• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.169-175
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• 1998

Background: Heliox is known to decrease $PaCO_2$ in patients with increased airway resistance by increasing minute ventilation and reducing work of breathing(WOB). Besides these effect, heliox is expected to decrease functional anatomic dead space owing to improvement of peak expiratory flow rate(PEFR) and enhancement of gas distribution. We investigated whether heliox can decrease $PaCO_2$ even at the same minute ventilation (VE) and WOB with $N_2-O_2$ to speculate the effect of the heliox on the anatomic dead space. Material and Method: The subjects were 8 mechanically ventilated patients with asthma or upper airway obstruction(M : F=5 : 3, $68{\pm}10$years) who were under neuromuscular paralysis. The study was consisted of three 15-minutes phases: basal $N_2-O_2$ heliox and washout Heliox was administered via the low pressure inlet of servo 900C, and respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). To obtain the same tidal volume(Vt) in heliox phase, the Vt on monitor was adjusted by the factor of relative flow rate of heliox to $N_2-O_2$. Dead space was calculated by Bohr equation. Results: 1) Vt, VE, peak inspiratory pressure(PIP) and peak inspiratory flow rate(PIFR) were not different between $N_2-O_2$ and heliox. 2) PEFR was higher on heliox($0.52{\pm}0.19$L/sec) than $N_2-O_2$($0.44{\pm}0.13$L/sec)(p=0.024). 3) $PaCO_2$(mmHg) were decreased with heliox($56.1{\pm}14.1$) compared to $N_2-O_2$($60.5{\pm}15.9$)(p=0.027). 4) Dead space ventilation(%) were decreased with heliox($73{\pm}9$ with $N_2-O_2$ and $71{\pm}10$ with heliox)(p=0.026). Conclusion: Heliox decreased $PaCO_2$ even at the same VE and WOB with $N_2-O_2$, and the effect was considered to be related with the reduction of anatomic dead space.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.465-473
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• 1995

Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.138-146
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• 1996

Background : Known as a kind of complication or a specific form of pulmonary tuberculosis, endobronchial tuberculosis caused several kinds of problems in diagnosis and managements. But the frequency of this disease are is widely variable, generally reported from as low as 10 - 20 % to as high as 40 - 50 %. We prospectively performed bronchoscopy in patients diagnosed as pulmonary tuberculosis to evaluate the frequency of endobronchial tuberculosis and its related findings. Method : From March, 1995 to February, 1996, we prospectively performed bronchoscopy in patients newly diagnosed as pulmonary tuberculosis and evaluated the frequency of endobronchial tuberculosis, its clinical features and laboratory findings including raiologic, microbiologic and physiologic aspects. Results : Number of patients diagnosed as pulmonary tuberculosis was 103 and 55 patients(53.4%) were found to have endobronchial tuberculosis. But the frequency were 43.8% in male and 76.7% in female, respectively. Frequently noted symptoms were nonspecific including cough, sputum, fever, weight loss in the order of frequency but cough was more frequent than in pulmonary tuberculosis. Physical examination showed rale, decreased breathing sound and wheezing and wheezing was more frequent than in pulmonary tuberculosis. All 7 subtypes were noted bronchoscopically and edema-hyperemia (stenotic without fibrosis) type was most frequently(32.7%) noted, and followed by chronic nonspecific bronchitis type, stenotic with fibrosis type and actively caseating type in the order of frequency. The relationship between subtypes of endobronchial tuberculosis and radiologic findings was insignificant. Right lung was involved more frequently than left lung and left upper lobe was most commonly involved site, and followed by right upper lobe and trachea. Acid-fast bacilli(AFB) positivity in sputum and / or bronchial washing fluid was 73% and suggested high risk of infectivity. Conclusion : The frequency of endobronchial tuberculosis in patients with pulmonary tuberculosis was higher than known and also suggested bronchoscopic examination to detect endobronchial involvement should be recommanded and careful management is also needed to prevent complications.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.45-49
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• 2019

