• Title/Summary/Keyword: 호흡주기

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The Changes in Polysomnographic Sleep Variables by Periodic Limb Movements During Sleep (주기성 사지운동증에 따른 수면다원검사 상 수면 변수들의 변화)

  • Choi, Jongbae;Choi, Jae-Won;Lee, Yu-Jin;Koo, Jae-Woo;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.24-31
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    • 2017
  • Objectives: Periodic limb movement disorder (PLMD) has been debated with regard to its clinical significance and diagnostic criteria. The current diagnostic criterion for PLMD in adults has been changed from periodic limb movement index (PLMI) > 5/hour to PLMI > 15/hour by the International Classification of Sleep Disorders (ICSD). In this study, we aimed to investigate the changes in polysomnographic sleep variables according to PLMI and to determine the relevance of the diagnostic criterion for PLMD. Methods: Out of 4195 subjects who underwent standard polysomnography, we selected 666 subjects (370 males and 296 females, aged $47.1{\pm}14.8$) who were older than 17 years and were not diagnosed with primary insomnia, sleep apnea, narcolepsy, or REM sleep behavior disorder. Subjects were divided into three groups according to PLMI severity: group 1 ($PLMI{\leq}5$), group 2 (5 < $PLMI{\leq}15$), and group 3 (PLMI > 15). Demographic and polysomnographic sleep variables and Epworth sleepiness scale (ESS) were compared among the three groups. Results: There were significant differences among the three groups in age and gender. Sleep efficiency (SE) and stage 3 sleep percentage in group 1 were significantly higher than those in groups 2 and 3. The wake after sleep onset (WASO) score in group 1 was significantly lower than those in groups 2 and 3. However, there were no significant differences in SE, stage 3 sleep percentage, or WASO between groups 2 and 3. Sleep latency (SL) in group 1 was significantly lower than that in group 3, but there was no difference in SL between group 2 and group 3. ESS score in group 1 was significantly higher than that in group 3, but there was no difference between group 2 and group 3. Partial correlation analysis adjusted by age showed that PLMI was significantly related to SE and WASO. Conclusion: This study suggests that PLMI influences polysomnographic sleep variables. In addition, we found the individuals who did not have PLMD but had PLMI > 5 were not different in polysomnographic sleep variables from the individuals who had PLMD according to the current criterion. These results raise questions about the relevance of the current diagnostic criterion of PLMD.

Early Response of Cardiopulmonary Exercise Test in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Systemic Chemotherapy (국소진행성 폐암환자에 대한 전신항암화학요법이 운동부하 심.폐기능에 미치는 영향 : 초기변화를 중심으로)

  • Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.369-378
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    • 2002
  • Background : The effects of chemotherapy on pulmonary function are mainly a reduced diffusion capacity and a restrictive ventilatory impairment. Exercise can expose cardiovascular and pulmonary abnormalities not evident at rest. Exercise related cardiopulmonary function is important in patients with malignant disease as a determinant of quality of life. We performed this study to evaluate the changes of body composition and cadiopulmonary exercise perfoemance of patients with locally advanced, non-small cell, lung cancer (NSCLC) before and after chemotherapy. Methods : We evaluated resting pulmonary function, body composition, physiologic performance status, and cardiopulmonary exercise function in 11 patients with locally advanced NSCLC, at diagnosis and prior to the fourth cycle of chemotherapy. Results : After chemotherapy, 4 patients (36.4%) showed partial response and 7 (63.4%) had stable disease. After chemotherapy, diffusion capacity of the lung for carbon monoxide was reduced ($89.7{\pm}34.1%$, vs. $71.9{\pm}20.5%$) but not significantly. There were no significant changes in body composition or the state of physiologic performance after chemotherapy. There was a significant impairment of cardiopulmonary exercise tolerance in patients with NSCLC, evidenced by a reduction of maximal oxygen uptake ($VO_2$max, ml/kg/min, $17.9{\pm}2.6$ : $12.6{\pm}6.1$, <0.05) and $O_2$pulse ($O_2$ pulse, ml/beat, $7.0{\pm}1.7$, $5.2{\pm}2.1$, <0.05). Conclusion : Systemic chemotherapy resulted in a loss of cardiopulmonary exercise function in patients with locally advanced NSCLC within the short-term period, but not a physiologic change of body composition within the same period.

