• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.53-61
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• 2020

Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment. The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records. Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil. Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

• The Korean Nurse
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• v.36 no.1
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• pp.59-76
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• 1997

The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.77-84
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• 2004

Background : We hypothesized that there was a relationship between body weight change and bronchodilator response (BDR) in patients with chronic renal failure (CRF) on hemodialysis (HD). Several mechanisms such as pulmonary edema due to water retention or increased permeability of alveolar capillary may play a important role in pulmonary function impairment and bronchial hyperresponsiveness in patients with CRF on HD. But, no studies have been published concerning BDR in patients with CRF on HD. This study was aimed to know the immediate effect of hemodialysis on pulmonary function and BDR in patients with CRF on HD. Methods : This study included 30 patients with CRF on HD. We collected data including age, sex, height, pretibial and pedal pitting edema, interdialysis weight gain, postdialysis weight loss, underlying diseases, duration of HD, $FEV_1$, FVC, $FEV_1/FVC$, and BDR before and after HD. Results : Interdialysis weight gain of the patients was $3.4{\pm}1.0kg$, and postdialysis weight loss was $3.2{\pm}0.7kg$. Before HD,$FEV_1$, FVC, and $FEV_1/FVC$ of the patients were $89{\pm}22%$, $86{\pm}19%$ of predicted, and $87{\pm}10%$. After bronchodilator inhalation, these parameters were changed to $95{\pm}22%$, $90{\pm}19%$ of predicted, and $88{\pm}9%$ respectively. BDR was positive in 15 patients. After HD, $FEV_1$, FVC, and $FEV_1/FVC$ of the patients were $100{\pm}23%$, $94{\pm}18%$ of predicted, and $88{\pm}11%$. After bronchodilator inhalation, these parameters were changed to $102{\pm}23%$, $96{\pm}18%$ of predicted, and $89{\pm}8%$ respectively. BDR was positive in 9 patients. Conclusion : First, HD increases $FEV_1$, FVC, and $FEV_1/FVC$ but little affects BDR. Second, there is no correlation between postdialysis weight loss and increases in $FEV_1$, FVC, and $FEV_1/FVC$ after HD. Third, there is also no correlation not only between interdialysis weight gain and BDR before HD but between postdialysis weight loss and BDR after HD.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.495-499
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• 2003

Purpose : Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages. Methods : Twenty-five children(22 male and three female) aged $11.87{\pm}3.82$ years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter( Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The $FEV_1$ less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as ${\mu}gEPX/mmol$ creatinine. Results : An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma. Conclusion : Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.

• Journal of Environmental Health Sciences
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• v.46 no.2
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• pp.136-149
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• 2020

Objectives: The purpose of this study was to perform an aggregate human risk assessment for benzene in an industrial complex using the CalTOX model and to improve the reliability and predictability of the model by analyzing the uncertainty and sensitivity of the predicted assessment results. Methods: The CalTOX^TM 4.0 beta model was used to evaluate a selected region, and @Risk 7.6 software was used to analyze uncertainty and sensitivity. Results: As a result of performing the aggregate risk assessment on the assumption that 6.45E+04 g/d of benzene would be emitted into the atmosphere over two decades, 3% of the daily source term to air remained in the selected region, and 97% (6.26E+04 g/d) moved out of the region. As for exposure by breathing, the predicted LADD_inhalation was 2.14E-04 mg/kg-d, and that was assessed as making a 99.99% contribution to the LADD_total. Regarding human Risk_cancer assessment, the predicted human cancer risk was 5.19E-06 (95% CI; 4.07E-06-6.81E-06) (in the 95th percentile corresponding to the highest exposure level, a confidence interval of 90%). As a result of analyzing sensitivity, 'source term to air' was identified as the most influential variable, followed by 'exposure time, active indoors (h/day)', and 'exposure duration (years)'. Conclusions: As for the results of the human cancer risk assessment for the selected region, the predicted human cancer risk was 5.19E-06 (95% CI; 4.07E-06-6.81E-06) (in the 95th percentile, corresponding to the highest exposure level, a confidence interval of 90%). As a result of analyzing sensitivity, 'source term to air' was found to be most influential.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.124-131
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• 2003

The concentration of nitrous oxide in dental environment has increased especially in pediatric department. In pediatric department frequently met the behavior disordered patients who need the deep sedation. As the deeply sedated patients could not respond well to verbal command, the amount of mouth breathing would be increased especially with mouth prop which backward transposition of mandible. Inhalation of low concentration of nitrous oxide for a long duration has caused various side effects such as spontaneous abortion and inhibition of methionine synthetase activity which is harmful to DNA synthesis. For evaluation of factors of mouth breathing during deep sedation. The author measured the concentration of nitrous oxide in breathing zone by the change of the scavenging methods. One is drain the gas through the tail part of reservoir bag of Jackson Ree's system naturally. Another is scavenge from tail portion of reservoir bag with negative pressure. Last one is scavenge from nasal mask with negative pressure. The nitrous oxide concentration in breathing zone was the lowest in nasal part drainage but high above the recommended concentration of NIOSH. The order of nitrous concentration in breathing zone was: natural drainage, tail part with negative pressure, nasal part with negative pressure. This would reflect the order of resistance of nasal airway and showed the amount of mouth breathing. From the above experiment, the resistance of nasal airway by the increment of gas flow in corrugating tube and reservoir bag would be one of the causative factors of mouth breathing in deeply sedated patients.

