• 수면정신생리
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• 제4권2호
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• pp.129-139
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• 1997

수면 무호흡을 포함한 다양한 원인의 수면과 관련된 호흡장애를 동반한 환자들에서는 여러가지 심혈관계 기능부전이 초래되어 이들 환자의 임상경과에 중대한 영향을 미친다. 수면 무호흡증후군, 특히 폐쇄성 수면 무호흡증후군은 수면장애의 여러 가지 원인 중 임상영역에서 가장 흔히 볼수 있는 질환으로 전신성 고혈압, 심부정맥, 폐동맥 고혈압 및 우심실 부전, 협심증 및 심근경색증, 뇌졸증등의 발병률이 정상인에 비하여 현저히 높은 것으로 알려져 있다. 폐쇄성 수면 무호흡과 달리 중추성 수면 무호흡은 수면중에 호흡중추를 불안정하게 하는 다양한 원인에 의해 발생하며 역시 심혈관계의 기능에 영향을 미칠 수 있다. 수면중에 환기장애가 더욱 악화될 수 있는 호흡기계 질환이 있는 환자들은 수면 무호흡증후군과 달리 만성적인 저산소증과 고탄산증이 동반되며 이로 인해 심부정맥, 폐동맥 고혈압, 우심실 부전(폐성심) 등의 심혈관계 이상이 초래될 수 있다. 따라서 수면 무호흡을 포함한 수면과 관련된 호홉 장애의 진단과 치료에 있어서는 호흡기계 질환에 대한 정확한 평가와 더불어 동반될 수 있는 심혈관계의 기능부전에 대한 정밀한 분석이 반드시 필요하며, 이들 자료를 바탕으로 기관절개술, 기계적 호흡, 지속적 양압공급치료, 적절한 산소요법 등의 적극적이고도 효과적인 치료법을 적용함으로서 심혈관계 합병증의 발생과 이로 인한 사망률을 감소시킬 수 있을 것으로 생각된다.

• 한국가시화정보학회:학술대회논문집
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• 한국가시화정보학회 2005년도 추계학술대회 논문집
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• pp.93-98
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• 2005

CT 스캔 데이터를 이용하여 호흡기의 컴퓨터 모델을 얻고, RP 를 이용하여 고형 모형으로 정교한 호흡기 유로 모형을 제작하였고, 호흡을 정확하게 모사하는 펌프를 만들었다. 사람의 호흡에 관한 생리적 테이터를 이용하여 캠을 제작하고 대형 피스톤 펌프를 만들어 사람의 호흡을 정확하게 모사하였다. 이를 이용하여 생리적 주기를 갖는 호흡기 내 유동에 대항 PIV 결과를 획득하였다. 최초로 정확한 기하학적 형상 및 입구와 출구 조건 하에서 인후부와 기관 내의 공기 유동장의 테이터베이스를 확보하였으므로, 향후 기존의 단순화된 모델을 이용한 실험적 수치해석적 결과들을 검정하는데 활용될 것이며 호흡기 질환의 진단과 치료에 기여할 수 있는 생리학적 병리학적 데이터를 제공할 수 있으리라 생각된다. 또한 공해 물질, 유독 물질, 흡입 약품 등의 호흡기 내 흡착 현상 규명 등에도 활용될 수 있을 것으로 보인다.

• 대한기계학회논문집B
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• 제30권11호
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• pp.1051-1056
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• 2006

The mean and RMS velocity field of the respiratory gas flow in the human airway was studied experimentally by particle image velocimetry (PIV). Some researchers investigated the airflow for the mouth breathing case both experimentally and numerically. But it is very rare to investigate the airflow of nose breathing in a whole airway due to its geometric complexity. We established the procedure to create a transparent rectangular box containing a model of the human airway for PIV measurement by combination of the RP and the curing of clear silicone. We extend this to make a whole airway including nasal cavities, larynx, trachea, and 2 generations of bronchi. The CBC algorithm with window offset (64 $\times$ 64 to 32 $\times$ 32) is used for vector searching in PIV analysis. The phase averaged mean and RMS velocity distributions in Sagittal and coronal planes are obtained for 7 phases in a respiratory period. Some physiologic conjectures are obtained. The main stream went through the backside of larynx and trachea in inspiration and the frontal side in expiration. There exist vortical motions in inspiration, but no prominent one in expiration.

