• 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.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.63-70
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• 2018

Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

• 대한핵의학회지
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• 제19권2호
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• pp.57-63
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• 1985

To evaluate the clinical significance of lung ventilation scan using $^{99m}Tc-DTPA$ in patient with bronchiectasis, we compared the involovement area of bronchogram and lung ventilation scan according to lobar and segmental distribution. There were no correlation between impairment of pulmonary function test and the number of bronchiectatic lobe and segment(p>0.5). Lung ventilation scan showed 66.7% of sensivity, 100% of specificity, ana 91.7% of accuracy according to lobar distribution, and 51.9% of sensivity, 96.9% of specificity, and 88.9% of accuracy according to segmental distribution. These results suggest that lung ventilation scan can be used as diagnostic tool in patient with bronchiectasis in whom bronchogram is not tolerable.

• Journal of Chest Surgery
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• 제18권4호
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• pp.771-779
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• 1985

It has been recognized that the proper matching of ventilation and perfusion within the lung is essential for the efficient exchange of gases following open heart surgery. Physiologic shunt reflects the amount of blood going to lung units with inadequate ventilation and these are also areas of the lung with adequate ventilation but inadequate blood flow. This can be quantified by measuring physiological dead space. From January to August 1985, The physiologic dead space and shunt during postoperative course had been taken in 30 patients of open heart surgery in Soonchunhyang University Hospital. Twenty cases had congenital heart disease and acquired valvular heart disease were noticed in 10 cases. The physiological dead space and shunt during postoperative periods were calculated and we made 5 items of conclusion: 1. There is high probability of ventilation-perfusion mismatch in the acquired heart disease group compared to the congenital group. 2. Duration of the CPB can exert significant influences in the physiological dead space but less in the shunt fraction. 3. There is positive relationship between Qs/Qt and Vd/Vt in the group B [CPB>90 min.] but less reliable in correlation. 4. Perfusion impairment is more significant in the diminished pulmonic blood flow group compared to the increased pulmonic blood flow [Qp/Qs>2.0] group. 5. There is no significant ventilation-perfusion mismatch within the lung during all postoperative courses.

• 환경위생공학
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• 제17권2호
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• pp.26-33
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• 2002

Ultimate objective of industrial hygiene is the prevention of health impairment that may result from exposure to chemicals at workplace. Workers in solvent thinner-using occupation environment may be highly exposed to VOCs (volatile organic compounds) because solvent thinner has been used extensively such as painting, spraying, degreasing, coating and so on in Korea. The purpose of this study was to recognize, evaluate, and propose the control methods of VOCs from solvent thinner-using workplace. Five target volatile organic compounds (benzene, toluene, ethylbenzene, o-xylene, and m-xylene) were monitored in H company of Shiwa Industrial Complex and analyzed in perosnal, occupational indoor and outdoor during working hours simultaneously. Engineering control such as local ventilation should be made in considering the long-term exposure, though measured VOCs concentration did not exceed the workplace exposure standards. In addition, air cleaning device should be installed in local ventilation because Shiwa Industrial Complex has had the serious ambient air pollution. Currently, environmental purification using $TiO_2$ photocatalyst have attracted a great deal of attention with increasing number of recent environmental problems. In this study, $TiO_2$ sol coated on the ceramic bead was prepared by sol-gel method and the photodegradation of target compounds was investigated in gas phase by the exposure to UV-A lamp(365nm) in a batch system.

• 한국방사선학회논문지
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• 제17권5호
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• pp.767-773
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• 2023

본 연구에서는 폐용적에 영향을 미치는 관련 인자들과 폐기능 환기장애에 대한 유의성을 평가하고자 하였다. 실험대상으로는 저선량 흉부 CT검사와 폐활량검사를 동시에 수행한 정상 성인 남·여 206명을 선정하였으며 실험방법으로는 저선량 흉부 CT검사로 획득한 폐 CT 영상을 이용하여 폐용적을 딥러닝 기반의 AVIEW LCS 자동진단 프로그램을 이용하여 측정하였다. 그리고 폐활량계를 이용하여 폐기능을 측정한 결과를 획득하였으며 폐용적에 영향을 미치는 관련 인자로 성별 및 BMI를 선정하여 폐용적과의 독립표본 T-test를 통하여 유의성을 평가하고자 하였다. 실험결과 성별에 따른 폐용적의 평가에서 남성의 모든 폐용적이 여성의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 성별 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 남성이 여성보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내었다(p<0.001). 그리고 BMI 지수에 따른 폐용적의 평가에서 BMI 지수 24 이상의 성인의 모든 폐용적이 BMI 지수 24 미만의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 그러나 BMI 지수 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 BMI 지수 24 이상이 BMI 지수 24 미만보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내지 않았다(p<0.055). 폐기능 환기장애 유무에 따른 폐용적의 평가에서 폐기능 환기 정상성인의 모든 폐용적이 폐기능 환기 장애성인의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 그리고 폐기능 환기장애 유무 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 폐기능 환기 정상성인이 폐기능 환기 장애성인보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내었다(p<0.001). 폐용적과 폐활량 검사 결과는 폐 건강을 평가하는데 가장 중요한 지표이며, 이 두 지표를 함께 사용하여 폐 기능을 평가하는 것이 가장 정확한 평가 방법이다. 그러므로 본 연구에서는 폐용적과 폐활량 검사에 대한 향후 유사 연구 시 폐기능 환기 정상 성인과 폐기능 환기 장애 성인에 대한 폐용적 평균값을 제시하여 기초자료로 활용될 것이라고 사료된다.

