• 수면정신생리
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• 제6권1호
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• pp.19-25
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• 1999

Sleep alters both breathing pattern and the ventilatory responses to external stimuli. These changes during sleep permit the development or aggravation of sleep-related hypoxemia in patients with respiratory disease and contribute to the pathogenesis of apneas in patients with the sleep apnea syndrome. Fundamental effects of sleep on the ventilatory control system are 1) removal of wakefulness input to the upper airway leading to the increase in upper airway resistance, 2) loss of wakefulness drive to the respiratory pump, 3) compromise of protective respiratory reflexes, and 4) additional sleep-induced compromise of ventilatory control initiated by reduced functional residual capacity on supine position assumed in sleep, decreased $CO_2$ production during sleep, and increased cerebral blood flow in especially rapid eye movement(REM) sleep. These effects resulted in periodic breathing during unsteady non-rapid eye movement(NREM) sleep even in normal subjects, regular but low ventilation during steady NREM sleep, and irregular breathing during REM sleep. Sleep-induced breathing instabilities are divided due primarily to transient increase in upper airway resistance and those that involve overshoots and undershoots in neural feedback mechanisms regulating the timing and/or amplitude of respiratory output. Following ventilatory overshoots, breathing stability will be maintained if excitatory short-term potentiation is the prevailing influence. On the other hand, apnea and hypopnea will occur if inhibitory mechanisms dominate following the ventilatory overshoot. These inhibitory mechanisms include 1) hypocapnia, 2) inhibitory effect from lung stretch, 3) baroreceptor stimulation, 4) upper airway mechanoreceptor reflexes, 5) central depression by hypoxia, and 6) central system inertia. While the respiratory control system functions well during wakefulness, the control of breathing is commonly disrupted during sleep. These changes in respiratory control resulting in breathing instability during sleep are related with the pathophysiologic mechanisms of obstructive and/or central apnea, and have the therapeutic implications for nocturnal hypoventilation in patients with chronic obstructive pulmonary disease or alveolar hypoventilation syndrome.

• 대한소아치과학회지
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• 제45권4호
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• pp.508-513
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• 2018

세보플루란에 의한 일회 환기량은 낮은 용량에서는 호흡수의 증가로 안정적이다. 그러나 진정 깊이가 증가하면 폐포 환기는 세보플루란에 의해 감소되어 결과적으로는 $PaCO_2$가 증가한다. 호흡 억제의 발생은 깊이 진정된 장애 환자에서 심한 저산소증과 고탄산혈증의 위험을 증가시킨다. 세보플루란 흡입 마취는 여러 위험성이 내제되어 있으며 체내 산 염기 상태에 따라 혈역학적 변화가 발생하기에 예기치 못한 문제 상황이 발생할 수 있다. 세보플루란으로 장애인의 마취 유도 시 발생하는 호흡 억제로 인한 체내 산 염기 상태가 안정한지 알아보고자 이 연구를 진행하였다. 마취 유도는 4 vol% 세보플루란, 4 L/min 아산화질소, 4 L/min 산소를 자발 호흡 하에서 환자 안면부에 마스크를 거치하여 유도하였다. 그 뒤 환자의 의식소실 및 근육 긴장 완화 후 즉시 전문가에 의해 IV line을 거치한 뒤 정맥 채혈을 하여 정맥 내 혈액가스 분석을 하였다. 깊은 진정 상태에서 전체 환자의 평균 pH는 $7.36{\pm}0.06$으로 측정되었다. $PvCO_2$는 전체 환자에서는 평균 $48.8{\pm}8.50mmHg$로 측정되었다. $HCO_3{^-}$는 전체 환자에서 평균 $27.2{\pm}3.0mmol/L$로 측정되었다. 결론적으로 장애인을 대상으로 한 치과 진료시 세보플루란을 이용한 흡입 진정에 대한 체내 산 염기 반응은 비교적 안정적이었다.