Epidemiological Pattern of Mycoplasma pneumoniae Pneumonia from 1993 Through 2002 and Clinical Characteristics during Recent Five Years (10년간(1993~2002) Mycoplasma 폐렴의 역학적 양상과 최근 5년간 Mycoplasma 폐렴의 임상소견에 대한 고찰)

  • Oh, Kyung-Chang;Yoo, Jung-Suk;Ahn, Seung-In;Kim, Bong-Rim;Kim, Sung-Seob;Kim, Yeon-Ho;Chang, Jin-Keun;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.101-111
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    • 2004
  • Purpose : This study was performed to observe the epidemiological pattern of M. pneumoniae pneumonia during the period from 1993 to 2002 and also to see some clinical characteristics of M. pneumoniae pneumonia during recent five years. Methods : We had performed a retrospective analysis of epidemiological pattern of occurrence in 682 patients with M. pneumoniae pneumonia admitted to Department of Pediatrics of Han-il General Hospital from January, 1993 to December, 2002. Results : The annual ratio of M. pneumoniae pneumonia was compared with the total numbers of respiratory tract infection patients. The ratios were 19.1% in 1993, 13.0% in 1994, 5.6% in 1995, 12.8% in 1996, 18.6% in 1997, 22.6% in 1998, 1.1% in 1999, 13.3% in 2000, 9.1% in 2001, 6.0% in 2002, and 19.9% in 2003. The epidemics have occurred in 1993, 1997, 1998, 2000, and 2003 years showing 3~4 year intervals. The peak incidence of age was four to six years old(286 cases; 41.9%) and male-to-female ratio was 1 : 1.1. Monthly distribution showed a high frequency from August to December and the major outbreak occurred in November(119 cases; 17.4%), in October(106 cases; 15.5%), and in December(96 cases; 14.1%) in order of frequency. The most common symptoms were cough (660 cases; 96.8%), fever(569 cases; 83.4%), and sputum(522 cases; 76.5%) in that order. Leukocytosis was observed in 31.2% of patients based on a normal range according to the adjusted age. Increased ESR(${\geq}20mm/hr$) was noted in 42.5% of cases and CRP was positive in 37.8% of cases. On the chest X-ray examination, pulmonary infiltration was noted in 557 cases(81.7%), and the patterns of pneumonic infiltration were bronchopneumonia(78.0%), lobar(35.5%), lobular(19.2%), and interstitial pneumonia(28.7%). Complications were paranasal sinusitis(41 cases), acute otitis media(23 cases), pleural effusion(19 cases). cervical lymphadenitis(18 cases), and glomerulonephritis(1 case). Conclusion : The pattern of M. pneumoniae pneumonia from 1997 to 2003 noted 3~4 year interval with peak monthly distribution of October and November compared with 3 year interval and peak incidence of summer period before 1996.

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Balloon dilatation for bronchial stenosis in Endobronchial Tuberculosis (협착성 기관지 결핵의 풍선카테타요법(II))

  • Ohn, Joon-Sang;Lee, Young-Sil;Yoon, Sang-Won;Son, Hyung-Dae;Kim, Chang-Seon;Seo, Jee-Young;Park, Mi-Ran;Rheu, Nam-Soo;Cho, Dong-Ill;Kwak, Byung-Kook
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.701-708
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    • 1996
  • Background : To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. Material and Methods: Thirteen women with tuberculous bronchial stenosis(9cases : left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PIT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. Result : 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(1/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. 8m, significant improvement of PFT was noted in only 25%(1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(1/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. Conclusion : We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery. and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.

