• Title/Summary/Keyword: Abdominal breathing

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Effect of Enidural Analgesia on the Post-thoracotomy Patient (경막외 진통법이 개흉술후 환자에게 미치는 영향)

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    • Journal of Chest Surgery
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    • v.25 no.4
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    • pp.391-397
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    • 1992
  • Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

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Interpretation of Excess and Deficiency Syndromes(有餘不足證) Described in "Somun . Jogyongron(素問.調經論)" ("소문(素問).조경론(調經論)"의 유여(有餘).불족증(不足證)에 대(對)한 연구(硏究))

  • Bang, Jung-Kyun
    • Journal of Korean Medical classics
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    • v.20 no.3
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    • pp.49-56
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    • 2007
  • The "Somun Jogyongron(素問 調經論)" describes excess and deficiency syndromes. The study suggests that excess syndrome(實證) is caused by vigorous pathogenic fire(火邪)(the spirit(神)), pathogenic dryness(燥邪)(Gi(氣)), pathogenic wind(風邪)(blood(血)), pathogenic dampness(濕邪)(physique(形)) or pathogenic coldness(寒邪)(will(志)). When pathogenic fire is dominant within the body, Gi and blood becomes excessive and come out of the body, but the body cannot take them back, leading to the symptom in which the patient cannot stop laughing. When pathogenic dryness prevails, the lung(肺) cannot function properly. This means that the convergence(收斂) function of the clearing the lung and descending Gi(肅降) is deteriorated, and the patient shows symptoms of dyspnea and cough. Strong pathogenic wind increases the ascencling Gi in the liver(肝氣) and fuel angry emotion when the patient becomes upset. When pathogenic dampness is dominant, spleen(脾) function drops due to lumping effects, and the patient will experience abdominal distention(腹脹), which will disturb urination and defecation. When pathogenic coldness prevails, abdominal distention occurs due to condensating effects, and Yang Gj(陽氣) in the kidney(腎) is disturbed, leading to digestion disorders and eventually water-grain dysentery. Deficiency syndrome is caused by the lack of essential Gi(精氣) in the five viscera(五藏). Deficiency of sprit means the lack of Gi in the heart(心氣), so the patient becomes vulnerable to sadness. Deficiency of Gi means the lack of Gi in the lung(肺氣), so the patient may have breathing disorders. Deficiency of blood means the lack of Gi in the Liver(肝氣), so the patient can be easily scared. Deficiency of physique means the lack of Gi in the spleen(脾氣), making it difficult to use arms and legs. Deficiency of will means the lack of Gi in the kidney(腎氣), so Gowl syndrome(厥證) can ensue.

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Development of RMRD and Moving Phantom for Radiotherapy in Moving Tumors

  • Lee, S.;Seong, Jin-Sil;Chu, Sung-Sil;Yoon, Won-Sup;Yang, Dae-Sik;Choi, Myung-Sun;Kim, Chul-Yong
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.63-63
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    • 2003
  • Purpose: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. We developed a simple and handy method, which can reduce PTV margins in patients with moving tumors, respiratory motion reduction device system (RMRDs). Materials and Methods: The patients clinical database was structured for moving tumor patients and patient setup error measurement and immobilization device effects were investigated. The system is composed of the respiratory motion reduction device utilized in prone position and abdominal presser (strip device) utilized in the supine position, moving phantom and the analysis program, which enables the analysis on patients setup reproducibility. It was tested for analyzing the diaphragm movement and CT volume differences from patients with RMRDs, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using a treatment planning software. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose(TD50). Results: In case of utilizing RMRDs, which was personally developed in our hospital, the value was reduced to $5pm1.4 mm$, and in case of which the belt immobilization device was utilized, the value was reduced to 3$pm$0.9 mm. Also in case of which the strip device was utilized, the value was proven to reduce to $4pm.3 mm$0. As a result of analyzing the TD50 is irradiated in DVH according to the radiation treatment planning, the usage of the respiratory motion reduction device can create the reduce of 30% to the maximum. Also by obtaining the digital image, the function of comparison between the standard image, automated external contour subtraction, and etc were utilized to develop patients setup reproducibility analysis program that can evaluate the change in the patients setup. Conclusion: Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.

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Toxoplasmosis in piglets (자돈의 톡소플라즈마증 발생)

  • Roh, In-soon;Han, Jeong-hee;Kim, Jae-hoon;Ahn, Byeong-woo
    • Korean Journal of Veterinary Research
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    • v.37 no.4
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    • pp.817-823
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    • 1997
  • Suckling piglets and weaned pigs showed anorexia, dehydration, severe abdominal breathing, emaciation and paresis from Oct. 1993. to Nov. 1993. Five 2-week-old piglets were submitted for diagnosis in Kangwon National University. At necropsy, the pin-point well demarcated yellowish white foci were scattered on the surface of the lung, heart, liver, spleen and kidney. Histologically, multifocal areas of necrosis with mononuclear cells infiltration were found in the lung, heart, liver, lymph node, spleen, kidney and small intestine. These lesions tended to be associated with blood vessels. Variable round to ovoid tachyzoites were located at the periphery of the lesions. The organisms were demonstrated as Toxoplasma gondii by immunohistochemical staining method. Ultrastructurally, this parasite was surrounded with parasitophorous vacuole in alveolar macrophage. The parasite was crescent-shaped and $6{\sim}8{\times}1{\sim}2{\mu}m$ in size. It was enclosed by an thick outer membrane and an underlying thin inner membrane. Several club-shaped paired organelles and conoids lay in the cytoplasm at the anterior. Numerous round body and one to several mitochondria were presented in the cytoplasm. Based on the gross findings, histopathology, immunohistochemical and electron microscopic findings, this case was diagnosed as toxoplasmosis in piglets.

