• Title/Summary/Keyword: Dynamic compliance

Search Result 167, Processing Time 0.021 seconds

The Effect of External PEEP on Work of Breathing in Patients with Auto-PEEP (Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과)

  • Chin, Jae-Yong;Lim, Chae-Man;Koh, Youn-Suck;Park, Pyung-Whan;Choi, Jong-Moo;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.43 no.2
    • /
    • pp.201-209
    • /
    • 1996
  • Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

  • PDF

Design and Implementation of Distributed QoS Management Architecture for Real-time Negotiation and Adaptation Control on CORBA Environments (CORBA 환경에서 실시간 협약 및 작응 제어를 위한 분사 QoS 관리 구조의 설계 및 구현)

  • Lee, Won-Jung;Shin, Chang-Sun;Jeong, Chang-Won;Joo, Su-Chong
    • The Journal of Korean Institute of Communications and Information Sciences
    • /
    • v.27 no.1C
    • /
    • pp.21-35
    • /
    • 2002
  • Nowadays, in accordance with increasing expectations of multimedia stream service on the internet, a lot of distributed applications are being required and developed. But the models of the existing systems have the problems that cannot support the extensibility and the reusability, when the QoS relating functions are being developed as an integrated modules which are suited on the centralized controlled specific-purpose application services. To cope with these problems, it is suggested in this paper to a distributed QoS management system on CORBA, an object-oriented middleware compliance. This systems we suggested can provides not only for efficient control of resources, various service QoS, and QoS control functions as the existing functions, but also QoS control real-time negotiation and dynamic adaptation in addition. This system consists of QoS Control Management Module(QoS CMM) in client side and QoS Management Module(QoS MM) in server side, respectively. These distributed modules are interfacing with each other via CORBA on different systems for distributed QoS management while serving distributed streaming applications. In phase of design of our system, we use UML(Unified Modeling Language) for designing each component in modules, their method calls and various detailed functions for controlling QoS of stream services. For implementation of our system, we used OrbixWeb 3.1c following CORBA specification on Solaris 2.5/2.7, Java language, Java Media Framework API 2.0 beta2, Mini-SQL 1.0.16 and the multimedia equipments, such as SunVideoPlus/Sun Video capture board and Sun Camera. Finally, we showed a numerical data controlled by real-time negotiation and adaptation procedures based on QoS map information to GUIs on client and server dynamically, while our distributed QoS management system is executing a given streaming service.

Preliminary Evaluation of Handling Qualities of a SAR(Search & Rescue) Helicopter Simulator Based on ADS-33 Requirements (ADS-33 평가기준에 따른 소방헬기 비행시뮬레이터의 비행조종성 예비평가)

  • Yoon, Sugjoon;Kim, Donghyun;Seong, Eunhye;Park, Taejun;Hwang, Hoyon;Ahn, Jon;Lee, Junghoon
    • Journal of the Korean Society for Aeronautical & Space Sciences
    • /
    • v.44 no.9
    • /
    • pp.796-805
    • /
    • 2016
  • As a part of the first stage in the helicopter flight simulator development, this study numerically evaluates handling qualities of the dynamics model. The flight dynamics model was generated using public information for AS365 N2, the target aircraft of the simulator. The flight simulator is under development as a pilot training and research tool for firefighting missions. The assessment of the model intends to validate general characteristics and suitability before the model is enhanced with flight test data. The evaluation is based on the ADS-33E-PRF(Aeroautical Design Standard Performance Specification Handling Qualities Requirement) criteria, with consideration of category of the aircraft, missions, and environment. The numerical operations follow required or recommended procedures of flight test for compliance demonstration. Evaluation results are evaluated according to the rating specified in maneuverability ADS-33E-PRF. Results have identified to provide a satisfactory platform for flight dynamic model in the general helicopter simulator generated based on the RotorLibFDM, and can be used as a base for basic training and research.

The effect of tulobuterol patches on the respiratory system after endotracheal intubation