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A Study on Anjoon-gut Music in Daejeon - Focused on Sir Shin Seok-bong's Antaek-gut Music- (대전의 앉은굿 음악 연구 - 신석봉 법사의 안택굿을 중심으로 -)

  • Park, Hye-jeong
    • Korean Journal of Heritage: History & Science
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    • v.38
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    • pp.5-42
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    • 2005
  • Based on a field investigation of intangible cultural asset # 2, author Sir Shin Seok-bong of Daejeon Metropolitan Cityinvestigated the music of Antaek-gut, which is the base and core of Anjoon-gut, and found the following musical features: A Jang-gu(drum) and Kkoaengkwari(gong) were used to recitethe Sutra(kyungmoon) of Anjoon-gut. The Jang-gu, located on the right side, played an accompaniment role with regular beats when the Sutra was recited. The Kkoaengkwari, located on the left side, played the role of covering the caesura of the Sutra passages, so it is played with various rhythmic variations in accordance with Kojang(鼓杖). This is one way of playing Korean national classical music that has temporary caesuras, depending on the rector's bre! ath or the contents of a Sutra during the Sutra chanting, with the Jang-gu covering the pause with its variation. In other words, when being played in concert, the instruments that play the main melody are at rest while another instrument takes its turn to play the main melody as a form of prolonged sound. The rhythmic cycles of the sutras of Antaek-gut recited with this instrumental accompaniment consist of five types; a) Woemarch-jangdan (a single beat) of 4 meter by 3 bit, b) Dumarch-jangdan (two beats) of 8 meter by 3 bit, c) Saemarch-jangdan (three beats) of 4 meter by 3 bit with a fast tempo, d) Mak-gojang, uniform beats with a standardized rhythm, and e) incomplete beats deviated from the regular beats. Sir Shin Seok-bong chanted Chang (唱), a traditional native song which he called 'Cheong (淸)' with a cycle of 'Dumarch-jangdan' throughout the places of Antaek-gut. Only 'Toesonggyung' a chant for the gate that was the last location of the Antaek, was chanted with a cycle of 'Woemarch-jan! gdan'. In addition, 'Saemarch-jangdan' and 'Mak-gojang' that had comparatively faster tempos than the former two jangdans, were played without a chant when a female shaman was dancing and catching her spirit-invoking wand. The 'Saemarch-jangdan', particularly, was played while dancing began at a relatively slow tempo, then proceeded at a violent tempo and then back again to the slow tempo. This shows one of the representative tempos of our music with a slow-fast-slow tempo. The organizational tones were 'mi-la-do'-re'', and its key tones of 'mi-la-do'' were performed with perfect fourth and minor third, which was the same as those of Menari-tori. However, it did not show a typical Sigimse, an ornamental tone, of Menari-tory, whose first tone, 'mi', is vibrated and its Sigimse is gliding down from the tone 're' to 'do'. That is because the regional tone-tori of Chungcheong-do have a relatively weaker musical expression than that of Gyeongsang-do. In addition, the rhythmic types in accordance with the words of a song for the Antaek-gut music had a comparatively faster tempo than the other sutras. Also, it was only with 'Toesonggyeong' that the tone 'la' continuously appeared throughout the melody and showed 'a syllabic rhythm', while other places consisted of either a 'syncopation' or 'melismatic' rhythm. Finally, according to a brief investigation of the tone organization in accordance with each sutra, the tone 'la' was given more weight. The tone procedure showed a mainly ascending 'la-do'' and the descending 'la-mi' with minor third and perfect fourth. Also, the overall tempo proceeded with M.M.♩.=116-184, while the tempo for the Gut proceeded with M.M.♩.=120-140, which was suitable for reciting a Sutra.

Clinical Response to Etoposide Plus Carboplatin and Topotecan Chemotherapy in Small Cell Lung Cancer (소세포폐암에 대한 Etoposide와 Carboplatin 병합요법과 Topotecan 화학요법의 효과)

