Sleep alters both breathing pattern and the ventilatory responses to external stimuli. These changes during sleep permit the development or aggravation of sleep-related hypoxemia in patients with respiratory disease and contribute to the pathogenesis of apneas in patients with the sleep apnea syndrome. Fundamental effects of sleep on the ventilatory control system are 1) removal of wakefulness input to the upper airway leading to the increase in upper airway resistance, 2) loss of wakefulness drive to the respiratory pump, 3) compromise of protective respiratory reflexes, and 4) additional sleep-induced compromise of ventilatory control initiated by reduced functional residual capacity on supine position assumed in sleep, decreased $CO_2$ production during sleep, and increased cerebral blood flow in especially rapid eye movement(REM) sleep. These effects resulted in periodic breathing during unsteady non-rapid eye movement(NREM) sleep even in normal subjects, regular but low ventilation during steady NREM sleep, and irregular breathing during REM sleep. Sleep-induced breathing instabilities are divided due primarily to transient increase in upper airway resistance and those that involve overshoots and undershoots in neural feedback mechanisms regulating the timing and/or amplitude of respiratory output. Following ventilatory overshoots, breathing stability will be maintained if excitatory short-term potentiation is the prevailing influence. On the other hand, apnea and hypopnea will occur if inhibitory mechanisms dominate following the ventilatory overshoot. These inhibitory mechanisms include 1) hypocapnia, 2) inhibitory effect from lung stretch, 3) baroreceptor stimulation, 4) upper airway mechanoreceptor reflexes, 5) central depression by hypoxia, and 6) central system inertia. While the respiratory control system functions well during wakefulness, the control of breathing is commonly disrupted during sleep. These changes in respiratory control resulting in breathing instability during sleep are related with the pathophysiologic mechanisms of obstructive and/or central apnea, and have the therapeutic implications for nocturnal hypoventilation in patients with chronic obstructive pulmonary disease or alveolar hypoventilation syndrome.
Objectives: The aim of this study was to investigate the preventive effects of Sambok-go for upper respiratory tract infection. Methods: Sambok-go was performed to outpatients which had visited Daejeon university oriental medicine hospital. The number of participants who received Sambok-go at least once were 85, 21 patients did not receive Sambok-go three times were excluded first. Participants who received treatment three times were 64 patients. After the 2011 winter, 2012.05 we follow-up by telephone, except eight, 56 patients were analyzed. Sambok-go is composed of 8 kinds of medicinal herbs. Each Sambok-go weighs about 1.1g and attatchment surface diameter is about 1.5 cm. Sambok-go was attached to both side of 폐유(肺兪)(BL13), 심유(心兪)(BL15), 폐유(膈兪)(BL17), patients under the age of 15 were attached for an hour, patients over 15 years age were attatched for 3 hours. Results: Among the finally analyzed 56 participants, we compared the number of flu outbreak during winter before and after treatment. Before treatment measured $6.14{\pm}6.57$, after treatment measured $1.57{\pm}1.14$. In conclusion, the number of flu outbreak was significantly decreased(p<0.001). To investigate the effect of worsening factors on the pre-existing upper respiratory diseases, we checked whether the patients had pre-existing upper respiratory diseases. The patients who already had old upper respiratory diseases were 34. The increase in the frequency of deterioration in 5 patients, 4 patients no change, decreased in 24 cases, one patient was unresponsive. After evaluating the satisfaction of The patients who were treated with the Sambok-Go, the 29 cases were very satisfied, the 23 were satisfied, None of the paitents showed dissatisfaction or bad dissatisfaction. Conclusion: Sambok-go seems to be effective in the prevention of URI. Further studies are recommended to confirm this effect.
Objective: This study was designed to analyze the symptoms of chronic obstructive pulmonary disease (COPD) patients who attended a Korean medicine hospital and treatment effects through retrospective chart reviews.Methods: The medical records of 192 outpatients who had been diagnosed with COPD and visited the Allergy, Immune, and Respiratory System Department of Kyung Hee Korean Medicine Hospital from 1 February 2006 to 1 February, 2016 were retrospectively reviewed.Results: The study group consisted of 112 and 80 females. The median age of the patients was 59.80±15.46 y. Fifty of the patients had been diagnosed with chronic upper respiratory diseases, such as chronic rhinitis, nasopharyngitis, or sinusitis. The chief complaints were cough (n=136), sputum (n=124), and dyspnea (n=82). Other frequent symptoms were fatigue (n=11), hyperhidrosis (n=8), and a bad taste in the mouth (n=7). All the patients were prescribed Korean herbal medicine. In the study, 61 (31.77%) patients were treated with acupuncture, moxibustion, cupping therapy, or herbal steam therapy. Symptoms improved in 126 (65.63%) patients 141±272.82 d after the first treatment.Conclusions: Some of the COPD patients had chronic upper respiratory disease. The chief complains were cough, sputum, and dyspnea. Oher frequent symptoms related to body malfunction and pain. The symptoms improved in 126 (65.63%) patients 141.00±272.82 d post-treatment.
