• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.740-746
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• 2001

Background : A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapsed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsened. The patient suffered respiratory failure and received mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had received talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.170-174
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• 2013

Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.564-573
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• 1999

Background: With variable symptoms and nonspecific radiographic appearances, pulmonary embolism (PE) is a frequent and often undiagnosed cause of mortality and morbidity. The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study suggested that the majority of patients undergoing ventilation-perfusion (V-Q) scan would require additional studies to establish or to exclude the diagnosis of PE. Pulmonary angiography has been regarded as gold standard for diagnosis of PE. However, it is an invasive procedure that may be associated with significant notable morbidity and mortality. Thus, availability of an accurate, noninvasive screening examination is highly desirable. Method: From October 1994 to February 1997, twenty patients (male 13, female 7, range 23-91 years, median 58 years) who were suspected as pulmonary embolism on the basis of clinical evidence and underwent the spiral volumetric computed tomography (spiral CT), were studied retrospectively to evaluate the effectiveness of spiral CT as a diagnostic tool in PE. Results: PE could be excluded with spiral CT in 4 patients ; diagnoses of these patients were lung cancer, pneumonia with lung abscess, bilateral pleural effusion due to congestive heart failure, nonspecific pulmonary abnormality retrospectively. One patient who disclosed high probability in V/Q scan, could be diagnosed as pneumonia with lung abscess and underlying emphysema with spiral CT. Among 4 patients who showed intermediate and low probability in V/Q scan, 3 patients could be confirmed as PE with spiral CT. Spiral CT was helpful in 3 patients, in whom V/Q scan could not be performed due to other reasons (e.g. night time, mechanical ventilation) to confirm the diagnosis of PE. Spiral CT could demonstrate embolus above lobar artery level in 11 patients, and up to segmental artery level in 5 patients. Conclusion: This study demonstrated that spiral CT could allow accurate demonstration of thrombotic clots in centrally localized embolism. Spiral CT could be effective, specific, noninvasive and useful diagnostic screening modality for the diagnosis of pulmonary embolism.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.4
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• pp.518-527
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• 2014

Objectives: The adverse health effects attributed to exposure to radon have been well known over the world. However, the efforts for prevention and mitigation of radon have not been taken in Korea so far. The purpose of this study was to evaluate the effectiveness of mitigation methods applied for various types of houses and public buildings with high level of radon. Methods: Based on the results of "National Radon Survey" performed by the National Institute of Environmental Research(NIER) in 2010-2012, we selected 30 candidate buildings consisting of 20 houses and 10 public buildings with greater than $148Bq/m^3$ of radon level. We measured the concentration of radon in 30 buildings, using E-PERMs and RAD-7 during January to March of 2013. More than five E-PERMs and one RAD-7 per house were installed for seven days. Ten houses and five public buildings were finally chosen to be mitigated after mainly considering the level of radon and the location of buildings nationwide. Three mitigation methods such as Sealing, two types of Active Ventilation(window-shaped and wall-typed ventilations), and Active Soil Depressurization(ASD) were applied, and the concentrations of radon were measured before and after mitigation, respectively. To evaluate the effectiveness of mitigation methods, reduction rates of radon were calculated and Wilcoxon's signed-rank test was performed. Results: The mean concentration of 15 buildings just before radon mitigation was $297.8Bq/m^3$, and most of the buildings were located in Gangwon, Chungbuk, Chungnam, and Daegu areas(73.3%), and built in 1959-1998. The level of radon decreased from 48% to 90% and kept the below recommendation limit of $148Bq/m^3$ after installation of radon mitigation. Among mitigation methods applied, the reduction rate(58.7-90.4%) of radon attributed to ASD was the greatest than that of other methods, followed by Active Ventilation(48.4-78.4%) and Sealing(<22%). The effectiveness of radon reduction by window-shaped Active Ventilation(63.2-75.2%) was relatively better than that of wall-typed Active Ventilation(48.4-54.3%). Conclusions: The results of this study indicate that ASD could be more effective for radon mitigation. Moreover, our findings would be background information in future for making the strategy for radon mitigation nationwide, as well as for developing Korean-version of mitigation techniques according to types of dwellings in Korea.

