• Title/Summary/Keyword: 호흡생리현상

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Clinical and Electrophysiological Study on Guillain-Barr$\acute{e}$ Syndrome (Guillain-Barr$\acute{e}$ 증후군의 임상적 및 전기생리학적 연구)

  • Yun, Sung-Hwan;Hah, Jung-Sang;Joo, Sung-Gyun;Cho, Yong-Kook;Kim, Jung-Hyun;Chung, Ji-Yeun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.52-61
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    • 2005
  • Background: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. Materials and Methods: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. Results: The male to female ratio was 1.8:1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7 % of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3 %). Intravenous immunoglobulin therapy was performed in 29 cases (64.4 %). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. Conclusion: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

Effect of Glycopyrrolate on Cardiovascular System in Dogs Sedated with Medetomidine-Midazolam Combination (개에서 Medetomidine과 Midazolam 병용 투여 시 Glycopyrrolate가 심맥관계에 미치는 영향)

  • Han, Dae-Kyung;Shin, Beom-Jun;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Ji-Young;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.317-323
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    • 2009
  • This study was performed to evaluate the effect of intravenous administration of glycopyrrolate on cardiovascular and respiratory system in dogs given intravenous medetomidine (20 ${\mu}g$/kg) and intramuscular midazolam (0.3 mg/kg) (MM). Prior to administration of MM, glycopyrrolate was administered intravenously at doses of 5 ${\mu}g$/kg (Gly-5), 10 ${\mu}g$/kg (Gly-10) or 20 ${\mu}g$/kg (Gly-20), respectively. For the control group saline was administered intravenously. In the cardiovascular system, HR, BP, RAP, PAWP, CI, SI, SVR, and PVR were measured. RR, $V_T$, $P_{ETCO2}$, and arterial blood gas analysis were measured for respiratory system. Although rapid and satisfied depth of sedation was obtained by MM, life-threatening bradycardia, the outstanding side-effect on cardiovascular system in dogs were observed. This combination also decreased CO and increased SVR, RAP, and PAWP significantly. The bradycardia could be prevented in all the glycopyrrolate treated groups, but tachycardia was observed in Gly-10 and Gly-20 groups. Significant increases in blood pressure were shown in glycopyrrolate treated groups. Also, tachycardia depends on dose of glycopyrrolate, compensating the CO. However, these were not fully reserved. In conclusion, MM combination could induce rapid and satisfied depth of sedation but was not the suitable method for the deep sedation of dogs with cardiovascular or circulatory problems.

Changes in Lipid Contents of the Tomato Fruits during Storage (도마도과실(果實)의 저장중(貯藏中) 함유지질(含有脂質)의 변화(變化)에 관(關)하여)

  • Lim, Young-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.1
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    • pp.27-38
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    • 1986
  • This experiment was conducted to observe the changes of $CO_2$ production, firmness and lipid components of tomato fruits at the temperature of $15^{\circ}C,\;20^{\circ}C\;and\;25^{\circ}C$ each. The phenomenon of climacteric rise appeared first at $25^{\circ}C$. The firmness of tomato fruits during storage were decreased rapidly under $25^{\circ}C$ but slowly under $15^{\circ}C$. The total lipid contents of tomato fruits were decreased under $15^{\circ}C\;and\;20^{\circ}C$ until the middle stage of storage but were increased rapidly at $15^{\circ}C$ from 30 to 40 days in storage. Various changes were not observed at the neutral lipid contents of tomato fruits. But. glycolipid and phospholipid contents were increased. The results which were observed the composite fatty acid of each lipid components were a lot of palmitic acid as a saturated fatty acid and linoleic acid. linolenic acid and oleic acid as an unsaturaturad fatty acid at the all fractions which were neutral lipid, glycolipid and phospholipid. The ratios of saturated fatty acid to unsaturated fatty acid of tomato fruits during storage were generally increased at the fraction of neutral lipid. tended to decrease at the fraction of glycolipid and were almost constant at the fraction of phospholipid.