  • Lee, Do-Won;Kim, Eun-Soo;Do, Wang-Seok;Lee, Han-Bit;Kim, Eun-Jung;Kim, Cheul-Hong
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.17 no.4
    • /
    • pp.265-270
    • /
    • 2017
  • Background: Endotracheal intubation during anesthesia induction may increase airway resistance ($R_{aw}$) and decrease dynamic lung compliance ($C_{dyn}$). We hypothesized that prophylactic treatment with a transdermal ${\beta}2$-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube. Methods: Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each). The night before surgery, a 2-mg TP was applied to patients in the TP group. Standard monitors were recorded, and target controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. Simultaneously, end-tidal carbon dioxide, $R_{aw}$, and $C_{dyn}$ were determined at 5, 10, and 15 min intervals after endotracheal intubation. Results: There was no significant difference in demographic data between the two groups. The TP group was associated with a lower $R_{aw}$ and a higher $C_{dyn}$, as compared to the control group. $R_{aw}$ was significantly lower at 10 min (P < 0.05) and 15 min (P < 0.01), and $C_{dyn}$ was significantly higher at 5 min (P < 0.05) and 15 min (P < 0.01) in the TP group. A trend towards a lower $R_{aw}$ was observed showing a statistically significant difference 5 min after endotracheal intubation (P < 0.01) in each group. Conclusions: Prophylactic treatment with TP showed a bronchodilatory effect through suppressing an increase in $R_{aw}$ and a decrease in $C_{dyn}$ after anesthesia induction without severe adverse effects.

A Study for the Norms of Audiometric Tests in Koreans (정상한국인의 청력검사치에 관한 연구)

  • 오혜경;서장수;이근해;김희남;김영명;권영화;서옥기
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1981.05a
    • /
    • pp.38.1-38
    • /
    • 1981
  • Currently in the otologic field, there are various methods of special audiometric examinations, such as, tone decay, SISI, and impedance audiometry and only a few studies has been done in these fields sporadically in Korea. The purpose of this paper is to establish norms of various special audiometric tests, so we have performed the special audiometric tests on 100 male medical students in good physical condition and the follow results were obtained. 1. All cases showed over 90% of PB scores. The mean and its 2 S.D. were 98$\pm$4.9% in the right ear and 97$\pm$5.6% in the left ear. 2. The mean and its 2 S.D. of MCL(most comfortable level) were 45$\pm$15.4 dB in the right ear and 46$\pm$17.9 dB in the left ear, and its range was 12$\pm$12.2 dB in the right ear and 13$\pm$12.6 dB in the left ear. 3. The mean and its 2 S.D. of UCL (uncomfortable level) were 102$\pm$7.9 dB in the right ear and 102$\pm$7.9 dB in the left ear and about an half in cases showed over 106 dB of UCL. 4. In 95% of cases, SISIs(short increment sensitivity index) at 1, 000 Hz and 4000 Hz was below 45% in the right ear in both frequencies and below 55% and 75% in the left ear, respectively. 5. In 95% of cases, tone decays at 2, 000 Hz and 4, 000 Hz was below 10 dB in both ears. 6. The difference between SRT and PTA (speech reception threshold minus pure tone average) was 4$\pm$9.2 dB in the right ear and 4$\pm$10.0 dB in the left ear. 7. The dynamic range(uncomfortable level minus speech reception threshold) was 98$\pm$13.5 dB in the right ear and 99$\pm$13.5 dB in the left ear. We had trouble in estimating the dynamic range in about an half in cases, in which we couldn't estimate the UCL with our conventional audiometry. 8. The results of impedance audiometric tests were as follow: A. In the tympanogram, all cases were of A type with one exception of B type in the left ear. The mean and its 2 S.D. of its peak level were 22.8$\pm$32.94mm $H_2O$ in the right ear and 23.9$\pm$29. 81mm $H_2O$ in the left ear. B. The mean and its 2 S.D. of the compliance were 0.6$\pm$0.54cc in the right ear and 0.6$\pm$0.53cc in the left ear. C. The results of stapedial reflex: a. The mean and its 2 S.D. of the controlateral stapedial reflex at 500Hz, 1, 000Hz, 2, 000Hz, 4, 000Hz were 99$\pm$17.7 dB, 87$\pm$14.4 dB, 79$\pm$13.7 dB, 77$\pm$20.0 dB in the right ear and 99$\pm$15.9 dB, 88$\pm$13.9 dB, 79$\pm$13.7 dB, 77$\pm$21.3 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wasn't generated in 6 cases in the right ear and 11 cases in the left ear. b. The mean and its 2 S.D. of the ipsilateral stapedial reflex at 1, 000Hz, and 2, 000Hz were 89$\pm$16.3 dB, 82$\pm$15.9 dB in the right ear and 89$\pm$18.0 dB, 83$\pm$18.9 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wans't generated in 1 case in the right ear and 2 cases in the left ear. 9. Eustachian tube function using with impedance audiometry was malfunctioned in21 cases depending on the tested pressure and the range of peak level of tympanogram was 14$\pm$26.9mm $H_2O$(tested pressure:+250mm $H_2O$), 8$\pm$21.9mm $H_2O$ (tested pressure:-250mm $H_2O$) in the right ear and 11 cases depending on the tested pressure and the range of the peak level of tympanogram was 12$\pm$22.5mm $H_2O$ (tested pressure: +250 mm $H_2O$, 9$\pm$17.3mm $H_2O$(tested pressure: -250mm $H_2O$) in the left ear.

