• Title/Summary/Keyword: 호흡 구간

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Systematic Review of Effects of Nasal Continuous Positive Airway Pressure on Apnea of Preterm Infants (미숙아 무호흡을 위한 비강 지속적 양압환기법 효과에 대한 체계적 고찰)

  • Kim, Eun-Joo
    • Child Health Nursing Research
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    • v.20 no.3
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    • pp.225-235
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    • 2014
  • Purpose: The purpose of this study was to analysis the effects of nasal Continuous Postive Airway Pressure (nCPAP) for preterm infants using systematic review and meta-analysis. Methods: Thirteen peer-reviewed journals including preterm infants and apnea and nCPAP published between 1973 and 2013 were included. Effect size and statistics of homogeneity were done using STATA 10.0. Results: The design for 9 studies was Randomized Control Trial. In most of studies the pressure of nCPAP was set to 4-6 cm$H_2O$. The effect size of 5 studies for the effect on apnea rate using nCPAP compared to nasal Intermittent Positive Pressure Ventilator (nIPPV) showed that the Standardized Mean Difference (SMD) was -0.11 and was not significantly different (Z=0.41, p=.680). But the difference in nCPAP for nasal Synchronizes Intermittent Positive Pressure Ventilator (nSIPPV) (subgroup) was significant (SMD=-.44). The effect size of 7 studies on effect for ventilator weaning of using nCPAP compared to nIPPV showed the Risk Ratio (RR) as 1.60 and was not significantly different (Z=1.12, p=.268). But the difference between nCPAP and nSIPPV (subgroup) was significant (RR=3.94). Conclusion: The results indicate a need for an advanced care system and suggest continuous studies of apnea in preterm infants.

Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증후군의 진단에 있어 턱 압박술의 유용성)

  • Kim, Moo-Jin
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.22-29
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.

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Development of Voice Activity Detection Algorithm for Elderly Voice based on the Higher Order Differential Energy Operator (고차 미분에너지 기반 노인 음성에서의 음성 구간 검출 알고리즘 연구)

  • Lee, JiYeoun
    • Journal of Digital Convergence
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    • v.14 no.11
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    • pp.249-255
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    • 2016
  • Since the elderly voices include a lot of noise caused by physiological changes in respiration, phonation, and resonance, the performance of the convergence health-care equipments such as speech recognition, synthesis, analysis program done by elderly voice is deteriorated. Therefore it is necessary to develop researches to operate health-care instruments with elderly voices. In this study, a voice activity detection using a symmetric higher-order differential energy function (SHODEO) was developed and was compared with auto-correlation function(ACF) and the average magnitude difference function(AMDF). It was confirmed to have a better performance than other methods in the voice interval detection. The voice activity detection will be applied to a voice interface for the elderly to improve the accessibility of the smart devices.

제한적 열풍처리에 따른 조생 감귤의 저장중 품질특성 변화

  • 홍석인;이현희;이주원;김동만
    • 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.138-139
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    • 2003
  • 감귤의 수확후 저장, 유통과정에서 부패 억제 및 약제 후숙처리 대체 효과를 얻기 위하여 환경친화적 방법으로서 제한적 열처리 기술의 적용 가능성을 확인하고자, 제주 서귀포산 조생종 온주 감귤의 열풍(hot air)처리에 따른 저장중 품질특성 변화를 살펴보았다. 상처가 없는 일정한 크기(약 120 g 내외)의 건전 과실을 선별한 후, 45$^{\circ}C$에서 2, 4, 6시간 동안 열풍을 가한 다음 5$^{\circ}C$에서 2시간 냉각하였다. 충분히 냉각시킨 과실을 통기성 천공 LDPE 필름에 포장하여 5$^{\circ}C$에서 3주, 18$^{\circ}C$에서 1 주간 저장하면서 생리적, 이화학적, 관능적 특성변화를 측정하였다. 열풍처리 직후 초기 호흡률은 처리구 모두 무처리구와 비교하여 높았으나 처리시간과는 유의적 상관성이 없었고, 저장중 처리구 감귤의 호흡률은 감소하여 21일째는 무처리구와 유사한 수준을 나타내었다. 과실내 기체조성은 처리구간에 차이를 보이지 않았으나 저장 21일부터는 저장온도 상승에 따라 $O_2$는 다소 감소하고 $CO_2$는 증가하는 양상을 보였다. 또한 과즙의 pH, 산도, 당 함량은 열처리에 의해 거의 영향을 받지 않았으며, 과실의 생체 중량감소율과 경도에서도 처리구간의 유의적인 차이를 구분할 수 없었다. 과피 표면색은 저장중 초기에 비해 다소 붉은 색으로 변하였으나, 6시간 처리구에서는 비교적 자은 노란색을 유지하였다. 한편 부패과 발생률에 있어서는 4시간 처리구가 축부병 등에 의한 짓무름 현상과 곰팡이 발생정도, 검은 썩음병에 따른 흑변 정도에서 저장중 가장 낮은 수준을 나타내었다. 그러나 관능적 평가에서는 열풍처리구와 무처리구 사이에서의 유의적인 차이를 발견할 수 없었다. 결과적으로 45$^{\circ}C$, 4시간이상의 제한적 열풍처리는 조생종 온주 감귤의 저장중 부패과 발생률을 현저히 감소시킴으로서 수확후 품질유지에 효과적인 열처리 조건임을 확인할 수 있었다.