Objectives: This study was aimed to figure out an agreement between the diagnosis of nasal endoscopy and a preexisting questionnaire focusing on Cold-Heat pattern. Methods: 52 patients with cough who met the criteria filled out a pattern questionnaire and the examiner looked at their nasal cavities through nasal endoscopy. According to the checked questionnaire results, the subjects were identified by 6 patterns. After examining subject's mucous membrane of oropharynx and nasal cavity through nasal endoscopy, we classified each to the Cold or Heat group. Correlation between questionnaire and nasal endoscopy results was analyzed. Results: In diagnosing Cold-Heat, there was no significant difference by McNemar test (p=0.227) between nasal endoscopy and the questionnaire, and the two methods agreed moderately (${\kappa}=0.428$). The color of mucous membrane of oropharynx and the Cold-Heat pattern on questionnaire agreed slightly (${\kappa}=0.133$). The color of mucous membrane of nasal cavity and the Cold-Heat pattern on questionnaire agreed fairly (${\kappa}=0.384$). In the patients with cough related to upper respiratory tract, they got higher diagnosis accuracy than the patients with cough related to lower respiratory tract did. Similarly, external cough patients got higher diagnosis accuracy than internal cough patients did. Conclusions: To identify Cold or Heat, examining oropharynx and nasal cavity using nasal endoscopy is a meaningful method in patients with cough, showing that two diagnosis methods which use nasal endoscopy and questionnaire agreed moderately. Especially, it is more useful diagnosing patients with cough related to the upper respiratory tract than diagnosing the patients with cough related to the lower respiratory tract.
The number of dairy cows diagnosed and treated at Hyup-dong Animal Hospital from July 1983 to June 1984 was amounted to 3,073 heads of Holstein breed and the result of analysis of diseases was as follows : 1. In the topographic diagnostic categories, 41.23% of all cases involved the urogenital system and were observed most prominent. Next were digestive system (22.10%), general and regional (14.55 %), respiratory system (8.20%) and musculoskeletal system (7.06%) in decreasing order. 2. In urogenital system 50.20% of all diagnosis involved metritis and this were most prominent disease. Next were repeat breeder(15.31%), retained placenta (12.79%) and ovary disfunction(9.40 %) in decreasing order. 3. In digestive system 36.82% of all diagnosis involved enteritis and were most prominent. Next were abomasal displacement (29.31%), lumen indigestion (20.32%) and lumen bloat (9.57%) in decreasing order 4. In general and regional diseases, 52.80% of all diagnosis involved ketosis and were most prominent. Next were milk fever (25.50%), downer cow (5.82%) and omphalitis (4.47%) in decreasing order. 5. In respiratory system, 82.54% of all diagnosis involved upper respiratory tract infections and were most prominent. Next were pneumonia (15.87%). 6. In musculoskeletal system, 49.31% of all diagnosis involved foot rot and were most prominent. 7. In milk secreting system, 61.64% of all diagnosis involved mastitis and ere most prominent. Next were stenosis of teat canal (16.35%). 8. Among the individual disease entities, endometritis marked 20.7%, enteritis 8.13%, ketosis 7.68% upper respiratory tract infection 6.77%, repeat bheeder 6.31%, retained placenta 5.27%, abomasal displacement 4.69%, and lumen impaction 4.49%, respectively of total 3,073 cases in decreasing order.
Sweet's syndrome also known as acute neutrophilic dermatosis is a multisystem inflammatory disorder characterized by fever, malaise, leukocytosis, and skin lesions. Sweet's syndrome affects multiple organs though only rarely does it affect the central nervous system (CNS) when it does it is called Neuro-Sweet disease (NSD). We report on a case study of a biopsy-proven NSD in a 50 year old man. Serial magnetic resonance imaging (MRI) showed repeated CNS involvement of Sweet's syndrome after a respiratory tract infection preceded it. On the MRI, T2 hyperintense lesions occurred at multiple sites and disappeared after steroid therapy.
