• Title/Summary/Keyword: 가이드 호흡

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The feasibility evaluation of Respiratory Gated radiation therapy simulation according to the Respiratory Training with lung cancer (폐암 환자의 호흡훈련에 의한 호흡동조 방사선치료계획의 유용성 평가)

  • Hong, mi ran;Kim, cheol jong;Park, soo yeon;Choi, jae won;Pyo, hong ryeol
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.149-159
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    • 2016
  • Purpose : To evaluate the usefulness of the breathing exercise,we analyzed the change in the RPM signal and the diaphragm imagebefore 4D respiratory gated radiation therapy planning of lung cancer patients. Materials and Methods : The breathing training was enforced on 11 patients getting the 4D respiratory gated radiation therapy from April, 2016 until August. At the same time, RPM signal and diaphragm image was obtained respiration training total three steps in step 1 signal acquisition of free-breathing state, 2 steps respiratory signal acquisition through the guide of the respiratory signal, 3 steps, won the regular respiration signal to the description and repeat training. And then, acquired the minimum value, maximum value, average value, and a standard deviation of the inspiration and expiration in RPM signal and diaphragm image in each steps. Were normalized by the value of the step 1, to convert the 2,3 steps to the other distribution ratio (%), by evaluating the change in the interior of the respiratory motion of the patient, it was evaluated breathing exercise usefulness of each patient. Results : The mean value and the standard deviation of each step were obtained with the procedure 1 of the RPM signal and the diaphragm amplitude as a 100% reference. In the RPM signal, the amplitudes and standard deviations of four patients (36.4%, eleven) decreased by 18.1%, 27.6% on average in 3 steps, and 2 patients (18.2%, 11 people) had standard deviation, It decreased by an average of 36.5%. Meanwhile, the other four patients (36.4%, eleven) decreased by an average of only amplitude 13.1%. In Step 3, the amplitude of the diaphragm image decreased by 30% on average of 9 patients (81.8%, 11 people), and the average of 2 patients (18.2%, 11 people) increased by 7.3%. However, the amplitudes of RPM signals and diaphragm image in 3steps were reduced by 52.6% and 42.1% on average from all patients, respectively, compared to the 2 steps. Relationship between RPM signal and diaphragm image amplitude difference was consistent with patterns of movement 1, 2 and 3steps, respectively, except for No. 2 No. 10 patients. Conclusion : It is possible to induce an optimized respiratory cycle when respiratory training is done. By conducting respiratory training before treatment, it was possible to expect the effect of predicting the movement of the lung which could control the patient's respiration. Ultimately, it can be said that breathing exercises are useful because it is possible to minimize the systematic error of radiotherapy, expect more accurate treatment. In this study, it is limited to research analyzed based on data on respiratory training before treatment, and it will be necessary to verify with the actual CT plan and the data acquired during treatment in the future.

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TREACHER COLLINS SYNDROME : A CASE REPORT (Treacher Collins 증후군 환아의 증례보고)

  • Park, Ji-Hyun;Kim, Seung-Hae;Song, Je-Seon;Kim, Seong-Oh;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.374-380
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    • 2010
  • Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

Comparison for the Optimal Pressure between Manual CPAP and APAP Titration with Obstructive Sleep Apnea Patients (한국인 폐쇄성 수면 무호흡 환자의 적정 양압을 위한 수동화 양압 측정법과 자동화 양압 측정법의 비교)