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Comparison of Single-Breath and Intra-Breath Method in Measuring Diffusing Capacity for Carbon Monoxide of the Lung (일산화탄소 폐확산능검사에서 단회호흡법과 호흡내검사법의 비교)

  • Lee, Jae-Ho;Chung, Hee-Soon;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.555-568
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    • 1995
  • Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

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Dose verification for Gated Volumetric Modulated Arc Therapy according to Respiratory period (호흡연동 용적변조 회전방사선치료에서 호흡주기에 따른 선량전달 정확성 검증)

  • Jeon, Soo Dong;Bae, Sun Myung;Yoon, In Ha;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.137-147
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    • 2014
  • Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the patient's breathing cycle in Gated Volumetric Modulated Arc Therapy Materials and Methods : TrueBeam STxTM(Varian Medical System, Palo Alto, CA) was used in this experiment. The Computed tomography(CT) images that were acquired with RANDO Phantom(Alderson Research Laboratories Inc. Stamford. CT, USA), using Computerized treatment planning system(Eclipse 10.0, Varian, USA), were used to create VMAT plans using 10MV FFF with 1500 cGy/fx (case 1, 2, 3) and 220 cGy/fx(case 4, 5, 6) of doserate of 1200 MU/min. The regular respiratory period of 1.5, 2.5, 3.5 and 4.5 sec and the patients respiratory period of 2.2 and 3.5 sec were reproduced with the $QUASAR^{TM}$ Respiratory Motion Phantom(Modus Medical Devices Inc), and it was set up to deliver radiation at the phase mode between the ranges of 30 to 70%. The results were measured at respective respiratory conditions by a 2-Dimensional ion chamber array detector(I'mRT Matrixx, IBA Dosimetry, Germany) and a MultiCube Phantom(IBA Dosimetry, Germany), and the Gamma pass rate(3 mm, 3%) were compared by the IMRT analysis program(OmniPro I'mRT system software Version 1.7b, IBA Dosimetry, Germany) Results : The gamma pass rates of Case 1, 2, 3, 4, 5 and 6 were the results of 100.0, 97.6, 98.1, 96.3, 93.0, 94.8% at a regular respiratory period of 1.5 sec and 98.8, 99.5, 97.5, 99.5, 98.3, 99.6% at 2.5 sec, 99.6, 96.6, 97.5, 99.2, 97.8, 99.1% at 3.5 sec and 99.4, 96.3, 97.2, 99.0, 98.0, 99.3% at 4.5 sec, respectively. When a patient's respiration was reproduced, 97.7, 95.4, 96.2, 98.9, 96.2, 98.4% at average respiratory period of 2.2 sec, and 97.3, 97.5, 96.8, 100.0, 99.3, 99.8% at 3.5 sec, respectively. Conclusion : The experiment showed clinically reliable results of a Gamma pass rate of 95% or more when 2.5 sec or more of a regular breathing period and the patient's breathing were reproduced. While it showed the results of 93.0% and 94.8% at a regular breathing period of 1.5 sec of Case 5 and 6, it could be confirmed that the accurate dose delivery could be possible on the most respiratory conditions because based on the results of 100 patients's respiratory period analysis as no one sustained a respiration of 1.5 sec. But, pretreatment dose verification should be precede because we can't exclude the possibility of error occurrence due to extremely short respiratory period, also a training at the simulation and careful monitoring are necessary for a patient to maintain stable breathing. Consequently, more reliable and accurate treatments can be administered.