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Clinical Ewperiences of Rib Fixation Using Judet's Strut (Judet's strut를 사용한 늑골 고정술의 임상적 고찰)

  • Kim, Jae-Ryeon;Im, Jin-Su
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.847-850
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    • 1995
  • For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

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The Effect of Singing Therapy on Classical Singers with Voice Problems (음성장애가 있는 성악인에 대한 성악치료의 효과)

  • 문영일;홍현정;신혜정;박애경;정성민
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.32-38
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    • 2000
  • Background and Objectives : Voice therapy has been used as a viable adjuvant to surgery and pharmacological therapy fir the management of voice disorders. The singing voice features a special brand of emotion, intensity, and energy so successful therapeutical approach requires the doctor is able to involve himself into the physical and psychic condition and artistic usage of the voice. The purpose of this study was to evaluate the effect and utility of singing therapy as an initial treatment for classically trained singers with voice disorders. Material and method : Twenty-one male and fifty-five female classic singers with voice disorders were treated with singing therapy. At first, abdominal breathing, resonant phonation, and relaxation method was trained, then after accessing each patient's singing abilities, treatment methods for each specific problems was applied. The results were compared according to age, sex, treatment duration, part, laryngeal pathology, patient subjective evaluation, perceptual evaluation of voice, and maximal phonation time. Results : Patients subjective evaluation, perceptual evaluation, pathologic findings of larynx, maximal phonation time showed superior results after singing therapy. Conclusion : Singing therapy changes the mode of respiration and phonation and enhances the vocal function and improves the laryngeal pathology, The result of this study indicate that singing therapy is an effective treatment method that laryngologists can use for classical singers with voice disorders.

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Relationship with Physical Suffering, Emotional State, and Nursing Needs of Pregnant Women in Preterm Labor (조기진통 임부의 신체적 불편감, 정서적 상태 및 간호 요구도와의 관계)

  • Go, Jeong-Im;Kim, Kyung-Hee;Yeoum, Soon-Gyo
    • Women's Health Nursing
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    • v.15 no.4
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    • pp.280-293
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    • 2009
  • Purpose: This study was to identify the relationship between physical suffering, emotional state, and nursing needs of pregnant women in preterm labor and the difference depending on general characteristics. Methods: The participants in this descriptive survey, selected by convenience sampling, were 126 pregnant women who were hospitalized after being diagnosed with preterm labor at 3 university hospitals. Results: The level of personal hygiene was assessed in physical suffering, level of fear was assessed by the emotional state, and level of perterm labor was assessed by the nursing cares. In the analysis, physical suffering, emotional state, and nursing needs in the subjects all showed a significantly positive correlation. Differences in physical suffering, emotional state, and nursing needs depending on general characteristics were as follows; age, job, family type, economic condition, smoking, drinking admission days, previous delivery type, and artificial insemination. Conclusion: Based on the results of this study, the nurse should focus on the domain of personal hygiene, and teaching contents specific for abdominal breathing exercises for relieving the women's fear and anxiety should be added.

Mind-Body Approach in the Area of Preventive Medicine: Focusing on Relaxation and Meditation for Stress Management (예방의학 영역에서 심신의학적 접근의 적용 가능성: 스트레스 관리를 위한 이완과 명상 기법을 중심으로)

  • Kang, Yune-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.5
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    • pp.445-450
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    • 2010
  • Objectives: Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. Methods and results: The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Conclusions: Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mindbody approach in the preventive service area of medicine.

Immunohistochemical detection of viral antigen and pathological lesion in piglets experimentally infected with encephalomyocarditis virus (뇌심근염 바이러스의 실험적 감염자돈에 대한 병리학적 소견과 바이러스 항원의 면역조직화학적 검출)

  • Cho, Sung-hwna;Joo, Han-soo;Kim, Hyun-soo
    • Korean Journal of Veterinary Research
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    • v.33 no.2
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    • pp.301-308
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    • 1993
  • Three or 7day old piglets were infected experimentally with different encephalomyocarditis virus isolates to detect the viral antigen by the immunoperoxidase technique and to observe strain difference in their pathogenecity in newborn pigs by comparing clinical signs and pathologic lesions. Clinical signs of the infected pigs were different depending on the virus strain, pig age and infection route. Encephalomyocarditis virus(EMCV) NVSL-PR isolate was more pathogenic than MN-25 and MN-30 isolate. Three day old piglets showed more severe illness than 7 day old piglets. Predominant clinical signs were sudden death without noticeable clinical signs and dyspnea manifested as heavy abdominal breathing. Contact-infection from infected piglets to controls was observed in the oro-nasally infected group but not the intramuscular group. Common necropsy findings of dead piglets in both age groups infected with MN-25 and NVSL-PR were accumulation of excessive fluid in the body cavities and mild to diffuse necrotic areas observed in the hearts and occasionally in the livers. Microscopically, myocarditis with inflammatory cell infiltration, necrosis of the myocardial muscle fibers and occasional mineralization were observed along with interstitial pneumonia and centrolobular necrosis in the liver. Using an immunoperoxidase technique, viral antigen was detected in myocardial muscle fibers of piglets infected with EMCV.

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A Case of Green Tobacco Sickness (GTS) in Elderly Patient (담뱃잎농부병으로 진단된 고령 환자 1례)

  • Jeong, Dong Kil;Kim, Doh-Eui
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.132-134
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    • 2019
  • Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.