• 재활복지공학회논문지
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• 제10권4호
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• pp.243-249
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• 2016

본 논문에서는 건강한 성인 26명(남자 14명, 여자 12명)을 대상으로 기계승마의 적용을 통한 심폐기능의 변화 및 그에 따른 운동 강도를 정량적으로 측정하여, 기계식 승마 치료의 임상 적용가능성과 유효성을 추정하였다. 기계승마 장비인 JOBA(R)(Panasonic Electric Works, Osaka, Japan)을 이용하였고, 운동의 강도는 level 2 (0.73 Hz)에서 4 (0.9 Hz), 6 (1.03 Hz), 8 (1.2 Hz), 9 (1.3 Hz)까지 증가시키고, 각각의 level에서 3분간 유지하였다. 운동 중 참여자의 심폐 반응은 호흡가스분석 시스템(TruOne 2400, Parvo Medics, USA)과 운동부하검사 시스템(Q Stress, Cardiac Science, USA)을 이용하여 심박수, 혈압, 최대산소소모량(VO2max)을 측정하였다. 또한 기계승마를 통해 유발되는 유산소 운동 강도를 평가하기 위해 대사당량(MET)을 측정하고, 예비심박수율(%HRR), 최대심박수율(%peak HR)과 칼로리소모량을 계산하였다. 그 결과는 SPSS 18.0 프로그램을 이용해 분석하였으며, 건강한 성인에서 간단한 사전 교육 후 15분간의 JOBA(R)를 이용한 기계식 승마 치료시 증등도의 운동 강도에 도달할 수 있는 것으로 평가되었다.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• The Korean Journal of Physiology and Pharmacology
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• 제15권6호
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• pp.397-403
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• 2011

The proliferation, migration, cytokine release, and contraction of airway smooth muscle cells are key events in the airway remodeling process that occur in lung disease such as asthma, chronic obstruction pulmonary disease, and cancer. These events can be modulated by a number of factors, including cigarette smoke extract (CSE). CSE-induced alterations in the viability, migration, and contractile abilities of normal human airway cells remain unclear. This study investigated the effect of CSE on cell viability, migration, tumor necrosis factor (TNF)-${\alpha}$ secretion, and contraction in normal human bronchial smooth muscle cells (HBSMCs). Treatment of HBSMCs with 10% CSE induced cell death, and the death was accompanied by the generation of reactive oxygen species (ROS). CSE-induced cell death was reduced by N-acetyl-l-cysteine (NAC), an ROS scavenger. In addition, CSE reduced the migration ability of HBSMCs by 75%. The combination of NAC with CSE blocked the CSE-induced reduction of cell migration. However, CSE had no effect on TNF-${\alpha}$ secretion and NF-${\kappa}B$ activation. CSE induced an increase in intracellular $Ca^{2+}$ concentration in 64% of HBSMCs. CSE reduced the contractile ability of HBSMCs, and the ability was enhanced by NAC treatment. These results demonstrate that CSE treatment induces cell death and reduces migration and contraction by increasing ROS generation in normal HBSMCs. These results suggest that CSE may induce airway change through cell death and reduction in migration and contraction of normal HBSMCs.

• 한국융합학회논문지
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• 제9권1호
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• pp.85-93
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• 2018

본 연구는 국민건강영양조사 제6기(2013-2015) 자료를 이용하여, 비흡연자 만성폐쇄성폐질환의 유병률과 위험인자를 파악하고 비흡연자 만성폐쇄성 폐질환자의 질병악화예방과 관리방안을 모색하고자 시행되었다. 40세 이상 만성폐쇄성폐질환자 중 비흡연자 4, 911명을 대상으로 복합 표본 교차분석과 로지스틱 회귀분석을 실시하였다. 연구결과 65세 이상(p<.001), 남자(p<.001), 농촌(p=.044), 무 배우자(p<.001), 낮은 학력(p<.001), 농림어업종사자(p<.001)에서 유병률이 높았고, 폐결핵(p<.001)과 천식(p<.001)이 있는 경우 유병률이 높게 나타났다. 또한, 위험인자로는 연령(p<.001), 성별(p<.001), 학력(p=.022), 직업(p<.001), 폐결핵(p<.001), 천식(p<.001)으로 나타났다. 따라서 유병률, 위험인자와 관련된 변수를 고려한 간호사정과 이를 바탕으로 임상에서 적용 가능한 호흡재활 및 호흡중재 프로그램개발이 필요할 것으로 사료된다.

