• Title/Summary/Keyword: respiratory mask

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Use of Noninvasive Mechanical Ventilation in Acute Hypercapnic versus Hypoxic Respiratory Failure (급성 환기부전과 산소화부전에서 비침습적 환기법의 비교)

  • Lee, Sung Soon;Lim, Chae-Man;Kim, Baek-Nam;Koh, Younsuck;Park, Pyung Hwan;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.987-996
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    • 1996
  • Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

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Analysis of Changes in Skin Dose During Weight Loss when Tomotherapyof Nasopharynx Cancer (비인두암 토모테라피 시 체중 감소에 따른 피부선량 변화 분석)

  • Jang, Joon-Young;Kim, Dae Hyun;Choi, Cheon Woong;Kim, Bo-Hui;Park, Cheol-Soo
    • Journal of the Korean Magnetics Society
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    • v.26 no.3
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    • pp.99-104
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    • 2016
  • For patients receiving chemotherapy and radiation therapy treatment progresses as vomiting, nausea, weight of the patient because of a loss of appetite it is reduced. The patient's weight and the distance from the skin and the treatment site is expected to be closer, thereby reducing the change in the skin because of this dose. This study tests using a loose see the difference between the volume change appears as the weight of the patient using the same phantom and the phantom body of the patient. To using the same as the position EBT film is attached to the skin of the treatment site and was adjusted to the thickness of the Bolus. And using a computerized treatment planning only tomotherapy equipment was passed under the conditions according to the thickness of the radiation dose. To baseline for accurate reproduction position using the MVCT was applied to treated with verification. By passing a total of three dose reduced the error, it was a measure of the film by using a dedicated scanner, EBT VIDAR scanner. Got an increase in the skin dose is displayed each time the thickness of the bolus reduced, in a bolus was completely removed with the highest value. If the changes appeared dose was greater weight loss patients to chemotherapy and therefore bolus thickness variation considering the weight loss of the patient when applying the tomotherapy of nasopharynx cancer was found that the increase in skin dose be increased. This large patient before treatment due to weight loss over the image verification is considered to be established should consider how to re-create your mask and treatment plan for fixing it.

Clinical Aspects among Platers (도금공(鍍金工)에 대한 임상적(臨床的) 관찰(觀察))

  • Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.10 no.1
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    • pp.16-24
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    • 1977
  • This is a result of clinical examination for workers working with Chromic acid and Chromium compounds in the plating room of their companies. I selected two companies that the plating process and the kinds of plating were similar. One (SW Co.) was more or less improved the operating environment with the ventilation machine so on and another (SR Co.) did not it so. The former was examined at March 29th 1977, the latter was at June 28th 1976. But the respiratory communicable diseases, flue or common cold so on were not spreaded there at that time. The clinical aspects were compared between the group of SW, and SR. The swelling and hyperemic signs of nasal mucous membrane and the experience of nasal bleeding were about 50%, generally, in all the groups. The following problem was dizziness or vertigo. The nasal signs in the group of SW (improved ventilation of the room air) were relatively weak, but in another, it was some what severe; - there was necrotic sign with thick nasal clast. They were only used of gauze mask when the vapors of various solvents were deeply full in the room. And there was very high rate of bronchial signs, sputum or coughing in the group of SW improved ventilation so called, than another one. I suppose that it means chronic inflammatory change of the bronchial mucous membrane with deeper signs, due to the individual protectors were carelessly or not used according to the improving of the operating environment. Theses nasal signs mentioned the above were not nearly in the other groups had not been done the Chromium plating. The Status of RBC, Hb and Ht, of urine protein and urobilinogen were mostly in normal range. But the number of WBC was more or less showed with a positive correlation to the working duration.

