• Title/Summary/Keyword: Fatigue rate

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Effect of Tinnitus after Bleeding, Acupuncture, Moxa, and Laser treatment (부황, 뜸, 침 레이저요법 시술이 耳鳴에 미치는 영향)

  • Park, Gyung-hwa;Han, Young-mok;Ahn, Soo-Hyun;Hwang, Chung-yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.1
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    • pp.396-407
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    • 1999
  • Although tinnitus is a common disease, it's reason, pathogenesis and treatment are not examined clearly. As tinnitus is a subjective complaint, it is not easy to evaluate objectively and to compare with another. In this study, we intend to estimate the effect of a variety of oriental medical treatments to tinnitus. We inquired about 30cases of tinnitus patients visited the Kwang-ju Oriental Medical Hospital of Wonkwang University from Apr. 1998 to Sep. 1998. We examined the 30cases in the view of sex, age, occupation, duration, etiologic factors, past history, associating symptoms, quality of tinnitus, and recovery rate after treatments. The results were as follows: 1. In distribution of sex, the ratio of male was $63.3\%$(19cases)and\;female\;was\;36.6\%$(11cases). 2. In distribution of age, the ratio of the 2th decade was $6.6\%(2cases),\;the\;3th\;decade\;was\;20.0\%(6cases),\;the\;4th\;decade\;was\;16.6\%(5cases),\;the\;5th\;decade\;was\;23.3\%(7cases),\;the\;6th\;decade\;was\;30.0\%\;(9cases),and\;the\;7th\;decade\;was\;3.3\%(1case)$. 3. In distribution of occupation, the ratio of employee was $23.3\%$(7cases), house-keeper was $63.3\%(11cases),\;farmer\;was\;16.6\%(5cases),\;teacher\;was\;13.3\%$ (4cases), and student, merchant, soldier was each $3.3\%$(1case). 4. In distribution of duration, the ratio of under 1month was $6.6\%$ (2cases), 1 month -6 months was $20.0\%$(6cases), 6 months- 12months was $30.0\%$(9cases), 12months-36months was $23.3\%$(7cases), and over 36months was $20.0\%$(6cases). 5. In etiologic factor of tinnitus, the ratio of unknown reason was $40.0\%$ (12cases), overwork was $16.6\%$(5cases), emotional stress was $10.0\%$(3cases), noise was $6.6\%$(2cases), cases of laying overwork upon stress was $13.3\%$(4cases), head trauma was $3.3\%$(1case), gun report was $3.3\%$ (1case), and after sickness was $6.6\%$(2cases). 6. 9 cases had experienced such a disease as meniere's disease, tympanitis, labyrinthitis, trauma of tympanum, hypertension, etc. 7. Commonly associated symptoms were dizziness, deafness, uneasiness, headache, ear fullness, fatigue, insomnia, nausea, vomiting, and forgetfulness. 8. Most frequent quality of tinnitus were buzzing, whistling, humming etc. 9. In $76.6\%$(23cases) of tinnitus patients, it was improved, but in $23.3%$(7cases) of them, not improved. Total recovery rate was $42.2\%$.

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Human Health Factors and Traffic Accidents among Taxi Drivers in the Seoul Area (서울지역에 있어서 직업운전자의 건강상태가 교통사고에 미치는 영향)

