• Journal of Chest Surgery
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• v.31 no.1
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• pp.13-19
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• 1998

Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

• Tuberculosis and Respiratory Diseases
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• v.63 no.6
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• pp.515-520
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• 2007

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.31-36
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• 2008

One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

• Journal of Korean Physical Therapy Science
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• v.18 no.3
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• pp.9-16
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• 2011

Background : Smoking reduces the ability of the lungs to function. In particular, smoking reduces the vital capacity of the lungs, which is the amount of air the lungs can take in. This reduction in vital capacity has several important health effects. Purpose : The purpose of this study, therefore was to examine the effects of the respiratory muscle exercise on peak expiratory flow and respiratory muscle strength. Methods : For an experimental research design, it was employed 20 young healthy subjects and these subjects were assigned into two groups; a smoking group(n=10) and an non-smoking group(n=10). All groups were participated in respiratory muscle exercises twice a week for 5 weeks in same condition. For comparison between before and after for post treatment, it was analysed as paired t-test and ANCOVA. Results : The result of this study were as follows; In the case of smoking group, there were significant differences, from $427.77{\pm}76.61$ l/min to $526.66{\pm}58.52$ l/min of peak respiratory flow, from $94.33{\pm}22.07$ kg to $102.16{\pm}21.60$ kg of abdominal muscle strength between the before and the after of respiratory muscle strength exercises. In the case of nonsmoking group, there were significant differences, from $449.54{\pm}77.47$ l/min to $553.18{\pm}61.32$ l/min of peak respiratory flow, from $93.41{\pm}19.21$ kg to $101.58{\pm}18.92$ kg of abdominal muscle strength between the before and the after of respiratory muscle strength exercises. Conclusion : These results were suggested that the peak respiratory flow and muscle strength were improved after respiratory muscle strength exercises.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.876-881
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• 1998

Tracheal papillomatosis is rare. When the disease starts during childhood, it usually appears to be self-limiting if properly managed. In adults, however, the disease sometimes runs a more protracted course with a higher risk of developing cancer. The tumors are derived from the tracheal surface epithelium and tracheal mucous glands and usually grow exophytically. Treatment has traditionally been with repeated endoscopic resection. However, in view of its viral origin, attempts have been made to control the disease with interferon. A 67 years-old man was presented with exertional dyspnea. He was treated for bronchial asthma at another hospital. There was no improvement in his symptom. He was referred to this hospital, and a bronchoscopic biopsy showed tracheal papillomatosis. He was undergone bronchoscopic laser therapy with symptomatic improvement.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.71-76
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• 2009

서론(Introduction) : 의학 시뮬레이션(medical simulation)은 교육생 학습과정에서 내재된 위험이 환자에게 가해짐 없이 교육생이 실제적인 환자 상황을 경험할 수 있게 하고 여러 다양한 임상내용이 포함한 상황에 적용될 수 있다. 시뮬레이션 기술의 사용은 의학교육(medical education), 인증서(certification), 면허교부(Licensure)와 의료의 질 형성에 큰 잠재력을 가지고 있다. 복강경 수술, 내시경검사, 전문심장구조술, 응급기도관리와 외상소생을 포함한 다양한 임상시술의 수행에서 시뮬레이션이 교육생의 술기를 달성하고, 측정하고, 유지하는 유효성을 증명하였다 컴퓨터로 조절되는 시뮬레이터는 맥박, 혈압, 호흡, 대화가 가능하고, 중증질환 또는 외상환자의 치료에 필요한 같은 인명구조 시술을 수행할 수 있다. 의학 시뮬레이션은 의사, 간호사, 응급구조사와 응급 진료를 필요로 하는 환자를 치료하는 사람에게 필요하다. 최신 전문심장구조술 과정수업은 전통적인 강의와 제한된 팀 상호작용이 포함된 이틀 과정이다. 우리는 비 영어권 국제 응급구조학생의 전문심장구조술 술기능력을 알아보고, 그것을 미국 응급구조학생과 비교하고자 한다. 목적(Objective) : 이 연구의 목적은 다양한 전문심장구조술 증례 시나리오를 가진 의학 시뮬레이터를 이용하여 미국과 한국의 응급구조 학생의 능력을 비교하는 것이다. 시행 장소(Site Location) : 이 연구는 한국 제주도에 위치한 제주한라대학 스토니브룩 응급의료교육원에서 진행되었다. 학생들의 평가는 스토니브룩에 위치한 스토니브룩 대학 의료원의 한 명의 평가자(Dr. lee)에 의해 수행되었다. 방법(Methods) : 15명의 한국 응급구조학생들은 세 팀으로 무작위로 선정하였다. 5명이 한 팀이 되어 같은 증례의 시나리오를 받았다. 세 가지 시나리오는 : 첫째, 천식지속상태(Status asthmaticus), 둘째, 긴장기흉을 동반한 만성폐쇄성폐질환(COPD with tension penumothorax) 그리고 마지막으로 메가코드(megacode)를 가진 심정지 이다. 세 팀을 각각 그리고 기본인명구조술(BLS)과 전문심장구조술(ACLS)과정을 마친 미국 응급구조학생들과 비교하였다. 15명의 미국 응급구조학생들 또한 세 팀으로 무작위로 선정하였다. 이 응급구조 학생들은 플러싱병원 의료원 소속으로 그곳에서 이 연구에 참여할 뿐만 아니라 지속적인 의학교육(CME)이수를 받았다. 이들에게도 같은 세 가지 증례의 시나리오가 주어졌고 Dr lee는 총 여섯 팀을 평가하였다(한국 세 팀과 미국 세팀). 결과(Results) : 양 국가의 모든 15명의 학생이 의학시뮬레이터를 사용하여 전문심장구조술 메가코드시험을 포함한 시험에 모두 통과하였다. 비록 학생들을 무작위로 세 팀으로 나누었지만 한 팀이 이 모든 세 증례에서 다른 팀보다 뛰어났다. 제주한라대학 2번 팀은 더 나은 기도관리, 리듬인식과 임상술기를 가진 모든 중요한 활동을 얻기에서 우수했다. 그들은 핵심요구사항을 90% 이상 충족시겼다. 한국의 2번팀(G2K)은 메가코드에서 기도개방, 호흡평가, 순환징후 그리고 흉부압박수와 같은 신체검진 술기에서도 탁월했다. 게다가 다른 팀과 비교 시 리듬인식, 약물지식과 임상술기에서도 높은 점수를 받았으며 2번팀(G2K)이 6팀 중에 가장 뛰어나게 역활수행을 하였다. 결론(Conclusion) : 이 비교 연구에서 한국학생과 미국학생간에 전문심장구조술 메가코드 시험의 통과율에는 차이가 없었다. 그러나 미국학생은 세 팀 사이에 더 적은 변이로 더 일괄된 점수를 받았다. 한국학생들도 모든 세 가지 증례를 통과하였지만 이 세 팀은 미국학생 팀보다 점수에서 더 큰 변이를 보였다.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.619-627
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• 2004

