• Journal of Yeungnam Medical Science
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• 제22권1호
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• pp.104-112
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• 2005

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation.

• Journal of Chest Surgery
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• 제28권9호
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• pp.847-850
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• 1995

For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권5호
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• pp.301-304
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• 2018

Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received $50{\mu}g$ of fentanyl 2-3 times (total $2.2-2.3{\mu}g/kg$) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.

• 동의신경정신과학회지
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• 제16권1호
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• pp.143-157
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• 2005

Objective : It is a presentation of theoretical, clinical. historical foundation about using biofeedback in oriental medicine. Methods : We generalize definition, explanation, history and clinical application of biofeedback and study community with and clinical practice in oriental medical theory, referring to The neurofeedback book-An introduction to Basic Concepts in Applied Psychophysiology published by Michacl Thompson & Lynda Thompson Results : We acquire possibilities of application in oriental medicine as follows. 1. It is a view of treatment for the whole man not separating body and mind. 2. It make much of yin-ping-yang-bi(陰平陽秘) and spontaneous cure in the human body. 3. It make much of a curer's mental condition through dao(道). 4. It make much of a breathing corresponding to nature. 5. We make use of it in diagnosis and evaluation of disease. 6. It is psychologic treatment of self-leading. Conclusions : Biofeedback is expected that usefully applied to oriental psychotherapy of Kyungja-pyungji therapy(驚者平之療法). Oh-Ji-Sang-Seung therapy(五志相勝療法), Qigong therapy(氣功療法), Autogenic relaxation Training(自律弛緩療法) basing on oriental medical theory not separating body and mind.

• 한국임상수의학회지
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• 제36권5호
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• pp.248-252
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• 2019

Tracheal collapse is a common respiratory disease in dogs. There are many ways to treat tracheal collapse, one of which is the use of an intraluminal stent. In this study, we divided 21 dogs into two groups and implant conventional stents and new nitinol stents. Comparison of two groups was based on following, feature of stent fracture, form of stent migration, clinical sign improvement, complication and prognosis. Approaching was established via C-arm under spontaneous breathing and placing a stent at the site of collapse. Using radiographic images, determine stent size accurately. For a comparison of identical condition, all intraluminal stents were placed 10 mm caudal from larynx to 10 mm cranial from carina. In this study, new nitinol stents improve the problems of conventional stents and may be effective in the treatment of tracheal collapse in small dogs.

• 한국임상약학회지
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• 제28권2호
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• pp.101-106
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• 2018

Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.4.1-4
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• 1981

저자는 1975년부터 1980년까지 서울대학교병원 이비인후과에 입원치료한 15세 이하의 기도이물환자 74례를 대상으로 임상통계학적으로 관찰하여 다음과 같은 결과를 얻었다. 1) 성별 및 연령별로 보면 유소아의 기도이물 74례중 남자 55례, 여자 18례로 남녀비는 3 : 1이며 연령분포는 2세미만이 41.8%로 가장 많고, 3세까지의 증례는 75.5%이었고, 5세까지의 증례는 83.6%이였다. 2) 증상및 이학적 소견에서는 내원시의 증상은 호흡-곤란, 기침, 청색증등이었으며, 6.7%에서는 전혀 증상이 없었다. 초진시의 이학적소견은 흡기의 감소, 천식음, 거친호흡음등이었으며 10.8%에서는 전혀 이학적 소견이 없었다. 3) 내원까지의 시간은 48.6%가 24시간내에 내원하였으나 2년이 지나서 내원한 례도 있었다. 4) 방사선학적 소견에서는 내원시의 단순흉부X-선 소견은 무기폐 25.0%, 폐기종 32.8%, 확실한 이물음영 17.2%이었고. 17.2%에서 정상이었다. 5) 이물의 종류와 개재부위는 기도이물 74례중 식물성 60.8%, 금속류가 17.5%, 프라스틱류 16.2%, 어골류, 2.7% 기타 2.7%이었다. 이물의 개재부위는 우측기관지 40.5%, 좌측기관지 31.0%, 기관 9.4%, 다발성 6.7%이었다. 6) 연령에 따른 이물의 종류를 보딘 5세이하에서는 대부분이 식물성이물이었고, 6∼15세에는 금속류와 프라스틱제품도 있었으며 특히 프라스틱 제품은 10세이상의 남자에 많았다. 7) 이물적출방법을 보면 Ventilating Bronchoscopy 82.3%, 기관절개술 2.7%, 흡입적출 2.7%, 자연배출 1.3%, 개흉술 5.4%, 사망이 5.4%이었다.

• Journal of Chest Surgery
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• 제25권4호
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• pp.391-397
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• 1992

Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

• 동의신경정신과학회지
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• 제18권1호
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• pp.173-814
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• 2007

Objective : This Study is attempted to compare respiration training method on Sun-Do Training it is quadrivalence. Method : We used all books and paper, journal of inside and outside of the country on Sun-Do Training. Results and Conclusions: 1. Respiration training method on Mu-Eou-Do is spontaneous breathing, breath follows in individual’s respiratory. 2. Respiration training method on Suk-Mun, Guk-Seon-Do, Dan-Hak is all of the position differ, but all considers and breathes naturally abdominal region named Dan-Jeoun, the hypogastric center (丹田). 3. Respiration training method that intend in Guk-seon-do should be soft and slow and long and deep and the moment must not be stoppage. 4. Difference of respiration training method is that region that mean at practice differs. Suk-Mun and Guk-Seon-Do have respiration training method that do with anus as is special in practice process. Dan-Hak thinks that breath has entered as Myung-Mun(命門), means fundamental force.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.295-302
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• 2020

Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cut-off value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.