Background: Vibration response imaging (VRI) is a new technology that records energy generated by airflow during the respiration cycle. Analysis of lung sound using VRI may overcome the limitations of auscultation. Objectives: To set a VRI standard for healthy Koreans, we conducted a clinical assessment to evaluate breath sound images and quantification in healthy subjects and compared the findings with reported breath sound characteristics. Methods: Recordings were performed using the VRIxp. Eighty subjects took a deep breath four times during a 12-second interval while sitting upright. The quantitative aspect was analyzed using the VRI quantitative lung data (QLD) for total left lung, total right lung and for six lung regions: left upper lung (LUL), left middle lung (LML), left lower lung (LLL), right upper lung (RUL), right middle lung (RML), right lower lung (RLL). The qualitative aspect was provided through image assessments by three reviewers. Results: In all regions the left lung had significantly higher QLD than the right lung (P<0.005, paired t-test). The inter-rater agreement was 0.78. 84% of the images were found normal by the final assessment. Among the 16% (n=13) of images with abnormal final assessment, the most common flawed features were dynamic image (77%, n=10) and maximum energy frame (MEF) shape (77%, n=10). No significant differences were found between males and females for QLD but there were significant differences in qualitative aspects including dynamic images, MEF shape, and missing LLL. Conclusion: The characteristics of healthy Koreans are similar to those of Western subjects reported previously. VRI is easy to use and objective, and so is helpful to diagnose patients with respiratory diseases and to monitor the progress of diseases after medical treatments.
Although upper respiratory tract infections (URTIs) are common diseases, there have been no studies of their relationship with the indices obtained from tongue image analyses. The purpose of this study was to identify a tongue index through an analysis of tongue images (TIs) showing significant changes before and after treatment in patients with URTIs. A computerized tongue image acquisition system was developed to acquire TIs from subjects in the same environment. An image was taken from each of 39 URTI patients and 39 healthy controls. For the patients, images were acquired before and after treatment to identify changes. The tongue area was classified into a tongue body and a tongue coating, and the coating ratio between the two areas, the average value of the colour of each area, and teeth marks were calculated. No significant difference was observed in age or sex between the URTI patients and control participants. Heart rates were slightly different. The analysis of TIs showed that the luminance of the tongue coating and the coating area ratio were decreased, while the reddish value of the tongue body at the centre area increased as the treatment progressed. Tongue coating and body in URTIs had different colour and shape from those in the normal. It is expected that this result will contribute not only to the objectification of traditional Chinese medicine but also to diagnostic methods that do not involve face-to-face physician visit during the pandemic.
Journal of the Korean Society of Physical Medicine
/
v.11
no.3
/
pp.119-124
/
2016
PURPOSE: The aim of this study was to evaluate activation of accessory respiratory muscles using electromyography during chest expansion upper extremity flexion, abduction, and external rotation exercises with an elastic band in children with cerebral palsy. METHODS: The subjects were 10 children with cerebral palsy. The inclusion criterion for participation was a Gross Motor Function Classification System level of I to III. The subjects were instructed to perform upper extremity flexion, abduction, and external rotation exercises with inspiration, and extension, adduction, and internal rotation exercises with expiration while seated on a chair without a backrest. PM (Pectoralis major), SCM (sternocleidomastoid), RA (rectus abdominis), and EO (external oblique) muscle activities were measured using electromyography. RESULTS: All tested muscles showed a statistically significant increase in activity after elastic band exercise. There were significant differences in PM, SCM, RA, and EO results after chest expansion exercise using elastic band. SCM showed the largest increase in activity after use of elastic bands, at $52.37{\pm}45.88$%, followed by the RA ($50.56{\pm}79.31$), EO ($35.42{\pm}35.45$), and PM ($31.72{\pm}25.64$). The increase in the SCM was greatest, followed by increases in the RA, EO, and PM CONCLUSION: These finding suggest that activity of accessory respiratory muscles increases with use of elastic bands during chest expansion exercise in cerebral palsy.
Objective : Hyperhidrosis is the secretion of sweat in amounts greater than physiologically needed for thermoregulation. Ryodoraku is a physiological function test using electric current, and is closely related to skin sympathetic tone. The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with hyperhidrosis. Methods : For this study, we conducted Ryodoraku on 56 people, comprising 33 with palmar-plantar hyperhidrosis and 23 with head-face hyperhidrosis, who visited the 5th Internal Department of the Oriental Medicine Hospital of Kyung Hee University during the period from March 1, 2008 to May 31, 2009. Ryodoraku scores were evaluated and compared by 7 indices(upper, lower, left, right, yin, yang, total score). Results : Ryodoraku scores were significantly higher in hyperhidrosis patients than the normal group. Ryodoraku scores of palmar-plantar hyperhidrosis patients were significantly higher than of head-face hyperhidrosis patients and the normal group. The difference of Ryodoraku indices among palmar-plantar hyperhidrosis patients were insignificant. In head-face hyperhidrosis patients, the upper index was significant higher than the lower index. Conclusions : In hyperhidrosis patients, all indices were significant higher than lower. The upper/lower ratio was significant higher in head-face hyperhidrosis patients.
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