• Title/Summary/Keyword: 호흡패턴이상

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Relationship between Breathing Pattern Disorder and Pain in Patients with Chronic Low Back Pain (만성요통환자의 호흡패턴이상과 통증과의 상관관계)

  • Lim, Chae-Gil
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.355-363
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    • 2020
  • To investigate the relationship between breathing pattern disorder and pain in patients with chronic low back pain(CLBP). One hundred four patients were measured the End-tidal CO2(EtCO2) and respiration rate(RR) using capnography. Also, The Breathing-hold time(BHT), Nijmegen Questionnaire(NQ), and Thoracic excursion examinated. There was a significant correlation between EtCO2 and BHT, thoracic excursion(r=.302, r=.281)(p<.01), and a low negative correlation with RR, VAS(r=-.253, -200)(p<.05). There was a significant correlation between NQ and RR(r=.237)(p<.05). There was a low correlation between thoracic excursion and VAS(r=-.370)(p<.01). There was a significant difference in the EtCO2, RR, BHT, thoracic excursion, and VAS between the thoracic and diaphragm breathing pattern(p<.05). There were no significant differences in the NQ(p>.05). There was a correlation between EtCO2 and BHT, thoracic excursion, RR, VAS in patients with CLBP. In addition, There was a correlation between RR and NQ, thoracic excursion, and VAS. As a result, it was found that there is a close relationship between breathing pattern disorder and pain. There was a significant difference in the EtCO2 level, RR, BHT, thoracic excursion and VAS value in the comparison of thoracic breathing pattern and diaphragm breathing pattern. This is a meaningful result of suggesting a breathing pattern treatment approach in the rehabilitation and pain management of chronic low back pain patients in clinical practice.

성대 결절 환자의 발성 패턴에 따른 음성 치료 접근의 효과

  • 안철민;최영화
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.139-140
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    • 2003
  • 성대 결절 환자들은 잘못된 발성 패턴으로 인한 음성의 오용과 남용이 질환의 원인인 경우가 대부분이다. 관찰할 수 있는 발성 패턴은 성대 내근과 외후두근의 사용, 인두, 혀, 턱의 움직임, 호흡 방법, 억양의 변화 등 다양하다. 이러한 발성 패턴이 하나 혹은 그 이상 잘못 되어 있을 경우에는 후두에 좋지 않은 영향을 미쳐 기능성 후두 질환, 성대 결절, 성대 폴립 등의 기질적 질환과 연계될 수 있다. 성대 결절에서 일반적으로 관찰되는 발성 패턴으로는 성대 전체를 강하게 접촉하여 발성하는 경우와 반대로 성대 수직면 위쪽 즉 상순쪽만 가볍게 부딪혀서 발성하는 경우로 나타난다. 두 경우 모두에서 성대 결절이 발생하며 그 기와 위치가 조금씩 달라지게 된다. 이렇게 성대 결절이 발생했을 경우 널리 제시되고 있는 치료 방법으로 환자의 잘못된 발성 습관에 대한 상담과 함께 하품-한숨 접근법이나 노래 조로 말하기, 저작하기와 같은 성대 접촉을 줄일 수 있도록 하는 것이다. 그러나 성대 접촉이 되지 않아 발생된 성대 결절 환자의 경우는 일시적으로 결절의 크기는 줄일 수 있을 것이나 치료 결과가 유지되는 측면의 고려가 부족한 것이 사실이다. 따라서 본 연구에서는 성대 결절 환자들의 발성 패턴을 관찰하고 그 상태에 따라 음성 치료를 접근하여 치료 결과 및 유지 효과를 확인하고자 한다. (중략)

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Development of New 4D Phantom Model in Respiratory Gated Volumetric Modulated Arc Therapy for Lung SBRT (폐암 SBRT에서 호흡동조 VMAT의 정확성 분석을 위한 새로운 4D 팬텀 모델 개발)

