• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.179-192
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• 2023

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.217-222
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• 2005

Purpose: To develop the respiration simulating phantom with thermocouple for evaluating 4D radiotherapy such as gated radiotherapy breathing control radiotherapy and dynamic tumor tracking radiotherapy. Materials and Methods: The respiration monitoring mask(ReMM) with thermocouple was developed to monitor the patient's irregular respiration. The signal from ReMM controls the simulating phantom as organ motion of patients in real-time. The organ and the phantom motion were compared with its respiratory curves to evaluate the simulating phantom. ReMM was used to measure patients' respiration, and the movement of simulating phantom was measured by using $RPM^{(R)}$. The fluoroscope was used to monitor the patient's diaphragm motion. relative to the organ motion, respectively. The standard deviation of discrepancy between the respiratory curve and the organ motion was 8.52% of motion range. Conclusion: Patients felt comfortable with ReMM. The relationship between the signal from ReMM and the organ motion shows strong correlation. The phantom simulates the organ motion in real-time according to the respiratory signal from the ReMM. It is expected that the simulating phantom with ReMM could be used to verify the 4D radiotherapy.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.155-161
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• 2020

Purpose : This study was conducted to investigate the effect of positive active pressure technique and active breathing technique on lung function in healthy adults. Methods : In this study, the passive lung expansion technique and active respiration enhancement technique using an air mask bag unit were conducted in 30 normal adults to observe changes in pulmonary function with forced vital capacity (FVC), Forced expiratory volume at one second (FEV1). In order to observe the change in the level of respiratory function, we would like to investigate the peak expiratory flow (PEF) and the forced expiratory flow (FEF 25-75 %). Results : As a result of this study, there was no significant difference in comparison between the passive lung expansion technique and the active breathing enhancement technique (p>.05). The passive lung expansion technique effectively increased the effortful expiratory volume and the median expiratory flow rate of 1 second (p<.05). And the passive lung expansion technique effectively increased the effortless lung capacity and the maximum expiration flow rate (p<.05). Conclusion : The passive lung expansion technique effectively increases the range of motion of the lungs and chest cages, intrathoracic pressure, and elasticity of the lungs, and the active breathing technique increases the muscle functions such as the diaphragm and the biceps muscles. It is expected that it will be able to selectively improve the respiratory function of patients with respiratory diseases or functional limitations as it is found to be effective.

• Fashion & Textile Research Journal
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• v.25 no.2
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• pp.248-254
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• 2023

This study aims to measure the skin rigidity of different facial areas among Koreans and propose guidelines for each area's skin rigidity that can be applied with a facial robot for testing respiratory protective devices. The facial skin rigidity of 40 participants, which included 20 men and 20 women, aged 20 to 50, was analyzed. The rigidity measurement was conducted in 13 facial areas, including six areas in contact with the mask and seven non-contact areas, by referring to the facial measurement guidelines of Size Korea. The facial rigidity was measured using the Durometer RX-1600-OO while in a supine position. The measurement procedure involved contacting the durometer vertically with the reference point, repeating the measurement of the same area five times, and using the average of three values whose variability was between 0.4 and 4.2 Shore OO. The rigidity data analysis used precision analysis, descriptive statistics analysis, and mixed-effect ANOVA. The analysis confirmed the rigidity of the 13 measurement areas, with the highest rigidity of the face being at the nose and forehead points, with values of 51.2 and 50.8, respectively, and the lowest rigidity being at the chin and center of the cheek points, with values of 19.2 and 20.7, respectively. Significant differences between gender groups were observed in four areas: the tip of the nose, the point below the chin, the area below the lower jaw, and the inner concha.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.4
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• pp.269-282
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• 2017

