• 제목/요약/키워드: respiratory patterns

검색결과 264건 처리시간 0.036초

허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰 (Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease)

  • 정태은
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.225-233
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    • 1996
  • 허혈성 심질환의 치료로서 시행되는 관동맥우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥우회술을 대상으로 수술성적 및 술전 위험인자들이 술후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총 63례의 환자 중 남자가 44례, 여자가 19례였으며 연령 분포는 36세에서 71세까지 평균 $58.3{\pm}8.6$세였으며 50대와 60대에서 대부분을 차지하였다. 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석해 본 결과 술전 관동맥질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령 환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitroglycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다.

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절제 불가능한 식도암에서 고선량 외부조사 방사선 치료의 결과 (Treatment Results of Increased Dose External Beam Radiation Therapy for Unresectable Esophageal Cancer)

  • 이승헌;이석호;이규찬;신동복;심선진;이재익
    • 대한기관식도과학회지
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    • 제15권2호
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    • pp.49-56
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    • 2009
  • Purpose : To evaluate the treatment outcome for patients with locally advanced, unresectable esophageal cancer treated with relatively high dose radiation therapy(RT). Materials and Methods : From January 2000 to December 2008, 32 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated with radiation therapy(RT) with or without concurrent chemotherapy. Ten patients were excluded from analysis because of distant metastasis and drop off. Patient distributions according to AJCC stages II, III IVa were 7(31.8%), 12(54.6%), 3(13.6%) respectively. The locations of tumor were cervical/upper thorax 3 (13.6%), mid thorax 13(59.1%), and lower thorax/abdominal 6(27.3%), respectively. Eleven patients received RT only, and 11 patients received cisplatin based concurrent chemoradiotherapy(CCRT). Median radiation dose was 65 Gy(range 57.6~72 Gy). Results : The median follow-up was 9.1 months(range 1.9~43.8 months). The response rates for complete response, Partial response, stable disease and Persistent disease were 6(27.3%), 11(50.0%), 4(18.2%) and 1(4.5%), respectively. Two patients(9.1%) suffered from esophageal stenosis and stents were inserted. Two patients(9.1%) had Grade 3 radiation pneumonitis and one of them expired due to acute respiratory distress syndrome(ARDS) at 36 days after completion of radiation therapy. The recurrence rate was 11(50.0%). The patterns of recurrence were persistent disease and local progression in 5(22.7%), local recurrence 3(13.7%) and concomitant local and distant recurrence in 3(13.7%). The overall survival(OS) rate was 32.1% at 2 years and 21.4% at 3 years(median 12.0 months). Disease free survival(DFS) rate was 17.3% at 2 and 3 years. All patients who had no dysphagia at diagnosis showed complete response after treatment and 100% OS at 3 years(p=0.0041). The OS for above 64.8 Gy group and 64.8 Gy or below group at 3 years were 60.6% and 9.1%(p=0.1341). The response to treatment was the only significant factor affecting OS(p=0.004). Conclusion : Relatively high dose radiation therapy in unresectable esophageal cancer tended to have a better outcome without increased complication rate. Further study with more patients is warranted to justify improved result.

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지역약국에서 보고된 전문의약품과 일반의약품의 이상사례 보고현황 비교 분석 (Comparative Analysis of Ethical-the-counter Drugs and Over-the-counter Drugs for the Adverse Events from the Community Pharmacy)

  • 이모세;박소희;김나영;오인선;이정민;이의경;신주영
    • 한국임상약학회지
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    • 제28권3호
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    • pp.230-237
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    • 2018
  • Objective: To compare adverse event reporting patterns between ethical-the-counter and over-the-counter drugs from community pharmacies and outpatient settings. Methods: We conducted a descriptive study using the adverse event reporting database, wherein data were collected from the regional pharmacovigilance centers of the Korean Pharmaceutical Association between January 1, 2016 and December 31, 2016. The reported drugs were classified into either ethical-the-counter or over-the-counter drugs, and we compared the distribution of patient age and gender, frequent adverse events and medications, serious adverse events, and causality assessment results, where causality assessments were performed according to the World Health Organization-The Uppsala Monitoring Centre's system. Results: We included 17,570 reports (75,451 drug-adverse event pairs). Ethical-the-counter and over-the-counter drugs accounted for 81.4% and 18.6% of the total adverse event reports, respectively. The use of over-the-counter drugs was higher in females and patients aged <18 years, whereas the use of ethical-the-counter drugs was higher in those aged >65 years. Alimentary tract and metabolism drugs, and respiratory system drugs were the most frequent ethical-the-counter and over-the-counter drugs, respectively. From causality assessment results, "possible" (75.4%) was the most commonly assigned category for ethical-the-counter drugs, while "possible" (44.0%) and "unlikely" (47.7%) were the most common categories for over-the-counter drugs. The distribution of serious adverse events were similar for both ethical-the-counter and over-the-counter drugs. Conclusion: Differences were observed in age, gender, reported medications, and symptoms for both ethical-the-counter and over-the-counter drugs. Further pharmacovigilance activities considering the adverse event characteristics of over-the-counter drugs, which are comparable to ethical-the-counter drugs, should be performed.

