• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.156-165
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• 2002

Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.37 no.4
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• pp.42-48
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• 2000

Generally an operator would take notice at putting a patient under anesthesia. If the operation is executed in mistake, the patient is exposed to danger. The object of this Paper is that a system is developed for an accuracy of system and a convenience of user interface to prevent an operation of several elements of risk by mistake. The part of electrical system particularly is made for convenience of a manipulation using electrical switch and encoder. A real-time monitoring system is developed for an airway pressure and a gas concentration of carbon dioxide of patient using graphic LCD(liquid crystal display). Moreover, this flow control system could be developed control with accuracy by feedback control method. This is implemented using flow control valve and flow sensor. The implemented system gives convenience and precision of a manipulation of variable value using developed technique. This system shows guaranteed stabilization and confidence of anesthesia ventilator by notifying us that patient's state and information in case of being out of alarm range of variable value.

• Journal of Biomedical Engineering Research
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• v.23 no.6
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• pp.485-489
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• 2002

In this study. respiratory efforts were monitored by the change of pulse transit time (PTT) which is related with the arterial pressure PTT is the time interval between the peak of R wave in ECG and the maximal slope point of photoplethysmogram(PPG). Biosignals, ECG and finger photoplethysmogram(PPG), were converted to digital data, and PTT was evaluated in personal computer with every heart beat. Results were presented as a graph using spline interpolation. The software was implemented in C$\^$++/ as a window-based application program. PTT was periodically changed according to airflow in resting respiration. In the resting respiration, PTT was changed according to the respiratory cycle. The amplitude of PTT fluctuation was increased by deep respiration, and increased by partial airway obstruction. These results suggest that PTT is responsible to respiratory effort which could be evaluated by the pattern of PTT change. And it is expected that PTT could be applied in the monitoring of respiratory effort by noninvasive methods, and is very useful method for the evaluation of respiratory distress.

• Journal of Korean Biological Nursing Science
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• v.15 no.4
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• pp.210-218
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• 2013

Purpose: The purpose of this study was to identify the characteristics and nursing activities of severe trauma patients regarding damaged body parts in Busan Regional Emergency Medical Center. Methods: A survey using a 'trauma patient information questionnaire and a list of nurse activities' was conducted with 133 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. The collected data were analyzed by the SPSS/WIN 12.0 program. Results: Almost all of the subjects were men, and the mean age was 48.8. The amount of road traffic accidents was 60.4%, and the mean RTS and ISS were 6.08, and 23.14 points. Nursing activities in common were airway management, assessment of LOC & GCS, and EKG monitoring. Most of head and neck trauma patients were cared for manasing using intracranial pressure: each patience had the following assessed: pupil size and light reflex, they were checked the leak of CSF, kept $30^{\circ}$ head elevation, and administered medications. Some of chest trauma patients were treated for chest tube and central venous catheter insertion. Partial abdominal trauma patients were administered analgesic and cared for using arterial pressure measurement. Part of the limbs and pelvis trauma patients were given a blood transfusion. Conclusion: Based on the results, the characteristics and nursing activities were specific according to the specific damaged body parts.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.18-26
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• 1997

There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1039-1046
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• 1998

Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.