  • Kim, Ihm-Soon;Lee, Kyung-Jong;Roh, Jae-Hoon;Moon, Young-Hahn
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.3 s.27
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    • pp.313-322
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    • 1989
  • The present status of the traffic accident rate in Korea shows that it is the highest in the world with a continuously increasing trend. Human factors account for 90% of the causes of traffic accidents. Therefore, the purpose of this study was to determine some human factors related to traffic accidents by studying the relationship between health status and traffic accidents. To accomplish this purpose, all taxi companies located in the Seoul area were divided in three groups according to the number of taxi possessed, then some companies in each ?roup were randomly selected for study, and a total of 222 drivers in those selected companies were questioned and examined from April 15 to April 22, 1989. Seventy drivers among 222 had experienced a traffic accident. A $x^2$-test was performed on the data, then, factor analysis and discrminant analysis were executed with the following results: 1. The drivers complaining of gastroenteric symptoms numbered 110(49.5%), which was the major symptom among all drivers complaining of poor health. 2. In the primary analysis, variables related to traffic accidents were divided into general, occupational, and health characteristics. Drivers having no traffic accident experience and drivers having that experience were subjected to question about age, educational level, residential status, monthly average income, working hours and days, degree of satisfaction with their profession and homelife, degree of worry about health. degree of fatigue, medication, drunken driving, and illness, but there were no statistical significances. 3. In the factor analysis, the 8 health variables which cause traffic accidents were classified into 3 common factors which were perceived health factor, sleeping and drunken driving, and visual acuity and smoking factor. Perceived health was the factor which contributed most to explaining accidents. 4. In the discriminant analysis, a correct prediction rate of 68.0% was obtained in the factors of all the characteristics. 5. Degree of sttisfaction with their homelife and educational and economic factor in the general characteristics, degree of satisfaction with their profession in the occupational characteristics, and sleeping and drunken driving in the health characteristics were selected as statistically significant factors to discriminant the traffic accident. 6. Among the factors of the general, occupational, and health characteristics, degree of satisfaction with their homelife, driving experience, family factor, perceived factor were selected as the statistically significant factors.

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The Effects of Different Surface Level on Muscle activity of the Upper Body and Exercise Intensity during Mountain Climbing Exercise (지면에서의 마운틴 클라이밍 운동 시 상체의 위치 변화가 운동 강도와 근활성도에 미치는 영향)

  • Park, Jun-Ho;Jung, Jae-Hu;Kim, Jong-Geun;Chae, Woen-Sik
    • Korean Journal of Applied Biomechanics
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    • v.31 no.1
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    • pp.72-78
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    • 2021
  • Objective: The purpose of this study was to investigate relations and effectiveness about mountain climbling exercise with different level of support surfaces by analyzing heart rate and EMG data. A total of 10 male college students with no musculoskeltal disorder were recruited for this study. Method: The biomechanical analysis was performed using heart rate monitor (Polar V800, Polar Electro Oy, Finland), step-box, exercise mat, and EMG device (QEMG8, Laxtha Inc. Korea, sampling frequency = 1,024 Hz, gain = 1,000, input impedance > 1012 Ω, CMRR > 100 dB). In this research, step-box were used to create different surface levels on the upper body (flat surface, 10% of subject's height, 20% of subject's height, and 30% of subject's hight). Based on these different conditions, data was collected by performing mountain climbing exercise during 30 seconds. Subjects were given 5 minutes of break to prevent muscular fatigue after each exercise. For each dependent variable, a one-way analysis of variance with repeated measures was conducted to find significant differences and Bonferroni post-hoc test was performed. Results: The results of this study showed that exercise intensity was reduced statistically as increased surface level on the upper body. Muscle activity of the upper rectus abdominis and biceps femoris for 30% of surface level was significantly higher than the corresponding values for flat surface. However, the opposite was found in the rectus femoris. In general, muscle activity of the lower rectus abdominis, erector spinae, external oblique abdominis, and gluteus maximus increased when surface level increased, but the differences were not significant. Conclusion: As a result, the increase in surface level of the body would change muscle activity of the upper body, indicating that different surface level of the upper body may cause significant effect on particular muscles to be more active during mountain climbing exercise. Based on results of this study, it is suggested to set up an appropriate surface level to target particular muscle to expect an effective training. It is also important to set adequate surface levels to create an effective training condition for preventing exercise injuries.