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The Study of Scattering Dust and Radiation Dose in Pedestrian Tunnels in Metropolitan Area (수도권 보행터널 내부에 존재하는 비산 먼지와 방사선량의 연구)

  • Jung, Hongmoon
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.385-390
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    • 2020
  • In the present, external environmental factors affect human health. In particular, the most important issue is fine dust in these days. Because fine dust is inhaled through the human respiratory system is known to be harmful to health. Tunnels for cars and people can also be easily seen around us. This study, the amount of scattering radiation was measured for walkable tunnels about dust. For the measurement method, dust and radiation dose in the tunnel were measured on good weather (fine dust level: 0 ~ 30 ㎍/㎥) and normal day (fine dust level: 0 ~ 80 ㎍/㎥). The measurement resulted in an increase of 10~20 % of dust in the center of the tunnel on a good weather day and an increase of 20~30 % of dust in the center of the tunnel on normal weather. On the other hand, the results of tunnel measurement of radiation dose increased by 10~20 % at the center of the tunnel non-depending on the weather. As a result, pedestrians should pay attention to scattering dust and scattered radiation while moving through the tunnel. Therefore, it is recommended to wear a filter mask of PM2.5 or less during frequent tunnel walking.

Capnographic Monitoring of End-Tidal Partial Pressure of Carbon Dioxide in Anesthetized Cinereous vultures (Aegypius monachus) (독수리(Aegypius monachus)의 흡입마취에서 Capnography를 이용한 호기말 이산화탄소분압 모니터링)

  • Park, Won-Kyu;Seok, Seong-Hoon;Park, Se-Jin;Lee, Seung-Yong;Kim, Young-Ki;Hwang, Jae-Min;Jeong, Dong-Hyuk;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.380-384
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    • 2015
  • The relationships between end-tidal partial pressure of carbon dioxide ($P_{ET}CO_2$) and arterial partial pressure of carbon dioxide ($P_aCO_2$), and between $P_{ET}CO_2$ and blood pH in isoflurane-anesthetized cinereous vultures were evaluated. Nine cinereous vultures (weighing 7.3-9.5 kg) were anesthetized via mask with isoflurane, intubated, and connected to a mechanical ventilator. By mechanical ventilator, respiratory rate was altered to achieve a $P_{ET}CO_2$ randomly selected among 30 to 35 mmHg. $P_aCO_2$ and blood pH were determined in serial arterial samples and compared with concurrent $P_{ET}CO_2$ measured with a sidestream capnography. Thirty six samples, nine cinereous vultures were tested 4 times each, were used to determine correlations coefficients between $P_aCO_2$ and $P_{ET}CO_2$, and between $P_{ET}CO_2$ and blood pH. Strong correlations were observed between $P_aCO_2$ and $P_{ET}CO_2$ (r = 0.951, P = 0.000, y = 1.679x - 30.236, $R^2=0.905$) as well as between $P_{ET}CO_2$ and blood pH (r = -0.728, P = 0.000, y = -0.024x + 8.389, $R^2=0.530$) with Pearson's correlation coefficient and simple linear regression. These results suggest that the capnography used provided a sufficiently accurate estimation of $P_aCO_2$ and blood pH. Thus, the monitoring of $P_{ET}CO_2$ can be useful method to prevent hypoventilation for cinereous vultures receiving mechanical ventilation.

Nasal Continuous Positive Airway Pressure Titration and Time to Reach Optima1 Pressure in Sleep Apnea Syndrome (수면 무호흡 증후군에서 지속적 양압 치료시의 최적압 및 그 도달기간)

  • Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.84-92
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    • 1995
  • Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

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The Effect of Nasal CPAP in Obstructive Sleep Apnea Syndrome (폐쇄형 수면무호흡증후군 환자에서 Nasal CPAP의 치료 효과)

  • Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.501-508
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    • 1993
  • Background: Sleep apnea syndrome is a common disorder which is estimated to affect about 1~4% of adult male population. And if untreated, sleep apnea can cause significant sequelae, such as hypertension, nocturnal cardiac arrhythmia, daytime hypersomnolence, and cognitive impairment. Various kinds of treatment for obstructive sleep apnea (OSA) have been developed. Among them nasal CPAP, first introduced by Sullivan et al in 1981, has received widespread interest and acclaim as a treatment of OSA, and is currently recommended as first-line treatment for OSA. We evaluated the effect of nasal CPAP in OSA and the side effects of nasal CPAP hindering patients from using nasal CPAP. Methods: We performed sleep studies in 20 OSA patients at 2 consecutive nights; baseline night at first day and CPAP night at second day. We compared apnea index, lowest oxygen concentration during apnea, maximal apnea time, and total apnea duration per total sleep time before and after CPAP. We also evaluated the side effects of CPAP with inquiry to the patients. Results: 1) Apnea index was significantly decreased after CPAP in 17 out of 20 OSA patients (85%) and increased in 3 patients (15%). 2) Average apnea index was significantly decreased after CPAP ($34.1{\pm}18.9/h{\rightarrow}15.4{\pm}10.3/h$, p<0.01). 3) Total apnea duration per total sleep time was also significantly decreased after CPAP ($28.5{\pm}16.0%{\rightarrow}11.9{\pm}9.3%$, p<0.05). 4) The lowest oxygen satuation and maximal apnea time were not significantly changed after CPAP. 5) The most frequent side effect of nasal CPAP was mask discomfort (80%), and the next was drying of nasal passages (65%). Conclusion: Nasal CPAP is an effective treatment for OSA. Futher studies should be concentrated on long term follow up of nasal CPAP for its therapeutic effects and the study of methods to enhance patients' compliance.

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A Survey on the Workplace Environment and Personal Protective Equipment of Poultry Farmers (양계 농업인의 작업장 환경 및 개인보호구 착용 실태조사)

  • Kim, Insoo;Kim, Kyung-Ran;Lee, Kyung-Suk;Chae, Hye-Seon;Kim, Sungwoo
    • Journal of Environmental Health Sciences
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    • v.40 no.6
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    • pp.454-468
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    • 2014
  • Objectives: This study was conducted to investigate the actual condition of the farm work environment and personal protective equipment as part of the effort to improve livestock work for the safety and health of poultry farmers and provide basic data for establishing plans to improve and develop personal protective equipment. Methods: For this purpose, a questionnaire survey on general information about stables, the poultry work environment, accidents, the wearing of work clothes and personal protective equipment, and the level of awareness related to personal protective equipment was conducted among 148 poultry farmers. Results: As a result, it was found that poultry workplace environment was exposed to such risks as fine dusts; organic dusts; poisonous gases; odorous substances; chicken excrement; contact with chickens, bacteria or viruses; and accidents related to machine operation. Thirteen percent of respondents suffered severe respiratory diseases, and the most frequently injured sites due to accidents were the hands (25.7%), knees (23.8%), arms (17.3%), and head (10.9%). The most frequent type of accident was collisions between the body and obstacles or machinery during movement (36.4%), followed by erroneous machine operation such as feeders and electric shocks (8.5%). Regarding the wearing of work clothes and personal protective equipment, 51.7% of the respondents wore worn-out clothing or everyday clothes, whereas only 32.0% wore work clothes. The percentage of farmers who wore proper protective equipment for the work environment during poultry work was 48.4%. The most frequently used type of protective equipment was boots (38.9%), followed by mask (36.7%), gloves (36.3%), appropriate work clothes (22.6%), quarantine clothes (17.6%), helmets (13.4%), and goggles (12.6%). The rate of wearing goggles was low because they were considered inconvenient and lowered work efficiency. Furthermore, they purchased everyday products available on the market for their personal protective equipment which were not appropriate for maintaining safety in an actual harmful environment and its consequent risks. As a result of the survey of the awareness level related to personal protective equipment, their levels of awareness of accidents and attitude proved to be average or higher, but the practice of wearing protective equipment and the level of knowledge and management of personal protective equipment were lower. Conclusion: This survey found that the wearing status of personal protective equipment among poultry farmers was insufficient even though they were exposed to risks. Most respondents were aware of the necessity of wearing personal protective equipment and of the potential for accidents, but they did not wear proper protective equipment. Their wearing rate was low due to a lack of knowledge about protective equipment, as well as the inconvenience of wearing it. Therefore there is a need to improve and develop specialized personal protective equipment for respiration, hands, and eyes, as well as work clothes that can protect farmers from major harmful matter that is generated in the poultry workplace. Based on the results of this investigation, we will conduct further studies on the required performance and design directions of personal protective equipment while collecting more objective data through field-oriented assessments.