• 한국융합학회논문지
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• 제10권12호
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• pp.169-175
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• 2019

본 연구는 경도의 지적장애를 가진 20대 대학생이 다양하게 누운 자세변화 따른 복합적 폐활량에 미치는 영향을 알아보고자 하였다. 경도의 지적장애를 가진 20대 남자 대학생 20명을 대상으로 실험에 참여하였다. 실험 대상자들은 누운 자세, 오른쪽 옆으로 누운 자세, 원쪽 옆으로 누운 자세, 엎드러 누운 자세에 따라 폐기능 측정기를 이용하여 폐활량을 평가해 보았다. 자료분석은 SPSS 18.0 버전을 이용하여 실험 대상자의 자세변화에 따란 호흡변화를 분석하기 위해 일요인 반복측정 분산분석으로 검증하였다. 결과는 오른쪽 옆으로 누운 자세에서 폐활량이 가장 크게 나타났고 엎드러 누운 자세에서 가장 낮게 나타났다. 이 연구를 통해 경도의 지적장애인이 일상이나 임상에서 침상생활을 할 때 취침에서 가장 안정된 호흡능력을 확보할 수 있는 이상적인 누운 자세를 제시하고 효율적 환기능력에도 긍정적인 효과를 나타날 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제59권6호
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• pp.271-275
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• 2016

Purpose: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-$Barr{\acute{e}}$ syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. Methods: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. Results: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). Conclusion: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.

• 대한한방소아과학회지
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• 제25권2호
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• pp.55-72
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• 2011

Objectives: The purpose of this study is to investigate clinical features of children and adolescents patients admitted to the oriental medical hospital. Methods: The study composed of 1284 inpatients aging from 0 to 19 who had been admitted in 4 oriental medical hospitals located in Daejeon and Chungcheong. Results: 1. In this study, 688 boys and 715 girls were examined, giving the ratio of 0.96:1. Average age of the children and adolescents was 11.5, and the number of inpatients has increased as getting older. 2. The percentage of children and adolescents inpatients has increased every year : 9.1% in 2005, 13.0% in 2006, 13.8% in 2007, 16.3% in 2008, 18.0% in 2009, with 22.2% in 2010, 7.8% until May 2011. The month scored the highest admittance was December and the lowest was March. 3. In systemic division, the musculoskeletal system was the most common, followed by neuromuscular system, respiratory system, digestive system, psychological system, and nervous system. 4. Most patients have admitted in acupuncture & moxibustion department, followed by oriental pediatrics, oriental rehabilitation medicine. 5. In Pediatrics, 196 boys and 166 girls were admitted. The age distribution showed that 6.4% were in infancy, 43.6% in preschool period, 30.1% in prepuberal period, 18.8% in early puberty and 1.1% in late puberty. The percentage of pediatrics inpatients has increased every year. Conclusions: More data of patients should be collated for further study. More detailed study with different kinds of diseases are expected based on this study.

• 대한통합의학회지
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• 제8권2호
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• pp.53-61
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• 2020

Purpose : We investigated the correlation between body composition and lung function in healthy adults. Methods : This study included 204 healthy adults in whom all measurements were obtained once, and all data were analyzed using the SPSS software for Windows, version 22.0. Pearson's correlation analysis was performed to determine the correlation between body composition (represented by the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, skeletal muscle mass, and body fat percentage) and lung function (represented by the forced vital capacity [FVC], forced expiratory volume in 1 second [FEV₁], the FEV₁/FVC ratio, maximum voluntary ventilation [MVV], maximum expiratory pressure [MEP], and the maximum inspiratory pressure [MIP]). All measurements were obtained by two investigators to improve reliability. A significance level of α=.05 was used to verify statistical significance. Results : Among the lung function measurements obtained in both men and women, the FVC, FEV₁, MVV, and MIP were positively correlated with the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, and skeletal muscle mass in men (p<.05). The FEV₁/FVC ratio was negatively correlated with the total body water, soft lean mass, mineral mass, basal metabolic rate, fat-free mass and the body fat percentage (p<.05). Notably, the FVC, FEV₁, and MVV were positively correlated with the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, and skeletal muscle mass in women (p<.05). Conclusion : This study showed a significant correlation between body composition and lung function in healthy adults. In combination with future studies on lung function, our results can provide objective evidence regarding the importance of prevention of lung disease, and our data can be utilized in rehabilitation programs for patients with respiratory diseases.

• The Journal of Korean Physical Therapy
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• 제30권5호
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• pp.181-186
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• 2018

Purpose: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). Methods: Forty seven patients with CHF (males 33, females 14, age $61.3{\pm}9.8years$) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. Results: The NHE group significantly showed lower peak $VO_2$ and a higher $VE/VCO_2$ slope than the MIHE (p<0.05) and HIHE (p<0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. Conclusion: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.