• Korean Journal of Veterinary Service
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• v.38 no.3
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• pp.195-198
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• 2015

Mannheimia haemolytica is an opportunistic bacterium that is widely recognized among the bovine respiratory disease (BRD) complex in cattle. Five Hanwoo with a history of fever, anorexia and dyspnea were died within 2 days in a the middle of summer. Four cattle were pregnant. The cattle house were located in mountainous area but the window for air ventilation was open only one side. In addition, the fecal material for fermentation was located indoor. Air ceiling fan did not work. The indoor temperature was $40^{\circ}C$. After working on air fan, the indoor temperature was still $36^{\circ}C$. On necropsy, there was fibrinous pleuritis with a rich yellowish pleural fluids in the thorax. The cross-section of the lung showed lobar fibrinonecrotic pneumonia with expanded interlobular septa by edema and fibrin. Microscopically, parenchymal necrosis with dense layer of inflammatory cells were observed surrounding interlobular septum. Fibrin and inflammatory cells were filled in the alveoli. Bacteriological cultures of pulmonary tissue showed growth of M. haemolytica. This pneumonia case in Hanwoo suggests that environmental stressors such as high temperature, insufficient air ventilation, and pregnancy be the cause of mannheimoisis. Control of environmental stressor, such as temperature indoor is necessary to prevent BRD caused by M. haemolytica.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.6
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• pp.775-781
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• 1997

Although reoxygenation is the best way to salvage hypoxic tissues, reduced oxygen species (ROS) generated during reoxygenation are blown to cause further tissue injuries and the induction of heat shock proteins (HSPs). The present study was undertaken to determine any causal relationship between the severity of hypoxia and the opposite outcomes, either beneficial or detrimental, of the subsequent reoxygenation by measuring the HSP72. To this aim, one group (6 male cats, $2.5{\sim}3.5\;kg$) was subjected to a 5-min episode of hypoventilation (H, ventilation rate: 5/min) for the induction of slight hypoxia and the other group (6 male cats, $2.4{\sim}3.7\;kg$) was subjected to a 5-min episode of apnea (A) for severe hypoxia. Each 3 animals from both groups received a 10-min episode of ventilation with $(95%\;O_2\;(0)$, whereas the remainder did not. After these procedures, all animals were allowed to be ventilated within physiological range for 1, 4, or 8 hours (1H, 1HO, 4H, 4HO, 8H, 8HO, 1A, 1AO, 4A, 4AO, 8A and 8AO groups). Control animals did not receive any manipulation. The arterial blood $pCO_2$ was significantly higher just after apnea than hypoventilation, while $pCO_2$ and pH were significantly lower just after apnea than hypoventilation. Western blot analysis revealed that the magnitude of HSP72 synthesis is larger in 1H, 4H and 8H groups than in 1HO, 4H and 8HO groups, respectively. In contrast, 1AO, 4AO and 8AO groups more induced HSP72 than 1A, 4A and 8A groups, respectively. These results suggest that the reoxygenation is beneficial after slight hypoxia but detrimental after severe hypoxia.

• Applied Chemistry for Engineering
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• v.26 no.2
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• pp.229-233
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• 2015

In this study, we examined the removal characteristics of suspended particulate matters which are one of carcinogens to cause lung cancer. The fine dust capture by a pilot scale filtration system depends on several important variables such as humidity, initial fine dust injection volume, and flow rate. The average concentration of particulate matters in the test chamber decreased, but the ultimate collection efficiency did not change during the filtration under high humidity, compared to those of using ambient conditions The initial injection amount of fine dust did not influence the particle capturing efficiency. When the flow rate reduced from 0.6 m/s to 0.3 m/s, the dust collection time increased approximately 1.4 times. Among all variables tested, the flow rate showed the most significant effect on the removal efficiency of fine particulate matter.

• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.120-123
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• 2013

Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.

• International Journal of Advanced Culture Technology
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• v.6 no.3
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• pp.211-215
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• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.235-238
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• 1996

Hyperhidrosis is the distressing condition of abnormal sweating which affects the palm, sole and axillary region. Transthoracic endoscopic sympathectomy is recommended as the treatment of choice for hyperhidrosis, especially when the upper limbs are affected. We experienced a case of accidental cauterization of right azygos vein in a healthy 23 year old male during endoscopic transthoracic sympathectomy. We changed the single lumen endotracheal tube to a double lumen tube which made it easier to perform the explo-thoracotomy and bleeder ligation under one lung ventilation. Crystalloid and colloid solutions, and packed RBC were loaded during explo-thoracotomy. Monitoring showed the signs indicating pulmonary edema. Pulmonary arterial catheterization revealed global heart failure. The patient was transfered to ICU for intensive management for heart failure. On the 4th postoperative day, pulmonary edema and heart failure were cured; and the patient was extubated. But in the evening of the same day ST-segment elevation and Q-wave were noted on ECG monitoring. On the 13th postoperative day coronary angiography was performed. This revealed left apex focal hypokinesia, patent coronary artery and accidental right coronary spasm, treated by vasodilator. On the 14 day, after surgery, he was discharged to return to work.