• Title/Summary/Keyword: Airway pressure

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Effect of the water extract of Peucedani Japonici Radix on ovalbumin-induced allergic asthma in mice (난알부민으로 유도된 천식 마우스에서 식방풍(植防風)의 알레르기 면역반응 조절효과 연구)

  • Kang, Seok Yong;Oh, Tae Woo;Kim, Jin Woong;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.28 no.6
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    • pp.1-7
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    • 2013
  • Objectives : The root of Peucedanum japonicum Thunberg (Peucedani Japonici Radix; PJR) has been traditionally used as an herbal medicine for the treatment of anti-headache, anti-paralysis, anti-cancer, vascular protection, and blood pressure regulation. In this study, we investigated the anti-allergic effect of PJR water extract on ovalbumin (OVA)-induced allergic asthma in mice. Methods : Mice were sensitized at days 1, 8 and 15 with OVA and airway challenged at days 22, 24, 26, 28, and 30 to induced allergic asthma. PJR-W extract at doses of 100 and 300 mg/kg/body weight (bw) was orally administered during OVA challenge once per a day. The levels of allergic mediators such as immunoglobulin (Ig) E, and Th1/Th2 cytokines (IFN-${\gamma}$ and IL-4) were measured in the sera of mice by ELISA. The histological change of lung tissue was observed with hematoxylin and eosin (H&E) staining. Results : The administration of PJR-W extract significantly decreased the serum levels of IgE, IL-4, and IFN-${\gamma}$ compared with those of OVA control group. In H&E staining, PJR-E extract inhibited OVA-induced airway inflammation and the inflammatory cells infiltration in the peribronchial regions of the lung. Conclusions : These results indicate that PJR-W extract has an anti-inflammatory and anti-allergic effect on allergic response through the down-regulation of allergic mediators, suggesting that this herb may be used as a useful source for the treatment of allergic inflammatory diseases such as asthma.

Cardiovascular-metabolic Diseases Affecting Hearing loss in Workers Exposed to Noise (소음 노출 근로자의 청력손실에 미치는 심혈관-대사성 질환의 영향)

  • KyooSang Kim;Jungmin Sung;Eun-A Kim
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.33 no.3
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    • pp.332-345
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    • 2023
  • Objectives: We examined the association of hearing with cardio-metabolic diseases, dyslipidemia, hypertension and diabetes mellitus according to the personal and occupational characteristics of workers exposed to noise. Methods: The subjects of the study were 237,028 workers who underwent 2, 3, and 4 kHz airway pure tone audiometry in 2015 and who underwent clinical tests to diagnose cardiovascular-metabolic diseases. Cardiovascular-metabolic diseases were defined using reference values for respective items including blood pressure (systolic/diastolic), fasting blood glucose, cholesterol, and triglycerides. The airway pure tone hearing threshold of 2, 3, and 4 kHz, the average threshold of 2-3-4 kHz, and the hearing loss by the average threshold of the primary examination were distinguished. Results: Workers with cardiovascular-metabolic disease had significantly higher average hearing thresholds and higher rates of hearing loss. Logistic regression analysis, which adjusted for demographic variables of gender and age and occupational variables such as workplace size, industry, and type of work, and cardiovascular-metabolic disease as independent variables, showed that the odds ratio of hypertension to hearing loss in the mid-frequency was 1.239 (95% confidence interval: 1.118-1.374). For hypertension was 1.159 (1.107-1.214) and for diabetes it was 1.166 (1.104-1.230) for hearing loss in the high-frequency. Hearing loss measured by mean hearing was 1.178 (1.105-1.256) for hypertension and 1.181 (1.097-1.271) for diabetes. Conclusions: Cardiovascular-metabolic diseases in noise-exposed workers are associated with an increased risk of hearing loss and should be accompanied by bio-monitoring of cardiovascular-metabolic diseases in addition to auditory surveillance.