  • PDF

The Dynamic and Histologic Changes of Variously Fixed Bovine Pericardiums Specimens after Mechanical Fatigue Stimuli (다양한 고정 처리법을 이용한 소 심낭의 기계적 피로 자극 후 역학적 및 조직학적 변화)

  • Chang, Hyoung-Woo;Kim, Yong-Jin;Kim, Soo-Hwan;Park, Ji-Eun;Park, Chun-Soo;Kim, Woong-Han;Kim, Kyung-Hwan
    • Journal of Chest Surgery
    • /
    • v.42 no.2
    • /
    • pp.148-156
    • /
    • 2009
  • Background: As cardiovascular operations become more complex and sophisticated, there is an increasing need for various bioprostheses for use as components of blood vessels and heart valves. We developed a fatigue stimuli test instrument to objectively evaluate the mechanical durability of a bioprosthesis, and we tested several currently known processing methods for bovine pericardium and we then compared the results. Material and Method: Fresh bovine pericardium was collected at the butcher shop with using aseptic technique, and each piece of pericardium was fixated and/or decellularized by 16 representative methods. We measured the permeability and compliance of the processed bovine pericardium samples, and measured them again after exposure to the fatigue stimuli. All the pieces of pericardium underwent microscopic examinations before and after the fatigue stimuli. Result: A mixture of glutaraldehyde and solvent treatment showed better mechanical durability than did the single glutaraldehyde treatment. High concentration glutaraldehyde treatment showed equal or no worse results than did low concentration glutaraldehyde treatment. After SDS (sodium dodecylsulfate) decellularization, the mechanical property of the bioprosthesis became much worse ($20{\sim}190$ times) and the mechanical durability to the fatigue stimuli was also very poor. Conclusion: We obtained the basic durability data after various fixation methods with using a home-made fatigue test instrument.

Keeping Distance from Pathos and Turning Rational Trade into Emotions -The Change of Genres and the Reorganization of Emotions in the South Korean Films in the 1990s (파토스에의 거리와 합리적 거래의 감성화 -1990년대 한국영화 장르의 변전(變轉)과 감성의 재편)

  • Park, Yu-Hee
    • Journal of Popular Narrative
    • /
    • v.25 no.3
    • /
    • pp.9-40
    • /
    • 2019
  • This study presents an investigation into South Korean films in the 1990s in the aspects of genre change and emotional reorganization. The 1990s witnessed a change of genres and a paradigm shift in the history of Korean films according to the revolutionary changes of the film industry structure and media environment. Believing that these changes had something to do with emotional changes driven by global capitalization symbolized by democratization in 1987 and the foreign currency crisis in 1998, the investigator analyzed the phenomena in film texts and examined the opportunities and context behind them. Unlike previous researches, this study made an approach to the history of Korean films in the 1990s with three points: first, this study focused on why the romantic comedy genre emerged in the 1990s and what stages its formation underwent since there had been no profound discussions about them; secondly, this study analyzed the biggest hits during the transitional period from 1987~1999 to figure out the mainstream genres and emotions during that period since these hits would provide texts to show the genre domain and public taste in a symbolic way; and finally, this study grew out of the separate investigation approach between melodramas and romantic comedies and looked into an emotional structure to encompass both genres to make a more broad and dynamic approach to South Korean films in the 1990s. History flows continuously without severance from previous times. When there is attention paid to inflection points and opportunities in the continuum, it can show the dynamics and structures of changes. This research led to the following conclusions: the mainstream genre of South Korean films had been melodramas until the 1980s. The old convention had been kept to offset or suture contradictions and excessive elements deviant from the structural consistency. Here, the structural consistency refers to no compliance to rational regulations or trade. The process of genre reorganization in the 1990s happened while securing some distance from the convention of making the structural consistency a sacrifice. The direction was to reinforce control through reasonable rationalism and logic of capital. It developed into romance, which would start with comedy to keep distance from the objects through laughter, heighten the level of remarks, and expand criticality, symbolize emotions with taste items, and build through the logic of mutual consensus and practical trade. In the 1990s, the South Korean films thus developed in a direction of moving away from the narrative of urgent pathos based on unconditional familism. It was on the same track as the entry of the South Korean society into the upgraded orbits of democracy and capitalism as the twins of modern rationalism since the latter part of the 1980s.