Effect of environmental temperature on respiration rate, rectal temperature and body-surface temperatures in finishing pigs (환경온도가 비육돈의 호흡수, 직장 온도 및 체표면 온도에 미치는 영향)

  • Cheon, Si-Nae;Park, Kyu-Hyun;Choi, Hee-Chul;Kim, Jong-bok;Kwon, Kyeong-Seok;Lee, Jun-Yeob;Woo, Saem-Ee;Yang, Ga-Yeong;Jeon, Jung-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.103-110
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    • 2019
  • Recently, Korea has been affected by extreme weather events including extended summers and increased temperatures caused by global warming and climate change. Environmental temperature is especially important to the livestock industry because it is closely related to livestock productivity. This study was conducted to investigate the influence of different environmental temperatures on respiration rate, rectal temperature and body-surface temperature in finishing pigs. Pigs ($98.3{\pm}6.6kg$) were housed in individual cages inside an experimental chamber and exposed continuously to one of five environmental treatments ($22^{\circ}C$, $24^{\circ}C$, $26^{\circ}C$, $28^{\circ}C$, $30^{\circ}C$) for 10 days without providing additional rest time. Feed and water intake, respiration rate, rectal temperature and body-surface (head, ear, neck, back, side) temperature were measured two times daily during the experimental period. A significant increase in respiration rate from $26^{\circ}C$ and in body-surface temperature from $24^{\circ}C$ (p<0.05) was observed. At $30^{\circ}C$, the respiration rate had almost doubled and the body-surface temperature increased by about $5^{\circ}C-7^{\circ}C$. Moreover, ear skin temperature was very sensitive to environmental temperature. However, feed intake, water intake and rectal temperature did not change significantly during the experiment.

Evaluation of difference in respiratory phase between amplitude- and phase-based four-dimensional computed tomography (위상 기반 사차원전산화단층촬영과 진폭 기반 사차원전산화단층촬영 영상에서의 위상차 평가)

  • Lee, So Hyang;Park, Soo Yeon;Kim, Jong Sik;Choi, Byung Ki;Park, Hee Chul;Jung, Sang Hoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.73-78
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    • 2015
  • Purpose : Under the assumption of change to the amplitude based sorting, the study will use four dimensional computed tomography imaging (4DCT) arrayed using the phase based sorting to analyze the respiratory phase difference. Materials and Methods : The study analyzed the 4DCT (4-dimensional computed tomography) images of 10 liver cancer patients that were treated with respiratory gated radiotherapy from 2015 February to March. Using RPM respiratory gating (RPM 1.7.5, Varian, USA) equipment, imaging according to respiratory cycle of phase based sorting was acquired and using a treatment planning system (Pinnacle 9.2, Philips, USA) the acquired imaging according to respiratory cycle was used to measure the abdominal movement value by respiratory cycle. The measuring point was the point where the center point of the Marker Block and the body surface met in the 50% phase image and here the coordinate values Lateral, Vertical, Longitudinal (X, Y, Z) were set as reference points, and on the X, Z plane identical to the reference point, using the identical method the Y axis coordinate value of each 0%, 30%, 40%, 50%, 60%, 80% phase images were acquired to quantitatively measure the variation of distance to the Y axis. The abdominal movement value according to respiration was applied to the theoretical model that the value decreases linearly from maximum inhalation to maximum exhalation to divide the variation of my value to predict as amplitude value by respiratory cycle and conversely the variation in amplitude was recalculated with the phase variation deviation value to analyze. Results : The deviation value between expected value and actual location was the largest in the 30% phase with 0.24 cm, and standard deviation was also the largest in 30% phase with 0.13 cm. The effective value of the deviation value derived from the average of the deviation squared value of each patient appeared as minimum 0.7 cm, maximum 0.18 cm, average 0.12 cm, and standard deviation 0.4 cm. Also by dividing the actual movement distance value with the peak expiration value then converting it into %Phase, the deviation value with actual phase 16.5% in 30% phase, 10.0% and 40% phase, 10.0% and 60% phase, 15.4% and 80% phase, and overall average about 13%, and arraying based on amplitude, phase shift occurred and further it was from peak expiration the chance of deviation occurrence was increasingly measured. Conclusion : Based on the results of the study there were differences between value acquired based on theoretical model and actual value. Therefore in respiratory gated radiotherapy using external surrogates, there needs to be establishment of respiration gated radiation system that avoids the combination of two Sorting methods considering that there will be occurrence of treatment and corresponding clinical differences due to the phase difference that occur due to the Amplitude based Phase Sorting.