  • Kim, Dae Jin;Choi, Byoung Geol;Cho, Jae Wook;Mun, Sue Jean;Lee, Min Woo;Kim, Hyun-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.191-197
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    • 2019
  • Although auto-adjusting positive airway pressure (APAP) titration at home has several advantages over a CPAP titration in terms of convenience and time saving, there are still concerns as to whether it will show corresponding accuracy when compared to laboratory-based polysomnography (PSG) and CPAP titration. To obtain more evidence supporting home-based auto-titration, APAP titration was performed at home for patients who were presented with OSA on laboratory-based diagnostic PSG followed by CPAP titration. A total of 79 patients were included in the study. They all underwent split-night PSG with CPAP titration, and APAP titration for more than 7 days. The patients with successful titration at both situations were selected. The optimal pressure and apnea-hypopnea index (AHI) of CPAP and APAP titration were compared. The optimal pressure for CPAP and APAP titration were $7.0{\pm}1.8cmH_2O$ and $7.6{\pm}1.6cmH_2O$ (P<0.001), whereas the corresponding AHI were $1.3{\pm}1.5/h$ and $3.0{\pm}1.7/h$ (P<0.001). As a result, the achievement rates of optimal pressure for CPAP and APAP titration were 96.2% and 94.9% (r=-0.045, P=0.688), respectively. The results of this study did not differ with regard to the optimal pressure between CPAP and APAP titration. Overall, CPAP and APAP titrations should be chosen depending on a required situation.

Korean Clinical Imaging Guidelines for the Appropriate Use of Chest MRI (한국형 흉부 MRI 영상 진단 정당성 권고안)

  • Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.562-574
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    • 2021
  • MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Comparative Study of Subjective Mental Workload Assessment Techniques for the Evaluation of ITS-oriented Human-Machine Interface Systems (지능형 교통체계 기반 인간-기계 인터페이스 시스템 평가를 위한 정신적부하 측정방법의 비교 연구)

  • Cha, Doo-Won;Park, Peom
    • Journal of Korean Society of Transportation
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    • v.19 no.3
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    • pp.45-58
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    • 2001
  • Subjective mental workload assessment technique becomes a standard human factors and human-machine interface evaluation tool for the evaluation of ITS(Intelligent Transport Systems)-oriented information systems as well as the drivers visual activity analysis, physiological indices(GSR, EEG, ECG, etc.), secondary task performance, reaction time. vehicle control parameters(speed, steering behavior, accelerator control) that are widely applied for transportation and vehicle systems to evaluate the safety, to decide the system or design alternatives, and to establish the design guidelines. This paper reviewed and compared the most globally employed four mental workload assessment techniques that have been designed for the use of various human-machine systems and ITS-oriented in-vehicle information systems. NASA-TLX(National Aeronautics and Space Administration-Task Load Index). SWAT(Subjective Workload Assessment Technique), MCH(Modified Cooper-Harper) scale, and recently developed RNASA-TLX(Revision of NASA-TH) were compared in terms of sensitivity and subjective evaluations to derive the human-machine interface evaluation guidelines for the application of ITS-oriented in-vehicle information systems. Then, experiment results supported that RNASA-TLX is the prospective tool for the mental workload assessment of ITS-oriented in-vehicle information systems.

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The changes of symptom, EKG and hemodynamic in healty firefighters after delivering multiple cycles of cardiopulmonary resuscitation (반복적인 심폐소생술 시행 후 건강한 소방대원에서 나타나는 증상, 심전도 및 혈역학적 변화)

  • Lee, Hyo-Ju;Kim, Ho-Jung;Jung, Eun-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.381-388
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    • 2017
  • The CPR guidelines emphasize the delivery of effective chest compressions but do not address the effects of chest compressions on CPR providers. This study determined the effects of chest compressions on healthy adult firefighters' symptoms, hemodynamics, and electrocardiography after performing multiple cycles of CPR. Healthy adult firefighters were trained in CPR and performed CPR on mannequins. The provider vital signs, electrocardiography, and fatigue scores were determined immediately before CPR, after 5cycles of CPR, and after 10 cycles of CPR. In addition, the presence of clinical symptoms among the providers was determined after CPR; 39 firefighters participated in the study. Their mean age was $35.54{\pm}10.26years$. Many providers developed fatigue, shortness of breath, and dizziness. Significant changes in heart rate (p=0.000), respiratory rate (p=0.010), end-tidal CO2(p=0.000), O2 saturation(p=0.000), and pulse pressure (p=0.000) were observed after both 5 and 10 cycles of CPR. One participant developed sinus dysrhythmia and premature ventricular contractions after 10 cycles of CPR. The delivery of chest compression results in fatigue and hemodynamic alterations in many young healthy adults after performing 5 or 10 cycles of CPR. The CPR guidelines and education should take into consideration the effects of chest compressions on CPR providers.

