• 한국의류학회지
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• 제44권3호
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• pp.516-538
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• 2020

The present study investigated regional and sex differences in knowledge, perception, cognition and behavior of fine-dust protective masks for periods of high concentration of fine dust in Korea. A total of 2,012 adults from seven provinces responded to the questionnaire. The results (all p<.05) showed that 78% of respondents considered pollution from China to be the greatest contributor of fine dust. Seoul and Gyeonggi residents more frequently checked fine dust forecasts than other provinces and consulted their smartphone applications to do so more than other residents. Jeju, Gwangwon, and Jeonla residents had less knowledge of KF 80, 94, and 99 masks than residents of other provinces. Gwangwon and Jeju residents had less trust in the effectiveness of protective masks than other residents. Females perceived themselves as unhealthier respiratory, more frequently checked the concentration of fine dust, trusted more the effectiveness of masks, and more frequently wore masks, compared to male respondents. Those who self-identified their respiratory function as poor, more frequently checked fine dust forecasting, and had greater knowledge of masks, which resulted in greater trust in the protective function of masks, and finally had higher wear frequency of masks for days with high concentrations of fine dust.

• 한국학교보건학회지
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• 제16권1호
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• pp.1-8
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• 2003

Purpose : While there have been growing concerns about the effects of Asian dusts on health, there are few studies for relationship between Asian dusts and health outcome. This study was designed to examine the perceived symptoms and behavior change of children during the Asian Dust events. Methods : We surveyed 459 students at an elementary school in Seoul, Korea from November 20th to 27th 2002. Children with parents were asked to return the completed questionnaires within a week. The questionnaires included the sociodemographic factor, previous respiratory disease, and perceived symptom, hospital visits and behavior change during the Asian dusts. Results : The majority of children reported that they restrained going out and outdoor recreational activity during the Asian dusts. The rate of children who worn the mask was 49% and 47% in second grade and fifth grade, respectively. Regarding the perceived symptom during the Asian dusts, the children in 2nd were more likely to have symptom than 5th and there were significant difference between two groups in cough, asthma symptom, dry cough, phlegm and medication for allergy or asthma symptom. In addition, children who had previous disease were more likely to change behavior in order to prevent the effects of Asian dusts. Conclusions : This study suggested that the younger children and children who had past respiratory disease were susceptible to the effect of Asian dusts. There is a need for providing public information and health education to prevent the impact of Asian dusts on health.

• 대한수의학회지
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• 제45권2호
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• pp.279-285
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• 2005

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

• 대한소아치과학회지
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• 제37권4호
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• pp.545-550
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• 2010

Freeman-Sheldon Syndrome(FSS)은 드물게 발생하는 선천성 유전 질환으로 휘파람을 부는 듯한 특징적인 안모로 인해 'Whistling face syndrome'으로 불리워진다. 또한 편평한 안모, 긴 인중(philtrum), 낮은 비연골이 나타나 두드러진 안면이상을 보이고, 내반족(club foot, 內反足), 손가락의 관절구축(joint contracture)으로 인한 풍차 모양의 손을 가지며, 지능은 보통 정상이다. 본원에 내원한 환아는 이 질환의 특징적 양상인 구강 주위 근육의 수축으로 소구증 및 개구제한, 높은 구개 및 부정교합, 치열의 심한 총생을 보여 구강위생이 매우 불량하였고 치과치료에 비협조적이었다. 소아치과적 행동조절 및 구강위생관리, 섭식장애의 상담으로 치과적 문제는 다소 개선되었으나, 안과 및 정형외과, 신경정신과, 교정과, 마취과적 문제로 인해 다양한 협진이 필요하며 계속적인 관찰 및 치료가 요구되기에 이를 보고하는 바이다.

