• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• The Korean Journal of Physiology and Pharmacology
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• v.15 no.6
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• pp.397-403
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• 2011

The proliferation, migration, cytokine release, and contraction of airway smooth muscle cells are key events in the airway remodeling process that occur in lung disease such as asthma, chronic obstruction pulmonary disease, and cancer. These events can be modulated by a number of factors, including cigarette smoke extract (CSE). CSE-induced alterations in the viability, migration, and contractile abilities of normal human airway cells remain unclear. This study investigated the effect of CSE on cell viability, migration, tumor necrosis factor (TNF)-${\alpha}$ secretion, and contraction in normal human bronchial smooth muscle cells (HBSMCs). Treatment of HBSMCs with 10% CSE induced cell death, and the death was accompanied by the generation of reactive oxygen species (ROS). CSE-induced cell death was reduced by N-acetyl-l-cysteine (NAC), an ROS scavenger. In addition, CSE reduced the migration ability of HBSMCs by 75%. The combination of NAC with CSE blocked the CSE-induced reduction of cell migration. However, CSE had no effect on TNF-${\alpha}$ secretion and NF-${\kappa}B$ activation. CSE induced an increase in intracellular $Ca^{2+}$ concentration in 64% of HBSMCs. CSE reduced the contractile ability of HBSMCs, and the ability was enhanced by NAC treatment. These results demonstrate that CSE treatment induces cell death and reduces migration and contraction by increasing ROS generation in normal HBSMCs. These results suggest that CSE may induce airway change through cell death and reduction in migration and contraction of normal HBSMCs.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.85-93
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• 2018

The purpose of the study was to investigate the prevalence and risk factors of chronic obstructive pulmonary disease(COPD) among nonsmokers from the 6th Korea National Health and Nutrition Examination Survey(2013-2015). We used complex sample cross analysis and logistic regression analysis on 4, 911 non-smokers among the patients with chronic obstructive pulmonary disease over 40 years of age. In general characteristics, the prevalence of COPD is higher in the old(p<.001), men(p<.001), rural(p=.044), without spouses(p<.001), less educated(p<.001), agriculture(p<.001). Also, the non-smoker's COPD risk factor is age(p<.001), gender(p<.001), education(p=.022), occupation(p=.022), pulmonary tuberculosis(p<.001), asthma(p<.001). It is necessary to develop a respiratory rehabilitation and intervention program that can be applied in clinical practice based on nursing assessment considering the COPD prevalence and risk factors.

• Journal of the Korea Convergence Society
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• v.10 no.12
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• pp.169-175
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• 2019

The purpose of this study was to determine whether changes of multiple lying position might effect the convergence pulmonary function of the 20s men of mild intellectual disabilities. Twenty subjects of mild intellectual disabilities were participated in the experiment. Subjects were assessed for vital capacity by using Fit mate according to the multiple lying position changes(supine position, right sidelying position, left sidelying position, prone position). One-way repeated ANOVA analyzed each region data of vital capacity of subjects according to their multiple lying position. The result of the experiment showed that the 20s men of mild intellectual disabilities have more higher vital capacity to right sidelying position than another lying position. This study suggests that the pulmonary functional data of 20s men of mild intellectual disabilities in this experiment can be used as a basic respiratory one for the bed exercise programs in the area of the physical activities.

• Clinical and Experimental Pediatrics
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• v.59 no.6
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• pp.271-275
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• 2016

Purpose: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-$Barr{\acute{e}}$ syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. Methods: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. Results: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). Conclusion: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.

