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Tracheal gas insufflation (TGI) in patients with increased deadspace fraction: the effect and its determining factors (사강호흡율이 증가된 환자에서 기관내 가스주입법(Tracheal Gas Imsufflation)이 가스교환에 미치는 효과와 그 결정인자)

  • Lim, Chae Man;Jung, Bok Hyun;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Park, Pyung Hwan;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.136-145
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    • 1997
  • Background : Tracheal Gas Insufflation (TGI) is one of the newer ancillary measures in mechanical ventilation employed to enhance carbon dioxide elimination. TGI exerts its effect through reduction of deadspace ventilation, but the factors determining its effect are not well studied yet. Method : The subjects were seven mechanically-ventilated patients ($58.8{\pm}10.6$ yrs) who showed increased physiologic deadspace greater than 60%. After 30 nun of stabilization with 100% oxygen on pressure control ventilation, continuous flow TGI was administered via the insufflation lumen of Hi-Lo Jet Tracheal Tube (Mallincrodt, USA) for 15 min at 3 L/min and 5 L/min each. Results : $PaCO_2$ was decreased ($51.4{\pm}17.6$ at baseline, $49.1{\pm}18.9$ at TGJ 3 L/min $45.0{\pm}14.9$ mm Hg at TGI 5 L/min, p=0.050), and pH was increased ($7.37{\pm}0.12$, $7.38{\pm}0.13$, $7.39{\pm}0.12$, respectively, p=0.037) while mixed expired $CO_2$ ($P_ECO_2$) was not changed significantly from baseline (p=0.336) by TGI. Physiologic deadspace(Vdphy) was decreased ($73.0{\pm}7.9$% at baseline, $69.8{\pm}10.0$% at TGI 3 L/min, and $67.1{\pm}10.1$% at TGI 5 L/min, p=0.015). $AaDO_2$(p=0.147), Vt(p=0.2140), Pmean(p=0.7788) and mean arterial pressure(p=0.4169) were not changed. The correlation between % maximal decrease of Vdphy were r=0.790 with the ratio of baseline Vdana/Vdphy(p=0.035) and r=-0.754 with baseline Vdalv(p=0.050). Conclusion: TGI was effective in reducing $PaCO_2$ and deadspace, and the deadspace-reducing effect was best correlated with baseline anatomic/physiologic deadspace ratio.

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Studies on the Germination Characters of Korean Ginseng (Panax ginseng C.A. Meyer) Seed (고려인삼종자(高麗人蔘種子)의 발아특성(發芽特性)에 관(關)한 연구(硏究))