Effects of CP AP Therapy on Systemic Blood Pressure, Cardiac Rhythm and Catecholamines Concentration in Patients with Obstructive Sleep Apnea (폐쇄성 수면 무호흡에서 CPAP 치료가 전신성 혈압, 심조율 및 catecholamines 농도에 미치는 영향)

  • Kang, Ji-Ho;Lee, Sang-Haak;Choi, Young-Mee;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.715-723
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    • 2000
  • Background : Obstructive sleep apnea syndrome (OSAS) affects systemic blood pressure and cardiac function. The development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac rhythm, suggests that recurrent hypoxia and arousals from sleep may increase a sympathetic nervous system activity. Continuous positive airway pressure (CPAP) therapy has been found to be an effective treatment of OSAS. However, only a few studies have investigated the cardiovascular and sympathetic effects of CPAP therapy. We evaluated influences of nasal CPAP therapy on the cardiovascular system and the sympathetic activity in patients with OSAS. Methods : Thirteen patients with OSAS underwent CPAP therapy and were monitored using polysomnography, blood pressure, heart rate, presence of arrhythmia and the concentration of plasma catecholamines, before and with CPAP therapy. Results: The apnea-hypopnea index (AHI) was significant1y decreased (p<0.01) and the lowest arterial oxygen saturation level was elevated significantly after applying CPAP (p<0.01). Systolic blood pressure tended to decrease after CPAP but without statistical significance. Heart rates during sleep were not significantly different after CPAP. However, the frequency and number of types of arrhythmia decreased and sinus bradytachyarrhythmia disappeared after CPAP. Although there was no significant difference in the level of plasma epinephrine concentration, plasma norepinephrine concentration significantly decreased after CPAP (p<0.05). Conclusion : CPAP therapy decreased the apnea-hypopnea index, hypoxic episodes and plasma norepinephrine concentration. In addition, it decreased the incidence of arrhythmia and tended to decrease the systemic blood pressure. These results indicate that CPAP may play an important role in the prevention of cardiovascular complications in patients with OSAS.

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Determination of Minimal Pressure Support Level During Weaning from Pressure Support Ventilation (압력보조 환기법으로 기계호흡 이탈시 최소압력보조(Minimal Pressure Support) 수준의 결정)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.380-387
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    • 1998
  • Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

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Two Cases of Subcutaneous Emphysema and Pneumomediastinum caused by Oral Trauma (구강외상 후 발생된 피하기종과 기종격동 2예)

  • Kim Chul-Ho;Mo Jung Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.58-62
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    • 2004
  • Spontaneous rupture of the pulmonary alveoli after a sudden increase intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present two cases of pneumomediastinum following cervicofacial subcutaneous emphysema after oral trauma. They constitute an uncommon clinical entity, So its radiologic appearance, clinical presentation, and diagnosis are described.

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Respiratory Review of 2012: Bronchoscopic Innovations and Advances

  • Nam, Sung-Jin;Hwangbo, Bin
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.4
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    • pp.197-203
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    • 2012
  • Recent advances in bronchoscopy have led to changes in clinical diagnostics and therapeutics in pulmonary medicine. In diagnostic bronchoscopy, there have also been new developments in endobronchial ultrasound technology which may be incorporated into clinical practice in the near future. Functional bronchoscopy, which evaluates information such as airway pressure, airflow, or gas exchange, suggests promising clinical advances in the near future. In therapeutic bronchoscopy, bronchoscopic volume reduction is a novel approach for the treatment of severe emphysema. In this review, seven recently published articles representing current advances in bronchoscopy are summarized and discussed.

