• 음성과학
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• 제10권2호
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• pp.111-128
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• 2003

Aerodynamic study is valuable information about the vocal efficiency in translating airflow to acoustic signal. The purpose of this study was to investigate the differences between trained singers and untrained controls under different two pitch by simultaneous using the airway interruption method and electroglottography (EGG). Under singing a Korean lied 'Gene', 20 (Male 10, Female 10) trained singers were studied on two one-octave different tone. Mean flow rate (MFR) , subglottic pressure (Psub) and intensity were measured with aerodynamic test using the Phonatory function analyzer (Nagashima Ltd. Model PS 77H, Tokyo, Japan). Closed quotients (Qx), jitter and shimmer were also investigated by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). These data were compared with those of normal controls. MFR and Psub were increased on high pitch tone in all subject groups. Statistically significant increasing of Qx and intensity were observed in male trained singers on high pitch tone (Qx;p = .025, intensity;p < .001). Beacasue of increasing of Qx and intensity, vocal efficiency was also significantly increased in male singers (p < .001). The trained singers' phonation was more efficient than untrained singers. The result means that the trained singers can increase the loudness with little changing of mean flow rate, subglottic pressure but more increasing of glottic closed quotients.

• Journal of Chest Surgery
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• 제40권4호
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• pp.313-316
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• 2007

전신마취 회복기에 발생하는 음압성 페부종은 드물게 발생하나, 여러 종류의 수술 후 발생할 수 있는 잠재적으로 심각한 합병증이다 음압성 페부종의 발생 기전은 기관 내 튜브 발관 후 심한 자발적인 호흡시도와 성문폐쇄 및 후두경련으로 인한 기도폐쇄와 연관하여 현저하게 기도 내 음압이 상승하여 생긴다고 한다. 저자들은 건장한 26세 남자 환자에서 양성 늑골종양에 대한 늑골 부분절제술 후 기관 내 튜브 발관 후 심한 음압성 폐부종과 각혈이 발생하였으나 성공적으로 보존적 치료를 시행하였다. 이에 문헌고찰과 함께 보고한다.

• 성인간호학회지
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• 제14권2호
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• pp.265-275
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• 2002

Pursose: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. Method: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky & Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. Result: The results of this study are as follows. 1. The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2. Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3. Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. Conclusion: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.

• Tuberculosis and Respiratory Diseases
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• 제42권5호
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• pp.752-759
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• 1995

연구배경: 심부전 환자에서 기관지 과민성의 여부를 확인하고 이러한 기관지 과민성과 혈역학적 지표사이의 상관관계를 알기위해 메타콜린을 이용하여 기관지 유발검사를 실시하였다. 방법: 1994년 3월부터 8월까지 본원에 내원하여 흉부 X선 촬영, 심에코도 검사, 심도자술로 승모판 심장질환이 진단되고 호흡곤란의 정도가 NYHA 기능적 분류 2인 11명의 환자를 대상으로 PARI nebulizer I을 이용하여 메타콜린 용액의 농도를 올리면서 기관지 유발검사를 시행하여 최대호기 유속이 20%이상 감소를 보이면 양성반응으로 간주하였다. 또한 각각의 환자는 심도자술을 통해서 혈역학적인 지표와 기관지 과민반응과의 상관 관계를 알아보고저 하였다. 결과: 1) 11명의 환자중 남자 2명 여자 9명이였으며 평균연령은 38.0세이였고 흡연력은 1명이외에는 없었다. 2) 각 환자의 호흡곤란 정도는 NYHA 기능적 분류 2였고 승모판 협착증만 있는 환자는 5명이였고 이외는 승모판 질환과 대동맥 판막질환이 동반되어있었다. 3) 환자들의 평균폐동맥압과 평균폐모세혈관 쐐기압은 각각 21.72mmHg(${\pm}8.55$), 15.45mmHg(${\pm}8.69$)로 정상보다 높았고 심장지수와 좌심실분획률은 각각 2.64L/min/m2(${\pm}0.41$), 61.81%(${\pm}7.21$)로 정상범위이였다. 4) 11명의 환자중 1명만 메타콜린 기관지 유발검사에 양성이었다. 결론: NYHA 기능적 분류 2인 승모판 심장질환이 있는 심부전환자 11명중 1명만 기관지 과민반응이 관찰되었으며 그 이유로 지속적인 심부전의 치료에 의한 간질성 폐부종의 소설로 인해 기관지의 반응성이 증가되지 않았다고 사료되며 NYHA 기능적 분류 3 또는 4인 승모판 심장질환 환자를 대상으로 기관지 과민 반응에 대한 추후의 검사가 필요할 것으로 생각된다.