해산어류 6종의 산소소비 경향에 관한 연구 (The Patterns of Oxygen Consumption In Six Species of Marine Fish)

  • KIM Il-Nam;CHANG Young-Jin;KWON Joon-Yeong
    • 한국수산과학회지
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    • 제28권3호
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    • pp.373-381
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    • 1995
  • 유용 해산어류에 대한 산소소비 경향을 파악하기 위하여 넙치 Paralichthys olivaceus, 자주복 Takifugu rubripes, 조피볼락 Sebastes schlegeli, 농어 Lateolabrax japonicus, 참돔 Pagrus major, 감성돔 Acanthopagrus schlegeli 등 6종의 추어를 주대상으로 수온별, 밀도별, 체중별 산소소비량및 치사산소량에 관한 실험을 실시하였다. 모든 어종에서 산소소비량 $(Oc,\;ml/kg\;\cdot\;hr)$은 수온$(T,\;^{\circ}C)$의 상승에 비례하여 증가하였으며, 그 경향은 다음과 같은 회귀직선식으로 표시되었다. 넙치= Oc=34.0515T-339.5987 $(r^2=0.9730)$, 자주복. Oc=34.4941T-479.8732 $(r^2=0.9483),$, 조피볼락: Oc=44.7970T-634.2627 $(r^2=0.9718),$, 농어: Oc=26.1488T-318.0633 $(r^2=0.9316),$, 참돔: Oc=61.1020T-722.8926 $(r^2= 0.9805),$, 감성돔: Oc=75.1460T-947.9370 $(r^2=0.9392).$. 어체의 수용밀도가 증가함에 따라 단위체중당 산소소비량은 감소하는 경향을 보였다. 넙치는 체중(W, g) 증가에 파라 산소소비량이 감소함으로써 Oc=2532.0268W-0.6565 $(r^2=0.9229)$의 관계를 나타냈다. 넙치, 조피볼락, 자주복, 참돔의 치사산소량은 각각 0.66, 0.79, 0.75 및 1.36m1/1였다

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Health risk assessment for radon of groundwater in Korea

  • Kim, Yeshin;Kim, Jinyong;Park, Hoasung;Park, Soungeun;Dongchun Shin
    • 한국환경독성학회:학술대회논문집
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    • 한국환경독성학회 2003년도 추계국제학술대회
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    • pp.170-170
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    • 2003
  • An initial study has been conducted with Korea Institute of Geoscience and Mineral resources and National Institute of Environment Research to evaluate the distribution of radon levels and their risk levels of groundwater in Korea. Probability distribution of 616 samples was log-normal one with 1,867pCi/L as arithmetic value, 920pCi/L as median and 40,010pCi/L as maximum during iou. years(1999-2002). In addition, 10% of total samples are in excess of 4,000pCi/L, 20% in excess of 2,700pCi/L, and 30% in excess of 1,700pCi/L, and 15 samples exceeds 10,000pCi/L. Total samples are grouped into 10 areas and 5 rocks unit, and difference of concentrations among areas and rocks are statistically significant(respectively, p<0.0001). The highest area is Daejeon located in ogcheon metamorphic rocks and granitic rocks, and most of all sites with high concentration sites are located in granitic rocks. The lowest area is Jeju located in volcanic rocks. We have estimated excess cancer risks of radon based on these data. To estimate risks, first of all, use patterns of groundwater are categorized with 6 groups: for drinking, household, farming, washing cars, raising stock, and others. We considered risk only for drinking water and household water because radon is rapidly dispersed before it of other use reach human respiratory organs. We select 565 samples for risk analysis, and applied unit risk which is 6.6210-7 per pCi/L to be recommended by NAS committee. Unit risk was derived from considering radon ingestion and radon inhalation from water use. When estimating risk, we analyzed PDF of concentration and represented risk as 50 and 95 percentile values to consider uncertainty with Monte-Carlo simulation. It results in 10-4 level of their excess cancer risk and in 10-2 level in some areas with high concentration of radon. It must be monitor periodically and take adequate actions in these risky sites. We recommend that it needs to take more survey and finally set guideline for radon regulation in groundwater.