• 대한물리의학회지
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• 제9권1호
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• pp.107-113
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• 2014

PURPOSE: The purpose of this study was to investigate the correlation between craniovertebral angle (CVA) and cardiorespiratory function ($VO_2max$ and $VCO_2max$) in young adults. METHODS: For this study, the students of D college were questioned and 50 members of D college were participated in our research.. Side-view pictures of each subject were taken in standing positions, in order to assess forward head posture (FHP) by measuring the craniovertebral angle. The craniovertebral angle was measured as the angle between a horizontal line at C7 and a line from the tragus of the ear to the spinous process of C7. And $VO_2max$ and $VCO_2max$ were measured by Quark CPET (cosmed co, USA) while the subjects were performed the treadmill running task of a intensity to set with respiratory mask. Subjucts were Then Pearson's correlation coefficient was calculated to estimate the relationship between craniovertebral and cardiorespiratory function ($VO_2max$ and $VCO_2max$) using SPSS for window. RESULTS: There was a significant positive correlation between craniovertebral angle and $VO_2max$ during treadmill running task (r=0.528, p<0.05). And there was a significant positive correlation between craniovertebral angle and $VO_2max$ during treadmill running task (r=0.566, p<0.05). CONCLUSION: Foreward head posture is related to cardiorespiratory function, and it has a negative correlation with cardiorespiratory function.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
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• pp.140-143
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• 2004

To appropriately control or compensate breathing motion of targets in thorax or abdomen during radiotherapy is still demanding. Our idea is that a visual signal may help regulate patient's breathing pattern, by controlling its amplitude and cycle. The system involving breathing control with a visual signal for aperture maneuver with controlled breath (AMC) has been developed. A thermocouple is used to detect the temperature change due to patient's breathing. The system also consists of a mask, in which the thermocouple is installed, an operational amplifier, a converter, etc. Patients were instructed to control their respiration by breathing following the visuals signal, as watching a display that shows both patients' current breathing pattern and the signal. The patterns of patients' controlled breathing and the signals coincided well. Therefore, when AMC technique is applied, a target moves in the range that is 60 % less than the range of free breathing motion with the help of the system and so target margins can be reduced significantly. This study reveals that a visual signal is not only useful to control patient's breathing but also clinically effective.

• 중환자간호학회지
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• 제16권2호
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• pp.1-14
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• 2023

Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.172-179
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• 2023

Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

• Tuberculosis and Respiratory Diseases
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• 제50권4호
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• pp.415-425
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• 2001

배 경 : 폐기종의 중증도 판정에 있어서 병리학적 기준은 기강(air space)의 확장 정도에 있으며, 이는 고해상도 전산화 촬영 (high resolution computed tomography, HRCT)에 의해 결정되는 폐기종 점수(emphysema scoring)와 좋은 상관성을 보인다는 것은 주지의 사실이다. 한편 폐기종의 주증상은 운동성 호흡곤란이므로 폐기종에 대한 임상적 평가는 운동능력의 감소를 측정하는 것이 타당하다고 알려져 있다. 그러나 대개의 경우 폐기종의 중증도 판정은 안정시 폐기능 검사에 의존하는 경우가 흔하며, 병리학적 중증도 판정과 상관성이 높다고 알려져 있는 고해상도 전산화 촬영에 의한 폐기종 점수와 운동부하 폐기능검사 지표들과의 상관성 여부에 대한 연구는 드문 실정이다. 이에 본 연구에서는 폐기종의 중증도 판정에 있어서 HRCT와 안정시 폐기능 검사 및 운동부하 폐기능 검사간에 상호 관련성을 확인하여 보았다. 방 법 : 평균 연령 $60.6{\pm}10.3$세인 14명의 폐기종 환자들을 대상으로 HRCT, 안정시 폐기능 검사(forced expiratory flow volume curve, lung volumes by He dilution method, DLco, ABGA), 그리고 점진적운동부하폐 기능검사(incremental cycle ergometer)를 시행하였으며 HRCT는 GE highlight를 이용하여 조영증강 없이 최대흡기시에 1.5mm collimation, 10mm 간격으로 폐전체를 스캔하였고, 환자마다 모든 스캔에서 density mask를 이용하여 -400 HU를 기준으로 한 총폐면적과 -900 HU를 기준으로 한 폐기종 면적을 각각 구하여 백분율로 환산하여 폐기종 점수를 구하였다. 결 과 : 평균 폐기종 점수는 $37.4{\pm}14.9%$ 이었다. 폐기종 점수와 안정시 폐기능 검사의 DLco(r=-0.75)와 $PaO_2$(r=-0.66) 사이에서만 유의한(p<0.05) 상관성이 관찰되었다. 반면 폐기종 점수와 운동부하폐기능 지표들간의 상관성은 최대 산소섭취량(r=-0.68), 혐기성 역치(V-slope method, r=-0.690), 최대운동부하(r=-0.74), 최대운동시 $O_2$ pulse(r=-0.73), 최대운동시의 생리적 사강비율 (r=0.80) 등과 높은 유의성 (p<0.01)을 나타내었다. 그러나 호흡예비율과 심박수 예비율간에서는 유의한 상관성이 없었고, pulse oxymeter로 측정한 산소포화도와의 상관성도 유의하지 않았다. 결 론 : 이상의 결과에서 폐기종의 병리학적 중증도를 잘반영한다고 알려진 HRCT 폐기종 접수는 폐기종에 의한 생리학적 장애를 잘 반영하는 운동부하 폐기능 검사의 주요 지표들과 유의한 상관성이 있음을 확인할 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제41권3호
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• pp.270-276
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• 1994