  • Won, Jun Yeon;Jo, Jae Seong
    • Korean Journal of Agricultural Science
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    • v.15 no.1
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    • pp.47-68
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    • 1988
  • This study was conducted to define the optimal conditions for embryo growth during seed stratification and for breaking dormancy as well as seed germination of stratified ginseng seeds. The experiments were also carried out to detect some materials which were expected to induce seed dormancy in the ginseng seeds. The results summarized as follows; 1. The growth of embryo during seed stratification was significantly inhibited by the existence of endocarp. The fastest embryo growth was resulted at $15^{\circ}C$ and an estimated optimal temperature for embryo growth was about $18^{\circ}C$. 2. There was no significant difference between the embryo growth and germination ratio of ginseng seeds which were sown in seed bed at Aug-5 without seed stratification and that of artificial seed stratification. 3. Embryo growth and germination ratio was significantly inhibited by high temperature treatment at $30^{\circ}C$ for 24 hours or respiration stress by immersing seeds in water for 10 days or more. 4. When the seed stratification was started at $10^{\circ}C$, growth of embryo in the ginseng seeds were almost stopped. But, when the seeds were stratified first at $20^{\circ}C$ for 50 days and next at $10^{\circ}C$ for 50 days, the embryo growth was significantly promoted compared with the embryo growth in the seeds which were stratified at $20^{\circ}C$ for 100 days. 5. The successive embryo growth after seed stratification was significantly accelerated at $10^{\circ}C$ but the seeds chilled at $5^{\circ}C$ for 100 days were resulted in the highest germination ratio as well as the shortest days for germination. 6. The successive embryo growth during chilling treatment and seed germination were significantly inhibited by immersing seeds in water just before chilling treatment or during chilling treatment and by interruption of chilling treatment with raising temperature to $20^{\circ}C$ for 20 days during chilling treatment. 7. The germination ratio of ginseng seeds which finished chilling treatment was highest at $10^{\circ}C$ and 62.5% was the estimated soil moisture for the best germination of ginseng seeds. The ginseng seeds were found to require high amount of oxygen for germination. 8. Only water soluble material in homogenized ginseng seeds showed a significant inhibiting effect on the seed germination of sesame, millet and soybean. Water soluble material dissolved from undehisced ginseng seeds showed stronger inhibiting effect on the seedling growth of sesame than material from dehisced ginseng seeds. Extraction temperature did not influence the inhibiting effect of the material dissolved from ginseng seeds on the seedling growth of sesame. 9. Water soluble materials dissolved from the berry pulps, leaves, fresh roots and dried roots also showed a significant inhibiting effect on the seedling growth of sesame. 10. Water soluble materials dissolved from the ginseng seeds, leaves and fresh roots showed a significant inhibiting effect on the germination of true fungi and the growth of spawn but the growth of phytopathogenic bacteria was not. 11. Among the water soluble materials dissolved from ginseng seeds, the materials of low molecular weight less than 3,000 were resulted a significant inhibiting effect on the seedling growth of sesame and the materials of high molecular weight also showed an inhibiting effect.

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The Long-term Follow-up Study of Therapeutic Effects of 8 French Catheter for Spontaneous Pneumothorax (자연 기흉의 치료에서 8 French 도관삽입의 치료 효과에 대한 장기적 관찰)

  • Shin, Jong-Wook;Lee, Byoung-Hoon;An, Chang-Hyeok;Choi, Jae-Sun;Yoo, Jee-Hoon;Lim, Seong-Yong;Kang, Yoon-Jung;Koh, Hyung-Ki;Kim, Jae-Yeol;Na, Moon-Jun;Park, In-Won;Sobn, Dong-Suep;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1094-1104
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    • 1997
  • Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.

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Dressing Effect of Phosphorus Fetilizer on the Growth of Soil Improving Species (비료목생장(肥料木生長)에 미치는 인산비료(燐酸肥料)의 시비효과(施肥效果))

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.45 no.1
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    • pp.26-36
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    • 1979
  • Through several trials that has done for making the fertilizing-counter plan on the soil improving species, some results have been got as follows; 1. In the non-phosphorus dressing plots soil improving species have very poor survial ratio and show us to be died step by step. It may be resons that root can not make the nodule in case of non-phosphorus dressing and so tree could not absorb the nitrogen nutrient fixed by the nodule. And root competition with the weedy speces for utilizing the nutrient and oxygen in the soil could be reasons when planting in the heavy weedy rooting site. 2. Triple super phosphate, Fused Mg Phosphate and Fused super phosphate have showed the remarkable effects on the growth of soil improving species within 3rd year after planting. But Koreaan tablet fertilizer(9-12-4) for forest purpose have reacted considerably lower effect in comparision with the above powder and grain type phosphorous fertilizer. 3. In case of tablet type fertilizer tree root will have very little phosphorus absorbing surface because phosphorus can be utilized only from the tablet surface and root can not penetrate into the tablet. This my be reson to show the poor dressing reaction of tablet fertilizer but tablet fertilizer has a possibility to be utilized during long years as a sympton in photo 6. So tablet fertilizer can have a recommendation to dress much fertilizer at p]anting year and then tree root can get much more chance for absorbing the phosphorus that could keep the high survival and for utilizing it during many years without after dressing. 4. The granurar and powder type phosphate can develop the dense root mat like photo 8 because of giving the large surface for absorbing the phosphorus and weedy root can approch to the nodule for taking the nitrogen element. So this type seems to present better effect than tablet type to control the soil movement, stem weight as 200g per meter(l meter long${\times}$0.1m width). When added the lime any effect could not be found and rather give the negative effect. So Lespedeza seed sowing and phosphorus dressing system seems us to be very reasonable method for covering the raw material of basket making, fodder and fuel wood supply. 7. Fused Mg phosphate and Fused super phosphate are good fertilizer to the soil improving species and dressing more than 30g per seedling can be recommendable amount. 5. In the unproductive and dry soil with phosphorus fertilizer Robinia pseudoacacia and Alnus firnui can grow more than 2.3m in height at 3rd year and Alnus inokumae have the rapid height growth that is more than 1.8m at 2nd year. Depending on the growth situation like the above example minirotated management has possibilities and rapid covering of erosed land can be done with the soil improving species and phosphorus fertilizer. 6. In the Lespedeza sowing plot with 40g Fused Mg phosphate dressing per meter in the eroded and unproductive forest soil Lespedeza have completely covered this poor land and produced the green.

