• Tuberculosis and Respiratory Diseases
• /
• v.48 no.6
• /
• pp.956-963
• /
• 2000

Backgrounds : Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional(PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometric data and polysomnographic recordings between the two types of sleep apnea syndrome. Materials : Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometric data and polysomnographic data were analyzed, statistically. Results : Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6$\pm$28.2min, 333.3$\pm$46.0min, (p<0.05). Sleep efficiency was high in the PP group(89.6$\pm$6.4%, 85.6$\pm$9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower( 17.0$\pm$10.6, 28.5$\pm$13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7$\pm$1.8%. p<0.05) than in the NPP group. Conclusion : Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.

• The Journal of the Korea Contents Association
• /
• v.8 no.12
• /
• pp.176-189
• /
• 2008

The purpose of this study was to analyze self-regulation about changing heart rate and perceived arousal variation when actors start their performance. Object of this study were 5 actors who belong to the theater selected using the purposive sampling method. This study used a measuring instrument of heart rate to measure arousal status, used behavior observation paper to observe and record self-regulation behavior and executed personal consultation after ending performance. There was graph mad by variation transition which calculated average and standard deviation about variation of heart rate each time of performance. The results of this study were as follows. First, there were high variation of awake level that actor's heart rates were rising before starting performance and the most high level of arousal was from 20minutes to 5minutes before starting performance. Second, there were self-regulation behaviors appeared such as deep breathing, breath controling, self talking, talking with other actors, concentrating an script, going to toilet, smoking, checking closes before starting performance. Third, when performance start, actors used psychological self-regulational method such as relaxation, self concentration, confidence reinforcement, coping with state or accommodation for controling raised arousal status.

• Journal of dental hygiene science
• /
• v.17 no.1
• /
• pp.46-55
• /
• 2017

Many people in Korea suffer from a fear of dental treatments; however, only a few studies have focused on this population. This study assessed the effectiveness of cognitive behavioral therapy (CBT) and its interventions in reducing dental anxiety, especially when administered by trained dental staff. Using case studies, the authors analyzed the content of each session and examined the process of reducing dental anxiety. First, the authors observed that the results of both dental fear scale and subjective unit of disturbance decreased significantly with changes in cognitive distortions related to dental anxiety and that rapid improvements were noted after two therapy sessions. Second, the study reported that practicing relaxation (deep-breathing) and muscle relaxation techniques; using hand signals to indicate anxiety or discomfort; establishing an empathic relationship with the therapist; making an anxiety list; and graded insensitive and exposure along with rehearsal, were effective in coping with dental anxiety and in changing negative thoughts towards the dentist. Third, a simple cognitive behavioral intervention can be effective in reducing dental anxiety. In summary, a short-term, five-session psychological intervention with CBT produced a sustained decrease in the symptoms of dental anxiety, allowing the patients to receive the required procedures. The authors discussed the study limitations and the implication of their results on future research.

• Journal of Oriental Neuropsychiatry
• /
• v.29 no.3
• /
• pp.183-195
• /
• 2018

Objectives: To investigate validity and effectiveness of Saam five element acupuncture treatment in psychological problems. Methods: We selected a Korean medicine doctor known to apply Saam five element acupuncture treatment to the psychiatry field. An investigator visited the doctor's clinic to observe the cases and interview patients. Duration of each interview was 30 minutes to one hour. A semi-structured questionnaire was used for in-depth interviews. All interviews were recorded and converted into texts. Converted texts were then summarized and analyzed qualitatively. Results and Discussion: Treatment process of Saam five element acupuncture designed for psychiatric use is divided into four stages: qi transformation (氣化), acupuncture treatment, deep breathing, and acupressure. In the first stage, patients are asked to express their feelings and emotions in a physical sense; to imagine their feelings have colors, weight, and physical form, and to describe those characteristics. Next, the doctor evaluates each patient's qi according to the six qi (六氣), and then determines protocol of Saam five element acupuncture treatment. This treatment is focused on suffering of the patient and specific symptoms or emotions. The treatment duration is brief and changes in symptoms are frequently checked during treatment sessions. Without discussing details of stressful events, the doctor enables patients to express physical aspects of their feelings. He also provides them with psychoeducational resources. As a result, patients experienced immediate changes in body sensation, emotions and thinking, decreased response to triggers, and increased self-control after treatment. Conclusions: The Saam five element acupuncture treatment has the potential to be used as a treatment for psychiatric disorders. Treatment can be effective in managing psychiatric disorders when applied by primary Korean medicine clinics.

