• 제목/요약/키워드: Respiratory Assessment

검색결과 394건 처리시간 0.027초

흉부의 자기공명영상 (Magnetic Resonance Imaging in Thorax)

  • 최병욱
    • Tuberculosis and Respiratory Diseases
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    • 제56권6호
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    • pp.571-584
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    • 2004
  • Magnetic Resonance Imaging (MRI) is one of the most advanced imaging techniques in clinical and research medicine. However, clinical application of MRI to the lung or thorax has been limited due to various drawbacks. Low signal intensity of the lung and cardiac and respiratory movements are the most serious problems with MRI in thorax. Nevertheless, MRI is superior to CT in some selected patients with thoracic diseases. The role of clinical MRI in thoracic disease has been widened with improvement of MR equipments and development of new pulse sequences. Otherwise, functional assessment of lung by MRI has been studied for the last decade. These include perfusion MRI with or without contrast enhancement and ventilation MRI with oxygen-enhancement or hyperpolarized noble gas, $^3He$ and $^{129}Xe$.

훈증요법을 병행한 기침환자 28명에 대한 임상적 평가 (Clinical Assessment of 28 Patients with Cough Treated with Herbal Steam Therapy)

  • 김관일;이희범;박의근;최연정;김동현;정희재;정승기
    • 동의생리병리학회지
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    • 제27권5호
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    • pp.660-666
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    • 2013
  • The purpose of this study was to investigate the clinical effects of herbal steam therapy on cough. Twenty-eight patients with cough who had treated with herbal steam therapy(chungsang, chungpae) between 3rd of January and 30th of April, 2013 were analyzed. The effects were evaluated the severity and frequency of cough as the modified questionnaire, severity of discomfort using visual analogue scale(VAS), and the patients' subjective satisfaction. Eighteen patients who had been treated herbal steam therapy over 3 times were analyzed improvements before and after therapy. Chungsang and Chungpae steam therapies significantly decreased the severity and frequency of cough. VAS scores also decreased from $7.78{\pm}0.878$ to $4.39{\pm}2.033$. Patients were satisfied with herbal steam therapy. Chungsang and Chungpae steam therapies seem to be effective in the treatment of cough. Further studies with a large number of cases will be needed in the future.

Effects of Farinelli Breating Exercise on Respiratory Function and Symptoms in Patients with Chronic Obstructive Pulmonary Disease

  • Ittinirundorn, Supawit;Wongsaita, Naiyana;Somboonviboon, Dujrath;Tongtako, Wannaporn
    • Tuberculosis and Respiratory Diseases
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    • 제85권2호
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    • pp.137-146
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    • 2022
  • Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO2max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO2max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

화학사고물질 노출에 따른 피해지역 주민 건강위해성평가: 폼알데하이드 사례를 중심으로 (Health Risk Assessment for Residents after Exposure to Chemical Accidents: Formaldehyde)

  • 박시현;조용성;임희빈;박지훈;이철민;황승율;이청수
    • 한국환경보건학회지
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    • 제47권2호
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    • pp.155-165
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    • 2021
  • Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.

Humidifier Disinfectant-Associated Lung Injury: Six Years after the Tragic Event

  • Kim, Won-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • 제80권4호
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    • pp.351-357
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    • 2017
  • In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

대기환경부문 건강위해평가의 국내 연구 동향과 발전방향 (The Domestic Research Trend and the Road Map of Health Risk Assessment of the Air Quality in Korea)

  • 신동천
    • 한국대기환경학회지
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    • 제29권5호
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    • pp.528-535
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    • 2013
  • Air pollution in large cities is reduced through the environmental health policies, but due to increased population and automobile, some pollutants are still a problem. These air pollutants are known to cause asthma and respiratory diseases. According to an OECD report, the number of premature deaths will increase. Hazardous air pollutants should be managed through a systematic monitoring, risk assessment, and many studies are in progress. In order to manage hazardous air pollutants, transformation of policy for the protection of human health is required. management policy through the calculation of the excess number of deaths that occur from hazardous air pollutants for the public health is necessary. Korea has put a lot of efforts for air quality, but health risk assessment should be more considered.

Quality of Same-Day Sputum Smears Microscopy and Presumptive Tuberculosis Patients Drop-out at Health Facilities of Addis Ababa, Ethiopia

  • Taddese, Boja Dufera;Misganaw, Abay Sisay
    • Tuberculosis and Respiratory Diseases
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    • 제83권1호
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    • pp.89-95
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    • 2020
  • Background: Same-day sputum microcopy is recommended in areas where sputum smear microscopy external quality assessment (EQA) is effectively implemented and sturdy. In Addis Ababa, the status of EQA and drop-out of same-day sputum smear microcopy has not yet been assessed. The objective of this study was to assess the quality of same-day sputum smear microscopy and diagnostic drop-out of presumptive tuberculosis (TB) patients in health facilities (HFs) across Addis Ababa, Ethiopia. Methods: Amulti-analysis was conducted from September 2016 to July 2017 to determine the status of external quality assessment and diagnostic drop-out of presumptive TB patients registered for same-day sputum smear microscopy. Data was coded and entered in Microsoft Excel, and subsequently transferred and analyzed using SPSS version 20.0. Results: The drop-out of same-day sputum smear microscopy was 209 (6.2%). More than 33% of the specimens collected for purposes of same-day sputum smears were of poor quality. Among the selected HFs for the study: 13 (46.4%) used filter reagents prior to sputum smear staining while 75% of the selected HFs for the study used smear microscopy services interruption in a year. The sensitivity and specificity of the HFs participating in regional quality assessment scheme for the diagnosis of TB was 97.4% and 99.6%, respectively. Conclusion: The diagnostic drop-out of same-day sputum smear microscopy was high in Addis Ababa. Strengthening EQA, competency-based laboratory professionals training on sputum smear microscopy might reduce the reading errors in sputum smear. Awareness creation of the community on the benefits gained from completion of specimen provision for the same-day approach decreases diagnostic drop-out and enhances TB control program.

