• 융합신호처리학회논문지
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• 제12권3호
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• pp.157-162
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• 2011

본 연구는 심폐소생술 (CPR) 중 인공호흡의 무선 전송 시스템 구현에 관한 것으로, 병원 전 단계에서의 CPR 성과를 높임으로써 응급환자의 생존율을 높이기 위한 환자-병원간 무선 통신 시스템이다. 기도삽관 기반 호흡기류센서를 적용하여 호흡량을 측정하였는데, 기도삽관을 통한 인공호흡은 기류량의 손실을 최소화하여 보다 정확한 흡기-호기량 계측이 가능하고, 기도-식도 구분을 통해 식도팽창을 방지하여 다른 인공호흡 방법에 비해 장점을 입증하였다. 또, 인공호흡 주요지표인 분당 평균호흡량 (V), 호기말 이산화탄소 농도 ($EtCO_2$), 기도압력 (Ptr)을 디지털화하여 정의하였으며 정의된 데이터를 무선 통신 시스템을 이용하여 전송망의 대역폭 및 지연시간을 확인하였다. 호흡신호를 전송하기 위해 필요한 최대대역폭 (815 Kbps) 에 비해 Wireless LAN의 대역폭 (54 Mbps) 이 충분하여 네트워크 부하는 1.5 % 미만이었으며, 전송지연시간은 0.3 초 이내로 측정되었다.

• The Korean Journal of Pain
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• 제11권2호
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• pp.220-225
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• 1998

Background: The patients of facial hyperhidrosis have been known that they had much difficulties in interpersonal relationships and social activities due to excessive hidrosis when they were in stress, hot weather, or having meals. Previous drug therapy and stellate ganglion block have only temporary effects. The surgical method, $T_1$ sympathetomy has the risk of Hornor's syndrome. For that reasons, the sympathicotomy of proximal and distal portions of $T_2$ sympathetic ganglion with electroresectoscope used in transurethral resection seemed to be appropriate procedure, and we would like to report the results of our procedure. Method: Under the general anesthesia with semi-sitting position, and the portal was made through the small incision along the upper border of the 4th rib at the crossing point of mid-axillary line. After the partial collapse of lung by insufflation of 300 to 500 ml of $CO_2$, $T_2$ sympathetic ganglion was identified and resected proximally and distally with electro-cauterization. Finally the lung was expanded by limiting flow until the airway pressure reached 30 to 40 cm$H_2O$, and the wound was closed after removal of electroresectoscope. Result: There was no postoperative complication requiring surgical interventions. The facial sweating was stopped immediately after the operation and all the patients appeared to be satisfied. Conclusion: $T_2$ sympathicotomy with TUR electroresectoscope is thought be the minimal invasive and highly successful method in the treatment of facial hyperhidrosis. But longer terms follow-up will be needed to prove this result.

• 대한임상독성학회지
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• 제10권2호
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• pp.91-96
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• 2012

Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.

• 전자공학회논문지SC
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• 제37권4호
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• pp.42-48
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• 2000

일반적으로 시술자가 환자에게 마취를 할 때에는 매우 주의하여야 한다. 만약 잘못 시행 될 때는 환자는 매우 위험한 상황에 빠지게 된다. 본 논문에서는 잘못 시술이 발생 될 수 있는 몇몇 위험요소들을 사전에 예방하기 위하여 시스템의 정밀성과 사용자의 편리성을 고려하여 구현하는 것을 목표로 하였다. 특히 시스템에서 전자적인 부분은 스위치와 엔코더를 이용하여 사용자 인터페이스에서 조작을 편리하게 하고, 그래픽 액정화면 표시기를 이용하여 환자의 기도압과 이산화탄소 파형을 실시간 모니터링 기능을 구현하였다. 또한 설정값의 정밀한 제어를 위해 기계적인 부분에서 유량 제어 밸브와 유량 센서를 이용하여 피드백 유량 제어 시스템을 구현하였다. 이러한 기술을 개발함으로써 시술자에게 설정치 조작의 편리성과 정확성을 가져다줄 뿐만 아니라 환자의 상태와 여러 가지 변수들의 허용 범위를 넘을 경우 정확하고 신속하게 정보를 알려줌으로서 마취기용 인공 호흡기의 안정성과 신뢰성이 확보될 수 있음을 알 수 있었다.

• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.204-209
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• 2013

Purpose: Children with cerebral palsy generally have a high incidence of respiratory problem, resulted from poor coughing, airway clearance problem, respiratory muscle weakness, kyphoscoliosis and so forth. The purpose of this study is to investigate the possible factors that can be affected to forced vital capacity (FVC) in children with cerebral palsy. Methods: Total thirty six children with diplegic and hemiplegic cerebral palsy were recruited in this study. They were evaluated by general demographic data (i.e., age, gender, body mass index (BMI)) and variables related to respiratory functions (i.e., chest mobility, waist mobility, maximal phonation time, and maximum inspiratory/expiratory pressure (MIP/MEP)). The correlation between forced vital capacity and the rested variables were analyzed, and multiple regression with stepwise method was conducted to predict respiratory function, in terms of FVC as the dependent variable, and demographic and other respiratory variables as the independent variable. Results: FVC showed a significant correlation with waist mobility (r=0.59, p<0.01), maximal phonation time (r=0.48, p<0.05), MIP (r=0.73, p<0.01), and MEP (r=0.60, p<0.01). In addition, the multiple regression analysis model indicated that FVC could be predicted by the assessment of each waist mobility and MIP. Conclusion: These finding suggest that respiratory function is related to body size and respiratory muscle strength, and that BMI, waist mobility, and MIP can be predictable factors to affected respiratory function in term of FVC.