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3형 아데노바이러스의 면역조절 유전자 다양성 (Genetic Variation in the Immunoregulatory Gene of Adenovirus Type 3)

  • 최은화;김희섭;이환종
    • Pediatric Infection and Vaccine
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    • 제16권2호
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    • pp.199-204
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    • 2009
  • 목 적: 아데노바이러스 early region 3 (E3) 유전자 단백은 세포독성 세포와 다양한 싸이토카인이 매개하는 세포파괴를 저해하는 기능을 한다. 본 연구는 E3 유전자의 다양성이 아데노바이러스의 분자생물학적 다양성을 설명할 수 있는지 밝히기 위하여 시행되었다. 방 법: 1990년부터 2000년까지 10년 동안 서울대학교 어린이병원에서 하기도 감염증으로 치료받은 소아로부터 분리 된 3형 아데노바이러스 14 주를 대상으로 하여 E3 유전자의 변이와 유전체형과의 연관성을 분석하였다. 결 과: 3형 아데노바이러스의 E3 유전자는 표준 주(M15952)와 비교하여 98%의 일치도를 보였으며, 국내 분리 주간의 일치도는 98.7%이었다. 아미노산 서열의 변이는 20.1 kDa, 20.6kDa, truncated 7.7 kDa, 10.3 kDa, 14.9 kDa, 그리고 15.3kDa에 나타났다. 또한, 14 주 모두에서 truncated 7.7 kDa의 시작 코돈에 missense 변이가 있었으며, 58개(10주) 혹은 94개(4주)의 염기쌍이 소실되는 변이가 동반되었다. 유전체형에 따른 E3 유전자의 변이는 대개 유전체형에 특이하게 나타나 연관성이 높은 것을 알 수 있었다. 결 론: 3형 아데노바이러스 주의 면역기능 조절 유전자 E3의 다양성은 유전체형과의 연관성이 높은 것으로 나타났다.

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전라북도 지역 동물병원에 내원한 반려견의 주요 품종별 질환 양상 조사 (Prevalence of common medical disorders among dog breeds examined in primary-care veterinary clinics at Jeollabuk-Do, Republic of Korea)

  • 김은주;최창용;류재규;오상익;정영훈;조아라;김수희;도윤정
    • 한국동물위생학회지
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    • 제41권2호
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    • pp.97-104
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    • 2018
  • Recently, demographic studies of veterinary medical database have been conducted to understand patterns of disease occurrence. Understanding incidence of breed-related disease would provide appropriate guidance for future health care strategies and offer useful information for early diagnosis of disease. However, in veterinary medicine, theses research has not yet been investigated in the Republic of Korea. The purpose of this study was to investigate the prevalence of common medical disorders among dog breeds examined at primary-care veterinary clinics in Jeollabuk-Do, Republic of Korea. The data were analyzed based on World Health Organization's International Classification of Disease. A total 13,176 medical records of canine patients were analyzed from six primary veterinary clinics in Jeollabuk-Do from January to December 2016. Results showed that the most common health problems were 'disease of skin' (17.7%); followed by 'diseases of digestive system' (12.26%), 'preventive medicine' (10.08%), and 'diseases of ear and mastoid process' (10.4%). In seven out of ten breeds, the most common medical disorder was skin disease. For poodle such as Pomeranian and Chihuahua, digestive system disease was most prevalent. On the other hand, respiratory system disease was found to be higher in Pomeranian than other breeds; while ear and mastoid process disease was most common for Maltese and Poodle. This study can help owners, breeders, and veterinarians prevent and manage various diseases of popular breeds in Jeollabuk-Do in the future.