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Protective Effect of Plantago asiatica L. Leaf Ethanolic Extract Against Ferric Nitrilotriacetate-Induced Prostate Oxidative Damage in Rats (랫드에서의 Fe-NTA 유발 산화스트레스에 대한 차전초 에탄올 추출물의 전립선보호 효과)

  • Hong, Seung-Taek;Hong, Chung-Oui;Nam, Mi-Hyun;Ma, Yuan-Yuan;Hong, Yun-Jin;Son, Da-Hee;Chun, Su-Hyun;Lee, Kwang-Won
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.260-265
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    • 2011
  • Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

A Studs on Farmers Syndrome and Its Risk Factors of Vinylhouse Workers and Evaluation of Risk Factors of Vinylhouse Works (일부 농촌지역 비닐하우스 농사자들의 작업환경 및 농부증 실태와 관련요인평가)

  • Lee, Jung-Jeung
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.101-119
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    • 2004
  • Objectives: In order to estimate risk factors affecting the health of vinylhouse workers and harmful environments in vinylhouse working. Methods: The investigator performed questionnaires and laboratory examinations on 102 vinylhouse workers and 69 farmers in 7 myoens (Korean subcounties). one eup (a Korean town), Goryeong-gun, Gyeongsangbuk-do between April 8 and 18, 2004 (for 11 days), and measured the heavy metal in the air and the soil, temperature, humidity, air current, harmful gases in vinylhouses. Results: Even in cloudy days, the temperature in vinylhouses in daylight was $33.4^{\circ}$ and the temperature difference between inside and outside vinylhouses was around $16^{\circ}$. Oxygen concentration was similar inside and outside vinylhouses, while carbon dioxide concentration was lower inside than outside vinylhouses. Carbon monoxide was not detected. In the air inside vinylhouses, cadmium was not detected. Lean concentration in the soil was lower inside vinylhouses than outside vinylhouses at surface, while cadmium concentration was similar inside and outside vinylhouses in the soil except some areas. Out of male vinylhouse workers. 16.4---- were positive farmer's syndrome and 49.2---- were suspicious, while out of females, 41.5---- were positive and 46.3---- were suspicious. Out of male farmers, 30.4---- were positive farmer's syndrome, while out of female farmers, 60.0---- were positive and 28.3---- were suspicious. There was no difference between vinylhouse workers and farmers in the distribution of hypertension and abnormal liver function, while diabetes mellitus was more common in farmers than in vinylhouse workers. Vinylhouse working, sex, and hours of farming per day were selected as significant variables affecting farmer's syndrome in this study, and the rate of positive farmer's syndrome was rather lower in vinylhouse workers than in farmers. Females were higher than males in the rate, and those who farmed at least 10 hours per day were higher in the rate than those who farmed less than 10 hours per day. Out of the vinylhouse workers, no differences were found between the distribution of farmer's syndrome and farming-related variables such as the total period of farming, the size of farm land, the mean farming hours per day, the number of family members who farm together, the frequency of scattering agricultural chemicals. In addition, there were no differences between the distribution and the wearing masks and protectors and personal sanitation among those who scattered agricultural chemicals by themselves. There were no differences found in blood lean concentration, urinary cadmium concentration, serum cholinesterase, and hemoglobin according to the distribution of farmer's syndrome. In the vinylhouse workers, females were higher than males in the rate of farmer's syndrome, and those who farmed at least 10 hours per day were higher in the rate than those who farmed less than 10 hours per day. Meanwhile, the rate was lower in those who slept at least 8 hours a day than in those who slept less than 8 hours. Conclusions: In conclusion, the physical environments inside vinylhouses were harmful, but no significant difference was found in harmfulness of the chemical environments. The chronic diseases such as farmer's syndrome. hypertension, diabetes, and dyshepatia were not common in the vinylhouse workers than in the farmers. Meanwhile, farmer's syndrome was more common in the vinylhouse workers who worked longer and slept less.

