• 대한방사선치료학회지
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• 제31권2호
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• pp.43-49
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• 2019

목 적: 본 연구는 좌측 유방암 방사선치료에서 환자 호흡방법에 따른 영향에 대하여 치료계획을 통해 비교 분석하고, 깊은 들숨 호흡 정지법(deep inspiration breath hold, DIBH)에서 지속적 기도 양압(continuous positive airway, CPAP)의 유용성을 평가하고자 하였다. 대상 및 방법: 좌측 유방암 환자 총 10명을 대상으로 하였다. 모의치료에서 총 세 가지 호흡법을 적용하여 영상을 획득하였다: 자유호흡법(free breathing, FB); 깊은 들숨 호흡 정지법(DIBH); 들숨 호흡 정지법(inspiration breath hold, IBH); 여기서 DIBH에서는 자가호흡확인 기구인 abches(APEX, Japan)와 IBH에서는 CPAP가 적용되었다. 치료계획은 Ray Station(5.0.2.35, Sweden)을 이용하였고, 용적 강도변조 회전방사선치료법(volumetric modulated arc therapy, VMAT) one partial Arc을 환자당 동일 각도로 적용하였다. 치료계획용적(planning target volume, PTV)의 총 처방선량은 50Gy(2Gy/fx)로 설정하였다. 치료계획분석은 PTV의 95% dose(D95), 처방선량지수(conformity index, CI)와 선량균질지수(homogeneity index, HI)를 비교 분석하였다. 손상위험장기(Organ At Risk, OAR)인 폐, 심장, 왼내림 앞가지동맥(left anterior descending artery, LAD)을 분석하였다. 결 과: 동축의 폐(ipsilateral lung)의 평균용적 FB, DIBH(Abches), IBH(CPAP)에서 각각 1245.58±301.31㎤, 1790.09±362.43㎤, 1775.44±476.71㎤였다. PTV의 평균 D95는 각각 46.67±1.89Gy, 46.85±1.72Gy, 46.97±2.34Gy였다. 평균 CI(HI)는 각각 0.95±0.02(0.91±0.01), 0.96±0.02(0.90±0.01), 0.95±0.02(0.92±0.02)였다. 폐 전체의 V20(동측 폐)은 각각 10.74±4.50%(20.45±8.65%), 8.29±3.14%(17.18±7.04%), 9.12±3.29%(18.85±7.85%)였다. 심장의 평균 선량(Dmean)은 각각 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy였다. LAD의 최대선량(Dmax)은 각각 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy였다. LAD에서 흉벽(Chest wall)까지 평균거리는 각각 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm였다. 결 론: DIBH와 CPAP에서 FB보다 폐 용적이 커짐으로써, 방사선치료영역인 흉벽과 심장의 거리가 멀어지는 효과 때문에 LAD의 선량을 감소시킬 수 있다. 좌측 유방암 방사선치료 시 DIBH방법의 대체방안으로 CPAP은 임상적 활용도가 높을 것으로 사료된다.

• 대한치과마취과학회지
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• 제14권1호
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• pp.17-27
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• 2014

Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.

• 대한한의학원전학회지
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• 제37권3호
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• pp.83-106
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• 2024

