• Clinical and Experimental Pediatrics
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• 제49권11호
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• pp.1194-1201
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• 2006

목 적 : 혼수 환자는 원인에 상관없이 혼수 상태가 오래 지속되었을 경우 회복불능의 상태로 될 수 있기 때문에 원인을 신속하게 발견하여 치료하는 것이 중요하다. 그 중 MRI 검사는 혼수 환자의 원인을 감별하는데 중요하나 자발호흡이 없는 환자에게 MRI 검사 시 여러 가지 제한점으로 인해 그 시행이 어려웠다. 저자들은 변형된 수동식 인공호흡기를 이용하여 일정 거리에서 환자에게 전달되는 환기량을 유지하면서 MRI 검사가 가능한지 알아보고 안정성을 확인하고자 본 연구를 실시하였다. 방 법 : 특별히 고안한 장치는 self-inflating bag type의 수동식 인공호흡기에 PVC 관을 연결하고 그 끝을 환자의 기도와 연결하여 만든 비교적 간단한 장치이다. 또한 안정성을 확인하기 위하여 기계식 인공호흡기를 이용하여 PVC 연결 관의 길이와 직경 및 일회호흡량(tidal volume)을 변화시켰을 경우 TVe, MVe, PIP를 측정하여 환기에 미치는 영향에 대해 알아보았다. 결 과 : 15 mm, 25 mm 직경의 2가지 종류의 PVC 연결 관을 이용하여 TVi를 변화시킴과 동시에 관의 길이를 1, 2, 3 m로 증가시킴에 따라 TVe, MVe, PIP 값을 측정하였으며, 그 결과 TVe, MVe 값은 대조군과 비교해 차이가 없었고 PIP 값은 TVi가 증가함에 따라, 관의 길이가 늘어남에 따라 의미 있는 증가를 보였다(P<0.05). 또한 관의 길이, TVi에 관계없이 PIP 값은 PVC 연결 관의 직경과 음의 상관관계를 보였다. 즉 관의 직경이 작을수록, 관의 길이가 길어질수록, 일회호흡량이 증가할수록, 환기량을 유지하기 위한 PIP값은 증가하였다. 5명의 환자들을 대상으로 이러한 방법을 이용하여 MRI 검사를 시행하였으며 성공적으로 검사를 실시하였다. 결 론 : 저자들이 고안한 수동식 인공호흡기를 이용한다면 자발호흡이 불안정하여 MRI 검사를 시행하지 못했던 많은 환자들에게 더 많은 검사의 기회가 주어질 것이며 환자의 질환을 진단하는데 많은 도움을 줄 것이다.

• 대한물리의학회지
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• 제7권2호
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• pp.157-164
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• 2012

Purpose : The Purpose of this study was on determine whether thoracic expension exercise might increase the pulmonary function of the patients with stroke. Methods : Fourty paients with stroke were randomly assigned to experimental(n=20) and control group(n=20). During four weeks, each group participated thirty minutes for five times per week. Subjects were assessed using pre-value and post-value measurement pulmonary function(Forced vital capacity, Forced expiratory volume at one second, FEV1/FVC, Peak expiratory flow, Tidal volume, vital capacity, Inspiratory capacity, Expiratory reserve volume, Inspiratory reserve volume). Results : These finding suggest that experimental group was significant increase in FVC, FEV1, PEF, TV, IC, IRV, ERV($p$<.05). In comparison of two group, experimental group was high pulmonary function than control group. Conclusion : This study showed experimental group can be used to improve pulmonary function than control group. Thus it indicates that the thoracic expension exercise will be more improved through the continued respiratory exercise program.

• 대한통합의학회지
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• 제4권4호
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• pp.13-19
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• 2016

PURPOSE : The purpose of this study was to determine whether tredmill exercise increases pulmonary function and decreases body mass index of the 20s obesity. METHOD : Thirty obesity in their 20s were randomly assigned to on experimental group (n=15) or control group (n=15). Over the course of four weeks, the experimental group participated in tredmill exercise for 30 minutes three times per week and the control group participated in auto-med exercise for 30 minutes three times per week. Subjects were assessed pre-test and post-test by measurement of pulmonary function (tidal volume, inspiration reserve volume, expiratory reserve volume, vital capacity) and body mass index. RESULT : Our findings show that the experimental group had significant difference in expiratory reserve volume and vital capacity and body mass index (p<.05). In the comparison of the two groups, the experimental group had higher pulmonary function and lower body mass index than the control group. CONCLUSION : In this study, the experimental group showed greater improvement in pulmonary function than the control group, which indicates that the tredmill exercise is effective at increasing the pulmonary function and body mass index 20s obesity.