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Determination of Total CO2 and Total Alkalinity of Seawater Based on Thermodynamic Carbonate Chemistry (해수중의 총이산화탄소와 총알칼리도 분석을 위한 탄산염 화학 이론 및 측정방법)

  • Mo, Ahra;Son, Juwon;Park, Yongchul
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.18 no.1
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    • pp.1-8
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    • 2015
  • To evaluate accuracy and precision of determination of total alkalinity ($Alk_T$) and carbon dioxide ($TCO_2$) derived from present study, experiment was applied with $CO_2$ CRM (Batch 132, Scripps Institution of Oceanography; $Alk_T=2229.24{\pm}0.39{\mu}mol/kg$, $TCO_2=2032.65{\pm}0.45{\mu}mol/kg$). As the result, average concentration of $Alk_T$ and $TCO_2$ was $2354.09{\mu}mol/kg$ (~5.6% difference with $CO_2$ CRM) and $2089.60{\mu}mol/kg$ (~2.3% difference with $CO_2$ CRM), respectively. For previous method (Gran Titration) by addition $NaHCO_3$ to deionized water($Alk_T$ $2023.33{\mu}mol/kg$), average concentration was $2193.39{\mu}mol/kg$ (sd=57.15, n=7). Whereas, average concentration was $2017.02{\mu}mol/kg$ (sd=10.98, n=7) for the present study. Recovery yield experiments of total alkalinity in deionized water and seawater were implemented by addition of $NaHCO_3$. The recovery yield of deionized water in the range 0 to $4952.39{\mu}mol/kg$ was 100.8% ($R^2$=0.999), and seawater in the range 0 to $2041.32{\mu}mol/kg$ was 102.3% ($R^2$=0.999). Comparison of $pCO_2$ sensor (PSI $CO_2-Pro^{TM}$) with present method showed very meaningful correlation coefficient ($R^2$=0.977) in the range of 427 to $705{\mu}atm$ and 9.16 to $15.24{\mu}mol/kg$ throught elapsed time for two weeks. Field experiment of diurnal variation of total carbon dioxide was accomplished at Sachon harbor in the coastal waters of East Sea of Korea. Concentration of $Alk_T$ and $TCO_2$ was increased during night, and decreased during daylight hours. The results showed mirror type between $TCO_2$ and dissolved oxygen, which was attributable to photosynthesis and respiration of phytoplankton. Also, open ocean field study was performed to obtain vertical profile of $Alk_T$ and $TCO_2$ in C-C zone (Clarion-Clipperton Fracture Zone), Northeastern Pacific. Average concentrations of $Alk_T$ in the surface mixed layer (0~60 m) and deeper layer below 200 m were $2422.38{\mu}mol/kg$ (sd=78.73, n=20) and $2465.87{\mu}mol/kg$ (sd=57.68, n=103), respectively. And average concentrations of $TCO_2$ were $2134.47{\mu}mol/kg$ (sd=65.4, n=20) and $2431.87{\mu}mol/kg$ (sd=65.02, n=103) in the same depth ranges such as $Alk_T$. Vertical distributions of $Alk_T$ and $TCO_2$ concentrations tended to increase with depth, and analyzed concentrations showed slightly higher than those of previous studies in this area.