• 수면정신생리
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• 제3권2호
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• 대한의용생체공학회:의공학회지
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• 제23권6호
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• pp.485-489
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• 2002

본 연구는 동맥의 압력에 따라 변하는 맥파전달시간(pulse transit time, PTT)을 이용하여 호흡노력을 검출하기 위하여 호흡에 따른 PTT 변화를 관찰하였다. PTT는 심전도의 R파 피크로부터 말초에서 나타나는 광전용적맥(photoplethysmograph, PPG)의 최대기울기점까지 시간이다. 생체 신호를 아날로그-디지탈 변환하여 PC에서 매번 심장주기마다 PTT를 측정하였으며 이산적인 결과를 스플라인 보간법을 사용하여 그래프로 제시하였다. 소프트웨어는 $C^{++}$을 사용하여 windows 환경에서 운용하였다. 안정상태 호흡 시에는 호흡의 주기와 일치하는 주기적인 PTT의 변화가 있었다. 호흡 심도를 증가시킴에 따라 PTT의 진폭이 증가하였으며, 기도저항을 증가시킨 경우에도 PTT의 진폭이 증가하는 양상을 보였다. 이러한 결과는 PTT가 호흡노력에 따라 반응하는 것을 시사한다. 아울러 PTT를 이용한 호흡노력 모니터링은 비침습적 방법으로써 호흡장애를 감시하는데 유용하게 사용될 수 있음을 시사한다.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.733-738
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• 2005

Theoretically one might suggest the abdominoplasty can cause respiratory decompensation resulting from musculofascial plication, which reduces the respiratory reserve by decreasing intra-abdominal volume and diaphragmatic excursion. This prospective study was perfomed to evaluate the effect of abdominoplasty and the change of intraoperative Paw on the pulmonary function of 20 consecutive otherwise healthy subjects. The pulmonary function test was performed preoperatively, and repeated 2 months after the operation. Additionally, we monitored intraoperative Paw. Comparison of the pulmonary function test showed a significant decrease(p<0.001) in the mean forced vital capacity(FVC) and the mean forced expiratory volume in one second($FEV_1$) throughout the study period. Postoperatively, the mean FVC decreased by 11.65% and the mean $FEV_1$ decreased by 16.15%. The mean Paw increased by $6.6cmH_2O$($3-12cmH_2O$) by musculofascial plication. And we found that the decrease in FVC and $FEV_1$ was significantly correlated with intraoperative changing of Paw in abdominoplasty(p<0.001). FVC and $FEV_1$ could be decreased by abdominoplasty due to decreasing intra-abdominal volume and diaphragmatic excursion, but there was no respiratory symptom clinically in all patients 2 months after the operation. In conclusion, We found that the decrease in FVC and FEV1 after 2 months of abdominoplasty was significantly correlated with intraoperative Paw change during operation. The intraoperative Paw was increased to $12cmH_2O$ without any respiratory symptom in this study. We suggested that the increase in intraoperative Paw less than about $10cmH_2O$ can not affect on respiratory function clinically.

• 대한임상독성학회지
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• 제13권1호
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• pp.36-39
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• 2015

Copper sulfate is a copper compound used widely in the chemical and agriculture industries. Most intoxication occurs in developing countries of Southeast Asia particularly India, but rarely occurs in Western countries. The early symptoms of intoxication are nausea, vomiting, diarrhea, and abdominal cramps, and the most distinguishable clue is bluish vomiting. The clinical signs of copper sulfate intoxication can vary according to the amount ingested. A 75-year old man came to our emergency room because he had taken approximately 250 ml copper sulfate per oral. His Glasgow Coma Scale (GCS) score was 14 and vital signs were blood pressure 173/111 mmHg, pulse rate 24 bpm, respiration rate 24 bpm, and body temperature $36.1^{\circ}$ .... Arterial blood gas analysis (ABGa) showed mild hypoxemia and just improved after 2 L/min oxygen supply via nasal cannula. Other laboratory tests and chest CT scan showed no clinical significance. Three hours later, the patient's mental status showed sudden deterioration (GCS 11), and ABGa showed hypercarbia. He was arrested and his spontaneous circulation returned after 8 minutes CPR. However, 22 minutes later, he was arrested again and returned after 3 minutes CPR. The family did not want additional resuscitation, so that he died 5 hours after ED visit. In my knowledge, early deaths are the consequence of shock, while late mortality is related to renal and hepatic failure. However, as this case shows, consideration of early definite airway preservation is reasonable in a case of supposed copper sulfate intoxication, because the patients can show rapid deterioration even when serious clinical manifestation are not presented initially.