  • Yoon, KyoungJun;Kwak, JungWon;Cho, ByungChul;Song, SiYeol;Lee, SangWook;Ahn, SeungDo;Nam, SangHee
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.100-109
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    • 2014
  • In stereotactic body radiotherapy (SBRT), the accurate location of treatment sites should be guaranteed from the respiratory motions of patients. Lots of studies on this topic have been conducted. In this letter, a new verification method simulating the real respiratory motion of heterogenous treatment regions was proposed to investigate the accuracy of lung SBRT for Volumetric Modulated Arc Therapy. Based on the CT images of lung cancer patients, lung phantoms were fabricated to equip in $QUASAR^{TM}$ respiratory moving phantom using 3D printer. The phantom was bisected in order to measure 2D dose distributions by the insertion of EBT3 film. To ensure the dose calculation accuracy in heterogeneous condition, The homogeneous plastic phantom were also utilized. Two dose algorithms; Analytical Anisotropic Algorithm (AAA) and AcurosXB (AXB) were applied in plan dose calculation processes. In order to evaluate the accuracy of treatments under respiratory motion, we analyzed the gamma index between the plan dose and film dose measured under various moving conditions; static and moving target with or without gating. The CT number of GTV region was 78 HU for real patient and 92 HU for the homemade lung phantom. The gamma pass rates with 3%/3 mm criteria between the plan dose calculated by AAA algorithm and the film doses measured in heterogeneous lung phantom under gated and no gated beam delivery with respiratory motion were 88% and 78%. In static case, 95% of gamma pass rate was presented. In the all cases of homogeneous phantom, the gamma pass rates were more than 99%. Applied AcurosXB algorithm, for heterogeneous phantom, more than 98% and for homogeneous phantom, more than 99% of gamma pass rates were achieved. Since the respiratory amplitude was relatively small and the breath pattern had the longer exhale phase than inhale, the gamma pass rates in 3%/3 mm criteria didn't make any significant difference for various motion conditions. In this study, the new phantom model of 4D dose distribution verification using patient-specific lung phantoms moving in real breathing patterns was successfully implemented. It was also evaluated that the model provides the capability to verify dose distributions delivered in the more realistic condition and also the accuracy of dose calculation.

The Effect of Rain Fall Event on $CO_2$ Emission in Pinus koraiensis Plantation in Mt. Taehwa (강우 이벤트가 태화산 잣나무 식재림의 각 발생원별 $CO_2$ 발생량에 미치는 영향)

  • Suh, Sanguk;Park, Sungae;Shim, Kyuyoung;Yang, Byeonggug;Choi, Eunjung;Lee, Jaeseok;Kim, Taekyu
    • Korean Journal of Environmental Biology
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    • v.32 no.4
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    • pp.389-394
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    • 2014
  • This study was conducted to find out the soil $CO_2$ emission characteristic due to rain fall pattern and intensity changes. Using Automatic Opening and Closing Chambers (AOCCs), we have measured annual soil respiration changes in Pinus koraiensis plantation at Seoul National University experimental forest in Mt. Taehwa. In addition, we have monitored heterotrophic respiration at trenching sites ($4{\times}6m$). Based on the one year data of soil respiration and heterotrophic respiration, we observed that 24% of soil respiration was derived from root respiration. During the rainy season (end of July to September), soil respiration at trenching site and trenching with rainfall interception site were measure during portable soil respiration analyzer (GMP343, Vaisala, Helsinki, Finland). Surprisingly, even after days of continuous heavy rain, soil water content did not exceed 20%. Based on this observation, we suggest that the maximum water holding capacity is about 20%, and relatively lower soil water contents during the dry season affect the vital degree of trees and soil microbe. As for soil respiration under different rain intensity, it was increased about 14.4% under 10 mm precipitation. But the high-intensity rain condition, such as more than 10 mm precipitation, caused the decrease of soil respiration up to 25.5%. Taken together, this study suggests that the pattern of soil respiration can be regulated by not only soil temperature but also due to the rain fall intensity.