Preparation of Powdered Smoked-Dried Mackerel Soup and Its Taste Compounds (고등어분말수우프의 제조 및 정미성분에 관한 연구)

  • LEE Eung-Ho;OH Kwang-Soo;AHN Chang-Bum;CHUNG Bu-Gil;BAE You-Kyung;HA Jin-Hwan
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.20 no.1
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    • pp.41-51
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    • 1987
  • This study was carried out to prepare powdered smoked-dried mackerel which can be used as a soup base, and to examine storage stability and the taste compounds of Products. Raw mackerel are filleted, toiled for 10 minutes and pressed to remove lipids, and then soaked in extract solution of skipjack meat. This soaked mackerel are smoked 3 times to $10-12\%$ moisture content at $80^{\circ}C$ for 8 hours. And the smoked-dried mackerel were pulverized to 50 mesh. Finally, the powdered smoked-dried mackerel were packed in a laminated film $bag(PET/Al\;foil/CPP:\;5{\mu}m/15{\mu}m/70{\mu}m,\;15\times17cm)$ with air(product C), nitrogen(product N) and oxygen absorber(product O), and then stored at room temperature for 100 days. The moisture and crude lipid content of powdered smoked-dried mackerel was $11.3-12.3\%,\;12\%$, respectively, and water activity is 0.52-0.56. And these values showed little changes during storage. The pH, VBN and amino nitrogen content increased slowly during storage. Hydrophilic and lipophilic brown pigment formation showed a tendency of increase in product(C) and showed little change in product(N) and (O). The TBA value, peroxide value and carbonyl value of product(N) and (O) were lower than those of product (C). The major fatty acids of products were 16:0, 18:1, 22:6, 18:0 and 20:5, and polyenoic acids decreased, while saturated and monoenoic acids increased during processing and storage of products. The IMP content in products were 420.2-454.2 mg/100 g and decreased slightly with storage period. And major non-volatile organic acids in products were lactic acid, succinic acid and $\alpha-ketoglutaric$ acid. In free amino acids and related compounds, major ones are histidine, alanine, hydroxyproline, lysine, glutamic acid and anserine, which occupied $80.8\%$ of total free amino acids. The taste compounds of powdered smoked-dried mackerel were free amino acids and related compounds (1,279.4 mg/100 g), non-volatile organic acids(948.1 mg/100 g), nucleotides and their related compounds (672.8 mg/100 g), total creatinine(430.4 ntg/100 g), tetaine(86.6 mg/100 g) and small amount of TMAO. The extraction condition of powdered smoked-dried mackerel in preparing soup stock is appropriate at $100^{\circ}C$ for 1 minute. Judging from the results of taste and sensory evaluation, it is concluded that the powdered smoked-dried mackerel can be used as natural flavoring substance in preparing soups and broth.

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Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children (일부 초등학생의 대표적 신체활동의 에너지소비량 측정 및 에너지소비량과 체중과의 상관성 분석)

  • Kim, Jae-Hee;Son, Hee-Ryoung;Choi, Jung-Sook;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.180-191
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    • 2015
  • Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

The Usefulness of Dyspnea Rating in Evaluation for Pulmonary Impairment/Disability in Patients with Chronic Pulmonary Disease (만성폐질환자의 폐기능손상 및 장애 평가에 있어서 호흡곤란정도의 유용성)

  • Park, Jae-Min;Lee, Jun-Gu;Kim, Young-Sam;Chang, Yoon-Soo;Ahn, Kang-Hyun;Cho, Hyun-Myung;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.204-214
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    • 1999
  • Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

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