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Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Effects of Ambient Particulate Matter($PM_{10}$) on Peak Expiratory Flow and Respiratory Symptoms in Subjects with Bronchial Asthma During Yellow Sand Period (황사기간 중 천식 환자에서 대기 중 미세먼지($PM_{10}$)가 최대호기 유속과 호흡기 증상에 미치는 영향)

  • Park, Jeong Woong;Lim, Young Hee;Kyung, Ssun Young;An, Chang Hyeok;Lee, Sang Pyo;Jeong, Seong Hwan;Ju, Young-Su
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.570-578
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    • 2003
  • Background : Ambient particles during Asian dust events are usually sized less than $10{\mu}m$, known to be associated with the adverse effects on the general populations. But, there has been no considerable evidence linking these particles to the adverse effects on airways. The objectives of this study was to investigate the possible adverse effects of Asian dust events on respiratory function and symptoms in subjects with bronchial asthma. Patients and Methods : From march to June 2002, Asthmatic patients who were diagnosed with bronchial challenge test or bronchodilator response were enrolled. We divided them into three groups; mild, moderate, and severe, according to the severity. Subjects with other organ insufficiency such as heart, kidney, liver, and malignancy were excluded. All patients completed twice daily diaries and recorded peak flow rate, respiratory symptom, and daily activity. Daily and hourly mean pollutant levels of particulate matter < $10{\mu}m$ in diameter($PM_{10}$), nitrogen dioxide($NO_2$), sulphur dioxide($SO_2$), ozone($O_3$) and carbon monoxide(CO) were measured at the 10 different monitoring sites. Results : Dust events occured 14 times during the study period. Daily averages of 4 air pollutant were measured with an increased level of $PM_{10}$, decreased level of $NO_2$ and $SO_2$, and no change in CO during dust days compared to those during control days. An increase in $PM_{10}$ concentration was associated with an increase of subjects with PEF variability of >20% (p<0.05), night time symptom(p<0.05), and a decrease in mean PEF (p<0.05), which were calculated by the longitudinal data analysis. Otherwise, there was no association between $PM_{10}$ level and bronchodialtor inhaler, and daytime respiratory symptoms. Conclusion : This study shows evidence that ambient air pollution, especially $PM_{10}$, during Asian dust events, could be one of the many aggravating factors at least in patients with airway diseases. This data can be used as a primary source to set up a new policy on air environmental control and to evaluate the safety of air pollution index. We also expect that this research will help identify precise components of dust, which are more linked to the adverse effects.

Expressions of Laminin-1 in Lung Alveolar Septa after CS gas Exposure in Rats (CS 가스 흡입이 흰쥐의 폐포막내 Laminin-1에 미치는 영향)

  • Chon, Soon-Ho;Paik, Doo-Jin;Lee, Chul Burm;Kim, Hyuck;Chung, Won Sang;Kim, Young Hak;Kang, Jung Ho;Jee, Heng Ok
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.397-405
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    • 2005
  • Background : Laminin-1 is known to have regular functions in the development and course of differentiation of the lungs. The morphogenesis and distribution of laminin-1 still remains as a mystery and its distribution and changes in the molecular structure of laminin-1 in the pathogenesis of the lung still is a subject of great controversy. In this study, experiments were done to delineate the distribution and changes in the amount of laminin-1 after inducing inflammation of the lungs by exposing experimental animals to CS gas and especially, to find compositions of laminin-1 within type II pneumocytes. Materials and Methods : The experimental subjects of study were newborn rats and the extracted tissue from the experimental rats were viewed under light microscope and electron microscope after the sections were treated with immunohistochemical methods and immunogold reaction methods using bounded gold particles. Results : 1) Lymphocytes and mononuclear phagocytes invaded the alveolar septa in the 2 day group rats after CS gas exposure and intense interstitial inflammation was seen in the 3 day group. 2) Laminin immunoreactions decreased to a moderate degree in the 2 and 3 day group rats after CS gas exposure and strong laminin immunoreactions were seen again in the 5 and 7 day group rats. 3) Gold particles in basal lamina of the lung blood-air barrier decreased and in the type I pneumocytes decreased in the 2 and 3 day group rats after CS gas exposure. 4) Gold particles were seen only on the surface of the cell membranes of type II pneumocytes of the 1 and 2 day group rats after CS gas exposure. 5) Few gold particles around the lamellar bodies and cytoplasm of type II pneumocytes in the control rat group and at 12 hours after CS gas exposure. Gold particles are seen only on the surface of type II pneumocytes of the 1 and 2 day group rats after CS gas exposure and are evenly distributed in small amounts in the cells of the 3 day group after CS gas exposure. Conclusion : CS gas exposure in the rats caused inflammation of lung alveolar septa and also induced a decrease in laminin-1 in basal lamina and loss of laminin-1 in the cytoplasm of type II pneumonocytes. As the inflammatory cells disappeared, an increase in the distribution of laminin-1 occurred. This reflects tissue regeneration functions of laminin-1 in the pneumocytes of rats and the distribution of laminin-1 in type II pneumocytes can be seen through the electron microscope using immunogold methods.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