Objectives : This paper aims to examine the meaning of Shengmaisan in relation to original qi based on the discussion of Zhangyuansu, Lidongyuan and other doctors. Methods : Discussion of Shengmaisan made by Zhang, Li and others were examined. Afterwards, the medicinal properties of renshen, maimendong, and wuweizi as written in the Bencaogangmu, Donguibogam, Benjingshuzheng and texts of Zhang and Li were studied in relation to original qi. Related concepts such as '肺中伏火'·'補肺中元氣不足'·'補天眞元氣'·'夏食寒' were analyzed as well. Results & Conclusions : 1. Various pathology related to deficiency in original qi could act as internal pathogen for Shengmaisan application with which external factors such as summerheat and dampness heat meet results in most damage in the Lung metal. Therefore the upper body Lung is emphasized as pathogen. 2. The pathology of Shengmaisan application is depletion of humor, which should be refined, due to summer or dampness heat in a state of original qi deficiency which damages the Lungs, disabling its function of managing clear and pure qi. 3. The disease pattern for Shengmaisan in relation to original qi, according to other doctors, includes symptoms related to the Lungs such as dryness in the mouth due to excessive perspiration, blankness, loss of consciousness, shortness of breath, coughing, fast breathing, along with general bodily symptoms such as heavy sensation of the body, lethargy, difficulty walking, limping. These general bodily symptoms are due to either qi deficiency of the Lung, or humor deficiency due to failure of qi convergence in the lower body, or symptoms caused by Jing deficiency in severe cases. Symptoms related to problems in the lower body could manifest as dysfunction in urination and defecation, weakness in the limbs caused by original qi deficiency. 4. The Lungs circulate the clear and pure qi, converging qi and creating humor to assist the Triple Burner's Qi-Humor metabolism, enabling smooth communication of original qi throughout the body. With the original qi well tonified, the shen mechanism which is rooted in original qi allows for autonomous and consistent qi circulation within the body. Therefore, both Zhang and Li emphasized the importance of original qi. The property of Shengmaisan is explained as 'supplement qi/create liquid, convergence of yin/stop perspiration'. Zhang and Li explained its property as managing the circulation of original qi, to tonify Lungs' original qi and origin of water-humor.

• 지역사회간호학회지
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• 제11권2호
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• pp.411-422
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• 2000

The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.

• 한국산업보건학회지
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• 제20권4호
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• pp.225-235
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• 2010

This study was aimed to assess the status of working environment, health care management status and cause of exposure in manufactories using dimethylformamide (DMF). For the purpose, airborne concentration of DMF in the workplaces and N-methylformamide (NMF) in worker's urine were measured with job type and process. In addition, management of local exhaust ventilation system (LEV) and personal protective equipment (PPE) was evaluated at 35 work places (107 workers) located in Busan and Gimhae area. Mean DMF concentrations in work places by job type and process were of high level measured in printing and record media reproduction (5.23 ppm) and flaking process (2.48 ppm). Workers in adhesive job were measured a large amount of urine NMF (21.59 mg/${\ell}$). 98.1% of DMF handling workers were provided respirators, but 67.3% of those workers used them. The main reasons for not using respirators were inconvenience and difficulty of breathing. Airborne concentrations of DMF were higher in the workplaces in which LEVs were working abnormally, but there was not statistically significant. In addition, the urine NMF levels were correlated with management of LEV within the workers who did not use the respirators (p<0.048). These results implied that LEV should be installed and maintained properly to protect the workers from the exposure to DMF. Management of PPE should be also necessary to protect the workers from chemical hazards.

• 한국융합학회논문지
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• 제11권4호
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• pp.71-78
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• 2020

본 연구에서는 마네킹을 이용해서 평상시 응급처치시 입는 옷, 레벨 B, 레벨 C PPE를 착용이 고품질의 심폐소생술에 미치는 영향을 알아보고자 한다. 본 실험에 참여한 응급구조사는 C 지역 소방 소속의 5년 이상의 경력을 가진 119 구급대원 20명을 대상으로 하였다. 심폐소생술 중 가슴압박이 중지되는 손이탈 시간 및 비율의 경우 유니폼 착용그룹에서 11.9 초, 레벨 C PPE 착용 그룹에서 11.4 초, SCBA 착용 그룹에서 13.1 초인 것으로 밝혀졌다. 개인보호장비 착용은 구급대원의 움직임을 방해하고 있고 보상동작을 사용하게 되어 효율적인 응급처치의 어려움이 나타날 가능성이 많아지며, 이러한 상황이 지속될 경우 구급대원의 신체에도 피로감과 손상을 줄 수 있다. 구조 및 구급대원들은 응급상황을 대비해서 레벨별 개인보호장비를 착용하고 구조 및 심폐소생술 훈련에 임하여야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.275-280
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• 2016

