• Title/Summary/Keyword: respiratory guidance

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Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy (호흡동조 방사선치료 시 호흡유도시스템의 유용성 평가)

  • Lee, Yeong-Cheol;Kim, Sun-Myung;Do, Gyeong-Min;Park, Geun-Yong;Kim, Gun-Oh;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.167-174
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    • 2012
  • Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Materials and Methods: Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and after the therapy. Results: The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. Conclusion: The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance system than free breathing or breathing with auditory guidance alone. In particular, the above system was excellent at the reproduction of respiratory cycles in care units. Such a system enables to reduce time due to unstable breathing and to perform more precise and detailed treatment.

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Evaluation of Appropriate Management of Chronic Obstructive Pulmonary Disease in Korea: Based on Health Insurance Review and Assessment Service (HIRA) Claims

  • Chung, Sang Mi;Lee, Sung Yong
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.241-246
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and effective treatment of outpatients can prevent worsening of the illness and hospitalization. Current COPD guidelines provide appropriate guidance for the diagnosis and treatment of patients with COPD. In fact, it has been shown that when appropriate guidance and treatment are performed, the morbidity and mortality rates of COPD patients are reduced. However, there is a gap between the clinical guidelines and the actual clinical treatment. Therefore, the Health Insurance Review and Assessment Service (HIRA) conducted an evaluation of the adequacy of COPD diagnosis and treatment using the Claims Database of HIRA. This review provides a summary of the COPD adequacy assessment results reported by the HIRA and some brief comments on the results.

Percutaneous Dilatational Tracheostomy

  • Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.3
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    • pp.261-274
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    • 2012
  • For decades, the standard technique for tracheostomy was the open, surgical technique. However, during the past 20 years, the use of percutaneous dilatational tracheostomy has been increased and shown to be a feasible and safe procedure in critically ill patients. The purpose of this report is to review the percutaneous dilatational tracheostomy technique, describe the role of bronchoscopy as guidance for the procedure, and identify the available evidences comparing percutaneous dilatational tracheostomy to surgical tracheostomy.

Development of Drugs, Devices, and Drug-Device Combinations: Through the Eyes of the Regulator

  • Spyker, Daniel A.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1995.04a
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    • pp.21-27
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    • 1995
  • This document collects Center for Drug Evaluation and Research (CDER) and Center for Devices and Radiological Health (CDRH) guidance documents, citations to the primary literature, and other published and unpublished documents relevant to development and approval of drug/device combinations collected by the CDRH Division of Cardiovascular, Respiratory and Neurological Devices (DCRND). Since the Master Bibliography number represents an accession number, an alphabetical (by author) listing appears at the end of the document, Any citation marked with a, is on file in the DCRND offices, 340B, in the Piccard Building (HFZ-450), 1390 Piccard Avenue, Rockville, MD 20850.

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Transthoracic Needle Biopsy of Thoracic Lesions (흉부 병터에 대한 경흉부 바늘생검)

  • Song, Jae-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.241-247
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    • 2004
  • In the diagnostic evaluation of thoracic lesions, the image-guided transthoracic needle biopsy was developed, and its role was expanded with the development of cross-sectional detection and characterization of thoracic lesions and advances in biopsy needle design and techniques. Particularly for diagnostic evaluation of solitary pulmonary nodules, transthoracic needle biopsy has emerged as the invasive procedure of choice. This article covers the indication, the pre-procedure preparation, various guidance-modalities and techniques, and complications.

Development and usability evaluation of portable respiration training device which is applied to personal respiration cycle (개인고유의 호흡주기를 적용한 휴대형 호흡 연습장치 개발 및 유용성 평가)

  • Park, Mun-kyu;Lee, Dong-han;Cho, Yu-ra;Hwang, Seon-bung;Park, Seung-woo;Lee, Dong-hoon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2014.05a
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    • pp.833-835
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    • 2014
  • On this study, we have developed respiratory training system to improve stability of respiration, one of the most important factors of Respiratory Gated Radiation Therapy, RGRT. Respiratory training system that we developed was applied to personal respiratory cycle so that it could provide comfortable respiratory triggering to patients. To give sufficient time for practice, we used modular portable device to practice easily and to be undetered by time and place. We have intended to improve efficiency and accuracy by providing it to patients. We are now planning to conduct experiment of 10 peoples to find out stability, degree of durability betterment and regularity of respiration when patients are using respiratory training system. There are three kinds of breathing style. First is free breathing that Individual patients can breathe freely. Second is guide breathing that patients apply to personal respiration cycle through the guiding sight and hearing program. Third is prediction breathing that patients breathe after respiratory training without guiding sight and hearing program. By using these 3 data of respiration method, we have evaluated usability of respiratory training system by quantitatively analyzing respiration period, amplitude and area's variation.

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Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

  • Jeon, Min-Cheol;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Lee, Jeong Eun;Moon, Jae Young;Chung, Chae Uk;Kang, Da Hyun;Park, Dong Il
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.330-338
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    • 2018
  • Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

The Effects of Acute Respiratory Training Feedback upon a Change on HRV-Autonomic Nervous System in Middle-aged Women (일회성 호흡훈련 피드백이 중년여성의 HRV-자율신경시스템 변화에 미치는 영향)

  • Kim, Ji-Sun
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.2
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    • pp.445-453
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    • 2018
  • The purpose of this study was to analyze the effect of acute respiratory training feedback upon a change on HRV-Autonomic nervous system in middle-aged women. The research subjects were totally 24 middle-aged women(40-60 years old), were randomly allocated 12 people to the respiratory training group and 12 people to the control group, and then were carried out the acute respiratory training. The feedback exercise in the respiratory training group was conducted for totally 15 minutes. Following the 10-minute breath awareness training according to the expert's guidance, the 5-minute autonomous breathing exercise was implemented. The data analysis was carried out Repeated Measures ANOVA with SPSS WIN 20.0. The conclusions that were obtained through this are as follows. The middle-aged women got significantly higher in SDNN, RMSSD, LF, HF after the acute respiratory training. Compared to the control group. the respiratory training group was indicated to have gotten higher significantly in SDNN, RMSSD, LF, HF. Mean HR and LF/HF were not shown a significant difference in both the main effect of group & period and the interaction effect of group & period. Above of a result the acute respiratory training feedback is effective for SDNN, RMSSD, sympathetic activity, parasympathetic activity in the middle-aged women. Thereby, the respiratory training program improves autonomic nervous system, being considered to be possibly expected the effective value of exercise intervention available for relieving stress and recovering autonomic dysfunction in the middle-aged women.

Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: a questionnaire survey for anticipated guidance in a neonatal follow-up clinic

  • Cho, Ji-Yun;Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Kim, So-Young;Sung, In-Kyung
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.272-279
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    • 2012
  • Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.