• Journal of Chest Surgery
• /
• v.24 no.1
• /
• pp.54-63
• /
• 1991

Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

• Korean Journal of Clinical Laboratory Science
• /
• v.52 no.4
• /
• pp.317-326
• /
• 2020

Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.4
• /
• pp.385-394
• /
• 2002

Background : Flexible fiberoptic bronchoscopy(FFB) has become a widely performed technique for diagnosing and managing pulmonary disease because of its low complication and mortality rate. Since the use of FFB can in patients with severely depressed cardiorespiratory function is increasing and hypoxemia during the FFB can induce significant cardiac arrhythmias, the early detection and adequate management of hypoxemia during FFB is clinically important. Method : To evaluate the necessity of the continuous monitoring of the oxygen saturation($SaO_2$) during the FFB, the $SaO_2$ was continuously monitored from the finger tip using pulse oximetry before, during and after the FFB in 379 patient. The patients were then divided into two groups, those with and without hypoxemia($SaO_2$<90%). The baseline pulmonary function data and the clinical characteristics of the two groups were compared. Results : The mean baseline $SaO_2$ was $96.9{\pm}2.85%$. An $SaO_2$ <90% was recorded at some point in 62(16.4%) out of 379 patients, with 12 out of 62 experiencing this prior to the FFB, in 37 out of 62 during the FFB, and in 13 out of 62 after the FFB. No differences were observed in the smoking and sex distribution between those with and without hypoxemia. The mean age was older in those with hypoxemia than in those without. Significant differences were observed in the mean baseline $SaO_2$ and the mean time for the procedure between the two groups. The $FEV_1$ was significantly lower in those with hypoxemia, and both the FVC and $FEV_1/FVC$ also tended to decrease in this group. Managing hypoxemia included deep breathing in 20 patients, a supplemental oxygen supply in 39 patients, and the abortion of the procedure in 3 patients. Conclusion : These results suggest that the continuous monitoring of the oxygen saturation is necessary during fiberoptic bronchoscopy, and it should be performed in patients with a depressed pulmonay function in order for the early detection and adequate management of hypoxemia.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.2
• /
• pp.18-24
• /
• 2012

Purpose : Although lung ventilation SPECT (LV-SPECT) has a good sensitivity in detection of deep lung lesions, it is difficult to apply the LV-SPECT to patients having breathing problems due to limited examination time. In this study, we evaluated the usefulness of LEAP collimator, which provides high detection sensitivity and tolerable resolution, for the LV-SPECT in terms of diagnostic accuracy and examination time. Materials and Methods : Four volunteers inhaled Technegas (370 MBq) and the lung ventilation planar scan (LVPS, 300 counts/view (cpv)) with LEHR collimator was performed using Siemens E.cam scanner as a reference test. LV-SPECT scans were performed with three collimators, LEHR, LEUHR, and LEAP, in low (7 kcpv) and high (70 kcpv) counting modes. The count ratios of left (LT) and right (RT) lung segments were calculated on the geometric mean view of anterior and posterior images for LVPS and on the summed coronal images of LV-SPECT, respectively. Comparing to LVPS, the usefulness of three different collimators for LV-SPECT was evaluated through statistical analysis (paired t-test), on count ratios of lung segments. Results : The average LT:RT ratio in LVPS was 47:53. For LV-SPECT, there were negligible difference of the LT:RT ratios (48:52 on average) among three different collimators in low and high counting modes. Comparing to standard LVPS with LEHR, all LV-SPECTs with different collimators resulted in similar diagnostic accuracy through paired t-test (p>0.05). The scan time in LVPS (6 views) was 17.3 min. For LV-SPECT (128 views) in low counting mode, it took 18.7 (LEUHR), 15.0 (LEHR), and 12.3 min (LEAP), respectively. Conclusion : Comparing to standard LVPS, the LV-SPECT with LEAP in low counting mode provided the comparable diagnostic accuracy in addition to shortened scan time.