보건지소(保健支所) 진료활동(診療活動)에 관(關)한 연구(硏究) (Study of Medical Carein Health Subcenter)

  • 김문식;김한중;김영기;김일순
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.109-116
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    • 1976
  • Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamenta, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Wha County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5%), Skin (12.7%) , diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and. all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test or X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case, The Total average cost per visit was 870.

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The effect of tulobuterol patches on the respiratory system after endotracheal intubation

  • Lee, Do-Won;Kim, Eun-Soo;Do, Wang-Seok;Lee, Han-Bit;Kim, Eun-Jung;Kim, Cheul-Hong
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권4호
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    • pp.265-270
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    • 2017
  • Background: Endotracheal intubation during anesthesia induction may increase airway resistance ($R_{aw}$) and decrease dynamic lung compliance ($C_{dyn}$). We hypothesized that prophylactic treatment with a transdermal ${\beta}2$-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube. Methods: Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each). The night before surgery, a 2-mg TP was applied to patients in the TP group. Standard monitors were recorded, and target controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. Simultaneously, end-tidal carbon dioxide, $R_{aw}$, and $C_{dyn}$ were determined at 5, 10, and 15 min intervals after endotracheal intubation. Results: There was no significant difference in demographic data between the two groups. The TP group was associated with a lower $R_{aw}$ and a higher $C_{dyn}$, as compared to the control group. $R_{aw}$ was significantly lower at 10 min (P < 0.05) and 15 min (P < 0.01), and $C_{dyn}$ was significantly higher at 5 min (P < 0.05) and 15 min (P < 0.01) in the TP group. A trend towards a lower $R_{aw}$ was observed showing a statistically significant difference 5 min after endotracheal intubation (P < 0.01) in each group. Conclusions: Prophylactic treatment with TP showed a bronchodilatory effect through suppressing an increase in $R_{aw}$ and a decrease in $C_{dyn}$ after anesthesia induction without severe adverse effects.

만성요통환자의 호흡패턴이상과 관절위치감각의 관계 (Relationship between Breathing Pattern Disorder and Joint Position Sense in Patients with Chronic Low Back Pain)

  • 조병윤;윤정규
    • 대한통합의학회지
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    • 제7권2호
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    • pp.1-10
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    • 2019
  • Purpose : To investigate the relationship between breathing pattern disorder and joint position error (JPE) in patients with chronic low back pain (CLBP). Methods : Thirty nine patients with CLBP participated. End-tidal $CO_2$ and respiration rate (RR) were measured using a capnography. Breathing-hold time (BHT) and Nijmegen Questionnaire (NQ) were investigated. Thoracic excursion was measured with a cloth tape measurement technique. Joint position error were measured using a small laser point mounted on a lightweight headband. they were asked to relocate the head, after the neck movement on the horizontal plane. Pearson 's test was used for correlation analysis between respiratory variables and JPE in patients with CLBP. Independent t-test was used to verify the difference between thoracic and diaphragm breathing pattern in patients with CLBP. The significance level was set at 0.05. Results : There was a significant correlation between JPE (LR) and JPE (RR, EX) (r=.639, r=.813) (p<.001) and a low negative correlation with end-tidal $CO_2$ (r=-.357) (p<.05). There was a significant correlation between RR and JPE (EX) (r=.750) (p<.001). There was a low correlation between JPE (EX) and NQ (r=.333) (p<.05). There was a somewhat high negative correlation between NQ and thoracic excursion (r=-.528) (p<.001). There was a somewhat high negative correlation between thoracic excursion and JPE (LR, RR, EX) (r=-.470, r=-.484, r=-.602) (p<.001). There were no significant differences in the RR, BHT, NQ, and thoracic excursion between the thoracic and diaphragmatic breathing (p>.05). There was a significant difference in the JPE (EX), end - tidal $CO_2$, and VAS values between the thoracic and diaphragm breathing (p<.05). Conclusion : There was a correlation between JPE (EX) and NQ in patients with CLBP, and correlation between thoracic excursion and JPE (LR, RR, EX) and NQ. There was a significant difference in the JPE (EX), end-tidal $CO_2$ level, and VAS value in the comparison of thoracic breathing and diaphragm breathing. The results showed that breathing patterns and JPE were related to each other.