• Title/Summary/Keyword: respiratory management

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Tuberculosis Management of Private Health Care Institution : Current Situation and Task (민간 의료기관 결핵관리의 오늘과 내일)

  • Park, Ki-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.579-589
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    • 2002
  • Since the inception of the National Tuberculosis Control Program in 1962, the incidence of tuberculosis and its associated mortality has declined dramatically due to effective anti-tuberculosis drugs and a systematic control program. The prevalence of radiographically active tuberculosis has fallen from 5.1% in 1965 to 1.0% in 1995. However, tuberculosis is still a major problem, as the mortality rate is still higher compared to other developed countries. Furthermore, tuberculosis is currently re-emerging in HIV/AIDS epidemic countries. In order to lower the tuberculosis death rate to the levels of developed countries, the tuberculosis control efforts in private healthcare institutions and the national tuberculosis control program in the public sector, need to work together more effectively and efficiently. In this paper, the quthor reviewed the current situation regarding tuberculosis management in private healthcare institutions of Korea based on the literature and the National Health Insurance Claim data, and the future tasks of tuberculosis management are suggested.

Characteristics of Prescription Drugs for Acute Upper Respiratory Tract Infection in Outpatient Clinics - Centered on Family Medicine, Internal Medicine, Pediatrics, Otorhinolaryngology and General Practitioner Clinics - (1차 의료기관의 급성 상기도 감염 질환자 의약품 처방특성 - 가정의학과, 내과, 소아청소년과, 이비인후과, 일반의 중심으로 -)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.11 no.3
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    • pp.37-49
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    • 2017
  • Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

Adjuvant Treatment of Proper Endobronchial Management in Leiomyosarcoma

  • Kim, Soo Jung;Kim, Junghyun;Park, Ju-Hee;Lee, Ae-Ra;Lee, Jung-Kyu;Kim, Tae Min;Park, Young Sik
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.6
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    • pp.250-255
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    • 2013
  • Endobronchial metastasis of leiomyosarcoma is rare, but it can cause life-threatening complications, such as massive hemoptysis, respiratory failure or even death. The development of new endoscopic modalities allows for effective endobronchial management. We report three patients with endobronchial metastases from advanced leiomyosarcomas which caused bronchial obstruction. The bronchoscopic examinations revealed masses obstructing the left main bronchus in all three patients. After removing the endobronchial tumor via interventional bronchoscopy, there was symptomatic and radiologic improvement. Moreover, the patients were able to undergo additional palliative chemotherapy. Therefore, endobronchial management of endobronchial tumors should be considered in the treatment of endobronchial metastasis, even in patients with advanced malignancies.

Anesthetic Management of an Amyotrophic Lateral Sclerosis Patient Undergoing Dental Care in Daysurgery Center (외래치료실에서의 근위축성 측삭경화증 환자(ALS)의 전신마취 하치과 치료시 마취관리)

  • Kim, Han-Su;Lee, Suk-Yung;Choi, Eun-Hye;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.195-201
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    • 2013
  • Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease caused by the degeneration of upper and lower motor neurons. The disorder causes muscle weakness and atrophy in airway muscles including pharyngeal, laryngeal and other respiratory muscles. The response to muscle realxant is also altered in patients with ALS. Because of the inherent muscle weakness and associated respiratory insufficiency, particular attentions are needed in anesthetic management of ALS patients. We used proper doses of inhalation anesthetics and opioids under EEG-entropy (electroencephalography-entropy)-monitoring without the use of muscle realxants in the anesthetic management of a patient with ALS. The patient early recovered and was discharged on the same day without any respiratory complications.

Respiratory signal analysis of liver cancer patients with respiratory-gated radiation therapy (간암 호흡동조 방사선치료 환자의 호흡신호분석)