Background : Corticosteroids in combination with cytotoxic drugs are the mainstays of therapy for idiopathic pulmonary fibrosis (IPF). However, there has been no regimen showing any survival benefit. The aim of this study was to describe a short-term clinical experience on interferon gamma-1b (IFN-${\gamma}1b$) therapy for IPF, as an antifibrotic agent. Methods : Medical records of 27 patients who were treated with IFN-${\gamma}1b$ (2 million IU, 3 times a week, subcutaneous injection) were retrospectively reviewed. Treatment response was assessed using ATS/ERS criteria in 17 patients who received IFN-${\gamma}1b$ for more than 6 months. In addition, we compared the efficacy of IFN-${\gamma}1b$ therapy with that of cyclophosphamide${\pm}$prednisolone therapy (n=26). Results : The median age of IFN-${\gamma}$ treated group (M:F=19:8) was 59 years (44-74 years). Compared to the patients who showed a stable response at 6 months (n=12), the deteriorated group (n=5) had worse baseline lung function (FVC, $55.4{\pm}11.3%$ vs. $70.7{\pm}10.9%$, p=0.019; DLco, $50.3{\pm}7.3%$ vs. $76.9{\pm}19.6%$, p=0.014). Lower baseline $PaO_2$ on room air breathing was observed in the deteriorated group ($68.6{\pm}7.8mmHg$ vs. $91.4{\pm}6.6mmHg$ p=0.001). Subcutaneous IFN-${\gamma}1b$ did not show better efficacy than prednisolone. Five patients discontinued IFN-${\gamma}$ because of severe side effects. ARDS developed in one patient, who eventually died. Conclusion : The administration of IFN-${\gamma}1b$ is not desirable for patients diagnosed with IPF with poor lung function. Long-term and large-scaled clinical studies are needed for its efficacy in IPF.

• Phonetics and Speech Sciences
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• v.11 no.1
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• pp.51-61
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• 2019

The purpose of this study was to develop a smartphone based voice therapy program for patients with voice disorders. Contents of voice therapy were collected through analysis of mobile contents related to voice therapy in Korea, experts and users' demand survey, and the program was developed using Android Studio. Content needed for voice therapy was collected through analysis of mobile contents related to voice therapy. The user satisfaction evaluation for application was conducted for five patient with functional voice disorders. The results showed that the mobile contents related to voice therapy in Korea were mostly related to breathing, followed by voice and singing, but only 13 applications were practically practiced for voice therapy. Expert and user demand surveys showed that the patients and therapists both had a high need for content that could provide voice training in places other than the treatment room. Based on this analysis, 'Home Voice Trainer', an smartphone based voice therapy program, was developed. Home Voice Trainer is an application for voice therapy and management based on Android smartphones. It is designed to train voice therapy activities at home that have been trained offline. In addition, the records of voice training of patients were managed online so that patients can maintain voice improvement through continuous voice consulting even after the end of voice therapy. User evaluations show that patients are satisfied with the difficulty and content of voice therapy programs provided by home voice trainers, but lack of a portion of user interface, such as the portion of home button and interface between screens. Further study suggests the clinical application of home voice trainer to the patients with voice disorders. It is expected that the development study and the clinical application of smart contents related to voice therapy will be actively conducted.

• The korean journal of orthodontics
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• v.40 no.2
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• pp.66-76
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• 2010

Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.32-35
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• 2013

Six English Bull dogs from the same dog training camp were referred with main complaints of stridor, gagging and coughing. Diagnostic imaging studies on these dogs revealed hypoplastic trachea with/without bronchopneumonia. The mean age of affected dogs was $4.83{\pm}2.63$ months, while the mean body weight was $9.03{\pm}5.30$ kg. The mean ratio of the tracheal diameter to the thoracic inlet distance (TD/TI) was $0.085{\pm}0.022$ (normally 0.16 or greater), whereas the mean ratio tracheal diameter to the width of the third rib (TD/W3R) was $1.36{\pm}0.36$ (normally 2 or greater). All dogs had marked inspiratory dyspnea with variable degree of coughing. Of 6 dogs, 4 dogs had either bronchitis or bronchopneumonia. Treatment with antibiotics and bronchodilators made improvement on clinical signs on these dogs. Although some dogs still had mild inspiratory dyspnea (especially after exercise or excitement), most dogs live normally.