Tracheal Reconstruction with High Frequency Jet Ventilation in Patients of Tracheal Stenosis (기관 협착 환자에서 고빈도 제트 환기법응 이용한 기관 성형술)

  • 김정택
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.1021-1026
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    • 1990
  • The patients with tracheal stenosis have become more increasing in recent due to the increased use of tracheostomy and assisted ventilation Anesthetic management during tracheal reconstruction is a concern to the anesthetist and the surgeon, who must share the airway as a operation field and at the same time provide good gas exchange. Multiple technique such as the tube ventilation system or C \ulcornerP bypass method have been recommended to achieve this goals. However, these methods have disadvantages of poor surgical exposure and hemorrhagic complication from using C \ulcornerP bypass The technique for HFJV was first described for bronchoscopy, and it involves positive-pressure breathing with high flow[40 \ulcorner60L/min] of oxygen This flow is directed to a semirigid catheter inserted in the endotracheal tube and the tracheal reconstruction can be done without interruption. From Dec. 1986 to July 1990 we have experienced 6 patients of tracheal stenosis necessitating circumferential resection and end to end anastomosis; 5 patients with tracheal stenosis following cuffed tracheostomy or intubation, a patient with tracheal stenosis due to invasive thyroid cancer. The specific advantages during tracheal reconstruction are unobstructed field during surgical reconstruction and good gas exchange through the procedure.

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Vacuum-assisted Closure Therapy for Treating Patients with Severe Subcutaneous Emphysema (피하기종의 Vacuum-assisted Closure Therapy)

  • Oh, Tak-hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.276-279
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    • 2015
  • Subcutaneous emphysema is a benign condition following trauma (pneumothorax and oropharyngeal), cervical or thoracic procedures, and mediastinal infection. However, severe subcutaneous emphysema may be related to serious complications such as respiratory failure, airway compromise, and tension- related phenomena. Many alternative therapies have been tried to treat patients with this condition. We report our experience with vacuum-assisted closure therapy for treating patients with severe subcutaneous emphysema.

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The Clinical Study of Ketamine HC1 on Oral Surgery (구강외과 영역에 있어서 Ketamine HC1의 임상적 고찰)

  • Cho, Byoung-Uk
    • The Journal of the Korean dental association
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    • v.11 no.1
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    • pp.45-52
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    • 1973
  • Ketamine HC1(Phencyclidine derivative) is a white, crystalline substance with melting point 259℃. It is soluble in water to a 20% clear, colorless solution. a 10% aqueous solution has a pH 3.5. The chemical structure is 2-(O-chlorophenyl)-2-(methylamino) cyclohexanone hydrochloride. It is a rapid acting, nonhypnotic, nonbarbiturate drug with a wide safety margin. The author used the anesthetic ketamine hydrochloride for oral surgery procedure in 16 patients(2 to 33 years). Anesthesia was achieved with a single intramuscular injection by introduction of manufacture. Result obtained as follows : 1. It was easily administered. 2. Onset time was rapid and duration was short. 3. The mild cardiac stimulation resulted in moderate increase in the blood pressure and pulse. 4. There was no significant respiratory depression. 5. The airway can be maintained without artificial support or endotracheal intubation. 6. All protective reflex maintained, which was important in oral surgery. 7. The best results were achieved in pediatric patients than adults.

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Diagnosis and Treatment of Sleep Apnea (수면무호흡증의 진단과 치료)

  • Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.5-11
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    • 2003
  • Sleep apnea syndrome is a common clinical disorder characterized by intermittent cessation of airflow at nose and mouth during sleep. The clinical significance of this syndrome is that it is one of the most common causes of excessive daytime sleepiness. It can also cause neuropsychiatric, cardiovascular, and cerebrovascular complications. The standard for diagnosis of sleep apnea syndrome is nocturnal polysomnography. Because polysomnography is a time-consuming and expensive test, many efforts have been made to replace polysomnography with a simpler system of monitoring, but no method has yet been approved as a definitive investigation method. The goals of treatment for this syndrome are to eliminate excessive daytime sleepiness and to reduce the risk of possible cardiovascular complications. Continuous positive airway pressure is the most definite and widely accepted treatment for achieving these goals. Other treatments such as surgical treatment, oral appliances, and behavioral therapy may be useful for selected patients who are mildly affected.

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