• 대한간호학회지
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• 제33권1호
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• pp.42-50
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• 2003

Purpose: This study was conducted to investigate the effects of the suction-induced hypoxemia interventions. Method: 30 suction-induced hypoxemia interventions were reviewed for the purpose of meta-analysis. Result: The study showed that both preoxygenation and insufflation were the most frequently examined oxygenation time periods, and hyperoxygenation combined with hyperinflation was the most commonly applied oxygenation method in order to prevent suction-induced hypoxemia. The greatest effect was obtained by providing oxygenation before and after suctioning, whereas negative effect(the contrary results from the study hypotheses) was frequently obtained by applying insufflation only. Applying hyperoxygenation combined with hyperinflation had the greatest effect over that of applying hyperoxygenation only, even though the difference between effect sizes of both methods were statistically significant. Conclusion: The results of meta-analysis showed that the occurrence rate of hypoxemia after suctioning was significantly reduced with the overall interventions for hypoxemia (decreasing 40% of occurrence rate), independent with time periods or methods for providing oxygenation.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.79-83
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• 1993

A 38-year-old female was admitted due to progressive exertional dyspnea and intermittent blood tinged sputum. Chest PA showed diffuse reticular infiltration accompanied by hyperinflation. $PaO_2$ was normal in resting state but profoundly decreased during exercise. Spirometry showed severe obstructive pattern but DLCO was markedly decreased. Lung volumes measured by helium equilibrium method was increased. On HRCT, numerous and relatively uniform sized cysts were evenly distributed throughout the bilateral lung fields. Open lung biopsy was performed and pulmonary lymphangioleiomyomatosis(LAM) was diagnosed based on the findings of abnormal proliferation of smooth muscle cells in the walls of lymphatic vessels, bronchioles, and small pulmonary veins. Immunohistochemical staining was negative for estrogen receptor but positive for progesterone receptor. Medroxyprogesterone therapy was initiated.

• 대한의용생체공학회:의공학회지
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• 제11권2호
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• pp.195-202
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• 1990

The hypothesis of asymmetric resistance to explain the phenomenon of lung hyperinflation (LHI) during hlgh frequency ventilation (HFV) was quantitatively studied. LHI was predicted by modeling the ism-volume pressure-flow (IVPF) data from 5 human subjects using the empirical Rohrer's equation. Non-steadiness during HFV was compensated by em- ploying recently proposed volume-frequency diagram. Tidal volume and ventilation frequency were 100 ml and 20 Hz, respectively. Airflow pattern was a symmetric sinusoid. The predic- tion results of mean pressure drop across the airways were averaged for those 5 subjects, and compared with zero by one-sided student's t-test. A marginally significant (P<0.1) increase in mean pressure drop was observed during HFV at low lung volumes (below FRC) , which could increase mean lung volume up to one liter When the lung volume was above FRC, no significant LHI (P >0.25) was resulted. LHI seemed to be inversely related to the lung volume. These results recommend to clinically apply HFV only at lung volumes above FRC.

• Journal of Chest Surgery
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• 제33권2호
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• pp.125-131
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• 2000

Background: Hyperinflation during lung ischemia has been known to improve pulmonary functions after reperfusion which may be exerted through a pulmonary vasodilation and avoidance of atelectasis by an increased surfactant release and been known whether the improvement of pulmonary function was the effect of hyperinflation itself or the oxygen content in inflation gas. Therefore we attempted to clarify the effect of hyperinflation with oxygen in pulmonary inflation gas during warm ischemia on pulmonary function after reperfusion to solve the problem of ischemia-reperfusion injury after lung transplantation. Material and Method: sixteen mongrel dogs were randomly divided into two groups: the left lung was inflated to 30-35 cm H2O with 100% oxygen in oxygen group and 100% nitrogen in nitrogen group. The inflated left lung was maintained with warm ischemia for 100 minutes. Arterial and mixed venous blood gas analysis and hemodynamics were measured before ischemia and 30, 60, 120, 180 and 240 minutes afer reperfusion. Lung biopsy was taken for the measurement of lung water content after the end of reperfusion. Result: In oxygen group arterial oxygen tension the difference of arterial and mixed venous oxygen tension and the difference of alveolar-arterial oxygen tension at 30-minute after reperfusion were not significantly different from those before ischemia and were stable during the 40hour reperfusion. However in nitrogen group these values were significantly deteriorated at 30-minute after reperfusion. there was no significant difference between two groups in hemodynamic data peak airway pressure and lung water content. Conclusion : The results indicated that the oxygenation one of the most important pulmonary functions was improved by pulmonary inflation with 100% oxygen during warm ischemia but the hemodynamics were not. Oxygen as a metabolic substrate during warm ischenia was believed to make the pulmonary tissues to maintain aerobic metabolism and to prevent ischemic damage of alveoli and pulmonary capillary.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.35-45
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• 2021

Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

• 대한간호
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• 제33권4호
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• pp.62-85
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• 1994

The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease. The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease.

• Journal of Chest Surgery
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• 제25권4호
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• pp.418-423
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• 1992

Tracheo-innominate artery fistula[TIF] is the uncommon delayed fatal complication of tracheostomy. The mortality rate of the lesion, if not treated surgically, approaches 100%. A 64-year-old man presenting with a TIF after tracheostomy was treated by lateral repair and muscle interposition between the innominate artery and trachea. Preoperatively, bleeding was controlled by gauze packing around the tude under manual compression and hyperinflation of the balloon cuff of the tracheostomy tube. No abnormality was found by angiographic evaluation. The patient failed to regain consciousness and died 4 days later from sepsis.

• Journal of the Korean Data and Information Science Society
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• 제6권1호
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• pp.63-71
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• 1995

We have consider the study of local influence for smoothing parameter estimates in spline regression model with heteroscedasticity. Practically, generalized cross-validation does not work well in the presence of heteroscedasticity. Thus we have proposed the local influence measure for generalized cross-validation estimates when errors are heteroscedastic. And we have examined effects of diagnostic by above measures through Hyperinflation data.

• 국제지역연구
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• 제21권4호
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• pp.141-158
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• 2017

본 연구의 목적은 첫째, 북한의 물가 상승률을 상대적 구매력평가를 이용하여 처음으로 추정을 시도하였다. 기존 연구의 경우 북한 쌀 가격을 대리변수로 이용하여 북한 물가 변화를 설명하는 것이 대부분이다. 본 연구에서는 과거 사회주의 국가의 물가를 추정하기 위해 사용된 방식인 구매력평가이론을 북한에 적용하여 북한 물가를 추정하였다. 둘째, 화폐개혁이라는 제도 변화 이후 북한의 물가에 미친 영향을 분석하는 것이다. 화폐개혁이라는 제도 변화 이후 북한 물가의 움직임을 살펴보고 여타 사회주의 국가의 화폐개혁 이후와 비교해 보았다. 경제적으로 화폐개혁이 북한에 어떠한 영향을 끼쳤는지 물가를 중심으로 알아본다. 분석결과 화폐개혁 이후인 2009년 이후 북한은 초인플레이션을 경험하였다. 모형에서 나타난 북한 물가상승률은 2010년 3,010.0%, 2011년 195.0%, 2012년 68.0%, 2013년 48.3% 였다. 북한의 화폐개혁 이후 물가 상승률은 이전에 화폐개혁을 경험한 중국, 베트남 등 사회주의 국가보다 매우 높은 수준이다. 북한의 화폐개혁은 경제적 측면만 고려 시 초인플레이션이라는 부작용을 가져오며 실패한 것으로 평가된다.

• Journal of Chest Surgery
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• 제27권11호
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• pp.965-969
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• 1994

Infantile lobar emphysema is a pulmonary hyperinflation state that has the clinical features of an air block syndrome characterized by bronchial cartilaginous abnormalities or unknown origin. Left upper lobe was affected in most of the reported infantile lobar emphysema. Infantile lobar emphyema is divided into two categories. e.g., congenital and acquired. We have experienced a case of left lower lobe involved infantile lobar emphysema which had undergone left pneumonectomy. She had progressive signs of tension accompanied by mediastinal displacement, ventilatory and circulatory failure in infant period. Because of the combined left upper lobe hypoplasia, left pneumonectomy was performed. And there was no cartiliginous abnormality in pathologic finding. This is the first domestic case which was affected in the lower lobe and successful surgical repaired.