology
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    • v.11 no.1 s.17
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    • pp.33-38
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    • 1975
  • The clinical efficacy of Ethaverine, a peripheral vasodilator, was studied according to a double-blind, non-cross over method in 29 diabetic patients with peripheral arterial diseases. The clinical improvement was assessed from the history of patients including the incidence and frequency of intermitten claudication. Ethaverine, after 4 weeks of therapy, was not effective in improving clinical symptoms compared to placebo. Ethaverine, however, was an efective vasodilator than placebo. The quality of vasodilation induced by Ethaverine, was similar to that of alcohol. A new clinical method of studying peripheral vasodilator was presented. The clinical symptoms of peripheral vascular arterial disease in the lower extrimities include reduced intensity of palpable pulses, coldness, and discoloration of the skin. Intermittent claudication may be present. Pathologic changes in vessel architecture precede the symptoms, and recognition of impending vascular insufficiency is a determining factor in selecting vasodilating therapy or surgical management. Also, post-operative patients who have chronic peripheral vascular arterial disease may be candidates for subsequent vasodilating therapy. Peripheral vasodilators, according to the series of reports, may be indicated in vasospastic peripheral vascular condition rather than an occlusive vascular disease and the vessel responds best when a relatively large vascular beds are involved rather than a small, capillary beds. Recently, the clinical efficacy of peripheral vasodilators have been challanged by many clinical investigators and clinicians. In this study, we have re-evaluated the efficacy of Ethaverine HCl as peripheral vasodilator in patients with vasospastic peripheral arterial disease. Ethaverine is claimed to be two to four times as potent a spasmolytic agent as papaverine in a variety of laboratory and clinical work.

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