• Journal of the Korean Society of Tobacco Science
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• v.15 no.1
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• pp.3-14
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• 1993

Oxidants in environment or cigarette smoke are known to be implicated in the oxidative damages of pulmonary system. Such cellular damages are prevented by the presence of adequate levels of antioxidants in the tissue. In the present study, we investigated the influences of smoking duration and concentration of smoke on lung antioxidant defense in rats. Subchronic exposure of rats to smoke generated from 6 cigarettes per day for 90 days caused the activities of catalase and superoxide dismutase (SOD) to increase. However, glutathione peroxidase (GP-Xase) was not significantly changed. Total sulfhydryl compounds (Total-SH) in the lung homogenates from the rats inhaled with cigarette smoke for 15 days was decreased by 44% , thereafter it was returned to the level of normal rats. On the contrary, when rats were daily exposed to a different concentration of smoke generated from 1 to 20 cigarettes per day for 15 days, the activity of catalase was increased gradually with dose, but total SOD activity was increased only in the rats of low dose groups less than 5 cigarettes. Three types of SOD (one Cu, Zn-SOD with pI 4.9, and two Zn-SOD with pI 4.7 and 7.9)were detected in the lung homogenates and Zn-SOD with pI 4.7 was the major and cigarette-smoke inducible form. These results indicate that the protection of lung against oxidants from cigarette smoke seems to be accomplished by the induction of catalase and SOD, especially a cyanide resistant Zn-SOD with pI 4.f, following the consumption of antioxidants such as GSH in the beginning of inhalation period.

• Journal of Radiation Protection and Research
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• v.39 no.2
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• pp.89-95
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• 2014

In potential accident consequence assessments for the licensing approval of LWRs, the ground deposition of radionuclides released into the environment is not allowed into the models, as recommended in the U. S. Nuclear Regulatory Commission's regulatory guide. Meanwhile, it is allowed into the assessment models for the licensing approval of PHWRs with consideration of more detailed physical processes of radionuclides in the atmosphere. Under these backgrounds, importance of exposure dose by ground deposition was quantitatively evaluated and comprehensively discussed. For potential accidental releases of $^{137}Cs$ and $^{131}I$, total exposure doses were more conservative in case of without consideration of ground deposition than in case of with its consideration. It was because of that the depletion of air concentration resulting from ground deposition is more influential in the contribution to total exposure doses than additional doses from contaminated ground. The exposure doses by the inhalation of contaminated air showed the contribution of more than 90% in total exposure doses, depending on atmospheric stability, release period of radionuclides and distance from a release point. The exposure doses from contaminated ground showed less than 10% at most in contribution of total exposure doses. The ratios of total exposure doses in case of with consideration of deposition to without its consideration for $^{131}I$ were distinct than those for $^{137}Cs$. As the atmosphere is more stable, release duration of radionuclides is longer, distance from a release point is longer, it was more distinct.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.618-623
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• 1995

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to $6{\mu}m$ in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other environmental areas, especially those contaminated by pigeon droppings. Humans and animals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum KOH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.730-735
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• 1993

BOOP is a clinopathologic entity consisting of a flu-like illness, late inspiratory crackles, and pathologically granulation tissue plugs within lumens of small airways sometimes with complete obstruction of small airways and granulation tissue extending into alveolar ducts and alveoli with a variable degree of interstitial infiltration of mononuclear cells and accumulation of foamy macrophages in alveolar spaces in a patch distribution, and preservation of background architecture of the lung. It has patch infiltrates roentgenographically, and restrictive ventilatory defect pysiologically such as decreased vital capacity. and diffusing capacity. The BOOP has been observed in the context of collagen vascular disease, and other autoimmune disease secondary to treatment with penicillamine, bleomycin, acebutolol and amiodarone, following the inhalation of toxic fumes, after several infections including measles, pertussis and influenza and idiopathic. Clinically, response to coricosteroid therapy is good and relapse dose not occur if sufficient theraphy is good. A flu-like illness occurs in one third, cough in one third, cough with dyspnea in the remaining patients. Hemoptysis are rare. The physical examination reveales dry crackles in the majority of the patients with BOOP but rarely associated with wheezing. The duration of illness is less than 2 months in 75% of patients. With a brief review of literature, we report a case of the BOOP which is good response to steroid, but frequent relapse and assoicated with wheezing.