  • Kang, dong im;Jung, sang hoon;Kim, chul jong;Park, hee chul;Choi, byung ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.23-30
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    • 2015
  • Purpose : External markers respiratory movement measuring device (RPM; Real-time Position Management, Varian Medical System, USA) Liver Cancer Radiation Therapy Respiratory gated with respiratory signal with irradiation time and the actual research by analyzing the respiratory phase with the breathing motion measurement device respiratory tuning evaluate the accuracy of radiation therapy Materials and Methods : May-September 2014 Novalis Tx. (Varian Medical System, USA) and liver cancer radiotherapy using respiratory gated RPM (Duty Cycle 20%, Gating window 40% ~ 60%) of 16 patients who underwent total when recording the analyzed respiratory movement. After the breathing motion of the external markers recorded on the RPM was reconstructed by breathing through the acts phase analysis, for Beam-on Time and Duty Cycle recorded by using the reconstructed phase breathing breathing with RPM gated the prediction accuracy of the radiation treatment analysis and analyzed the correlation between prediction accuracy and Duty Cycle in accordance with the reproducibility of the respiratory movement. Results : Treatment of 16 patients with respiratory cycle during the actual treatment plan was analyzed with an average difference -0.03 seconds (range -0.50 seconds to 0.09 seconds) could not be confirmed statistically significant difference between the two breathing (p = 0.472). The average respiratory period when treatment is 4.02 sec (${\pm}0.71sec$), the average value of the respiratory cycle of the treatment was characterized by a standard deviation 7.43% (range 2.57 to 19.20%). Duty Cycle is that the actual average 16.05% (range 13.78 to 17.41%), average 56.05 got through the acts of the show and then analyzed% (range 39.23 to 75.10%) is planned in respiratory research phase (40% to 60%) in was confirmed. The investigation on the correlation between the ratio Duty Cycle and planned respiratory phase and the standard deviation of the respiratory cycle was analyzed in each -0.156 (p = 0.282) and -0.385 (p = 0.070). Conclusion : This study is to analyze the acts after the breathing motion of the external markers recorded during the actual treatment was confirmed in a reproducible ratios of actual treatment of breathing motion during treatment, and Duty Cycle, planned respiratory gated window. Minimizing an error of the treatment plan using 4DCT and enhance the respiratory training and respiratory signal monitoring for effective treatment it is determined to be necessary.

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Epidemiological Investigation of Diseases in Dairy Suckling Calves (젖소 신생송아지의 질병발생에 관한 조사연구)

  • 권오덕;김남수;채준석;박명규;김민석;유제춘;이주묵
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.102-108
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    • 2000
  • This study was carried out to investigate the epidemiological prevalence of diseases from birth to weaning in 66 dairy calves which were delivered from three stock farm in Chonbuk area. We examined body weight gain, incidence rate of diseases and population mortality rate in relation to age, season, environmental temperature and rearing management conditions for one year. The results of this experiment were as follows: Birth weight of dairy calves born of primiparae was lower than those of multiparae. But no significant difference in body weight gain was observable between dairy calves born of primiparae and those of multiparae. Body weight gain of diseased calves was lower than normal calves. Of 66 delivered calves, 34 calves(51.5%) were affected with gastronitestinal and/or respiratory diseases. The prevalence of the diseases were gastrointestinal disease(28.7%), respiratory disease(18.2%), and gastronitestinal and respiratory disease(4.6%). The gastronitestinal disease was occurred contrinually regardless of the season. Whereas all of the respiratory disease were occurred in winter and a change of season(December to April). 68.4% of the gastronitestinal disease, and all of the respiratory disease were occurred at atmospheric temperatures below 1$0^{\circ}C$. 89.5% of the gastronitestinal disease were occurred within 3 weeks old, whereas 50% of the respiratory disease were occurred intensively between 3 weeks and 4 weeks old. Of 66 delivered dairy claves, 2 calves were died(3%) with respriratory disease.

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Evaluation of Respiratory Protection Program in Petrochemical Industries: Application of Analytic Hierarchy Process

  • Kolahi, Hadi;Jahangiri, Mehdi;Ghaem, Haleh;Rostamabadi, Akbar;Aghabeigi, Mandana;Farhadi, Payam;Kamalinia, Mojtaba
    • Safety and Health at Work
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    • v.9 no.1
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    • pp.95-100
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    • 2018
  • Background: Respiratory protection equipment (RPE) is the last resort to control exposure to workplace air pollutants. A comprehensive respiratory protection program (RPP) ensures that RPE is selected, used, and cared properly. Therefore, RPP must be well integrated into the occupational health and safety requirements. In this study, we evaluated the implementation of RPP in Iranian petrochemical industries to identify the required solutions to improve the current status of respiratory protection. Methods: This cross-sectional study was conducted among 24 petrochemical industries in Iran. The survey instrument was a checklist extracted from the Occupational Safety and Health Administration respiratory protection standard. An index, Respiratory Protection Program Index (RPPI), was developed and weighted by analytic hierarchy process to determine the compliance rate (CR) of provided respiratory protection measures with the RPP standard. Data analysis was performed using Excel 2010. Results: The most important element of RPP, according to experts, was respiratory hazard evaluation. The average value of RPPI in the petrochemical plants was $49{\pm}15%$. The highest and lowest of CR among RPP elements were RPE selection and medical evaluation, respectively. Conclusion: None of studied petrochemical industries implemented RPP completely. This can lead to employees' overexposure to hazardous workplace air contaminants. Increasing awareness of employees and employers through training is suggested by this study to improve such conditions.