Purpose Lung Ventilation Scan(LVS) images directly inhaled radiation gas to evaluate lung ventilation ability. Therefore, it is influenced by various factors related to inhalation, including number of breaths, respiratory duration, respiration rate, and breathing method. In actual LVS examinations, it is difficult for objectify the patient's ability to inhale, and there is currently no known index related to inhalation. Therefore, this study confirms the correlation between counts per second(cps) in LVS and the results of pulmonary function test(PFT) and evaluate its usefulness as an objective indicator of inhalation. Materials and Methods From October 2010 to September 2018, 36 Chronic Obstructive Pulmonary Disease(COPD) patients who had both LVS and PFT were classified by severity(Mild, Moderate, Severe). LVS was performed by creating Technegas with Vita Medical's Technegas Generator and inhaling it to the patient. LVS images were acquired with Philips's Forte equipment., and PFT used Carefusion's Vmax Encore 22. The correlation between the cps measured by setting the region of interest(ROI) of both lungs on the LVS and the forced vital capacity(FVC), forced expiratory volume in one second($FEV_1$), $FEV_1/FVC$ of the results of PFT was compared and analyzed. Results We analyzed the correlation between cps of LVS using Technegas and the results of PFT by classifying COPD patients according to severity. Correlation coefficient between $FEV_1/FVC$ and cps was Severe -0.773, Moderate -0.750, and Mild -0.437. The Severe and Modulate result values were statistically significant(P<0.05) and Mild was not significant(P=0.155). On the other hand, the correlation coefficient between FVC and cps was statistically significant only in Mild and it was 0.882(P<0.05). Conclusion According to the study, we were able to analyze correlation between cps of LVS using Technegas and the results of PFT in COPD Patients. Using this result, when performing a LVS, the results of PFT can be used as an index of inhaling capacity. In addition, it is thought that it will be more effective for the operation of the exam rooms.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.1
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• pp.15-20
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• 2021

Purpose This article studies the relationship between the length of a kidney measured by two scanning methods: Kidney Computed Tomography (CT) and ^99mTc-Dimercaptosuccinic acid (DMSA) renal scan. Kidney CT provides a better anatomic assessment, while ^99mTc-DMSA renal scan is superior in the kidney function test. Materials and Methods From January to December of 2019, two hundred patients who had Kidney CT and Tc^99m-DMSA renal scan were chosen for this study. SPSS17.0 was selected for statistical analysis. Results Due to the effect of the breathing and resolution of ^99mTc-DMSA renal scan, it showed the kidney's relatively longer length than the length of Kidney CT. For the same kidney, the length comparison among different brands' Gamma cameras was negligible. The length difference within the same age group did not show a noticeable discrepancy. However, there was a length difference between the radio technologists. Kidney CT and ^99mTc-DMSA renal scan indicated a strong positive correlation between the length of the left and right kidney. Conclusion It is necessary to establish a standardized measurement method for measuring kidney length using ^99mTc-DMSA renal scan. The kidney's functional changes and length changes are indications of Kidney diseases. Especially, pediatric patients tend to use ^99mTc-DMSA renal scan for assessing the kidney's shape and the function to avoid potential radiation exposure during the Kidney CT. Therefore, it is significant to provide not only the kidney's functional information but also an anatomic analysis, including the kidney's size, length, and location through the ^99mTc-DMSA renal scan.

• Journal of the Korean Society for information Management
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• v.39 no.2
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• pp.111-129
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• 2022

Insomnia is a chronic disease in modern society, with the number of new patients increasing by more than 20% in the last 5 years. Insomnia is a serious disease that requires diagnosis and treatment because the individual and social problems that occur when there is a lack of sleep are serious and the triggers of insomnia are complex. This study collected 5,699 data from 'insomnia', a community on 'Reddit', a social media that freely expresses opinions. Based on the International Classification of Sleep Disorders ICSD-3 standard and the guidelines with the help of experts, the insomnia corpus was constructed by tagging them as insomnia tendency documents and non-insomnia tendency documents. Five deep learning language models (BERT, RoBERTa, ALBERT, ELECTRA, XLNet) were trained using the constructed insomnia corpus as training data. As a result of performance evaluation, RoBERTa showed the highest performance with an accuracy of 81.33%. In order to in-depth analysis of insomnia social data, topic modeling was performed using the newly emerged BERTopic method by supplementing the weaknesses of LDA, which is widely used in the past. As a result of the analysis, 8 subject groups ('Negative emotions', 'Advice and help and gratitude', 'Insomnia-related diseases', 'Sleeping pills', 'Exercise and eating habits', 'Physical characteristics', 'Activity characteristics', 'Environmental characteristics') could be confirmed. Users expressed negative emotions and sought help and advice from the Reddit insomnia community. In addition, they mentioned diseases related to insomnia, shared discourse on the use of sleeping pills, and expressed interest in exercise and eating habits. As insomnia-related characteristics, we found physical characteristics such as breathing, pregnancy, and heart, active characteristics such as zombies, hypnic jerk, and groggy, and environmental characteristics such as sunlight, blankets, temperature, and naps.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.350-362
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• 1999

Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

• Tuberculosis and Respiratory Diseases
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• v.52 no.4
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• pp.385-394
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• 2002

Background : Flexible fiberoptic bronchoscopy(FFB) has become a widely performed technique for diagnosing and managing pulmonary disease because of its low complication and mortality rate. Since the use of FFB can in patients with severely depressed cardiorespiratory function is increasing and hypoxemia during the FFB can induce significant cardiac arrhythmias, the early detection and adequate management of hypoxemia during FFB is clinically important. Method : To evaluate the necessity of the continuous monitoring of the oxygen saturation($SaO_2$) during the FFB, the $SaO_2$ was continuously monitored from the finger tip using pulse oximetry before, during and after the FFB in 379 patient. The patients were then divided into two groups, those with and without hypoxemia($SaO_2$<90%). The baseline pulmonary function data and the clinical characteristics of the two groups were compared. Results : The mean baseline $SaO_2$ was $96.9{\pm}2.85%$. An $SaO_2$ <90% was recorded at some point in 62(16.4%) out of 379 patients, with 12 out of 62 experiencing this prior to the FFB, in 37 out of 62 during the FFB, and in 13 out of 62 after the FFB. No differences were observed in the smoking and sex distribution between those with and without hypoxemia. The mean age was older in those with hypoxemia than in those without. Significant differences were observed in the mean baseline $SaO_2$ and the mean time for the procedure between the two groups. The $FEV_1$ was significantly lower in those with hypoxemia, and both the FVC and $FEV_1/FVC$ also tended to decrease in this group. Managing hypoxemia included deep breathing in 20 patients, a supplemental oxygen supply in 39 patients, and the abortion of the procedure in 3 patients. Conclusion : These results suggest that the continuous monitoring of the oxygen saturation is necessary during fiberoptic bronchoscopy, and it should be performed in patients with a depressed pulmonay function in order for the early detection and adequate management of hypoxemia.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.57-67
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• 1998

Purpose : This study was undertaken to determine the preoperative predictors of mortality and morbidity after lung cancer resection. Method: During the period from October 1, 1995 to August 31, 1996, a prospective study was conducted in 92 lung resection candidates diagnosed as lung cancer. For preoperative predictors of nonpulmonary factors, we considered age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness, and for those of pulmonary factors, smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test. And predicted postoperative(ppo) pulmonary factors such as PPO-$FEV_1$, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}ppo$-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also considered. Results: There were 78 men and 14 women with a median age of 62 years(range 42 to 82) and a mean $FEV_1$ of $2.37\pm0.06L$. Twenty nine patients had a decreased $FEV_1$ less than 2.0L. Pneumonectomy was performed in 26 patients, bilobectomy in 12, lobectomy in 54. Pulmonary complications developed in 10 patients, cardiac complications in 9, other complications(empyema, air leak, bleeding) in 11, and 16 patients were managed in intensive care unit for more than 48hours. Three patients died within 30 days after operation. The ppo-$VO_2$max was less than 10ml/kg/min in these three patients, but its statistical significance could not be determined due to small number of patients. In multivariate analysis, the predictor related to postoperative death was weight loss(p<0.05), and as for pulmonary complications, weight loss, dyspnea scale, ppo-DLco and extent of resection(p<0.05). Conclusions: Based on this study, preoperative nonpulmonary factors such as weight loss and dyspnea scale are more important than the pulmonary factors in the prediction of postoperative mortality and/or morbodity in lung resection candidates, but exercise pulmonary fuction test may be useful Our study suggests that ppo-$VO_2$max value less than 10ml/kg/min is associated with death after lung cancer resection but further studies are needed to validate this result.

• Tuberculosis and Respiratory Diseases
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• v.48 no.1
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• pp.14-23
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• 2000

Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo) pulmonary factors such as ppo-$FEV_1$ ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}$ppo-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.