세기조절방사선치료 조사면의 최소 조각 크기에 대한 치료중 표적 움직임의 효과

  • 서예린;이병용;안승도;이상욱;김종훈;신성수;신승애;최은경
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.37-37
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    • 2003
  • 목적 : 일반적으로 세기조절방사선치료 조사면의 작은 조각 크기에 대해, 이상적인 플루언스 지도 혹은 치료계획장치로부터의 최적화된 결과에 가까운 선량분포에서 더 좋은 leaf sequence를 얻을 수 있다. 한편, 치료중 장기의 움직임이 가장 작은 조각 크기의 선택을 방해하는 문제는 항상 존재한다. 게다가, 전통적인 정지 조사면과 달리 표적이 움직이는 동안 조사면 자체도 움직이므로 움직이는 표적에 대한 세기조절방사선치료의 경우에서 적절한 표적 마진에 관한 질문이 제기되어왔다. 따라서, 이 연구에서는 조각 크기에 대한 치료중 표적 움직임의 효과를 연구하였다. 대상 및 방법 : 세기조절방사선치료 플루언스 지도에 대해, 다양한 크기 - 0.5$\times$0.5, 1.0$\times$1.0, $1.5\times$1.5, 2.0$\times$2.0, 3.0$\times$3.0, 4.0$\times$4.0, 5.0$\times$5.0 $ extrm{cm}^2$ - 의 정사각형 패턴들을 설계하였고, Leaf sequence 는 step-and-shoot 빔 전달 방법을 이용하였다. 인접 조각들 사이의 세기 비율은 0.2, 0.4, 0.6, 0.8, 1.0로 하였고, 표적 움직임은 범위가 0.5-2.0 cm인 사인곡선 형태로 가정하였다. 움직임 묘사를 위해 동적 leaf 의 움직임이 표적의 움직임 을 반영하도록 계산되었고 움직임의 효과를 분석하기 위해 필름선량측정을 수행하였다. 결과 : 인접 조각의 세기 비율은 모든 경우에서 저하되었고, 호흡 진폭의 반보다 작은 조각 크기에 대한 선량분포는 임상적으로 유의할만큼 저하된 세기 지도를 보였다. 조각에 대해 방사선 조사시간의 두 호흡주기이상에 대해서는, 표적 마진 주위의 선량분포가 통상적인 정지 조사면에서와 같았다. 결론 : 플루언스 지도에서 세기조절방사선치료 조각의 최소 크기는 치료중 장기 움직임을 고려한 후 선택되어야 한다. 조각에 대한 방사선 조사시간의 두 호흡주기이상에 대해서는, 표적 마진을 기존의 정지 조사면과 같게 정의할 수 있었다.

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Usefulness of Gated RapidArc Radiation Therapy Patient evaluation and applied with the Amplitude mode (호흡 동조 체적 세기조절 회전 방사선치료의 유용성 평가와 진폭모드를 이용한 환자적용)

  • Kim, Sung Ki;Lim, Hhyun Sil;Kim, Wan Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.29-35
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    • 2014
  • Purpose : This study has already started commercial Gated RapidArc automation equipment which was not previously in the Gated radiation therapy can be performed simultaneously with the VMAT Gated RapidArc radiation therapy to the accuracy of the analysis to evaluate the usability, Amplitude mode applied to the patient. Materials and Methods : The analysis of the distribution of radiation dose equivalent quality solid water phantom and GafChromic film was used Film QA film analysis program using the Gamma factor (3%, 3 mm). Three-dimensional dose distribution in order to check the accuracy of Matrixx dosimetry equipment and Compass was used for dose analysis program. Periodic breathing synchronized with solid phantom signals Phantom 4D Phantom and Varian RPM was created by breathing synchronized system, free breathing and breath holding at each of the dose distribution was analyzed. In order to apply to four patients from February 2013 to August 2013 with liver cancer targets enough to get a picture of 4DCT respiratory cycle and then patients are pratice to meet patient's breathing cycle phase mode using the patient eye goggles to see the pattern of the respiratory cycle to be able to follow exactly in a while 4DCT images were acquired. Gated RapidArc treatment Amplitude mode in order to create the breathing cycle breathing performed three times, and then at intervals of 40% to 60% 5-6 seconds and breathing exercises that can not stand (Fig. 5), 40% While they are treated 60% in the interval Beam On hold your breath when you press the button in a way that was treated with semi-automatic. Results : Non-respiratory and respiratory rotational intensity modulated radiation therapy technique absolute calculation dose of using computerized treatment plan were shown a difference of less than 1%, the difference between treatment technique was also less than 1%. Gamma (3%, 3 mm) and showed 99% agreement, each organ-specific dose difference were generally greater than 95% agreement. The rotational intensity modulated radiation therapy, respiratory synchronized to the respiratory cycle created Amplitude mode and the actual patient's breathing cycle could be seen that a good agreement. Conclusion : When you are treated Non-respiratory and respiratory method between volumetric intensity modulated radiation therapy rotation of the absolute dose and dose distribution showed a very good agreement. This breathing technique tuning volumetric intensity modulated radiation therapy using a rotary moving along the thoracic or abdominal breathing can be applied to the treatment of tumors is considered. The actual treatment of patients through the goggles of the respiratory cycle to create Amplitude mode Gated RapidArc treatment equipment that does not automatically apply to the results about 5-6 seconds stopped breathing in breathing synchronized rotary volumetric intensity modulated radiation therapy facilitate could see complement.