A Comparative Study of Hydrocolloid(Duoderm$\circledR$) and Hydrogel(Nu-Gel$\circledR$) Occlusive Dressing Materials in the Treatment of Full-Thickness Skin Wound in Dogs (개에서 전층피부 창상에 대한 Hydrocolloid(Duoderm$\circledR$)과 Hydrogel(Nu-Gel$\circledR$)의 치료 효과 비교 연구)

  • Kwon, Young-Sam;Rhee, Jung-Woo;Jang, Kwang-ho
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.294-301
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    • 2003
  • This study was performed to compare the effects of hydrocolloid(Duoderm$\circledR$, HC in this study) and hydrogel (Nu-Gel$\circledR$, HG in this study) occlusive dressing materials on degree of exudate, wound contraction, epithelialization, and healing of full-thickness skin wound in dogs. Three wounds measuring 2${\times}$2 cm in size were created bilaterally(6 wounds/dog) on the dorsolateral aspect of the trunk of 12 dogs. In each dog, the wounds were treated with HC, HG, and normal saline, respectively. For a 4 week period, the wounds were evaluated gross aspects and histopathological aspects. There were no statistically significant differences between treatment groups in percentage of wound contraction, percentage of epithelialization, and percentage of wound total healing during the first week. Significant differences were first detected on day 14. On day l4(P < 0.01) and 21 (P < 0.05), mean percentage of epithelialization of HG-treated wound was significantly greater than those in HC- and normal saline-treated wound. Mean percentage of wound contraction of HG-treated wound was significantly greater than that in HC- and control wounds on day 21(P< 0.05). On day 21, mean percentage of wound healing of HG-treated wound was significantly greater than that in HC- and control wounds(P < 0.02). On day 1, 4, and 7 after wound creation, although severe infiltration of PMN (polymorphonuclear leukocyte) cells in HC- and control wounds were observed in the subcutis and moderate infiltration of PMN cells in HG-treated wound were observed in the subcutis, we did not detect significant differences. On day 14 after wounding creation, in the wounds treated with HG dressing, epithelial cells were found over the surface, and edema further decreased in the tissue under the wounds, and the granulation tissue was replaced with collagen fibers. On day 21 after wound creation, in HG-treated wound compared with other experimental material-treated wounds, regenerated epidermis covered most of the wound surface, and the granulation tissue was more replaced with collagen fibers than that on day 14. Overall results indicated that the use of hydrogel dressing materials(Nu-Gel$\circledR$) as hydrocolloid dressing (Duoderm$\circledR$) materials and normal saline treatment on full-thickness skin wounds in dogs increased the rate of healing at repair stage.