• The Journal of Pediatrics of Korean Medicine
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• v.25 no.2
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• pp.55-72
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• 2011

Objectives: The purpose of this study is to investigate clinical features of children and adolescents patients admitted to the oriental medical hospital. Methods: The study composed of 1284 inpatients aging from 0 to 19 who had been admitted in 4 oriental medical hospitals located in Daejeon and Chungcheong. Results: 1. In this study, 688 boys and 715 girls were examined, giving the ratio of 0.96:1. Average age of the children and adolescents was 11.5, and the number of inpatients has increased as getting older. 2. The percentage of children and adolescents inpatients has increased every year : 9.1% in 2005, 13.0% in 2006, 13.8% in 2007, 16.3% in 2008, 18.0% in 2009, with 22.2% in 2010, 7.8% until May 2011. The month scored the highest admittance was December and the lowest was March. 3. In systemic division, the musculoskeletal system was the most common, followed by neuromuscular system, respiratory system, digestive system, psychological system, and nervous system. 4. Most patients have admitted in acupuncture & moxibustion department, followed by oriental pediatrics, oriental rehabilitation medicine. 5. In Pediatrics, 196 boys and 166 girls were admitted. The age distribution showed that 6.4% were in infancy, 43.6% in preschool period, 30.1% in prepuberal period, 18.8% in early puberty and 1.1% in late puberty. The percentage of pediatrics inpatients has increased every year. Conclusions: More data of patients should be collated for further study. More detailed study with different kinds of diseases are expected based on this study.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.53-61
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• 2020

Purpose : We investigated the correlation between body composition and lung function in healthy adults. Methods : This study included 204 healthy adults in whom all measurements were obtained once, and all data were analyzed using the SPSS software for Windows, version 22.0. Pearson's correlation analysis was performed to determine the correlation between body composition (represented by the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, skeletal muscle mass, and body fat percentage) and lung function (represented by the forced vital capacity [FVC], forced expiratory volume in 1 second [FEV₁], the FEV₁/FVC ratio, maximum voluntary ventilation [MVV], maximum expiratory pressure [MEP], and the maximum inspiratory pressure [MIP]). All measurements were obtained by two investigators to improve reliability. A significance level of α=.05 was used to verify statistical significance. Results : Among the lung function measurements obtained in both men and women, the FVC, FEV₁, MVV, and MIP were positively correlated with the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, and skeletal muscle mass in men (p<.05). The FEV₁/FVC ratio was negatively correlated with the total body water, soft lean mass, mineral mass, basal metabolic rate, fat-free mass and the body fat percentage (p<.05). Notably, the FVC, FEV₁, and MVV were positively correlated with the total body water, protein mass, soft lean mass, mineral mass, basal metabolic rate, fat-free mass, and skeletal muscle mass in women (p<.05). Conclusion : This study showed a significant correlation between body composition and lung function in healthy adults. In combination with future studies on lung function, our results can provide objective evidence regarding the importance of prevention of lung disease, and our data can be utilized in rehabilitation programs for patients with respiratory diseases.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.181-186
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• 2018

Purpose: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). Methods: Forty seven patients with CHF (males 33, females 14, age $61.3{\pm}9.8years$) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. Results: The NHE group significantly showed lower peak $VO_2$ and a higher $VE/VCO_2$ slope than the MIHE (p<0.05) and HIHE (p<0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. Conclusion: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.

• Journal of Home Health Care Nursing
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• v.24 no.2
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• pp.121-132
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• 2017

Purpose: This study aimed to investigate the hospital nurses' knowledge, emergency coping ability and educational need about nursing care for patients applied the home mechanical ventilator (PaHMV) and to compare the variables between yes or not experienced on that. Methods: Participants were 91 hospital nurses who worked at the wards where PaHMV can be highly admitted such as respiratory internal medicine, rehabilitation medicine, neurology and emergency room. Data were collected by questionnaires. The analytic methods were $n(%)/M{\pm}SD$, t-test/ANOVA and $X^2-test/ANCOVA$. Results: Knowledge and emergency coping ability were low as $2.27{\pm}0.52$(4 points) and $78.72{\pm}8.06$(100 points) respectively. But educational need was high as $3.10{\pm}0.34$(4 points). Knowledge and emergency coping ability showed the significant differences between two groups (p<.001, p=.048), and the scores of experienced nurses were higher. But the educational need didn't show the significant difference (p=.974). Conclusion: These findings indicate that education on nursing care of PaHMV is needed for hospital nurse. So we have to develop the educational program on nursing care of PaHMV and then operate it with practice and site education.