Potential Exposure of Nanoparticles from Laboratory to Office (실험실에서 사무실로의 나노입자의 잠재적 노출)

  • Shin, Hyeokjin;Kim, Younghun
    • Clean Technology
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    • v.28 no.2
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    • pp.123-130
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    • 2022
  • Nanoparticles are used in various fields such as chemistry, medicine, the environment, and information and communication. With the increasing use of engineered nanomaterials, exposure to nanoparticles is expected to increase in the workplace and the environmental media. However, while nanotechnology industries are expanding, research on the exposure assessment of nanomaterials to humans and the environment is only at a beginning stage. Especially, if nanoparticles with a size of 100 nm or less that are contained in nano-products are released unintentionally, they may pose potential risks to the human body through breathing or skin exposure. Therefore, in this work, the possibility of potential exposure of nanoparticles moving from the laboratory to the office was confirmed, and nanoparticle safety guidelines are proposed. A nano-collector was used to detect nanoparticles in the atmosphere, and through use of a scanning mobility particle sizer it was found that nanoparticle concentrations in the laboratory and the office tended to be similar. On the assumption that nanoparticles attached to a lab-coat move out of the laboratory, a lab-coat to which nanocarbon black was attached was shaken and the concentration of the remaining particles on the lab-coat determined. The results confirmed that sufficient amounts of nanoparticles attached to the lab-coat could move from the laboratory to the office along the path of a researcher; thus, safety guidelines for the handling of lab-coat nanoparticles are required.

Maleficent Effects of Phthalates and Current States of Their Alternatives: A Review (프탈레이트의 유해성과 대체재 현황: 소고)

  • Kim, Woong;Gye, Myung Chan
    • Korean Journal of Environmental Biology
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    • v.35 no.1
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    • pp.21-36
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    • 2017
  • Phthalates, known as typical endocrine disruptors, are plasticizers used to soften plastics such as polyvinyl chloride (PVC). Because of their material properties, phthalates are used extensively in the production of toys, flooring, wood processing, detergents, and even cosmetics as lubricants and perfume solvents. Due to their endocrine disrupting effect and other adverse health effects published, recently, phthalates have been regulated in many countries. Besides, in an effort to replace phthalates, several chemical plasticizers such as trioctyltrimellitate (TOTM) and dioctylterephthalate (DIOP) have been used instead of the existing harmful phthalates, and novel alternatives are continuously being developed. Nonetheless, phthalates are still being detected in several plastic products, and the safety of alternatives that are considered safe is being questioned. In this review, we describe the adverse health effects of phthalates, their regulation and the current status of their alternatives.

A Study on the Effect of Basic Life Support Training on the First Responsive Police Officers

  • Jo, Byung-Tae;Kim, Seon-Rye
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.175-182
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    • 2019
  • The study was conducted to verify the effect of basic life support training on the skill ability of police officers. The subjects of this study were 10 experimental group and 10 comparative group with voluntary consent after explaining the theory and significance of the training experiment at the police station located in K. The education program used in this study consists of theoretical education and practical training, and the theoretical education is 60 minutes and the practical training is 30 minutes. The measurement tool for basic resuscitation performance was measured based on the 'CPR and ECG Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care' presented by the American Heart Association. The results are as follows. The experimental group showed higher performance skills than the traditional control group in field confirmation performance skills, primary evaluation performance skills (A, B, C, medical evaluation), and BLS performance skills (heart compression, artificial respiration, medical evaluation) which are the basic resuscitation performance skills. In conclusion, this study confirmed that the theory and practice education program is more effective in improving the clinical performance of police officers than the traditional lectures and practice education, so it is possible to apply this simulation education program to the cardiac arrest patient emergency treatment.