• 대한치과의사협회지
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• 제51권9호
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• pp.511-517
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• 2013

To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

• Tuberculosis and Respiratory Diseases
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• 제77권2호
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• pp.81-84
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• 2014

A patient treated with venlafaxine for major depression developed an interstitial lung disease (ILD) with the characteristic clinical, radiological and pathological features of chronic hypersensitivity pneumonitis. A high resolution computed tomography scan demonstrated ground glass opacity, mosaic perfusion with air-trapping and traction bronchiectasis in both lungs. The pathological findings were consistent with a nonspecific interstitial pneumonia pattern. Clinical and radiological improvements were noted after the discontinuation of venlafaxine and the administration of a corticosteroid. This report provides further evidence that the anti-depressant venlafaxine can cause ILD.

• Journal of Sleep Medicine
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• 제15권2호
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• pp.43-47
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• 2018

Objectives: Obstructive sleep apnea (OSA) is common in people with epilepsy (PWE), and confers medical and seizure-related consequences when untreated. Positive airway pressure, the gold-standard for OSA management, is limited by tolerability. As serotonin is involved respiratory control and amelioration of seizure-induced respiratory events, this study aims to determine whether serotonin reuptake inhibitors (SRIs) may represent a potential therapeutic option. Methods: A retrospective study of 100 PWE and OSA ${\geq}18$ years of age was conducted. The primary outcome measure was OSA severity as function of SRI use, with rapid eye movement (REM)-related OSA as a secondary outcome. Results: Older age and depression were more common in those taking an SRI. There was no association between SRIs and OSA severity. However, the SRI group was less likely to have REM-related OSA. Conclusions: In PWE and OSA, SRI use is associated with reduced risk of REM-related OSA, and may represent a potential management strategy.

• 한국임상수의학회지
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• 제26권1호
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• pp.72-75
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• 2009

Pulmonary bullae are air-filled spaces within the lung parenchyma that result from the destruction, dilatation and confluence of adjacent alveoli. Pulmonary bullae are found most often in healthy, middle aged, large breed or deep-chested dogs that have no previous history of lung disease and bulla may occur as a result of emphysema, inflammation or trauma. Clinical signs include respiratory distress, anorexia, depression and tachypnea. In this study, a dog with respiratory distress by traffic accident was diagnosed as pulmonary bullae with pneumothorax using radiography at Veterinary Medical Teaching Hospital, GNU. In radiographs, various sized, smooth margin, well defined, oval shaped, gas or fluid filled multiple bullae are shown in the left cranial, left caudal and right accessory lobes. At the initial stage of observation, there were indications of four bullae, two of which were not found in the following radiograph. At the same time, there were serious indications of lung consolidation that caused respiratory distress of patient. Ultimately, the patient was expired after ten hours.

• Journal of the Korean Data and Information Science Society
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• 제25권2호
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• pp.373-384
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• 2014

데이터 마이닝이란 대량의 데이터나 복잡한 구조의 데이터들을 정교한 통계분석과 모델링 테크닉을 이용하여 정확히 식별되지 않는 패턴이나 자료간의 상관관계를 밝혀내어 여러 가지 결과를 예측해 내는 통계적 기법이다. 이러한 데이터 마이닝 기법은 금융, 통신, 유통, 의학 등 다양한 분야에 활용되는데, 본 연구에서는 의학 분야에 적용하여 호흡기질환에 영향을 끼치는 요인을 선별하였다. 분석은 2012년도 경상북도 지역사회건강조사에 참여한 사람 중 의사에게서 폐결핵, 천식, 알레르기성 비염을 진단받은 경험이 있는 호흡기질환군과 건강군으로 정리한 자료를 대상으로 하였다. 호흡기질환이 영향을 끼치는 주요인을 선별하기 위해 인공신경망, 로지스틱 회귀모형, 베이지안 네트워크, C5.0, CART 기법을 이용하였다. 공정한 모형 평가를 위해 전체 데이터를 훈련용 데이터와 검증용 데이터로 나누었고, 훈련용 데이터에서 설정된 모형을 검증용 데이터에 적용하여 정확도를 비교하였다. 그 결과 CART가 최적 모형으로 선정되었으며 CART의 의사결정나무를 통하여 우울감 인지 여부, 현재 흡연여부, 스트레스 인지 여부 순으로 호흡기질환에 영향을 주는 것으로 나타났다. 그리고 호흡기질환의 주요인들에 대한 오즈비를 구하여 개별적인 영향력에 대해서도 밝혔다.