The Effect of CSR Activity on Customer's Behavioral Intention in Insurance Industry (보험산업에서의 기업의 사회적책임(CSR) 활동이 고객행동의도에 미치는 영향에 관한 연구)

  • Hong, SoonRan;Bae, JeongHo;Park, HyeonSuk
    • Journal of Service Research and Studies
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    • v.10 no.1
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    • pp.33-53
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    • 2020
  • The purpose of this study is to empirically examine the causal relationship of CSR activities, customer trust and CCID, customer behavior intention(B.I) in the relationship between CSR activities and customer behavior intention(B.I) in the insurance industry, thereby enable top management of insurance company to take it in their consideration that CSR activity help link to customer behavioral intention by customer trust in them and CCID. To achieve the purpose of the study, the hypothesis was established based on preceding research and theoretical background regarding CSR, trust, CCID, behavioral intention(B.I). And this study conducted AMOS statistical analysis based on effective 526 survey data collected from insurance customers across country through online research company. The result of this empirical study is as follows. First, insurance company's CSR activity has a positive impact on customer's trust and CCID, but it did not have a direct significant effect on the customer's behavioral intention(B.I). Second, both customer's trust and CCID have a positive and significant effect on customer's behavioral intention. Third, we have also found that both Trust and CCID played a mediating role between CSR activity and B,I. Fourth, it was found that authenticity did not moderate the enfluence relationship between CSR activity and Trust, CCID. The result of this study shows that insurance company's active CSR activity increase customer trust, thereby create a sense of unity between the customer and the company, In addition, it shows that when CSR activities are mediated by customer trust and CCID, it could lead to customer behavioral intention(B.I) such as repurchasing and positive word-of-mouth activities. to others. The result of this study will contribute to the future research on CSR literature and the marketing strategy of insurance companies.

Crosshole EM 2.5D Modeling by the Extended Born Approximation (확장된 Born 근사에 의한 시추공간 전자탐사 2.5차원 모델링)

  • Cho, In-Ky;Suh, Jung-Hee
    • Geophysics and Geophysical Exploration
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    • v.1 no.2
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    • pp.127-135
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    • 1998
  • The Born approximation is widely used for solving the complex scattering problems in electromagnetics. Approximating total internal electric field by the background field is reasonable for small material contrasts as long as scatterer is not too large and the frequency is not too high. However in many geophysical applications, moderate and high conductivity contrasts cause both real and imaginary part of internal electric field to differ greatly from background. In the extended Born approximation, which can improve the accuracy of Born approximation dramatically, the total electric field in the integral over the scattering volume is approximated by the background electric field projected to a depolarization tensor. The finite difference and elements methods are usually used in EM scattering problems with a 2D model and a 3D source, due to their capability for simulating complex subsurface conductivity distributions. The price paid for a 3D source is that many wavenumber domain solutions and their inverse Fourier transform must be computed. In these differential equation methods, all the area including homogeneous region should be discretized, which increases the number of nodes and matrix size. Therefore, the differential equation methods need a lot of computing time and large memory. In this study, EM modeling program for a 2D model and a 3D source is developed, which is based on the extended Born approximation. The solution is very fast and stable. Using the program, crosshole EM responses with a vertical magnetic dipole source are obtained and the results are compared with those of 3D integral equation solutions. The agreement between the integral equation solution and extended Born approximation is remarkable within the entire frequency range, but degrades with the increase of conductivity contrast between anomalous body and background medium. The extended Born approximation is accurate in the case conductivity contrast is lower than 1:10. Therefore, the location and conductivity of the anomalous body can be estimated effectively by the extended Born approximation although the quantitative estimate of conductivity is difficult for the case conductivity contrast is too high.