연구배경 : 임상에서 기관지과민성의 측정은 천식의 진단과 심한 정도 판정에 유용하므로 널리 쓰이고 있다. 비특이적 기관지 과민성의 측정은 히스타민등의 약물에 의한 기관지 유발검사법이 비교적 쉽게 시행할 수 있으므로 흔히 사용된다. 약물에 의한 기관지 유발검사시 에어로졸의 흡입방법으로 정량 흡입법(dosing technique with counted number of breaths)과 일정시간 흡입법(timed tidal breathing technique)이 널리 사용되고 있다. 일정시간 흡입법은 간단하면서 정확도와 재현성은 정량 흡입법과 차이가 없으며, 비싼 dosimeter가 필요하지 않다. 저자들은 이러한 관점에서 이 검사법은 국내의 임상 현실에 적합한 방법으로 생각하여 히스타민을 이용하여 일정시간 흡입법으로 기관지과민성 측정하는 방법을 소개하고자 한다. 방법: 대상은 정상대조군 42예, 기관지천식 환자 12예, 비염 환자 10예, 그리고 상기도감염 10예이었다, Jet nebulizer를 사용하였으며, 히스타민을 buffered phosphate saline 에 녹혀서, 0.0625부터 25.0mg/ml까지 연속적인 농도의 용액으로 준비하였다. 검사방법은 코를 nose clip으로 막고 마스크를 이용하여 입으로 에어로졸을 2분간 흡입한다. 흡입 후 $FEV_1$을 30초와 90초 후 2번 측정한다. 먼저 생리식염수를 흡입한 후 기저 $FEV_1$ 구한 후, 최저 농도의 히스타민 용액부터 흡입하여 $FEV_1$이 20% 이상 감소할 때까지 반복 흡입한다. 유발농도 20은 먼저 대수 양-반응곡선을 그린 후, 마지막 두 점을 직선 보간(linear interpolation)하여 구하였다. 결과: 생리식염수 흡입후 FEV1보다 20% 이상 감소하는 농도까지 히스타민 흡입은 정상대조군 42예 중 10예를 제외하고 각각의 대상군에서 모두 가능하였으며, 히스타민 유발농도 20을 구할 수 있었다. 정상대조군의 히스타민 유발농도 20의 기하학적 평균값(Geometric Mean${\pm}$Standard Deviation)은 $8.27{\pm}2.22mg/ml$, 기관지 천식군은 $0.33{\pm}3.02mg/ml$, 비염군은 $0.85{\pm}3.24mg/ml $, 그리고 상기도감염군은 $1.47{\pm}1.98mg/ml$이었다. 히스타민 2.5mg/ml 이상의 고농도 용액의 에어로졸 흡입시는 가벼운 부작용은 있었으나 대부분 흡입이 가능하였다. 결론: 히스타민 일정시간 흡입법은 간단한 기구로 시행할 수 있으므로, 우리 현실에 적합한 기관지 유발검사법이라고 생각한다.