• Tuberculosis and Respiratory Diseases
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• 제62권1호
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• pp.11-18
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• 2007

연구배경: 만성폐쇄성폐질환(chronic obstructive pulmonary disease, COPD) 환자군에서 우울증 및 불안장애의 유병률이 높고, 이는 치료경과 및 사망률에도 영향을 주는 것으로 알려져 있다. 저자들은 국내연구가 미비한 COPD환자들의 우울과 불안심리에 대한 평가를 하고자 하였다. 방 법: 2005년 9월부터 2006년 8월까지 이화의료원 호흡기내과에서 외래치료 중인 72명의 COPD환자와 정상 대조군 50명에서 Beck Depression Inventory (BDI)와 State-Trait Anxiety Inventory (STAI)로 설문조사를 시행하였고, 임상기록을 분석하였다. 결 과: 1) 연령과 체질량지수, 혈청 알부민 수치는 환자군과 대조군간의 유의한 차이를 보이지 않았다(p>0.05). 우울심리는 BDI점수가 환자군 16(0-37), 대조군 12(1-30)으로 환자군에서 유의하게 높았고(p=0.001), 21점 이상의 우울집단은 환자군이 36%로 대조군 6%에 비해 많았다(p<0.0001). 환자군에서는 경증군 18%(4/22), 중등증군 30%(6/20), 중증군 52%(13/25), 심한 중증군 60%(3/5)로 중증일수록 빈도가 높았다(p=0.008). 2) 불안심리는 환자군에서 SAI 점수 44(20-67), TAI점수 47(20-66)로 각각 대조군 39(26-65), 44(33-90)보다 유의하게 높았다(p=0.005, p=0.022). 환자군에서 BDI와 STAI점수는 상관관계를 보였고(p<0.001), 우울집단에서 불안점수가 유의하게 높았다. 3) COPD환자군에서 우울집단은 비우울집단보다 체질량지수, 기관지확장제후 $FEV_1$의 예측치가 유의하게 낮았고, 현재 흡연자의 비율과 중증도, STAI점수가 유의하게 높았다(p<0.05). 4) 연령과 성별을 통제한 다변량 로지스틱 회귀분석상 95% 신뢰구간으로 비차비는 체질량지수 0.9(p=0.311), 현재 흡연자 3.2(p=0.051), 중증군이상 3.9로(p=0.027), 중증이상의 중증도가 유일한 우울증 발생의 독립적 위험요인이었다. 결 론: COPD환자군에서 우울증과 불안심리가 흔하게 관찰되며, 체질량지수, 폐기능, 현재 흡연력이 우울관련 요인으로 특히 중증도가 높을수록 우울증과 불안장애의 관리가 필요함을 보여주었다.

• Journal of Chest Surgery
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• 제9권2호
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• pp.143-147
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• 1976

A case of congenital funnel chest which was observed in 6 year old male was reported. The patient represented clinical status of depression of lower sternum, recurrent upper respiratory tract infection, and slight exertional dyspnea. The treatment was carried out by "turnover" method, and it was easy to do viable on sternum, costal cartilage, and intercostal muscles. And it is fit to reimplantation by free autograft when repair was indicated. The plane of the manubrium, an acute hump on the sternum, and asymmetry constitute limiting factors in the cosmetic results.

• The Journal of Korean Physical Therapy
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• 제3권1호
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• pp.59-73
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• 1991

The purpose of this study was to phychosomatic health status of physical therapy college mans. 130college mans analysis sex, habitation, religion, blood type, drinking, somoking by the todai health index questionaire. THI was modified front cornell medical index. Physical therapy college man showed complain score (E) Nervousness. (J) Mental irritability. (H) Impulsiveness. (F) Aggressiveness. (G) Irregular life (I), (L) Multiple subjective symtom(I), Live scale(L), (K) Depression. (C) Digestive, (A), (B) Respiratory(A), Eye and Skin(B). (D) Mouth and Anus.