• 대한방사선치료학회지
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• 제24권2호
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• pp.167-174
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• 2012

목 적: 호흡동조방사선치료(Respiratory Gating Radiation Therapy, RGRT)에서 호흡의 안정성은 매우 중요한 인자이다. 이러한 호흡의 안정을 위해 본인의 호흡주기를 직접 확인할 수 있도록 시청각시스템을 이용한 호흡유도시스템을 개발하였고 이의 유용성을 평가하고자 하였다. 대상 및 방법: 2011년 6월부터 2012년 4월까지 본원에서 호흡동조방사선치료를 받은 7명의 환자를 대상으로 시청각시스템을 이용하지 않는 자유호흡을 먼저 측정하고 자체개발한 호흡유도시스템을 이용한 호흡을 측정하였다. 시청각시스템을 이용한 호흡연습 후에는 치료실내에서의 자가호흡과 시청각시스템을 이용한 호흡을 각각 측정하였다. 측정된 데이터는 호흡주기, 호흡함수의 면적을 구하여 표준편차를 구하였으며, 이를 분석하여 치료전후의 호흡변화를 알아 보았다. 결 과: 자유호흡과 오디오 유도시스템, 시청각 유도시스템의 표준편차는 PTP (peak to peak)가 각각 0.343, 0.148, 0.078이다. 호흡주기는 각각 0.645, 0.345, 0.171이며, 호흡함수의 면적은 각각 2.591, 1.008, 0.877로 나타났다. 전체 환자의 CT실과 치료실에서의 차이를 평균한 값은 PTP가 0.425, 호흡주기가 1.566, 호흡면적이 3.671로 측정되었다. 호흡유도시스템 적용전후의 표준편자는 PTP가 0.265, 호흡주기가 0.474, 호흡면적이 1.714의 차이를 나타내었다. 자유호흡과 시청각유도시스템 적용전후의 값을 T-검정한 결과에서는 PTP, 주기, 호흡함수면적에서 각각 P-value 0.035, 0.009, 0.010의 값을 나타냈다. 결 론: 호흡동조방사선치료에서 호흡조절은 치료의 성패를 좌우할 만큼 중요한 인자이다. 자유호흡이나 청각에 의존한 호흡주기 획득에 비해 시청각 호흡유도 시스템을 이용한 경우에 보다 안정적인 호흡을 얻을 수 있었다. 특히, 치료실에서도 같은 시스템을 이용하여 호흡을 조절함으로써 호흡주기의 재현성이 뛰어났다. 이러한 시스템은 호흡불안정에 의한 치료시간의 지연을 줄이고 좀 더 정확하고 정밀한 치료가 가능하게 되었다.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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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.

• Tuberculosis and Respiratory Diseases
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• 제72권3호
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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.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1995년도 춘계학술대회
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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.

• Tuberculosis and Respiratory Diseases
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• 제56권3호
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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.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 춘계학술대회
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• pp.833-835
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• 2014

본 연구에서는 호흡동조방사선치료(Respiratory Gating Radiation Therapy, RGRT)에서 매우 중요한 요소 중에 하나인 호흡의 안정성을 효과적으로 향상 시킬 수 있는 호흡연습장치(respiratory training system)를 개발하였다. 개발한 호흡연습장치는 개인고유의 호흡주기를 적용하여 환자에게 편안한 호흡유도를 제공한다. 충분한 연습시간을 부여하기 위해 언제 어디서나 쉽고 간편하게 연습 할 수 있도록 휴대형 기기에 모듈화 시켰으며, 이를 환자에게 제공함으로써 호흡동조방사선치료의 효율성과 정확성을 높이고자 했다. 호흡연습장치를 사용했을 때 호흡의 규칙성, 안정성, 지속성 향상 정도를 알아보기 위해 5명을 대상으로 실험을 진행 하고자 한다. 개인이 자유롭게 호흡하는 '자유호흡(free breathing)' 개인고유 호흡주기를 적용하여 시청각 프로그램을 통해 호흡을 유도하는 '모니터호흡(guide breathing)' 호흡연습 후 시청각 프로그램 없이 호흡하는 '예측호흡(predict breathing)' 3가지 호흡법의 데이터를 이용하여 호흡주기(period)와 호흡깊이(amplitude) 및 호흡패턴(Area)의 변화를 정량적으로 분석함으로써 휴대형 호흡연습장치의 유용성을 평가하고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제77권5호
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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.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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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.

• 한국응용과학기술학회지
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• 제35권2호
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• pp.445-453
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• 2018

본 연구는 일회성 호흡훈련 피드백이 중년여성의 HRV-자율신경시스템 변화에 미치는 영향을 분석고자 하였다. 연구대상자는 중년여성(40-60세) 총 24명을 호흡군 12명, 통제군 12명으로 무선할당하여 일회성 호흡 훈련을 실시하였다. 호흡군의 피드백 훈련은 총 15분 동안 실시되었으며, 10분 간 전문가 지도에 따른 호흡 자각 훈련 후 5분 간 자율호흡 훈련을 실시하였다. 자료의 분석은 SPSS WIN 20.0으로 반복측정 변량분석(Repeated Measures ANOVA)을 실시하였으며, 이를 통해 얻어진 결론은 다음과 같다. 중년여성들은 일회성 호흡 훈련 후 SDNN, RMSSD, LF, HF가 유의하게 높아졌으며, 호흡군이 통제군보다 SDNN, RMSSD, LF, HF이 유의하게 높아진 것으로 나타났고, Mean HR과 LF/HF는 집단과 시기의 주효과, 집단과 시기의 상호작용효과 모두 유의한 차이는 나타나지 않았다. 이상의 결과로 일회성 호흡훈련 피드백은 중년여성들의 SDNN, RMSSD, 교감활성, 부교감활성에 효과적이며, 이러한 호흡 훈련 프로그램은 자율신경계 균형 능력을 향상시켜 중년여성들의 스트레스 완화 및 자율신경실조증을 회복할 수 있는 운동중재의 효용 가치를 기대할 수 있다고 사료된다.

• Clinical and Experimental Pediatrics
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• 제55권8호
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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.