  • Park, Kyung Hwa;Cho, Gye Jung;Ju, Jin Young;Son, Chang Young;Wi, Jeong Ook;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul;Park, Kyung Ok
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.415-428
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    • 2003
  • Background : This study assessed the efficacy and toxicity of etoposide and carboplatin(EC) combination regimen as a first line therapy for small cell lung cancer(SCLC), and determined the efficacy and toxicity of topotecan for relapsed SCLC. Methods : One hundred and ten patients with previously untreated SCLC received etoposide($100mg/m^2$ i.v., day 1 to 3) and carboplatin($300mg/m^2$ i.v., day 1) combination chemotherapy every 3 weeks. For patients with relapsed SCLC after EC therapy, topotecan($1.5mg/m^2$) was administered for 5 consecutive days every 3 weeks. Response rate, survival and toxicity profiles were assessed. Response was recorded as CR(complete remission), PR(partial remission), SD(stable disease) and PD(progressive disease). Results : One hundred and one patients were assessed for response to EC. Overall response rate to EC was 57.4%(CR 15.8%, PR 41.6%) with a time to progression of 10.3 months(median). The toxicity was tolerable and there was no treatment-related death. Twenty one relapsed SCLC patients were treated with topotecan. Of those who relapsed within 3 months of EC(refractory relapse, RR), 15.4%(2/13) showed PR, while of those who relapsed after 3 months(sensitive relapse, SR), 25%(2/8) exhibited PR. Grade 4 neutropenia was noted in 9.5% and 14.3% showed thrombocytopenia(G4). Conclusion : The EC regimen showed a moderate response rate for SCLC with minimal toxicity. The use of topotecan for relapsed SCLC warrants further investigation.

Verification of Gated Radiation Therapy: Dosimetric Impact of Residual Motion (여닫이형 방사선 치료의 검증: 잔여 움직임의 선량적 영향)

  • Yeo, Inhwan;Jung, Jae Won
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.128-138
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    • 2014
  • In gated radiation therapy (gRT), due to residual motion, beam delivery is intended to irradiate not only the true extent of disease, but also neighboring normal tissues. It is desired that the delivery covers the true extent (i.e. clinical target volume or CTV) as a minimum, although target moves under dose delivery. The objectives of our study are to validate if the intended dose is surely delivered to the true target in gRT and to quantitatively understand the trend of dose delivery on it and neighboring normal tissues when gating window (GW), motion amplitude (MA), and CTV size changes. To fulfill the objectives, experimental and computational studies have been designed and performed. A custom-made phantom with rectangle- and pyramid-shaped targets (CTVs) on a moving platform was scanned for four-dimensional imaging. Various GWs were selected and image integration was performed to generate targets (internal target volume or ITV) for planning that included the CTVs and internal margins (IM). The planning was done conventionally for the rectangle target and IMRT optimization was done for the pyramid target. Dose evaluation was then performed on a diode array aligned perpendicularly to the gated beams through measurements and computational modeling of dose delivery under motion. This study has quantitatively demonstrated and analytically interpreted the impact of residual motion including penumbral broadening for both targets, perturbed but secured dose coverage on the CTV, and significant doses delivered in the neighboring normal tissues. Dose volume histogram analyses also demonstrated and interpreted the trend of dose coverage: for ITV, it increased as GW or MA decreased or CTV size increased; for IM, it increased as GW or MA decreased; for the neighboring normal tissue, opposite trend to that of IM was observed. This study has provided a clear understanding on the impact of the residual motion and proved that if breathing is reproducible gRT is secure despite discontinuous delivery and target motion. The procedures and computational model can be used for commissioning, routine quality assurance, and patient-specific validation of gRT. More work needs to be done for patient-specific dose reconstruction on CT images.

Effect of Several Treatments on Chilling Injury of Paprika Fruits during Low Temperature Storage (몇 가지 처리가 파프리카 과실의 저온장해에 미치는 영향)