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EFFECTS OF GINSENG COMPONENTS ON RODENTICIDE VACOR-INDUCED DIABETES MELLITUS IN RATS (인삼성분이 살서제(Vacor)로 유발시킨 쥐의 당뇨에 미치는 영향)

  • Lee Min-wha;Lee Tai-hee;Ahn Bong-whan;Park Byung-ju;Yang Sung-yeul
    • Proceedings of the Ginseng society Conference
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    • 1984.09a
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    • pp.83-88
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    • 1984
  • It is now well established that the rodenticide Vacor (N-3-pyridyl-mehtyl-N'-p-nitropheny-lurea) causes a hyperglycemia in human and rats. It is also reported that there are some components (DPG-3) in ginseng radix which cause hypoglycemic effect on alloxan diabetic mice. In the present study, attempts were made to demonstrate in Vacor-poisoned rats the hypo-glycemic activity of red ginseng component(RGC), which was extracted by Kimura's DPG-3 extraction procedure and found to be effective for lowering a hyperglycemia in alloxan-diabetic rats. Vacor in a dose of $LD_{50}$ (10mg/kg) produced a glucose intolerance with a paradoxical moderate increase in blood immunoreactive insulin and derangement in glucose metabolism of epididymal adipocytes in rats. Although RGC (20mg/kg, i.p.) did not exert any significant influence on a hyperglycemia induced by large lethal doses (25mg/kg) of Vacor ingestion, it improved the LDso Vacor-induced glucose intolerance and caused a further increase in blood insulin levels in Vacor-poisoned rats. The administration of RGC (20mg/kg, i.p.) normalized Vacor-induced depression of glucose metabolism and lipogenesis in the epididymal adipocytes with an improvement of reduced responses to insulin of adipocytes from Vacor-poisoned rats. These results suggest that some red ginsneng components contained in RGC fraction normalize the depressed peripheral glucose unitlization and insulin response and eventually lead to an improvement of abnormal glucose tolerance developed in rats poisoned with small doses of Vacor.

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A Study on the Use of Dentifrice among Infants and Preschoolers (영유아의 세치제 사용에 관한 연구)

  • Chun, Ju-Yeon;Kang, Yung-Hee;Lee, Kyeong-Hee
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.267-274
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    • 2008
  • The purpose of this study was to examine the use of dentifrice among children in a bid to provide information on dentifrice including its function to children's parents, the major consumers of dentifrice for child. And it's additionally meant to offer useful information on the production of toothpaste for kid. The subjects in this study were parents with children, who dwelled in Seoul and Gyeonggi province. After a self-administered survey was conducted for about three months from May to July 2007 to gather data on their use of dentifrice for child, a comparative analysis was implemented. The findings of the study were as follows: 1. Concerning the state of the use of their children's dentifrice, the largest number of the children(58.1%) started to use toothpaste at the age of one or down, and the most common first toothpaste they used was dentifrice for preschooler(86.8%). As for whether to use fluoride-containing toothpaste, the largest group of the parents(58.1%) gave an affirmative answer. Regarding the form of the toothpaste in use, the majority of their children used toothpaste of cream type(86.2%). The greatest group of the children used the amount of toothpaste that was as large as the three-tenths or four-tenths of the bristles(35.9%). 2. As for the state of the use of dentifrice for kid, the greatest group used that kind of toothpaste(81.4%). In the event of those who didn't use it, the last time when their children used toothpaste for kid was when they were at the western age of 3(33.9%) and 4(33.9%). Concerning the reason why they replaced toothpaste for kid with one for adult, the largest group of the parents did that on their own judgment(58.1%). As to the right time for replacing toothpaste for kid by one for adult, the greatest group considered it advisable for children to start using toothpaste for adult at the western age of 4 or 5(43.2%). 3. In relation to the state of the purchase of toothpaste for their children, the largest group was under the moderate influence of the children when they bought it(45.2%). The greatest group attached importance to the ingredients of toothpaste(41.6%), and the most preferred ingredient was fluoride(56.3%). 53.0 percent took consideration on the content of ingredients or the instructions. 4. In regard to priorities for the choice of toothpaste for their children, they gave top priority to brand(16.7%), followed by quality(14.6%) and ingredients(13.5%). The age of the parents made a statistically significant difference to the children's age when they started using toothpaste, and how they started to do that and whether they used fluoride-containing toothpaste were statistically significantly different according to that as well(p < 0.01). In regard to the impact of the occupation of the parents, the use of fluoride-containing toothpaste was more common among the stay-at-home mothers(p < 0.01).

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