Objectives: Currently, masks against yellow dust and fine particulates are being certified with no consideration of facial dimensional variations among children and adults. The aims of this study were to develop masks against yellow dust and fine particulates for children in Korea and provide basic data to suggest new test methods for mask certification that consider the breathing capacity of children. Methods: A total of 730 study participants aged from six to 13 years old were recruited in the Seoul, Gyeonggi, and Incheon region. This study used a 3D scanning instrument to obtain 16 facial anthropometric data points. Literature reviews, a comparison of breathing capacity between adults and children, and analysis of children's pulmonary physiological data were conducted in order to suggest new test standards for certifying children's masks against yellow dust and fine particulates. In addition, types of children's masks, choice of wearing a mask or not, and reasons for not wearing masks were surveyed. Results: Based on a clustering analysis of participants' facial dimensions, facial shapes were classified into three groups: small, medium, and large. The sizes of children's masks were subtracted by using 3D sketch techniques(Large: $121.25mm{\times}89.46mm$, Medium: $111.92mm{\times}78.55mm$, Small: $102.13mm{\times}72.87mm$). In certifying children's mask, flow rates of $60{\ell}/m$ for the filtering efficiency test and $20{\ell}/m$ for the breathing resistance test were recommended, since children's pulmonary physiological capacity is about 60-70% of adults' pulmonary capacity. Conclusions: The results of this study suggest that three mask sizes for children would be sufficient and practical for providing protection against yellow dust and fine particulates. Revising current test methods for certifying respiratory protective devices for children is important, since children's pulmonary physiological capacity substantially differs from that of adults. Therefore, it is recommended that new test standards for certifying children's masks be promulgated in the near future.

• Korean Chemical Engineering Research
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• v.57 no.4
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• pp.475-483
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• 2019

Special chemical warfare agents are lethal gases that attack the human respiratory system. One of such gases are blood agents that react with the irons present in the electron transfer system of the human body. This reaction stops internal respiration and eventually causes death. The molecular sizes of these agents are smaller than the pores of an activated carbon, making chemical adsorption the only alternative method for removing them. In this study, we carried out a Computational Fluid Dynamics simulation by passing a blood agent: cyanogen chloride gas through an SG-1 gas mask canister developed by SG Safety Corporation. The adsorption bed consisted of a Silver-Zinc-Molybdenum-Triethylenediamine activated carbon impregnated with copper, silver, zinc and molybdenum ions. The kinetic analysis of the chemical adsorption was performed in accordance with the test procedure for the gas mask canister and was validated by the kinetic data obtained from experimental results. We predicted the dynamic behaviors of the main variables such as the pressure drop inside the canister and the amount of gas adsorbed by chemisorption. By using a granular packed bed instead of the Ergun equation that is used to model porous materials in Computational Fluid Dynamics, applicable results of the activated carbon were obtained. Dynamic simulations and flow analyses of the chemical adsorption with varying gas flow rates were also executed.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.167-171
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• 2022

In the era of the coronavirus disease 2019 (COVID-19) pandemic, countries worldwide have implemented several nonpharmaceutical interventions (NPIs) to contain its spread before vaccines and treatments were developed. NPIs included social distancing, mask wearing, intensive contact tracing and isolation, and sanitization. In addition to their effectiveness at preventing the rapid spread of COVID-19, NPIs have caused secondary changes in the epidemiology of other infectious diseases. In Korea, various NPI stages have been implemented since the first confirmed case of COVID-19 on January 20, 2020. This review, based on a PubMed database search, shows the impact of NPIs on several infectious diseases other than severe acute respiratory syndrome coronavirus 2 in the COVID-19 pandemic era in Korea.

• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.108-113
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• 2023

Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.190-200
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• 1996

Background : Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. Method : We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure $6-8cmH_2O$ and an expiratory positive airway pressure $3-4cmH_2O$. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. Results : Pretreatment and after 3 days of treatment, mean $PaO_2$ was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and $PaCO_2$ was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in cr group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean $PaO_2$, $PaCO_2$ and pH respectively. Conclusion: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPD, is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.

• Journal of Environmental Health Sciences
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• v.45 no.2
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• pp.134-141
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• 2019

Objectives: The study aimed to investigate the characteristics of health masks and to suggest the proper selection and use of protecting the respiratory system from particulate matters. Methods: The National Standard of masks promulgated by the Ministry of Food and Drug Safety (MFDS) and the Ministry of Employment and Labor (MOEL) were reviewed. The raw data of certified health masks were obtained from the MFDS database. Descriptive statistical analysis was performed. Results: Overall, 543 masks were certified by MFDS as of March 2019. Numbers of certified masks as KF80 (Korea Filter), KF94 and KF99 were 257 (47.3%), 281 (51.8%), and 5 (0.9%), respectively. Names of health masks, which were yellow sand, communicable diseases, health or its combination, were diverse that made customers be confused in selection. Health masks were also classified by particulate size, however, detailed information was not available. Conclusions: We investigated the status of health mask certification in Korea. Appropriate information on KF grade of health masks is required for customers to use them properly. MFDS should update the certification system of health masks periodically.