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Analysis of Respiratory Motion Artifacts in PET Imaging Using Respiratory Gated PET Combined with 4D-CT (4D-CT와 결합한 호흡게이트 PET을 이용한 PET영상의 호흡 인공산물 분석)

  • Cho, Byung-Chul;Park, Sung-Ho;Park, Hee-Chul;Bae, Hoon-Sik;Hwang, Hee-Sung;Shin, Hee-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.3
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    • pp.174-181
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    • 2005
  • Purpose: Reduction of respiratory motion artifacts in PET images was studied using respiratory-gated PET (RGPET) with moving phantom. Especially a method of generating simulated helical CT images from 4D-CT datasets was developed and applied to a respiratory specific RGPET images for more accurate attenuation correction. Materials and Methods: Using a motion phantom with periodicity of 6 seconds and linear motion amplitude of 26 mm, PET/CT (Discovery ST: GEMS) scans with and without respiratory gating were obtained for one syringe and two vials with each volume of 3, 10, and 30 ml respectively. RPM (Real-Time Position Management, Varian) was used for tracking motion during PET/CT scanning. Ten datasets of RGPET and 4D-CT corresponding to every 10% phase intervals were acquired. from the positions, sizes, and uptake values of each subject on the resultant phase specific PET and CT datasets, the correlations between motion artifacts in PET and CT images and the size of motion relative to the size of subject were analyzed. Results: The center positions of three vials in RGPET and 4D-CT agree well with the actual position within the estimated error. However, volumes of subjects in non-gated PET images increase proportional to relative motion size and were overestimated as much as 250% when the motion amplitude was increased two times larger than the size of the subject. On the contrary, the corresponding maximal uptake value was reduced to about 50%. Conclusion: RGPET is demonstrated to remove respiratory motion artifacts in PET imaging, and moreover, more precise image fusion and more accurate attenuation correction is possible by combining with 4D-CT.

Evaluation 4D-CT Simulation used of Motion Organ and Tumor for Respiratory Gated Radiation Therapy (호흡동조방사선치료를 위한 4D-CT simulation을 이용한 동적장기와 종양 움직임 평가)

  • Kim, Seung-Chul;Kim, Min-A
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.395-402
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    • 2015
  • when the radiation therapy of chest and abdomen, evaluation of the tumor motion and the data was used to minimize damage to normal tissues by separating the tumor and normal tissue and maximize tumor therapeutic effect. Lung and liver cancer each 20 patients based on the 50% top phase using 4D-CT simulation and Light speed-16 of shooting equipment 30 ~ 70 % gating phase interval and 0 ~90 % movement in the full phase interval was measured. If the full phase 0 ~ 90% with gating phase 30~70% of tumors in the liver and lung is shown the biggest difference compared to the motion and the size of the GTV was the largest difference in the I(inferior), full phase 0~90% degree of tumor motion only when a relatively large, gating phase to 30~70% of the tumor when the movement has been found that the reduced average 7.1mm. In the 4D-CT simulation comparing the motion value when the full phase 0~90 % and gating phase 30~70 % when the motion value, twice in the gating phase 30~70 % more than full phase 0~90 % showed a small movement value. The exposure to normal tissues, based on the results obtained from the 4D-CT simulation can be significantly alleviated, After treatment will reduce pain and disability in patients with radiation is expected to be able to effective treatment.