• The Journal of Internal Korean Medicine
• /
• 제26권1호
• /
• pp.1-11
• /
• 2005

Backgrounds : Gamichungsangboha-tang extract has been known to improve pulmonary functions and quality of life within four weeks of treatment. Cessation of treatment causes recurrence of symptoms and regression of pulmonary function and poorer quality of life. Long-term herbal therapy is difficult to maintain due to economic burden and other reasons. AF-365 is made with reduced dosage of Gamichungsangboha-tang extract. This study was designed to evaluate the effectiveness of AF-365 for maintenance therapy. Materials and Methods : The subjects consisted of 27 patients with asthma who had beed treated with AF-365 for four weeks. First, patients were treated with Gamichungsangboha-tang extract for four weeks. Second patients stopped herbal medicine for four weeks and after that they took AF-365. Pulmonary function test(PFT) was checked before and after four weeks of treatment. Quality of Life Questionnaire for Adult Korean Asthmatics(QLQAKA) was checked every two weeks from the beginning. The effects of AF-365 were analysed throughout the last four weeks. Results : Treatment of AF-365 for four weeks resulted in significant increase in PEFR%, QLQAKA. The QLQAKA of the step3, step4 group classified by Global initiative for asthma(GINA) showed significant improvement, and the QLQAKA of the step2 group showed no significant difference. In step3 group, PEFR% increased significantly. Conclusions : This study supports a role for AF-365 in maintenance of pulmonary function and quality of life, especially in persistent symptomatic asthmatics.

• Journal of Environmental Health Sciences
• /
• 제42권6호
• /
• pp.375-384
• /
• 2016

Objectives: This paper analyzes the intersection of tort law and environmental health in a recent court decision. Methods: This paper analyzes Supreme Court Decision 2011Da7437, Decided on September 4, 2014 and related lower court decisions. Results: The plaintiffs sought financial compensation from the defendants, arguing that air pollutants in gases emitted by vehicles produced by the defendants had caused them to acquire respiratory diseases. The district court highlighted the need to mitigate the burden of proof for the plaintiffs, but proceeded to review whether the plaintiffs proved the actual toxicity levels of the air pollutants, whether the defendant's vehicles were the main source of the emissions, the plaintiff's level of exposure to the pollutants, and causation between the emissions and the injury. By doing so, the district court required the plaintiffs to prove both indirect and direct facts of causation, increasing burden of proof for plaintiffs. The appellate court upheld the district court's decision, adding that the defendant's conduct did not constitute an illegal act because it did not violate the emissions standards set by environmental law. The Supreme Court upheld the appellate court's decision, reasoning that the epidemiological evidence cannot establish a direct causation for diseases that lack specificity. Conclusion: This case demonstrates that discussions in environmental health have significance in tort lawsuits. For each fact that the plaintiffs and defendants attempted to prove, environmental health research studies were offered as evidence. In addition, the courts decided the legality of the defendant's conduct based on emission standards set by environmental law.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• 제25권2호
• /
• pp.115-125
• /
• 2015

Objectives: The major objectives of this study are to review the EU CLP Regulations to propose ways of improving the reliability of MSDS and labels. Methods: To review the EU CLP Regulations, we used EU documents including directives and regulations on chemical management. In addition, we used EU governmental agency reports to illuminate the history and background of the CLP. We found the EU CLP's instruments for reliable hazard communication and evaluated the operations of the instruments. Results: EU CLP Regulations have four instruments for the EU CLP Regulations to make hazard communication reliable. These instruments are GHS, the harmonized CMR and respiratory sensitive substances classification list, C&L inventory and restriction of trade secrets. These are highly useful for achieving the objectives of REACH and CLP(no data-no market and changing the burden of proof). Conclusions: Changing the burden of proof is a key principle for achieving a society safe from hazardous chemicals. Chemical manufacturers and importers alone should bear the responsibility for reliable MSDS. We recommend benchmarking the EU CLP Regulations in order to change efficiently the burden of proof. Trade secrets should be limited to low-hazard substances and be approved by the government before the chemical product is on the market. Like the C&L inventory, chemical product information including substances identification and hazard properties should be notified, aggregated and be opened to public on the Internet. Finally, we recommend a MSDS registration system once again.