• 한국해안·해양공학회논문집
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• 제33권3호
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• pp.110-121
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• 2021

산업화에 의해 소실된 갯벌의 중요성이 근래에 주목을 받으며 인공 갯벌의 조성 및 자연 갯벌의 유지 관리에 관심을 기울이고 있다. 하지만, 갯벌을 조성하는 실트, 진흙, 모래 등과 같은 저질에 의한 거동특성에 관해서는 충분한 이해가 부족하다. 갯벌과 같이 혼합토사의 이동특성에 관한 연구가 현지조사와 수리실험을 통해 이루어지고 있으나 이러한 연구결과에 기초한 수치모델의 개발은 미진한 실정이다. 본 연구에서는 갯벌을 구성하는 저질의 동적 관리를 효율적으로 수행할 수 있는 혼합토사 모델의 구축을 목적으로 한다. 혼합토사에 대한 표사이동 수치모델을 구축함에 있어서 혼합토사를 구성하는 모래와 진흙의 재현 및 이동에 따른 수치적 안정성이 우선 검토되어야 하므로 혼합토사를 구성하는 모래와 진흙의 체적관계를 토사의 기하학적 구조를 나타내는 시상도를 바탕으로 제안하였다. 혼합토사의 건조체적밀도를 고려하기 위해 진흙이 물을 함유하는 함수비를 도입하여 진흙의 건조체적밀도를 고려할 수 있게 하였다. 또한, 제안된 혼합토사의 수치해석 모델을 혼합토사의 사면 붕괴에 적용하여 사면 붕괴에 따른 진흙과 모래의 이동계산이 안정적으로 수행되는 것을 확인하였다.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.165-170
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• 2018

Background: The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV). Methods: The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCV-VG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP ($5cmH_2O$; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure ($P_{peak}$), mean airway pressure ($P_{mean}$), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP ($5cmH_2O$), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more. Results: The $P_{peak}$ was significantly lower in group TV6 ($19.3{\pm}3.3cmH_2O$) than in group TV8 ($21.8{\pm}3.1cmH_2O$) and group TV6+PEEP ($20.1{\pm}3.4cmH_2O$). $PaO_2$ was significantly higher in group TV8 ($242.5{\pm}111.4mmHg$) than in group TV6 ($202.1{\pm}101.3mmHg$) (p=0.044). There was no significant difference in $PaO_2$ between group TV8 and group TV6+PEEP ($226.8{\pm}121.1mmHg$). However, three patients in group TV6 were dropped from the study because $PaO_2$ was lower than 80 mmHg after ventilation. Conclusion: It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with $5cmH_2O$ PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

• Journal of Yeungnam Medical Science
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• 제6권2호
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• pp.63-70
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• 1989

This paper describes to design and to examine the mechanical characteristics of high frequency jet ventilator. The device consists of Phase lock loop(PLL) system, solenoid valve driving control part and Air regulating system. This study is carried out by changing several factors such as endotracheal tube(E.T. tube)diameter, injector cannula diameter, 1%, and frequency(breaths/mim.) having direct effects on the gas exchange as well as parameters of the entrained gas by venturi effects, so as to measure the tidal volume and minute volume. This system characteristics were as follows : 1) Frequency : 6-594bpm 2) Inspiration time : 1-99% 3) Variance of input air pressure : 1-30PSI.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2012년도 춘계 종합학술대회 논문집
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• pp.173-174
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• 2012

To determine whether position affects measured lung capacity of spinal cord injury patients. The study subjects were 45 patients with spinal cord injury (cervical level 15, thoracic level 15, lumbar level 15). Subjects were provided with a full explanation of the experimental procedures and all provided written consent signifying their voluntary participation. We used a spirometer (Spirometer, Micromedical Ltd, UK) to measure pulmonary function in the supine and sitting positions (straightened upper body at an angle of $90^{\circ}$). Forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), tidal volume (TV), and maximum insufflation capacity (MIC) were also measured. FVC, FEV1, TV, MIC (%) were greater in the supine than in the sitting position for those with injury at the cervical or thoracic injury level. On the other hand, FVC, FEV1, TV, MIC (%) were lower in the supine position for those with an injury at the lumbar level. More attention should be paid to the effect of injury level on measured lung capacity.

• Journal of Chest Surgery
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• 제25권4호
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• pp.391-397
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• 1992

Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• The Korean Journal of Physiology
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• 제27권1호
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• pp.37-49
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• 1993

Ventilatory responses to inhaled $CO_2$ were measured during continuous negative pressure breathing (CNPB) in awake dogs. End expiratory lung volume (EELV) decreased linearly with pressure level during CNPB (correlation coefficient= 0.81, p<0.005) during air breathing. When CNPB was applied during 5% $CO_2$ inhalation, the decrease in EELV was not significantly different (p<0.5) from that during air breathing. As a result of a lowered EELV, tidal volume ($V_T$) significantly decreased by 22% and breathing frequency ($f_B$) increased by 68% in the steady state during air breathing (p<0.0001). These responses were similar during 5% $CO_2$ inhalation, thus the $CO_2$ response curve measured during CNPB shifted upward without a change in sensitivity (p>0.05). These results indicate additive effects of CNPB and $CO_2$ inhalation. The degree of hyperventilation during CNPB at eupnea was estimated to be 63% of that during control ventilation and was significantly greater than zero (p<0.0001), which suggests an alveolar hyperventilation due to CNPB. These results suggest that the mechanical alterations associated with n decrease in lung volume could play an important role in ventilatory control independently of chemical regulation of breathing. Thus, exercise hyperpnea, which is associated with a lowered functional residual capacity (FRC), may in part be explained by this mechanical stimulation of breathing.