3D Simulation Study to Develop Automated System for Robotic Application in Food Sorting and Packaging Processes (식품계량 및 포장 공정 로봇 적용 자동화 시스템 개발을 위한 3D 시뮬레이션 연구)

  • Seunghoon Baek;Seung Eel Oh;Ki Hyun Kwon;Tae Hyoung Kim
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.5
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    • pp.230-238
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    • 2023
  • Small and medium-sized food manufacturing enterprises are largely reliant on manual labor, from inputting raw materials to palletizing the final product. Recently, there has been a trend toward smartness and digitization through the implementation of robotics and sensor data technology. In this study, we examined the effectiveness of improvement through 3D simulation on two repetitive work processes within a food manufacturing company. These processes involve workers whose speed cannot match the capacity of the applied equipment. Two manual processes were selected: the weighing and packing process performed by workers after skewer assembly, and the manual batch process of counting randomly delivered frozen foods, packing (both internal and external), and palletizing. The production volume, utilization rate, and number of workers were chosen as verification indicators. As a result of the simulation for improving the 3D process, production increased by 13.5% and 56.8% compared to the existing process, respectively. This was particularly evident in the process of applying palletizing robots. In both processes, as the utilization rate and number of input workers decreased, robots could replace tasks with high worker fatigue, thereby reducing work overload. This study demonstrates the potential to visually compare the process flow improvement using 3D simulations and confirms the possibility of pre-validation for improvement.

The Results of Curative Radiation Therapy for 49 Patients of the Uterine Cervical Carcinomas (자궁 경부암의 근치적 방사선 치료 효과 -49예의 분석 -)

  • Ryu Mi Ryeong;Kim Yeon Sil;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Namkoong Sung Eun;Kim Seung Jo
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.219-225
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    • 1992
  • Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital from September, 1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to 11344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 ($12.2\%$) were in stage Ib, 6 ($12.2\%$) in stage IIa, 25 ($51\%$) in stage IIb, 7 ($14\%$) in stage III, and 5 ($10.2\%$) in stage IV. Age of the patients ranged from 33 to 76 years (median 60 years). Pathologically, fourty six ($94\%$) patients had squamous cell carcinoma, 2 ($4\%$) had adenocarcinoma, and 1 ($2\%$) had adenosquamous cell carcinoma. Overall response rate was $84\%$. 5-year survival rate was $49\%$ for entire group ($75\%$ for stage Ib, $83\%$ for Stage IIa, $42.5\%$ for stage IIb, $25\%$ for stage III, $40\%$ for stage IV). Complications were observed in 11 ($22.4\%$) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis (p<0.05).

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An Observation of the Chief Complint and a Weak Child of Prediatric outpatinets (소아과(小兒科) 외래(外來) 환자(患者)의 주소증(主訴症) 및 허약아(虛弱兒)에 관(關)한 연구(硏究))

