• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.124-131
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• 2003

The concentration of nitrous oxide in dental environment has increased especially in pediatric department. In pediatric department frequently met the behavior disordered patients who need the deep sedation. As the deeply sedated patients could not respond well to verbal command, the amount of mouth breathing would be increased especially with mouth prop which backward transposition of mandible. Inhalation of low concentration of nitrous oxide for a long duration has caused various side effects such as spontaneous abortion and inhibition of methionine synthetase activity which is harmful to DNA synthesis. For evaluation of factors of mouth breathing during deep sedation. The author measured the concentration of nitrous oxide in breathing zone by the change of the scavenging methods. One is drain the gas through the tail part of reservoir bag of Jackson Ree's system naturally. Another is scavenge from tail portion of reservoir bag with negative pressure. Last one is scavenge from nasal mask with negative pressure. The nitrous oxide concentration in breathing zone was the lowest in nasal part drainage but high above the recommended concentration of NIOSH. The order of nitrous concentration in breathing zone was: natural drainage, tail part with negative pressure, nasal part with negative pressure. This would reflect the order of resistance of nasal airway and showed the amount of mouth breathing. From the above experiment, the resistance of nasal airway by the increment of gas flow in corrugating tube and reservoir bag would be one of the causative factors of mouth breathing in deeply sedated patients.

• International journal of advanced smart convergence
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• v.12 no.3
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• pp.89-103
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• 2023

Obstructive sleep apnea (OSA) is one of the most prevalent sleep disorders that can lead to serious consequences, including hypertension and/or cardiovascular diseases, if not treated promptly. Continuous positive airway pressure (CPAP) is widely recognized as the most effective treatment for OSA, which needs the proper titration of airway pressure to achieve the most effective treatment results. However, the process of CPAP titration can be time-consuming and cumbersome. There is a growing importance in predicting personalized CPAP pressure before CPAP treatment. The primary objective of this study was to optimize the CPAP titration process for obstructive sleep apnea patients through EEG feature engineering with machine learning techniques. We aimed to identify and utilize the most critical EEG features to forecast key OSA predictive indicators, ultimately facilitating more precise and personalized CPAP treatment strategies. Here, we analyzed 126 OSA patients' PSG datasets before and after the CPAP treatment. We extracted 29 EEG features to predict the features that have high importance on the OSA prediction index which are AHI and SpO2 by applying the Shapley Additive exPlanation (SHAP) method. Through extracted EEG features, we confirmed the six EEG features that had high importance in predicting AHI and SpO2 using XGBoost, Support Vector Machine regression, and Random Forest Regression. By utilizing the predictive capabilities of EEG-derived features for AHI and SpO2, we can better understand and evaluate the condition of patients undergoing CPAP treatment. The ability to predict these key indicators accurately provides more immediate insight into the patient's sleep quality and potential disturbances. This not only ensures the efficiency of the diagnostic process but also provides more tailored and effective treatment approach. Consequently, the integration of EEG analysis into the sleep study protocol has the potential to revolutionize sleep diagnostics, offering a time-saving, and ultimately more effective evaluation for patients with sleep-related disorders.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.295-298
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• 2005

We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.118-123
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• 2017

Central sleep apnea (CSA) is a highly prevalent comorbidity in patients with heart failure and may present in 25 to 40 percent of heart failure patients. Continuous positive airway pressure (CPAP) is the primary therapeutic option and effective in treatment of obstructive sleep apnea (OSA). In heart failure patients with CSA, several trials of CPAP showed a number of positive effects in heart failure treatment. A 58-year-old male visited the hospital because of dyspnea and he was diagnosed as heart failure with ischemic heart disease. He underwent coronary angiography and received percutaneous coronary intervention due to stenosis at the middle of left anterior descending coronary artery. However, dyspnea was not completely improved after treatment with percutaneous coronary intervention. The patient also experienced snoring and sleep apnea which worsened with symptom of dyspnea in the recent year. We suspected CSA and the patient underwent polysomnography to confirm whether sleep apnea was present. During the polysomnography, CSA with Cheyne-Stokes respiration (CSR) was observed and apnea-hypopnea index was 45.9/hr. The patient was treated with CPAP. After CPAP treatment, hypoxemia and CSA were resolved and dyspnea was improved with reducing NYHA class. We report a case successfully treated with clinical improvement by presuming CSA in a patient with heart failure.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.457-464
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• 1998

This report describes a 5-month follow-up of the efficacy of Herbst oral appliance(OA) in a obstructive sleep apnea syndrome patient who has failed with uvulopalatopharyngoplasty(UPPP) and was unable to tolerate to subsequent nasal continuous positive airway pressure(CPAP) because of mouth air leak. The obstructive sleep apnea and daytime performance were markedly improved by regular home use of OA, and the patient still continues to use OA without complications. It is suggested that OA can be a successful alternative therapeutic modality in patients who are unable to tolerate to nasal CP AP, especially after UPPP.

• Journal of Chest Surgery
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• v.24 no.8
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• pp.797-801
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• 1991

Reexpansion pulmonary edema following pneumothorax, atelectasis, massive pleural effusion are clinically uncommon, but sometimes life threatening progression. Reexpansion pulmonary edema is usually ipsilateral but rarely contralateral or both. Reexpansion pulmonary edema was occurred when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. The pathogenesis of the reexpansion pulmonary edema is unknown but is probably mutifactorial. The etiological factors of the reexpansion pulmonary edema are chronicity of the lung collapse, technique of the reexpansion, airway obstruction, loss of the surfactant, and pulmonary artery pressure changes. In the treatment of the chronically collapsed lung, physician must be remembered the possible events, and to prevent of the complication.

• Journal of Biomedical Engineering Research
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• v.37 no.4
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• pp.127-133
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• 2016

This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.

• Journal of Biomedical Engineering Research
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• v.22 no.6
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• pp.479-486
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• 2001

Spirometer is a medical equipment which diagnoses respiratory function by measuring 9as volume across Patient's lunes through airway. Because a little overdose of anesthesia medicine can take away Patient's life in the ventilator for a surgical operation. an exact measurement of respiring volume is very important. This Paper Presented an exact flow volume calculation method from factors having an influence on measurement and introduced a spirometry system for an anesthesia ventilato. This system, using differential Pressure sensor measured flow by mutual relation with Pressure. temperature. gas density and linearization from the 2nd order characteristics of differential pressure with flow.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.122-136
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• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.190-197
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• 2018

Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.