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BackgroundBronchial asthma is a clinical syndrome characterized by reversibility of airway obstruction. However, many asthmatics have evidence of residual airway obstruction. It has become evident that the repair of the chronic inflammatory process can lead to various irreversible changes. It is generally accepted that the most common cause for the change is cigarette smoking but it is controversial whether asthma progresses to emphysema. High resolution computed tomography (HRCT) is more sensitive and more accurate than chest plain films in determining the type and extent of emphysema. This study was carried out to determine whether asthma can be a cause of emphysema without the effect of cigarette smoking and to evaluate clinical characteristics in asthmatics with emphysema.MethodsWe studied 58 asthmatic patients with reversible airway obstruction and evaluated the presence of emphysema using HRCT and pulmonary function test. According to HRCT findings, they were divided into 2 groups: Asthmatics with emphysema and the ones without emphysema.ResultsOf the 58 patients, 7 were revealed to have emphysema. (1) 6 asthmatics with emphysema were smokers, but one patient was a nonsmoker. (2) Highly significant differences between asthmatics with and without emphysema were found in cigarette smoking (p<0.01) and smoking consumption (p<0.01. (3) There were no significant differences in the duration of asthma, age or sex between patients with and without emphysema. (4) There were no significant differences in FEV1(%), FEV1/FVC (%), diffusing capacity for carbon monoxide (DLco) (%) and DLco/alveolar volume between patients with and without emphysema (5) Differences between asthma patients without emphysema and those with emphysema were found to be significant in bronchial wall thickeness (p<0.05) and in total IgE levels (p=0.07).ConclusionThese results indicate that smoking is a main factor in causing emphysema in asthmatics.

Purpose: The purpose of this paper is to analyze a sample of single corridor, pod type and composite type of ICUs in terms of patient visibility, spatial configurations and nurse walking distance focused on Korean cases. Methods:The measures of static visibility were used to quantify the patient visibility (upper third part of the patient bed) from the nurse station. The measure of space programme and area distribution (patient zone percentage, staff zone percentage, circulation zone percentage, corridor length per bed, distance from nurse station (NS) to patient bed and departmental gross square meter (DGSM) per patient bed) were calculated by using AutoCAD and MS Excel programs. In the second step of analysis the values of space distribution were compared among the three type of ICUs as well as the nurse walking distance, DGSM per bed and gross factor.in the third step of analysis regression analysis was conducted for the possible correlation between visibility and space programme and area distribution factors as well as nurse walking distance factors. Results: (1) It was found that on average composite type unit offer highest value of patient visibility followed by pod type, while single corridor type unit offers the minimum value of patient visibility among the three plan typologies. (2) Average patient visibility and DGSM per bed shows a strong positive correlation (r²=0.75) and p=0.026. (3) Average patient visibility and average distance from NS has a strong negative correlation (r²=0.78), and P=0.02. (4) On average composite type unit offer the minimum walking distance from NS (7.22 meter) followed by pod type unit (8.35 meter) and single corridor (9.76 meter). (5) Maximum distance from NS was noted in single corridor (18.19 meter) followed by pod type unit (15.14 meter) and Composite type unit (11.1 meter).Implications: This study may contribute to the visibility analysis of existing and future ICU design in Korea to achieve maximum patient visibility and reduced nurse walking distance.

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Purpose : This purpose of this study is to make a better public hospital patient room to reflect the views of the patient. Methods: Survey to examine patient experience on healing environment in According to the flow of modern times, wireless internet access is required to install of expand the space. Also be used to establish a regulations of internet space. 4) To create healing environment infection free environment should be provided. 5) Need for improvements of patient room for relatives of patient. It is necessary to secure a comfortable space to stay. 6) Separation is needed among the patients through therapeutic classification. Implication : In order to provide a better patient room environment, it is necessary to reflect the patient's opinion.