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The Tissues and Blood Components of Opsariichthys uncirostris amurensis in the Muddy Water Area (탁수역에 서식하는 끄리의 조직과 혈액 성분의 변화)

  • Shin, Myung-Ja;Lee, Jong-Eun;Seo, Eul-Won
    • Journal of Life Science
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    • v.17 no.1 s.81
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    • pp.97-104
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    • 2007
  • Present study aims to investigate the effect of muddy water on gill and kidney tissues and blood components of Opsariichthys uncirostris amurensis in Imha reservoir. As a result of observing the gill tissues in muddy water with light and scanning electron microscopes, the edema, the exfoliation of epithelial cells and fusion of the secondary lamellae were observed. The space between gill lamellae was irregular, and a lots of muddy debris around the secondary lamellae were observed. In case of kidney tissues, the size of glomerulus was smaller and thickness of basal membrane was broader and the empty space in Bowman's capsule was wider than those of the control. The blood cells of O. uncirostris amurensis in muddy water were increased in number. Of the white blood cells, acidophilic granulocytes were highly distributed, and the shapes were irregular. Among the plasma components, the concentration of TP, ALB, A/G ratio, TG, CHOL, and AST were low, whereas that of the inorganic materials was high. Based on the above results, it is considered that muddy water possibly involves in the decrease of respiratory and excretory rates, giving rise to secondary lesion of tissues.

Recent Research Status of Postharvest Management of Broccoli (브로콜리 수확후 관리의 최근 연구 동향)

  • Choi, Ji-Weon;Lee, Woo-Moon;Kwak, Jung-Ho;Kim, Won-Bae;Kim, Ji-Gang;Lee, Seung-Ku;Cho, Mi-Ae
    • Journal of the Korean Society of International Agriculture
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    • v.23 no.5
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    • pp.497-502
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    • 2011
  • Broccoli is considered as one of the functional foods to offer a hearty supply of the nutrient-rich vegetable in the world. Broccoli contains high level of phytochemicals, and that is selected as one of the top 10 vegetables for human health promotion. Especially, glucosinolates and flavonoids are well known as anti free oxygen radicals in vegetables and fruits. In Korea, broccoli consumption has increased to well known on the health-beneficial vegetables since 2000. However, broccoli has many problems of postharvest management since the quality of harvested heads quickly declines. Major problems are the floret yellowing, wilting, off-odor, and decay. The multiple postharvest applications improve broccoli quality and cold treatment including pre-cooling extends on the shelf-life with circumstance of optimum storage which is 0℃ temperature and a range of 95-100% relative humidity. Controlled atmosphere or modified atmosphere packaging can be used as supplemental treatments to extend postharvest life. 1-2% O2 + 5-10% CO2 is currently recommended for broccoli. Postharvest management is important for broccoli because price fluctuations depend on harvest time and quality. In this study, we tried to review physiological change of broccoli after the harvest, storage method, and various techniques to optimize quality during distribution.

Young Rabbit Model for Pathophysiologic Study of Acute Lung Injury in Early Childhood (유아기 급성폐손상 병태생리 연구를 위한 어린 토끼 실험모델)

  • 권영민;최석철;박종원;김양원;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.545-558
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    • 2003
  • Adult respiratory distress syndrome (ARDS) is of particular interest because of its severity of the associated lung injury and its high mortality. However, the pathophysiologies of ARDS in infant and childhood groups are still not well clarified inspite of many previous investigations. To investigate the time course of pathophysiology of ARDS in infant and childhood groups, this study was designed with experimental endotoxin-induced ARDS model using young rabbits (8 week-old). Material and Method: Rabbits were divided into the control group (n=8) and the endotoxin-treated group (n=32). The endotoxin group was subdivided into 4 groups by the sampling times as 3, 6, 12 and 24 hr-groups (G- $E_{3,6,12,24,}$ each n=8). The experimental ARDS was made by a bolus injection of endotoxin (Escherichia coli serotype 055 : B5, 0.50 mg/kg) via rabbit ear vein. For evaluation of the hematologic and inflammatory markers, and superoxide dismutase (SOD) concentrations, the blood samples were taken from the heart. The bronchoalveolar lavage fluid (BALF) were obtained for analysis of the leukocytes and protein concentration. With biopsy of the lung, histopathologic changes of the lung were also evaluated. Result: In the endotoxin groups, significant leukopenia (owing to pancytopenia) occurred in 3 and 6-hr groups, which was followed by significant leukocytosis (owing to neutrophilia) in the 12 and 24-hr groups (p<0.05). Serum levels of tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and interleukin-1 $\beta$ (IL-1 $\beta$) in the endotoxin groups were higher than those of control group (p<0.05). Serum levels of superoxide dismutase (SOD) of G- $E_{3}$ and G- $E_{6}$ were higher than those of control group, whereas those of G- $E_{12}$ were lower than those of control groups (p<0.05). Total leukocyte counts and protein con-centrations in BALF were significantly elevated in the endotoxin groups compared to the control group (p < 0.05). The hemorrhagic pattern of BALF showed occurred in the endotoxin groups. The endotoxin groups (in G- $E_{6}$) had severe infiltration of inflammatory cells (lymphocyte and monocyte) in the pulmonary interstitium and parenchyma, migrations of neutrophil and eosinophil into alveolar spaces and interstitial widening, which are the evidences of acute lung injury. In the endotoxin groups, there were significant positive correlations between the BALF findings and the immunologic markers (TNF-$\alpha$, IL-1$\beta$, SOD) (p<0.05). Conclusion: Severe acute lung injury occurred in all the endotoxin-treated rabbits. The pathophysiologic findings were so progressive until 6-hr by time dependant pattern, and then recovered slowly, Variable hematologic, immuno-logic, and pathologic factors were well correlated in the development and progression of endoxin-induced lung injury. The pathophysiologic responses were sensitive and rapid in young rabbit Young rabbit seemed to be a useful experimental animal model for infant and childhood groups.roups.