  • Shin Ji-Na;Shin Youn-Guo
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.149-168
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    • 2000
  • The Purpose of this study was to investigate the new effective oriential medicine tretments in pediatric disease and its clinical applicability The study was composed of 1245 new patients who had been treated at the all unit in the Dong-Seo oriential Medicine Hospitial for 1 year, from 1 April 1999 to 31 March 2000, and aged between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. Result 1. The numbers of children who involved in this study is total 1245: Male children are 668 and female children are 577 children. The sex rate between male and female is 1.15 to 1. 2. Most of the above patients came to the hospital at first time from diseases such as musculoskelectal disease, weakness, asthma, cough, anorexia, common cold, rhiorrhea, sweating, dyspepsia, dematitis, night terror, obesity, stomach, short stature, Besides, they also came to the hospital at first time from various diseases such as epistasxis, pyrexia. Bell's palsy, nocturia, contipation, cerebral palsy, disorder, CVA. diarrhea. stress disease, Allergic disease, Tic disorder. Visual disorder, Kawasaki disease, Pierre Robin's syndrom, hematuria, edema and so on. 3. Looking at the frequent diseases, Respiratory dis. children including asthma, cough, rhiorrhea, sweating, common cold, pyrexia covers 36%, in 399 numbers. digestive dis. children including anorexia, dyspepsia, stomach, diarrhea, constipation, indigestion covers 19%, in 211 numbers. cadiovasculary disease children including arrthymia, terror in frequency, night crying, sediation, Tic disorder covers 8%, in 85 numbers. Hepatobiliary disease children including short stature, dizziness, visual difficulty, sprain, disorder of nail covers 21%, in 238 numbers. renal disease. children including nocturia, hematuria, hemation, disorder of hair, menorrhea, cerebral palsy, edema in 44 numbers. Fatigue children covers 13%. in 143 numbers. 4. In case of respatory disease children. total number is 399 children. dematitis children are 108 numbers and asthma children are 96 numbers. These show that children seem to the best have dematitis and asththma. The age from 0 to 6 is 290 numbers, covering 73 percentage. The others are covering 27 percentage. These data demonstrate that the age from 0 to 6 age could easily get these kinds - of diseases. The 29 percent of children had these kinds of diseases in spring. The 28 percent of children had these kinds of diseases in autumn. These show that children seem to frequently have these kinds of diseases in both spring and autumn season.(inter-season) 5. In case of digestive disease, anorexia covers 39%, in 83 numbers, dyspepsia covers 28%, in 59 numbers, anorexia and dyspepsia were the lagest group in digestive disease and the age from 0 to 6 covers 59%, in 125 numbers and the other age covers 39%. According to these data, infant seems to be vulnerable to these kinds of diseases. The 24 percent of children had these kinds of diseases in spring and summer. The 33 percent of children had these kinds of diseases in winter, which means that children mostly had winter. but decreased significant in autumn. 6. In case of cadiovasculary diseases, it can be divided into two categories: night covers 73% and nervous characteristics covers 27%. The age from 0 to 6 occupies 75%, and the other age occupies 25%. These data also show that infants can easily infected with these kinds of diseases. Analyzing by the season, summer could be the most frequent season that children have these kinds of diseases. but decreased in autumn. 7. In case of hepatobiliary children, sprains covers 166 numbers, fatigue covers 32 numbers, epistasxia covers 24 members, the reasion which sprain occupyied most of % were sprain covered ages. The age from 0 to 14 covers 59% and from 15 to 18 covers 41%. In the conclusion the adolescent seems to be vulnerable to sprains. In spring 29%, insummer 31%, in autumn 23%, and in winter 28% of children got these kinds of diseases, which show that children seems to have this kinds of disease in summer season. and decreased in autumn. 8. In case of renal disease. nocturia and hematuria covers 52%(occupied overhalf). The age from 0 to 6 covers 52%(occupied overhalf). Analyzing by season, in spring increased in summer(59%), decreased in autumn(45%) Conclusion 1. The chief complant in pediatric diseases that needed an oriental medical tretment was mainly the disease that tends to take iong time and the weakness. and appeared frequency in respiratory disease : 2. The oriential medical tretment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In paticular, the study shows that the oriental medical tretment should be emphasized in terms of preventing the disease 3, The new disease, which were developed with the change of human life and envir oment(just like seual disorder, short stature, obesity, dynamic disorder, examinee disease), should be in vestigated as a new field of oriental medical tretment.

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A Literature Review of The Senile Hypotension (노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kwak, Ik-Hoon;Kim, Jong-Dae;Jeong, Ji-Cheon
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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A Study on the Relationship between Health Food and Health-Related Factors by Residence and Sex in Tong-Yeong Area (거주지역 및 성에 따른 통영지역주민의 건강식품 이용실태 및 건강관련 제요인과의 관련성)