Background: A tobacco-free workplace policy is identified as an effective means to reduce tobacco use and protect people from second-hand smoke; however, the number of tobacco-free policies (TFP) remains very low in workplaces in Malaysia. This study explored the factors affecting support for a tobacco-free policy on two healthcare campuses in Malaysia, prior to the implementation of TFP. Materials and Methods: This cross-sectional study was conducted among 286 non-smokers from two healthcare training centres and two nearby colleges in Malaysia from January 2015 to April 2015. A standardized questionnaire was administered via staff and student emails. The questionnaire collected information on sociodemographic characteristics, support for a tobacco-free policy and perceived respiratory and sensory symptoms due to tobacco exposure. Bivariate and multivariate logistic regression analyses were performed to estimate the independent effects of supporting a tobacco-free campus. Results: The percentage of individuals supporting completely tobacco-free facilities was 83.2% (N=238), as opposed to 16.7% (N=48) in support of partially tobacco-free facilities. Compared to the supporters of partially tobacco-free facilities, non-smokers who supported completely tobacco-free health facilities were more likely to be female, have higher education levels, to be very concerned about the effects of other people smoking on their health and to perceive a tobacco-free policy as very important. In addition, they perceived that tobacco smoke bothered them at work by causing headaches and coughs and, in the past 4 weeks, had experienced difficulty breathing. In the multivariate model, after adjusting for sociodemographic characteristics and other factors, only experiencing coughs and headaches increased the odds of supporting a completely tobacco-free campus, up to 2.5- and 1.9-fold, respectively. Conclusions: Coughs and headaches due to other people smoking at work enhances support for a completely tobacco-free campus among non-smokers.

• 동의생리병리학회지
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• 제22권1호
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• pp.32-50
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• 2008

This study is concerned with examining the causes and symptoms of Woman various diseases and clearing up the situations of pulses and their treatment. Woman various diseases are said to be various kinds of diseases including the disorder of menstruation and genitals except pregnancy and postpartum diseases. The main contents are the penetration of heat into worm, the discharge of much blood, stomachache, and the postpartum cyst diseases. Among them, the nature of the diseases which often occur in the gynecology, such as the menstrual diseases and stomachache, were described comparatively in detail. The reason why heat penetrates into the worm is that the external germs come into it under its weakness. To treat it, heat should be removed and lumping blood should be sent out of body. Especially only after whether the disease is serious or not is examined, and just after the process of the disease is examined, the lumping blood can be eliminated. The ways to cure it by sweating a patient too much, getting him or her to vomit, or forcing him or her to be urinated too much, should be avoided. The disorder of menstruation, as the disease which most often occur among the diseases of gynecology, includes menstrual irregularity and blood discharge, and non-menstruation. Among them, non-menstruation and blood discharge are comparatively often discussed. When they are treated, lumping blood and cold energy should be cured well through getting rid of the lumping blood and making the blood vessel flow well. The difficult urination after childbirth, which comes from the weak urinary cist, makes symptoms such as the stuffy chest, the difficulty of lying down, and breathing with his or her back something. To urinate better, the ability of the urinary cist should be supplemented and improved. The principle of the treatment for Woman various diseases is to examine the situation of the pulse closely, then set up the way to treat it, and prescribe a patient. In this study, besides the treatment of Chinese herb medicine, the medicine for washing genitals and the medicine placed in the worm were used to cure Woman various diseases. This treatment is the beginning of the surgical treatment in the gynecology.