The Respiratory and Hemodynamic Effects of Prone Position According to the Level of PEEP in a Dog Acute Lung Injury Model (잡종견 급성폐손상 모델에서 Prone position 시행시 PEEP 수준에 따른 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Chin, Jae-Yong;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.140-152
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    • 1998
  • Background: Prone position improves oxygenation in patients with ARDS probably by reducing shunt Reduction of shunt in prone position is thought to be effected by lowering of the critical opening pressure (COP) of the dorsal lung because the pleural pressure becomes less positive in prone position compared to supine position. It can then be assumed that prone position would bring about greater improvement in oxygenation when PEEP applied in supine position is just beneath COP than when PEEP is above COP. Hemodynamically, prone position is expected to attenuate the lifting of cardiac fossa induced by PEEP. Based on these backgrounds, we investigated whether the effect of prone position on oxygenation differs in magnitude according to the level of PEEP applied in supine position, and whether impaired cardiac output in supine position by PEEP can be restored in prone position. Methods: In seven mongrel dogs, $PaO_2/F_1O_2$(P/F) was measured in supine position and at prone position 30 min. Cardiac output (CO), stroke volume (SV), pulse rate (PR), and pulmonary artery occlusion pressure (PAOP) were measured in supine position, at prone position 5 min, and at prone position 30 min. After ARDS was established with warmed saline lavage(P/F ratio $134{\pm}72$ mm Hg), inflection point was measured by constant flow method($6.6{\pm}1.4cm$ $H_2O$), and the above variables were measured in supine and prone positions under the application of Low PEEP($5.0{\pm}1.2cm$ $H_2O$), and Optimal PEEP($9.0{\pm}1.2cm$ $H_2O$)(2 cm $H_2O$ below and above the inflection point, respectively) consecutively. Results : P/F ratio in supine position was $195{\pm}112$ mm Hg at Low PEEP and $466{\pm}63$ mm Hg at Optimal PEEP(p=0.003). Net increase of P/F ratio at prone position 30 min, however, was far greater at Low PEEP($205{\pm}90$ mm Hg) than at Optimal PEEP($33{\pm}33$ mm Hg)(p=0.009). Compared to CO in supine position at Optimal PEEP($2.4{\pm}0.5$ L/min), CO in prone improved to $3.4{\pm}0.6$ L/min at prone position 5 min (p=0.0180) and $3.6{\pm}0.7$ L/min at prone position 30 min (p=0.0180). Improvement in CO was attributable to the increase in SV: $14{\pm}2$ ml in supine position, $20{\pm}2$ ml at prone position 5 min (p=0.0180), and $21{\pm}2$ ml at prone position 30 min (p=0.0180), but not to change in PR or PAOP. When the dogs were turned to supine position again, MAP ($92{\pm}23$ mm Hg, p=0.009), CO ($2.4{\pm}0.5$ L/min, p=0.0277) and SV ($14{\pm}1$ ml, p=0.0277) were all decreased compared to prone position 30 min. Conclusion: Prone position in a dog with saline-lavaged acute lung injury appeared to augment the effect of relatively low PEEP on oxygenation, and also attenuate the adverse hemodynamic effect of relatively high PEEP. These findings suggest that a PEEP lower than Optimal PEEP can be adopted in prone position to achieve the goal of alveolar recruitment in ARDS avoiding the hemodynamic complications of a higher PEEP at the same time.