  • Lee, Bog-Ri;Jeong, Bo-Young;Kim, In-Soo;Moon, Soo-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.6
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    • pp.840-849
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    • 2005
  • In order to investigate the relationship between intake conditions of health food and health-related factors by residence and sex in Tong-Young area, a survey was carried out from 1,303 adults. Health foods were classified 3 groups including vitamin and mineral supplements, toner foods and manufactured health food supplements. Health-related factors were stress, fatigue, smoking and drinking. The $29.5\%$ of the subjects had taken some health food for health. Especially the male took more toner foods habitually than the female did. In take of vitamin and mineral supplements by residence, there was a significant difference $(p\leq0.01)$ as follows. The subjects in island $(20.0\%)$ who took vitamin/mineral supplements were about two times as compared with the subjects in Dong $(10.8\%)$, or Eub-Myeon $(10.0\%)$. The subjects taking supplementary food replied over fair $(82.8\%)$, the subjects taking toner food replied over fair (90.3$\%$) scored higher than who replied bad or very bad in self-perceived health status. Therefore, the better the subjects felt self-perceived health status, the more they took health foods for health themselves. In self-perceived stress status, the subjects who replied a little $(50.0\%,\;45.3\%)$ or little $(19.9\%,\;26.4\%)$, took vitamin and mineral supplements or manufactured health foods a lot. In toner food there was a significant correlation $(p\leq0.05)$ as follows. The less the subjects felt stress, the more they took dietry supplement. No smoker $(12.9\%)$intake rate of vitamin and mineral supplements was higher than smoker $(8.8\%)$. Smokers $(6.5\%)$ intake rate of toner food was higher than no smoker $(4.0\%)$. It was not significant the relationship between intake condition of health food and drinking. The main motivation for taking health food were by self-decision and invitation of friends or neighbors.

Effects of Different Exercise Intensity on Excess Post Exercise Oxygen Consumption (EPOC), Resting Metabolic Rate (RMR), and Biochemical Variables in Obese and NIDDM Patients (운동 강도의 차이가 제2형 당뇨병 환자와 비만인의 초과산소 섭취량, 안정 시 대사량 및 생화학적 변인에 미치는 영향)

  • Kwak, Yi-Sub;Ku, Woo-Young;Yoo, Byung-In;Jin, Young-Wan;Choi, Kyung-Suk;Cho, Joon-Yong;Woo, Jin-Hee;Hwang, Hye-Jin
    • Journal of Life Science
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    • v.18 no.10
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    • pp.1455-1463
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    • 2008
  • The purpose of this study was to evaluate the effect of various exercise intensity on Excess post exercise energy expenditure (EPEE), Resting Metabolic Rate (RMR),thyroid hormonal changes and biochemical variables in obese and NIDDM patients. The subject of the present study were divided into four groups and four periods: trained (T; n=10), control (C; n=10), obese (O; n=10) and NIDDM (N; n=10) group. And the periods were divided as follows; Resting (RE), Maximal (MA), High intensity (HI), and Low intensity (LI). There was significant difference in RMR among different intensity of exercise. in the T (p<0.05) not in the C, O, and N groups. however, there was no significant different percent body fat among all groups. In the energy expenditure, there was significant different among C, O, N groups compare to T in HIEE (high intensity exercise energy expenditure), LIEE (low intensity exercise energy expenditure), HIEEPE (high intensity exercise energy expenditure post exercise) and LIEEPE (low intensity exercise expenditure post exercise). In the hormonal level, there was significant different in T4 level in the T group at LI period and there was also significant difference in T4, Free T3, & Free T4 levels in T group at LI period, however there was no significant different in the O and N groups except LI period. In the fatigue variables, there was significant different in lactate and ammonia levels in the N group in the period of HI compare to C. The present cross-sectional study was design to investigate the relationship between exercise intensity and RMR in four groups. The focus of this investigation was to compare RMR in aerobically trained (T), control (C), obese (O) and NIDDM (N) group. The relationship among RMR, exercise intensity and percent body fat would best be investigated using Meta Lyzer 3B, MMX3B and body composition analyzer. Each subject completed measurement of percent body fat, RMR, hormone in the period of maximal oxygen uptake exercise (MA), high intensity exercise (HI), and low intensity exercise (LI). From the results, High and Low intensity of exercise, there was a trend for an increased RMR (kcal/day) in the trained groups and control group (in case of LI) not for the obese and N groups. This is best explained not by the reduced percent body fat but by the highly induced energy expenditure (during exercise and post exercise energy expenditure) and increased T4, Free T3, and Free T4 hormonal levels in the low intensity exercise for the T group and sometimes C group.

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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