• Journal of Korean Academy of Nursing
• /
• 제19권3호
• /
• pp.240-248
• /
• 1989

The increase in size and numbers of general hospitals in the process of conspicuous development of modem medicine has been accompanied by a serious increase in hospital acquired infections. Hospital aquired infections cause pain and discomfort, may threaten life, adds an economic burden, and delays recovery and return to society. Even though respiratory hospital infection rates resulting for tracheostomy and respiratory inhalation therapy, may be low, they are serious because of their bad prognosis and high mortality rates. This study was designed to assess certain aspects of respiratory infections of patients with a tracheostomy and thus provide baseline data for further research related to preventive or therapeutic nursing interventions. The specific objectives were to determine the incidence of colonization in the trachea, clinical signs, type of colonized bacteria and sensitivity to antibiotics. Data were collected from July 1 to December 10, 1989 at two university Hospital in Seoul. Subjects were 20 patients with a tracheostomy admitted to the Intensive Care Unit or Cerebral Vascular Accident Center. Clinical signs related to respiratory infection were observed using a checklist based on previous study outcomes. Bacterial culture, sensitivity test to antibiotics, WBC counts and chest X-ray were also performed. Cultures were done on the day of tracheostomy, and on the third, fifth and seventh day. Cultures were then done on seventh days after the first colonization. The results were as follows : 1. The incidence of bacteria colonization in a week was 90%(18 patients) 50% (10/20 patients) on the day of tracheostomy, 70%(7/10 patients) on the third day, and 0% on the fifth day, and 33%(1/3 patient) on the seventh day. 3 of 18 patients (16.7%) were colonies of mixed growth isolated. 2. The observed clinical signs related to respiratory infection were high fever 38.9%(7 patients), prulent secretion 16.7%(12 patients) and infiltration seen on chest X-ray 33.3%(6 patients). 3. The total number of types of bacteria isolated among the 18 subjects was 21 ; gram negative 71.4%, gram postive 28.6%. The dominant bacteria type was Staphylococcus aureus(5 cases) for gram(equation omitted) and Pseudomonas aeruginosa(3 cases), Klebsiella (4 cases), Enterobacter(3 cases) for gram (equation omitted). The results of culture on 7th day after the first colonization, 6 cases showed same type of bacteria, 3cases showed different type of bacteria and 1 cases showed no growth. 4. The sensitivity tests to antibiotics showed that Pseudomonas aeruginosa and Staphylococcus were strongly resistant to most kinds of antibiotics, but Klebsiella and the rest of gram negative bacteria were moderately sensitive to antibiotics.

• Safety and Health at Work
• /
• 제3권1호
• /
• pp.17-21
• /
• 2012

Objectives: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs. Methods: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared. Results: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01). Conclusion: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

• Health Policy and Management
• /
• 제25권4호
• /
• pp.256-263
• /
• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• Tuberculosis and Respiratory Diseases
• /
• 제85권2호
• /
• pp.175-184
• /
• 2022

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), FEV₁/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV₁ were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z₅), total airway resistance (R₅), central airway resistance (R₂₀), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X₅, X₂₀) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

• Pediatric Infection and Vaccine
• /
• 제30권1호
• /
• pp.1-11
• /
• 2023

Respiratory syncytial virus (RSV) is a pathogen with a high burden of disease and social cost among infants worldwide, but the development of a vaccine has been delayed. The recent understanding of the pathogenesis of RSV, progress in reverse genetics, and successful implementation of other maternal immunizations have prompted the recent rapid development of monoclonal antibodies (mAbs) and vaccines for RSV prevention. Phase 3 clinical trials for two next-generation mAbs (nirsevimab and clesrovimab) and two maternal RSV pre-F vaccines are currently underway or have been recently completed. Soon, we might be able to protect young infants through long-acting mAbs and/or maternal immunization. Additionally, the development of live-attenuated vaccine candidates that are capable of avoiding enhanced RSV disease is ongoing. We need to gain familiarity with these newly developed strategies and collect epidemiological data on domestic RSV to adequately prepare for a new era of RSV prevention.

• Journal of Korean Critical Care Nursing
• /
• 제2권1호
• /
• pp.69-80
• /
• 2009

Purpose: The purpose of this preliminary study was to describe the physical and psychosocial distress of critically ill patients undergoing noninvasive ventilation(NIV). Method: Open-ended question interviews were conducted with four patients using NIV. Considering the outcomes of the interviews, literature, and experts'opinions, a survey questionnaire was developed. Twenty patients in medical and surgical intensive care units answered the questions. Results: Through open-ended question interviews and survey, the patients using NIV reported feeling heavy, impotent feeling, pain, loss in feeling, loss in communication, and lack of sleep as physical distress and a loss in sense of time, pain, anxiety, mind of desiring to die, worry about family, and a sense of burden for medical-cure expenses as psychosocial distress. Conclusion: Critically ill patients undergoing NIV experience physical and psychosocial distress to artificial respiratory ventilation treatment. Further research should be performed with a large sample for generalization of the study result.

• Pediatric Infection and Vaccine
• /
• 제29권2호
• /
• pp.61-69
• /
• 2022

Coronavirus disease 2019 (COVID-19) has been a global pandemic for over 2 years. During the Omicron (B.1.1.529) variant-predominant period in South Korea, confirmed cases among children and adolescents surged. This review found that, although younger children may be less susceptible to COVID-19 than adolescents, more research is needed on the role of children and adolescents in the disease's spread. Detailed epidemiological information about the transmissibility of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain in children and adolescents is currently scarce, and more research is needed on the role of children and adolescents in disease's spread. There may be a difference in the proportion of cases with severe disease requiring hospitalization depending on the dominant mutant strain; however, COVID-19 generally presents with a mild-to-moderate course in children aged 5-11 years old.