• Title/Summary/Keyword: 폐쇄

Search Result 3,861, Processing Time 0.035 seconds

Effect of Posture on the Distribution of Pulmonary Ventilation in Patients with Increased Closing volume (폐쇄용적(Closing Volume)이 증가된 만성 폐질환 환자에서 체위에 따른 폐환기량의 변화)

  • Kim, Young-Tae;Kim, Mee-Kyung;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Ryu, Jin-Sook;Lee, Myung-Hae;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.40 no.6
    • /
    • pp.631-637
    • /
    • 1993
  • Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.

  • PDF

Implement the system of the Position Change for Obstructive sleep apnea patient (폐쇄성수면 무호흡 환자의 자세변환 시스템 구현)

  • Ye, Soo-young;Eum, Sang-hee
    • Journal of the Korea Institute of Information and Communication Engineering
    • /
    • v.21 no.6
    • /
    • pp.1231-1236
    • /
    • 2017
  • In this study, we developed a system that can change position to improve obstructive sleep apnea. Blocking of the breathing airway caused by obstruction of the apnea, lateral position is provided by the airway to improve the apnea. We used a pressure sensor (FSR402) in the form of an array to determine the position of patient. The air cylinder was controlled to raise and lower the bed. As a result of calculating the pressure difference between the supine position and the lateral position, it was $0.41{\pm}0.30$ and $1.09{\pm}0.73$. In other words, when the patient is lateral position, the difference between the sensor values on the right and left side is large. Therefore, it is confirmed that the system can maintain airway to breath for improvement of obstructive sleep.

Immediate Reoperation for Failed Mitral Valve Repair (승모판막성형술 실패 직후에 시행한 재수술)

  • 백만종;나찬영;오삼세;김웅한;황성욱;이철;장윤희;조원민;김재현;서홍주;김욱성;이영탁;박영관;김종환
    • Journal of Chest Surgery
    • /
    • v.36 no.12
    • /
    • pp.928-928
    • /
    • 2003
  • 승모판성형술 직후에 시행한 재수술에 대한 연구보고는 많지 않다. 저자들은 승모판성형술 직후 성형술 실패로 판단되는 환자에서 즉시 시행한 재수술 결과에 대해 알아보았다. 대상 및 방법: 1995년 4월부터 2001년 7월까지 세종병원에서 승모판성형술을 받은 환자 중 체외순환 이탈 직후 시행한 경식도초음파 검사에서 승모판막폐쇄부전 혹은 협착이 의미있게 잔존하거나 다른 이유로 재수술이 즉시 필요하였던 18명을 대상으로 후향적으로 조사하였다. 남녀비는 5 : 13이었고 평균 연령은 44세였다. 승모판막 질환은 폐쇄부전 12명, 협착 3명, 그리고 혼합형이 3명이었다. 원인은 류머치스성 9명, 퇴행성 8명, 그리고 심내막염이 1명이었다. 재수술의 원인은 잔존 승모판폐쇄부전 13명, 협착 4명, 그리고 좌심실천공이 1명이었다. 14명(77.8%)에서 재성형술을, 4명에서는 인공기계판막치환술이 시행되었다. 결과: 조기사망은 없었다. 조기결과는 승모판막치환을 한 4명을 제외한 14명 중 13명(92.9%)에서 0-I도의 폐쇄부전을 보였고 협착은 14명 모두 경도 이하 상태였다. 평균 33개월을 추적조사 한 결과 1명이 술 후 4개월 후 심기능부전으로 사망하였다. 승모판폐쇄부전은 9명(64.3%)에서 0-I도를, 승모판협착은 11명(78.6%)에서 경도 이하였고 재수술은 1명에서 시행되었다. 6년 생존율과 재수술로부터의 자유도는 각각 94%와 90%였다. 4년 후 승모판폐쇄부전 및 협착 재발로부터의 자유도는 각각 56%와44%였다. 결론: 승모판막성형술 직후 재수술은 양호한 조기 및 중기 생존율을 보이며 일차성형술 실패 후에도 높은 빈도에서 재성형술이 가능하다. 하지만 재성형술 시 특히 류머치스성 판막질환에서는 판막 기능부전 발생률이 높기 때문에 성형술 후 판막부전의 재발을 줄이기 위해서는 성형술의 적절한 적용 및 적응증 선별이 중요할 것으로 생각된다.

A Case of Esophageal Obstruction Complicated in a Patient with Chronic Granulomatous Disease - Esophageal obstruction in Chronic Granulomatous Disease (만성육아종질환 환자에서 합병된 식도 폐쇄 사례 -만성육아종질환의 육아종성 식도 폐쇄)

  • Kim, Ji Soo;Hwang, Jinsol;Choi, Young Hun;Kim, Woo Sun;Kim, Joong Gon
    • Pediatric Infection and Vaccine
    • /
    • v.21 no.1
    • /
    • pp.53-58
    • /
    • 2014
  • Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.