  • Choi, In-Lee;Lee, Yong Beom;Kim, Il Seop;Baek, Jun Pill;Kang, Ho-Min
    • Journal of Bio-Environment Control
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    • v.22 no.4
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    • pp.427-431
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    • 2013
  • Paprika fruits should be stored and distributed at above $7^{\circ}C$ to prevent chilling injury but the small amount of paprika that transports with other horticultural products in refrigerated container by ship usually stored less than $5^{\circ}C$ for other products. In this case, paprika fruits cannot help exposing chilling temperature, so that the paprika must be lost marketable value during a long period of transfer. This study was conducted to compare the alleviated effects of high $CO_2$ treatment (passive MAP), heat (hot water dipping), and UVc treatment on chilling injury of paprika fruits due to low temperature storage, and also to decide if these treatments can be used for transporting under $5^{\circ}C$. After each treatment the paprika were put in the low temperature storage ($4^{\circ}C$) for 20 days and afterwards change the in room temperature ($20^{\circ}C$) for 5 days. The fresh weight loss of all the treatments except the high $CO_2$ treatment showed around 7~12% after 25 days of storage and the ethylene concentration showed periodical increases and decreases as around 3 ${\mu}l/l$. The $CO_2$ concentration was rapidly increased 33% carbon dioxide in high $CO_2$ treatment during room temperature storage after cold storage for 20 days. The firmness which is key quality characteristics during storage and is decreasing caused by chilling injury was not significantly different among all treatments. However, the firmness of stored paprika was maintained highest in the treated with hot water dipping. Therefore, HWD and UVc treatment that showed 60% of electrolyte leakage in the $4^{\circ}C$ control (chilling injury control) and similar level with the $7^{\circ}C$ control (non-chilling injury control) would be effective to alleviate chilling injury in the stored paprika.

A Study on the Spectacles Wearing State of High School Students (고등학생들의 안경착용에 관한 연구)

  • Doo, Ha-Young;Sim, Sang-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.1
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    • pp.107-116
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    • 2000
  • This study is of investigation of refraction error, spectacles and contact lenses wearing state, visual acuity test, ophthalmologic common sense and vision care, using questionnaire study for 850 male and female high school students in Kunsan and Chongup City, Cheolla North Province. The results are as follows: 1. Among the 823 answerers, emmetropia is 18%, myopia is 55.1%, and hyperopia is 7%, respectively. 2. Among the 837 answerers, 381 students(45.5%) wear spectacles or contact lenses. Among the 381 students who wear spectacles or contact lenses, 78% wear only spectacles, 4% wear only contact lenses and 18% wears spectacles sometimes or contact lenses sometimes. 3. The places where the answerers had visual acuity test to wear spectacles or contact lenses are optical shop(64.7%), hospital(28.3%), unchecked(4.2%) and the others(2.7%). The places where the answerers had visual acuity test to change their spectacles or contact lenses are optical shop(82%), hospital(28.3%), unchecked(6.6%) and the others(1.9%). 4. As for the period of visual acuity test, from 6 months to one year is 54.1%, within 6 months is 9.2%, from one year to two years is 29.5%, and more than two years is 7.2%. 5. The contact lens wearers purchased their contact lenses at optical shops(94%) and at hospital(6%). 6. The reasons why they like wearing contact lenses are their appearance(51.2%), convenience in physical excercise(23.l%), lighter weight than spectacles(9.8%) and the others(15.7%). 7. As for the spectacles frame they like, plastic frame is 24.4%, gold or silver plated frame is 43.4%, coloured frame is 32.1%. 8. As for the considerations in choosing spectacles frame, their design is 37%, their quality is 36%, their price is 14.7% and their brand is 12.5%. 9. As for the period for changing spectacles, 10.5% is within 6 months, 57.3% is 6months to 1 year, 22.4% is 1 year to 2 months and 9.6% is more than 2 years. 10. There is a false fact, in Korea, that even though one has his poor eyesight, not wearing custom is helpful for the eyesight recovery. As for their conviction of the false fact, 10.5% of the answerers have 100% conviction, 22.5% of them have 22.5% conviction, 49.5% of them have 50% conviction and 17.5% of them don't have any conviction. 11. 48.5% of the answerers are interested in their vision care while 51.5% of them are not interested at all. As for the way of vision care, the vision-care way to keep enough distant when they are watching TV, when they are using computers and when they are reading, is 49% while the vision-care way such as hypogastric breathing or eye massage is 11%. And alimentotherapy is 4% and the rest who are not interested in vision care is 36%. 12. When they come to an age, the students who want vision correction operation are 45.9% while the students who do not want it are 27%. The students who do not have any idea about the operation are 27.1%

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Thyroplasty for the Restoration of a Normal Voice (음성개선을 위한 갑상연골성형술)

  • 김기령;김광문;정명현;이원상;정승규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.1-10
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    • 1982
  • The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

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