메탄올 작업장 노출 평가에의 EU REACH 프로토콜 적용: Targeted Risk Assessment (The Application of an EU REACH Protocol to the Occupational Exposure Assessment of Methanol: Targeted Risk Assessment)

  • 나진성;송문환;최은경
    • 한국환경보건학회지
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    • 제47권5호
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    • pp.432-445
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    • 2021
  • Background: The European Centre for Ecotoxicology and Toxicology of Chemicals' Targeted Risk Assessment (ECETOC TRA) tool has been recognized by EU REACH as a preferred approach for calculating worker health risks from chemicals. Objectives: The applicability of the ECETOC TRA to occupational exposure estimation from industrial uses of methanol was studied by inputting surveyed and varied parameters for TRA estimation as well as through comparison with measured data. Methods: Information on uses of methanol was collected from seven working environment monitoring reports along with the measured exposure data. Input parameters for TRA estimation such as operating conditions (OCs), risk management measures (RMMs) and process categories (PROCs) were surveyed. To compare with measured exposures, parameters from the surveyed conditions of ventilation but no use of respiratory protection were applied. Results: PROCs 4, 5, 8a, 10, and 15 were assigned to ten uses of methanol. The uses include as a solvent for manufacturing sun cream, surfactants, dyestuffs, films and adhesives. Methanol was also used as a component in a release agent, hardening media and mold wash for cast products as well as a component of hard-coating solution and a viscosity-controlling agent for manufacturing glass lenses. PROC 8a and PROC 10 of a cast product manufacturer without LEV (local exhaust ventilation) and general ventilation as well as no respiratory protection resulted in the highest exposure to methanol. Assuming the identical worst OCs and RMMs for all uses, exposures from PROC 5, 8a, and 10 were the same and the highest followed by PROC 4 and 15. The estimation resulted in higher exposures in nine uses except one use where measured exposure approximated exposures without RMMs. Conclusions: The role of ECETOC TRA as a conservative exposure assessment tool was confirmed by comparison with measured data. Moreover, it can guide which RMMs should be applied for the safe use of methanol.

일차성 다한증 환자 26명의 한의학적 치료 후 삶의 질 변화에 대한 임상적 평가 (Assessment of Quality of Life in 26 Patients with Primary Hyperhidrosis before and after Oriental Medicine Treatment)

  • 이성헌;노영래;황준호;정승연;정승기;정희재
    • 대한한방내과학회지
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    • 제28권3호
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    • pp.597-607
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    • 2007
  • Backgrounds and Objectives: Primary hyperhidrosis deeply affect a patient's quality of life, resulting in impairments of daily activities, social interactions and occupational activities. The objectives of the study were to assess quality of life(QOL) in patients with primary hyperhidrosis before and after treatment with oriental medicine. Methods : Between December 2006 and July 2007, 26 patients underwent oriental medicine treatment. which consisted of herb medicine. acupuncture and iontophosis (if palmar/plantar hyperhidrosis) treatment. QOL questionnaires comprised of dermatology life quality index (DLQI) and visual analogue scale (VAS) were employed before and after treatment Results : All 26 patients were evaluated. The treatment controlled primary hyperhidrosis in 84.6% of cases. The mean of DLQI score before treatment was 16.65 after treatment mean DLQI score was 8.18. The mean of VAS before treatment was 91.35 after treatment mean VAS was 49.92. QOL in patients with primary hyperhidrosis significantly improved after oriental medicine treatment. The improvements in QOL were similar in patientswith palmar/plantar, head, and systemic hyperhidrosis. Conclusions : Oriental medicine treatment leads to significantly improved QOL in patients with primary hyperhidrosis. Further studies are needed to evaluate the objective efficacy in patients with primary hyperhidrosis before and after oriental medicine treatment.

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Sputum Inflammometry to Manage Chronic Obstructive Pulmonary Disease Exacerbations: Beyond Guidelines

  • Venegas, Carmen;Zhao, Nan;Ho, Terence;Nair, Parameswaran
    • Tuberculosis and Respiratory Diseases
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    • 제83권3호
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    • pp.175-184
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    • 2020
  • Quantitative sputum cytometry facilitates in assessing the nature of bronchitis associated with exacerbations of chronic obstructive pulmonary disease (COPD). This is not assessed in most clinical trials that evaluate the effectiveness of strategies to prevent or to treat exacerbations. While up to a quarter of exacerbations may be associated with raised eosinophil numbers, the vast majority of exacerbations are associated with neutrophilic bronchitis that may indicate airway infections. While eosinophilia may be a predictor of response to corticosteroids (oral and inhaled), the limited efficacy of anti-interleukin 5 therapies would suggest that eosinophils may not directly contribute to those exacerbations. However, they may contribute to airspace enlargement in patients with COPD through various mechanisms involving the interleukin 13 and matrix metalloprotease pathways. The absence of eosinophils may facilitate in limiting the unnecessary use of corticosteroids. The presence of neutrophiia could prompt an investigation for the specific pathogens in the airway. Additionally, sputum measurements may also provide insight into the mechanisms of susceptibility to airway infections. Iron within sputum macrophages, identified by hemosiderin staining (and by more direct quantification) may impair macrophage functions while the low levels of immunoglobulins in sputum may also contribute to airway infections. The assessment of sputum at the time of exacerbations thus would facilitate in customizing treatment and treat current exacerbations and reduce future risk of exacerbations.