• 한국안전학회지
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• 제23권3호
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• pp.79-86
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• 2008

이소시안화물을 경화제로 하는 분사용 페인트를 취급하는 산업현장에서는 HDI 의해 이소시안화물이 호흡이나 피부 및 눈에 노출되는 것이 일반적이다. 이러한 분사페인트를 사용하는 자동차관련 산업이나 가구산업 등에 대한 정보의 부족 때문에 건강에 미치는 증상을 개인관리의 중요성으로 평가하기 위하여 설문조사가 수행되었으며, 분사페인트를 취급하는 근로자 33명과 취급하지 않는 근로자 91명을 대상으로 비교하였다. 그렇게 많지 않은 대상자에 대한 조사에도 불구하고 공통적으로 나타나는 건강에 미치는 영향으로서 피부에 나타나는 증상, 즉 건성피부 손상(61%)과 피부염/피부염증(33%)이 있고 호흡기에 나타나는 증상, 즉 담(49%)과 천식(21%)과 같은 증상이 발견되었다. 그 외에도 건강에 좋지 않은 증상으로는 피부 발진(12%), 기침(39%), 빈번한 호흡으로 인한 새근거림(30%), 가슴의 답답함과 호흡곤란(30%) 등이 나타났으며, 눈에는 어떤 증상이 나타나지 않았다. 이 연구에서 나타난 건강에 미치는 증후는 근로자들의 좋지 않은 작업형태나 부적절한 보호구에 관련된다는 것을 발견하였다. 따라서 보호구의 사용, 작업형태, 규칙적인 훈련이나 교육 등과 같은 적절한 개인적 관리가 건강의 위험을 최소화시키는 것이고, 개인적 건강에 미치는 영향을 확인하기 위하여 의학적인 조사도 추가적으로 제시하고자 한다.

• 혜화의학회지
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• 제11권1호
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• pp.151-162
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• 2002

Objective Many literature-based researches and clinical studies have been thus far reported of wha-byuong in Oriental medicine but acupunctural approaches to it have been little executed, which motivated this study to be conducted through acupunctural treatment. For that purpose, this study carried out incessant treatment on wha-byuong-having outpatients of this hospital who were suffering from gunhwa of wha in the saam acupuncture in order to inquire into the features of wha-byuong represented recently, and thereupon this got some intellect and knowledge out of clinical cases, which led this study to report them. Methodology Two wha-byuong outpatients were taken as subjects for this study who visited this hospital from January 10, 2002 through May 20, 2002. As for the contents of treatment and the administration of medicine, acupuncture utilized size $30{\times}50mm$ needles and the performance of treatment depended upon yuchim for 20 to 40 minutes at one time by means of simseunggyok (eumgok, sohae bo, taebaek, sinmun sa) on both right and left sides of the outpatients. As the case may be, sobu, baekhoi, and pungji were used at the same time. Bosa of simseunegyok took youngsu bosa. In order to evaluate treatment, symptoms were classified with diagrams into physical symptoms, dorgan symptoms, urinogenital organs symptoms, dermatological symptoms, cardiopulmonary symptoms, musculoskeletal symptoms, somnipathy symptoms, caput and sensual organ symptoms, psychomotor activity symptoms, and other symptoms, and then signs and marks were given to indicate the most objective values according to symptoms of the patients perceived in different sessions both prior and posterior to treatment. Conclusion As a result of having conducted treatment on two outpatients who visited this hospital for their wha-byuong from January 10, 2002 through May 20, 2002, conclusions were obtained, as follows: 1. Treatment depended very largely upon simseunggyok of the saam acupuncture, and as the case may be, baekhoi, pungji and sobu were utilized at the same time. 2. Much more effects were produced only when the patients had got rid of the causes of wha-byuong they had. Furthermore, the perceived seriousness of the symptoms presented had not been improved, regardless of their wha-byuong, 3. The main symptoms complained by the patients such as sangyeolgam, anxieties, impatience, hungmin, difficulty in breathing, cardiopalmus, insomnia, digestive troubles, etc. showed for the most part conspicuous therapeutical effects upon the symptoms of wha-byuong. In particular, a high degree of improvement was represented from melancholia and pyrexia.