• 수면정신생리
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• 제18권2호
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• pp.63-66
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• 2011

It has been controversial whether upper airway resistance syndrome (UARS) is a distinct syndrome or not since it was reported in 1993. The International Classification of Sleep Disorders classified UARS under obstructive sleep apnea syndrome (OSAS) in 2005. UARS can be diagnosed when the apnea-hypopnea index (AHI) is fewer than 5 events per hour, the simultaneously calculated respiratory disturbance index (RDI) is more than 5 events per hour due to abnormal non-apneic non-hypopneic respiratory events accompanying respiratory effort related arousals (RERAs), and oxygen saturation is greater than 92% at termination of an abnormal breathing event. Although esophageal pressure measurement remains the gold standard for detecting subtle breathing abnormality other than hypopnea and apnea, nasal pressure transducer has been most commonly used. RERAs include phase A2 of cyclical alternating patterns (CAPs) associated with EEG changes. Symptoms of OSAS can overlap with UARS, but chronic insomnia tends to be more common in UARS than in OSAS and clinical symptoms similar with functional somatic syndrome are also more common in UARS. In this journal, diagnostic and clinical differences between UARS and OSAS are reviewed.

• Journal of Medicine and Life Science
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• 제16권2호
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• pp.43-45
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• 2019

Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.

• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.872-879
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• 2010

Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.

• Safety and Health at Work
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• 제2권4호
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• pp.355-364
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• 2011

Objectives: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning, although localized effects in the upper airways can be expected. This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. Methods: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender. Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of $SO_2$. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. Results: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/$m^3$. Conclusion: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.

• 대한한의학회지
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• 제35권2호
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• 대한치과교정학회지
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• 제26권4호
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• pp.373-387
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• 1996

본 연구는 비인두와 adenoid의 성장발육 양상을 조사하여 부정교합자의 진단에 있어 비호흡 기능 평가시 유용한 기준을 얻기 위하여 시행되었다. 남자 19명, 여자 14명, 총 33명의 정상 교합자를 대상으로 8.5세부터 18.5세까지 촬영된 10년간의 누년적 측모 두부 X선 규격사진을 연구 자료로 비인두와 adenoid 부위의 거리와 면적 및 상대적 기도 비율을 계측 분석하여 다음과 같은 결론을 얻었다. 1. 각 연령(8.5세-18.5세)에서 남녀별 각 계측항목의 평균과 표준 편차를 얻었다. 2. 비인두의 height와 depth는 남자에서 14.5세까지, 여자에서 12.5세까지 성장하였다.(p<0.05). 3. 비기도의 상대적 면적은 8.5세에 최소치를 나타내었고 남자는 10.5세부터 12.5세 사이에, 여자는 12.5세부터 14.5세 사이에 유의한 증가를 나타내었다(p<0.05). 4. 비기도의 상대적 면적과 비기도 관련 계측항목 간의 상관분석에서 Ad2-PNS, Ad2-PNS/Ho'-PNS 및 Upper pharynx가 남녀 모두 전 연령구간에서 비기도의 상대적 면적과 상관성이 있었다 (p<0.01).

• 대한치과의사협회지
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• 제44권2호통권441호
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• pp.133-138
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• 2006

This is a report of one case about facial asymmetry involving maxilla & mandible. Le Fort I Maxillary Osteotomy & BSSRO is usually used for facial asymmetry patient involving maxilla & mandible. But Le Fort I Maxillary Osteotomy has demerits about more aggressive technique, more operation times, more discomforts of post operation nasal breathing than Unilateral maxillary Segmental Osteotomy. So we treated one patient successfully using Unilateral Maxillary Segmental Osteotomy, BSSRO & Post - Operation Rapid Orthodontics instead of Le Fort I Maxillary Osteotomy.