• International Journal of Vascular Biomedical Engineering
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• 제4권1호
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• pp.9-16
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• 2006

In this article we introduce computer models that have been developed in the past to determine the concentration of metabolic gases, the oxygen and carbon dioxide, along the pulmonary circulation. The terminal concentration of these gases in the arterial blood is related with the total change of the partial pressure of the same gases in the alveoli for the time beginning with inspiration and ending with expiration. It is affected not only by the ventilation-perfusion ratio and the gas diffusion capacity of the lung membrane but also by the pulmonary defect such as shunt, dead space, diffusion impairment and ventilation-perfusion mismatch. Some pathological pulmonary symptoms such as ARDS and CDPD can be understood through the mathematical models of these pulmonary dysfunctions. Quantitative study on the blood oxygenation process using various computer models is therefore of foremost importance in order to monitor not only the pulmonary health but also the cardiac output and cell metabolism. Reviewed in this paper include the basic and advanced methods that enable numerical study on the gas exchange and on the arterial oxygenation process, which might depend on the various heart and lung physiological conditions listed above.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.193-196
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• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Journal of Chest Surgery
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• 제16권3호
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• pp.368-374
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• 1983

Combined type of primary lung cancer is a very rare form in clinical experience, which is 3 histologically different variants of bronchogenic carcinoma. These type had a well differentiated squamous carcinoma forming keratin pearls, well differentiated adenocarcinoma and pleomorphic undifferentiated cell carcinoma, usually small cell carcinoma. The patient, a male, 49-Y-0, was complaint coughing, mild dyspnea, blood tinged sputum and chest pain. Under diagnosis of lung cancer preoperatively, the right total pneumonectomy was performed with very difficulty such as arrhythmia, ventilation impairment during post operation course. The histology of specimen was disclose as 3 different histological type, combined lung cancer as squamoadenoundifferentiated carcinoma. The mediastinal nodes were freed from metastasis but the parietal pleural metastatic loci was found. The radio & chemotherapy were performed post-operatively. The patient had been experienced empyema at post-pneumonectomy space and then open drainage procedure and thoracoplasty had been added for treatment course. The patient is alive recently.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.548-557
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• 1993

연구배경 : 기관지 확장증은 비가역적 병변으로 만성적이고 반복적인 폐기관지의 감염으로 인하여 많은 예에서 만성기관지염, 폐기종 및 기관지천식등이 동반되는 경우가 많다. 따라서 이들에서의 폐기능도 동반되는 질환이나 침범범위등에 따라서 다양하리라 생각이 되어 기관지 확장증의 병리해부학적 형태의 차이, 그리고 호흡곤란의 정도에 따른 폐기능의 차이를 조사하였다. 방법 : 1985년 1월부터 1991년 12월까지 경북대학병원에서 기관지 조영술사진에 의해 기관지확장증으로 확진된 93예를 대상으로 폐활량, 최대환기량, 노력성호기곡선 및 기류-용량 곡선에서 계측할 수 있는 각종지표와 closing volume을 구하여 기관지조영술상의 낭종형, 원통형 및 혼합형 등의 기관지확장증의 형태 및 Hugh-Jones의 호흡곤란의 정도에 따른 성적을 비교검토 하였다. 결과: 1) 이환된 폐구역수의 평균은 원통형(tubular), 낭종형(saccular) 및 혼합형(mixed) 에서 각각 4.7, 6.9, 7.8개였고 폐활량 및 노력성 호기곡선의 모든 계측치와 PEF를 제외한 호기류속도를 반영하는 계측치는 낭종형 및 혼합형에서 저명하게 감소하였다. 2) MVV는 낭종형 및 혼합형에서 감소하는 경향이었으며 CV/VC는 낭종형 및 혼합형에서 증가하는 경향이었다. 3) 호흡곤란의 정도가 심할수록 이환된 폐구역수는 유의하게 증가되었으며 폐환기능은 이와 비례하여 저하하였다. 결론 : 이상의 결과로 기관지확장증에서의 환기기능은 제한성환기 장애와 폐쇄성환기 장애가 동반되어 있으며 이는 호흡곤란의 정도가 심할수록, 낭종형 및 혼합형일수록 뚜렷하였다.