Chest CT Imaging Features of the Pulmonary Sequelae in Four Patients with COVID-19 (COVID-19 환자의 네 증례에서 폐 후유증에 대한 흉부 CT 소견)

  • Tae-Eun Kim;Su Young Kim;Byung Hoon Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.378-386
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    • 2022
  • With the ongoing coronavirus disease 2019 (COVID-19) pandemic, there is an increasing interest in the sequelae and care in recovered patients. Although the long-term sequelae of COVID-19 are still unknown, recently published reports suggest that some of the patients have persistent symptoms and show radiologic abnormalities after discharge. Herein, we present cases of four patients with previous COVID-19 infection manifesting pulmonary sequelae, including pulmonary fibrosis or organizing pneumonia pattern with persistent dyspnea after recovery.

참외.포도.방울토마토의 고품질 유통을 위한 저온유통용 골판지 포장상자 개선에 관한 연구

  • Lee, Won-Ok;Yoon, Hong-Sun;Lee, Hyun-Dong;Jung, Hoon;Cho, Kwang-Hwan;Kim, Man-Soo
    • Proceedings of the Korean Society of Postharvest Science and Technology of Agricultural Products Conference
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    • 2003.04a
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    • pp.139-139
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    • 2003
  • 원예작물은 수확 후 여러 가지 요인에 의해 품질이 저하되어 상품성을 잃게되는데, 특히 수확 후 품온상승에 의해 호흡작용이 왕성해져 품질변화를 촉진하게 된다. 그러므로 수확 후 품온을 가능한 한 빠르게 낮추어 신선도를 유지하기 위한 예냉, 저온저장, 저온수송기술등 저온유통시스템을 활용하는 것이 매우 필요하다. 저온유통시스템을 효과적으로 활용하기 위해서는 냉기의 순환이 원활하여 냉각효율이 좋고 파손의 위험과 물류비용을 줄일 수 있는 포장상자의 구조에 대한 연구가 필요하다. 포도, 방울토마토, 참외의 소비형태는 핵가족화와 더불어 신선 고품질의 농산물을 소량 구매하는 소비패턴으로 변화하면서 저온유통 및 소포장을 위한 포장형태의 개선이 요구되고 있다. 따라서 예냉.저온유통에 적합한 포장상자를 개발하기 위하여 연구소, 농협중앙회, 상자제작회사, 포장디자인 업체, 산지농협 작목반이 개발협의체를 구성하여 참외, 포도, 방울토마토의 저온유통용 골판지 상자를 개발하여 압축강도 및 냉각시험을 실시하여 소비지에 시범 보급하였다. 1. 참외 포장상자는 3kg용 상부 개방형 골판지상자로써 손잡이를 부착하고, 포장상자 상부에 덮개용 필름을 부착하였다. 제작된 상자의 압축강도는 저온유통 후 에도 안전압축강도 이상인 343kgf의 압축강도를 나타냈고, 냉각효율도 기존상자에 비하여 높게 나타났다. 또한 개발된 상자를 사용하여 시중에 출하할 경우 기존 5kg 상자에 비하여 8%이상의 부가가치를 높일 수 있었다. 2. 포도 포장상자는 소비자 기호도를 충족하고 다층적재시 손상을 방지하기 위하여 내용물을 1단 적재하고 상자를 개방형으로 하여 덮개용 필름을 부착하므로써 소비자가 내용물을 확인할 수 있도록 하고, 상자의 압축강도는 소비지까지 유통이 완료된 후 에도 수직압축강도가 400kgf이상으로 안전압축강도 보다 높아 저온에서 안전하게 유통할 수 있었다. 또한 개발된 상자를 사용하여 시중에 출하할 경우 기존 5kg 상자에 비하여 2kg상자는 21%, 4kg상자는 12%이상의 부가가치를 높일 수 있었음. 3. 방울토마토 포장상자는 외포장 상자를 4kg용 상부 개방형 골판지상자를 사용하고, 내포장상자는 500g용 PET용기를 사용하여 1상자에 8개의 내포장상자가 적재될 수 있도록 제작하였다. 제작된 외포장상자의 압축강도는 저온유통후에도 320kgf으로 안전압축강도보다 높게 나타났고, 파랫트 적재효율도 96%이상으로 나타나 물류의 효율성을 높일 수 있었다. 개발된 상자를 사용하여 시중에 출하할 경우 기존 산물형태의 4kg용 상자에 비하여 500g 내포장상자에 출하할 경우 20%이상의 부가가치를 높일 수 있었다.