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The Change of Alveolar-capillary Barrier by Germanium in Acute Lung Injury Induced by Lipopolysaccharide (LPS에 의한 급성 폐손상에서 게르마늄에 의한 폐포-모세혈관 장벽의 변화)

  • Lee, Yoon-Jeong;Cho, Hyun-Gug;Sin, Gun-Ho;Jeune, Kyung-Hee
    • Applied Microscopy
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    • v.39 no.1
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    • pp.27-40
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    • 2009
  • Acute respiratory distress syndrome (ARDS), also known as an acute inflammatory lung disease is developed by various factors that is originated from the destruction of alveolar-capillary barrier, and neutrophils plays an important role in the destruction. The study intended to confirm, the anti-inflammatory effect of germanium, whether a lung injury has been mitigated with the reduction of injury in alveolar-capillary barrier resulting from inhibition of neutrophils migration in lung tissue. Test groups were divided in saline administered CON, 5 hours of endotoxin administered LPS and 5 hours of endotoxin administered Ge+LPS following 1 hours of pre-processed germanium. $100{\mu}g$ endotoxin was melted in 0.5 mL saline and sprayed into airway and 26 mg germanium per 100 g weight was administered into abdominal cavity. The endotoxin group which induced an acute lung injury with administered endotoxin showed dramatic increase of pulmonary edema (p<0.001), protein contents in bronchoalveolar lavage fluid, BALF (p<0.05) and neutrophils of infiltration in BALF (p<0.001) comparing with a control group, while a pre-treated germanium group showed significant decrease in all categories comparing to the endotoxin administerd group. In the result of a microscopic observation, the structure of alveolar-capillary barrier which is constructed with basal lamina, alveolar type I cells and endothelial cell were preserved of the pre-treated germanium group relatively well compare to the endotoxin administered group. And the construction of lamellar body, microvilli and basal lamina of alveolar type II cells were also preserved relatively well. Hence, germanium activates as an anti-Inflammatory mediator in other words, it interfered neutrophils migration into lung tissue, thereby reduced injury of alveolar-capillary barrier from toxic substances of activated neutrophils. Consequently, the study has determined that the acute lung injury induced by endotoxin has been decreased by the pre-treated germanium.

Comparison of Changes in Cell Wall Characteristics during Storage in 'Niitaka' and 'Pingguoli' Pear Fruits (동양배 '신고'와 '사과배' 과실의 저장 중 세포벽 특성의 변화 비교)

  • Kim, Jin-Gook;Piao, Yilong;Chun, Jong-Pil;Kataoka, Ikuo;Hwang, Yong-Soo
    • Korean Journal of Agricultural Science
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    • v.36 no.1
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    • pp.1-10
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    • 2009
  • The characteristics of fruit ripening and cell wall modifications of two oriental pear fruits were compared during storage. The loss of fresh weight was lower in 'Pingguoli' than 'Niitaka', probably due to the difference in wax accumulation and skin structure. 'Pingguoli' produced much higher amount of ethylene and showed climacteric ripening pattern, but this response was not found in 'Niitaka'. A significant difference in soluble pectin contents was found, thus, the amount of water soluble pectins were much higher in 'Niitaka' at harvest but this difference was not significant at later stage of storage. A severe loss of water soluble pectins in 'Niitaka' was confirmed whereas a similar tendency was not found in CDTA soluble ones. Even the amount of $Na_2CO_3$ soluble pectins was relatively low, 'Pingguoli' contained approximately 2 times higher than 'Niitaka' and both cultivars showed an increasing tendency in $Na_2CO_3$ soluble polymers at later stage of storage. No significant difference in alkali soluble polysaccharides (hemicelluloses fraction) was found between both cultivars. There was a significant change in gel filtration profiles regardless of cultivars, especially in water soluble pectins resulting from severe depolymerization probably due to degradation of higher molecular weight pectins and loss of their side chains. In gel filtration profiles of $Na_2CO_3$ soluble pectins, neutral sugars were evenly distributed regardless of molecular size of pectic polymers but the decrease of high molecular weight fraction was found. In comparison of alkali soluble polymers, a similar trend was found, that is, there was no difference in gel filtration profiles but 'Niitaka' seemed to have longer side chains in alkali soluble polysaccharides in both 4% and 24% of KOH soluble fractions.

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