Effectiveness of the Respiratory Gating System for Stereotectic Radiosurgery of Lung Cancer (Lung Cancer의 Stereotactic Radiosurgery시 Respiratory Gating system의 유용성에 대한 연구)

  • Song Heung Kwon;Kim Min Su;Yang Oh Nam;Park Cheol Su;Kwon Kyung Tae;Kim Jeong Man
    • 대한방사선치료학회:학술대회논문집
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    • 2005.06a
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    • pp.13-17
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    • 2005
  • Introduction : For stereotactic radiosurgery (SRS) of a tumor in the region whose movement due to respiration is significant, like Lung lower lobe, the gated therapy, which delivers radiation dose to the selected respiratory phases when tumor motion is small, was peformed using the Respiratory gating system and its clinical effectiveness was evaluated. Methode and Materials : For two SRS patients with a tumor in Lung lower lobe, a marker block (infrared reflector) was attached on the abdomen. While patient' respiratory cycle was monitored with Real-time Position Management (RPM, Varian, USA), 4D CT was performed (10 phases per a cycle). Phases in which tumor motion did not change rapidly were decided as treatment phases. The treatment volume was contoured on the CT images for selected treatment phases using maximum intensity projection (MIP) method. In order to verify setup reproducibility and positional variation, 4D CT was repeated. Result : Gross tumor volume (GTV) showed maximum movement in superior-inferior direction. For patient $\#$1, motion of GTV was reduced to 2.6 mm in treatment phases ($30\%\~60\%$), while that was 9.4 mm in full phases ($0\%\~90\%$) and for patient $\#$2, it was reduced to 2.3 mm in treatment phases ($30\%\~70\%$), while it was 11.7 mm in full phases ($0\%\~90\%$). When comparing two sets of CT images, setup errors in all the directions were within 3 mm. Conclusion : Since tumor motion was reduced less than 5 mm, the Respiratory gating system for SRS of Lung lower lobe is useful.

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Research for the Development of an Integrated Medical System for Idiopathic Pulmonary Fibrosis: Based on an Analysis of Questionnaire Survey in Doctor and Patient Groups (특발성 폐섬유증의 통합의료 협진 모델 개발을 위한 의료진 및 환자 대상 설문조사 연구)

  • Jiwon Park;Beom-Joon Lee;Jeong-Won Shin;Su-Hyun Chin;Jung-Min Yang;Sooduk Kim;Kwan-Il Kim;Hye Sook Choi;Hee-Jae Jung
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.366-386
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    • 2023
  • Objective: In this study, a questionnaire survey was conducted for doctors and patients to obtain basic data necessary for the development of an integrated medical system for idiopathic pulmonary fibrosis (IPF). Methods: Questionnaires were developed separately for doctors and patients through an expert group meeting. The survey subjects were recruited online and offline, and finally, responses from 231 doctors and 59 patients were used for statistical analysis. Results: The most important parts in the treatment of IPF for both doctors and patients were the "improvement of respiratory symptoms," "improvement of quality of life," and "prevention of disease progression." Antifibrotic agents were prescribed at a high rate, and 100% of the specialists in Western medicine (WM) and 45.8% of patients reported experiencing side effects. As for the additional payment costs that patients considered as affordable for an integrated medical system, "under 50,000 won (about 38$)" was reported the most in both doctor and patient groups. With regard to the reasons for their reluctance to recommend an integrated medical system for IPF, specialists in WM responded highly to "uncertain evidence for treatment effectiveness." Regarding complementary and alternative medicine therapies that can be beneficial in patients with IPF, "lifestyle management," "diet management," "herb," "relaxation therapy," and "psychotherapy" were ranked high in both doctor and patient groups. Conclusions: In this study, a questionnaire survey on IPF was conducted to review actual treatment status, analyze shortcomings, and identify considerations for the development of an integrated medical system for IPF in the future.