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The Effect and Safety of Alveolar Recruitment Maneuver using Pressure-Controlled Ventilation in Acute Lung Injury and Acute Respiratory Distress Syndrome (급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성)

  • Chung, Kyung Soo;Park, Byung Hoon;Shin, Sang Yun;Jeon, Han Ho;Park, Seon Cheol;Kang, Shin Myung;Park, Moo Suk;Han, Chang Hoon;Kim, Chong Ju;Lee, Sun Min;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.423-429
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    • 2007
  • Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of $30cmH_2O$ and a PEEP of $20cmH_2O$ in a 2-minute PCV mode. The venous $O_2$ saturation, central venous pressure, blood pressure, pulse rate, $PaO_2/FiO_2$ ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean $PaO_2/FiO_2$ ratio was 130.3 before RM. The $PaO_2/FiO_2$ ratio increased by 45% after alveolar RM. The $PaO_2/FiO_2$ ratio reached a peak 60 minutes after alveolar RM. The Pa$CO_2$ increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.

Relationship between Breathing Pattern Disorder and Joint Position Sense in Patients with Chronic Low Back Pain (만성요통환자의 호흡패턴이상과 관절위치감각의 관계)

  • Cho, Byungyun;Yoon, Junggyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.2
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    • pp.1-10
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    • 2019
  • Purpose : To investigate the relationship between breathing pattern disorder and joint position error (JPE) in patients with chronic low back pain (CLBP). Methods : Thirty nine patients with CLBP participated. End-tidal $CO_2$ and respiration rate (RR) were measured using a capnography. Breathing-hold time (BHT) and Nijmegen Questionnaire (NQ) were investigated. Thoracic excursion was measured with a cloth tape measurement technique. Joint position error were measured using a small laser point mounted on a lightweight headband. they were asked to relocate the head, after the neck movement on the horizontal plane. Pearson 's test was used for correlation analysis between respiratory variables and JPE in patients with CLBP. Independent t-test was used to verify the difference between thoracic and diaphragm breathing pattern in patients with CLBP. The significance level was set at 0.05. Results : There was a significant correlation between JPE (LR) and JPE (RR, EX) (r=.639, r=.813) (p<.001) and a low negative correlation with end-tidal $CO_2$ (r=-.357) (p<.05). There was a significant correlation between RR and JPE (EX) (r=.750) (p<.001). There was a low correlation between JPE (EX) and NQ (r=.333) (p<.05). There was a somewhat high negative correlation between NQ and thoracic excursion (r=-.528) (p<.001). There was a somewhat high negative correlation between thoracic excursion and JPE (LR, RR, EX) (r=-.470, r=-.484, r=-.602) (p<.001). There were no significant differences in the RR, BHT, NQ, and thoracic excursion between the thoracic and diaphragmatic breathing (p>.05). There was a significant difference in the JPE (EX), end - tidal $CO_2$, and VAS values between the thoracic and diaphragm breathing (p<.05). Conclusion : There was a correlation between JPE (EX) and NQ in patients with CLBP, and correlation between thoracic excursion and JPE (LR, RR, EX) and NQ. There was a significant difference in the JPE (EX), end-tidal $CO_2$ level, and VAS value in the comparison of thoracic breathing and diaphragm breathing. The results showed that breathing patterns and JPE were related to each other.