• 대한장애인치과학회지
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• 제10권1호
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• pp.31-37
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• 2014

The general local cause of gingival bleeding is the vessel engorgement and erosion by odontogenic infection. Abnormal gingival bleeding is also associated with systemic causes. Bleeding disorders in which continuous gingival bleeding is encountered include the followings : vascular abnormalities, platelet disorders, hypoprothrombinemia and other coagulation defects. There are classic methods for gingival bleeding control, such as, direct pressure, electrocoagulation, suture, crushing and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the conventional methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency condition. This is a case report of continuous gingival bleeding control by primary endodontic drainage & suture in a disabled patient with systemic bleeding disorders.

• Journal of Chest Surgery
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• 제50권5호
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• pp.382-385
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• 2017

A 47-year-old man with myasthenia gravis (MG) was admitted for a lung transplant. He had bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia. MG developed after stem cell transplantation. Bilateral sequential lung transplantations and a total thymectomy were performed. The patient underwent right diaphragmatic plication simultaneously due to preoperatively diagnosed right diaphragmatic paralysis. A tracheostomy was performed and bilevel positive airway pressure (BiPAP) was applied on postoperative days 8 and 9, respectively. The patient was transferred to the general ward on postoperative day 12, successfully weaned off BiPAP on postoperative day 18, and finally discharged on postoperative day 62.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.273-281
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• 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

• 수면정신생리
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• 제15권2호
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• pp.67-70
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• 2008

Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

• 대한치과교정학회지
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• 제40권2호
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• pp.115-126
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• 2010

이 증례보고는 심한 수면무호흡증으로 진단된 환자로, 다른 구강 내 OSA치료 장치와 nCPAP치료에 적응을 못하는 66세 남자 환자였다. 하악골에 2개의 교정용 마이크로 임프란트를 식립한 후, 식립 2주 후부터 구강외 고정원인 개조된 안면마스크에서 마이크로 임프란트에 힘을 가하여 하악골을 전진시켰다. 마이크로 임프란트를 이용한 하악골전진술(MiMA)은 심한 수면 무호흡환자의 AHI (apnea-hypopnea index), 코골이 및 심한 수면 무호흡증상을 개선할 수 있었다.

• Journal of Yeungnam Medical Science
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• 제23권2호
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• pp.227-231
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• 2006

기도가 닫힌 상태에서 강하게 숨을 뿜어내는 발살바법은 망막의 정맥압을 상승시키고 이에 따라 망막 출혈을 유발시킬 수 있다. 힘든 배변을 경험한 55세 남자가 우안의 중심시력 감소로 인해 본원을 방문하였다. 전신적인 질환으로 고혈압, 만성 변비를 앓고 있었고 동공을 산대하여 정밀 안저검사를 한 결과 유두 한 개 정도 크기의 망막전 출혈과 황반와주위로 작은 크기의 망막내 출혈이 관찰되었다. 특별한 치료없이 망막 출혈은 자연 흡수되어 시력은 정상으로 회복되었다. 배변으로 인해 급작스런 시력감퇴를 나타낸 발살바 망막증을 경험하였기에 보고하는 바이다.