Clinical Efficacy of Pimobendan on Dogs with Chronic Mitral Valvular Diseases (만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과)

  • Nam, So-Jeong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
    • /
    • v.26 no.1
    • /
    • pp.17-22
    • /
    • 2009
  • Pimobendan is a recently developed cardiac drug which is useful to control moderate to severe congestive heart failure (CHF) from chronic mitral valvular diseases (CMVI). Because of controversy related to the efficacy and safety of pimobendan in dogs, the optimal efficacy and safety of pimobendan was assessed in 20 dogs with CMVI in this study. Scores for quality of life, respiratory failure, circulatory failure and heart failure were evaluated along with radiographical and echocardiographical assessments for about 2 months period after the addition of pimobendan into the regular cardiac medications. This study proved clear evidence that pimobendan had beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.

A Study on the Optical flow Method for Analysis of Ipper Airway Deformation from Magnetic Resonance Images for Children with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡 증후군을 가진 어린이 환자들의 MRI 영상으로부터 상기도 면적 변화 분석을 위한 광류 방법에 대한 연구)

  • Lee, Min Hee;Kim, Dong Youn
    • Journal of the Institute of Electronics and Information Engineers
    • /
    • v.51 no.4
    • /
    • pp.201-209
    • /
    • 2014
  • Obstructive sleep apnea syndrome(OSAS) is a respiratory disease caused by partial or complete obstruction of the upper airway during sleep. In this paper, we proposed the optical flow method to analyze the upper airway dynamic changes during respiration for children with OSAS and control subjects. We compared the absolute value of difference between inspiration and expiration for airway area analysis method and optical flow method for 5 children with OSAS and 6 control subjects. From the statistical analysis, airway area analysis method and optical flow method are statistically significant at the 0.1 (p value is 0.0977) and 0.01 (p value is 0.0011) significance level respectively. From this simulations, the optical flow method could provide more accurate information to diagnose the OSAS patients than the traditional airway area analysis method.

An Empirical Study on Public Service Recruitment System and Public Sector Corruption (공직임용제도의 폐쇄성과 공직 부패에 관한 실증분석)

  • Kim, Jaehoon;Lee, Hojun
    • KDI Journal of Economic Policy
    • /
    • v.34 no.4
    • /
    • pp.157-188
    • /
    • 2012
  • We study the relationship between the closedness of public service recruitment system and the corruption rampant between private firms and public servants. Empirically we test our claim that the closedness of public service recruitment system tends to heighten the corruption level of each country. Our results show that the closedness is positively correlated with bureaucracy corruption levels indexed by IMD, WEF, and World Bank.

  • PDF

Right coronary artery atresia in Marfan's syndrome: A case report (Marfan 증후군에 동반된 우관상동맥 폐쇄증 - 1 례 보고 -)

  • 이재원
    • Journal of Chest Surgery
    • /
    • v.34 no.9
    • /
    • pp.720-723
    • /
    • 2001
  • A case of Marfan’s syndrome with atresia of right coronary artery is reported. A 45-year-old woman, who was diagnosed as Marfan’s syndrome 1 year ago, came to the hospital complaining of acute chest pain. The patient showed arachynodactyly, pectus carinatum, and long and slender extremities. In echocardiography there were severe aortic regurgitation measured grade IV and aortic dilatation of ascending aorta maximally 5.9 cm in diameter. Mitral regurgitation was mild, but there were also moderate left ventricular dilation and moderately decreased ejection fraction of left ventricle. At operation, atresia of right coronary artery was found. We performed Bentall type operation with SJM 27mm valved conduit for left coronary artery, and Piehler’s modification for right coronary artery bypass using 6mm PTFE graft. The atretic portion of right coronary artery from the suspected right coronary ostium to distal coronary flow was about 4 cm in length. The combination of right coronary artery atresia and Marfan’s syndrome is very rare. The author describes the rare case, which is treated with combined technique of Bentall and Piehler modification for reconstruction of coronary circulation.

  • PDF

Severe Tricuspid Insufficiency after Correction of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery(ALCAPA) (ALCAPA 교정후 발생한 심한 삼첨판 폐쇄부전)

  • 백만종;김웅한;오삼세;류재욱;공준혁
    • Journal of Chest Surgery
    • /
    • v.34 no.9
    • /
    • pp.724-728
    • /
    • 2001
  • We report a case of an 8 years and 11 month-old male patient who had developed severe tricuspid insufficiency(TI) after correction of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Transthoracic echocardiogram and coronary angiography confirmed ALCAPA, ischemic mitral regurgitation and trivial TI. He underwent direct reimplantation of the left coronary artery to the aortic root by using additional cannulation at the main pulmonary artery for arterial inflow and cardioplegia delivery to the left coronary artery. After the correction of ALCAPA, transesophageal echocardiogram(TEE) revealed good antegrade flow at the aortic implantation site of the left coronary artery and severe TI(Gr III-IV/IV). Cardiopulmonary bypass was reestablished and tricuspid valve was repaired with Kay-type annuloplasty, artificial chordae formation and chordal shortening plasty. The postrepair TEE revealed trivial to mild TI.

  • PDF