• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.5-11
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• 2017

The use of alcohol is associated with the development and worsening of sleep disorder. Alcohol is generally known to have a sedative effect, but it has an arousal or sedative effect depending on the timing and drinking dose and directly affects REM sleep physiology. Alcohol acts on the central nervous system (CNS) to interfere with the sleep-wake cycle and to affect sleep-related hormone secretion. In addition, the ingestion of alcohol pre-sleep is associated with deterioration and development of sleep related breathing disorders (SBD). The increase in resistance of the upper respiratory tract and the decrease in sensitivity of the CNS respiratory center and the respiratory muscles are major mechanisms of alcohol-induced SBD, and result in snoring or apnea in healthy men or aggravating apnea in patients with OSA. Sleep-related restless leg syndrome and circadian rhythm disorders are common in alcohol use disorder patients. This review provides an assessment of scientific studies that investigated on the impact of alcohol ingestion on nocturnal sleep physiology and sleep disorders.

• Clinical and Experimental Pediatrics
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• v.53 no.10
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• pp.872-879
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• 2010

Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.

• Journal of the Korean Society of Visualization
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• v.9 no.3
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• pp.65-70
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• 2011

Three major physiological functions of nose can be described as air-conditioning, filtering and smelling. Detailed knowledge of airflow characteristics in nasal cavities is essential to understanding of the physiological and pathological aspects of nasal breathing. In our laboratory, a series of experimental investigations have been conducted on the airflows in normal and abnormal nasal cavity models by means of PIV under both constant and periodic flow conditions. In this work, more specifically experimental and numerical results on the surgically modified inferior turbinate model were presented. With the high resolution CT data and a careful treatment of the model surface under the ENT doctor's advice yielded quite sophisticated cavity models for the PIV experiment. Physiological nature of the airflow was discussed in terms of velocity distribution and vortical structure for constant inspirational flow. Since the inferior and middle turbinate are key determinants of nasal airflow, the turbinectomy obviously altered the main stream direction. This phenomenon may cause local changes in physiological function and the flow resistance.

• Journal of Convergence for Information Technology
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• v.9 no.10
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• pp.234-243
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• 2019

This study was conducted to investigate the effects of whole body vibration stimulation training combined with respiratory resistance on respiratory and balance function in stroke patients. 17 patients with chronic stroke were randomly assigned to the experimental group (n = 8) and the general vibration exercise program (n = 9). The intervention was conducted three times a week for 30 minutes once a week for 4 weeks. The respiratory function and balance ability were evaluated before and after the intervention to evaluate the degree of functional improvement. As a result, there was a significant difference (p<.05) between the respiratory function and the balance ability in the experimental group, and a significant difference(p<.05) in the respiratory function between the experimental group and the control group. The balance ability was not significantly different among the experimental groups. Through the results of this study, whole body vibration stimulation training combined with respiratory resistance may be useful as a program for improving respiratory function and balance ability of stroke patients.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.813-822
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• 1998

Background: Extubation is recommended to be performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. Methods: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventilation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate $\times$ total ventilatory system resistance) at the 15cm $H_2O$ of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at PSmin). The measurements were repeated at PSmm, during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extubation. In intervention group, failure to continue weaning process was also considered as weaning failure. Results: Thirty-six patients with 42 times weaning trial were satisfied to the protocol. Mean PSmin level was 7.6 (${\pm}1.9$)cm $H_2O$. There were no differences in total ventilation times (TVT), APACHE III score, nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, and tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group ($10.4{\pm}1.25$ and $1.66{\pm}1.08$ J/L in work of breathing) ($191{\pm}232$ and $287{\pm}217$cm $H_2O$ s/m in pressure time product) ($0.33{\pm}0.09$ and $0.29{\pm}0.09$ L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success ($246{\pm}195$ hr, $0.43{\pm}0.11$ L) and the those with weaning failure ($407{\pm}248$ hr, $0.35{\pm}0.10$L) (P<0.05 in each). Conclusion : There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PS min.

• The Korean Journal of Physiology
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• v.9 no.2
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• pp.7-15
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• 1975

The maximum breathing capacity (MBC) and the maximum mid-expiratory flow rate (MMF) are widely used in evaluation of the ventilatory function, among various parameters of pulmonary function. The MBC volume is the amount of gas which can be exchanged per unit time during maximal voluntary hyperventilation. Performance of this test, unlike that of single breath maneuvers, is affected by the integrity of the respiratory bellows as a whole including such factors are respiratory muscle blood supply, fatigue, and progressive trapping of air. Because of this, the MBC and its relation to ventilatory requirement correlates more closely with subjective dyspnea than does any other test. The MMF is the average flow rate during expiration of the middle 50% of the vital capacity. The MMF is a measurement of a fast vital capacity related to the time required for the maneuver and the MMF relates much better to other dynamic tests of ventilatory function and to dyspnea than total vital capacity, because the MMF reflects the effective volume, or gas per unit of time. Therefore, it is important to have a prediction formula with one can compute the normal value for the subject and the compare with the measured value. However, the formulas for prediction of both MBC and MMF of the Korean children and adolescents are not yet available in the present. Hence, present investigation was attempt to derive the formulas for prediction of both MBC and MMF of the Korean children and adolescents. MBC and MMF were measured in 1,037 healthy Korean children and adolescents (1,035 male and 1,002 female) whose ages ranged from 8 to 18 years. A spirometer (9L, Collins) was used for the measurement of MBC and MMF. Both MBC and MMF were measured 3times in a standing position and the highest values were used. For measurement, the $CO_2$ absorber and sadd valve were removed from the spirometer in order to reduce the resistance in the breathing circuit and the subject was asked to breathe as fast and deeply as possible for 12 seconds in MBC and to exhale completely as fast as possible after maximum inspiration for MMF. During the measurement, investigator stood by the subject to give a constant encouragement. All the measured values were subsequently converted to values at BTPS. The formulas for MBC and MMF were derived by a manner similar to those for Baldwin et al (1949) and Im (1965) as function of age and BSA or age and height. The prediction formulas for MBC (L/min, BTPS) and MMF (L/min, BTPS) of the Korean children and adolescents as derived in this investigation are as follows: For male, MBC=[41.70+{$2.69{\times}Age(years)$}]${\times}BSA$ $(m^{2})$ MBC=[0.083+{$0.045{\times}Age(years)$}]${\times}Ht$ (cm) For female, MBC=[45.53+{$1.55{\times}Age(years)$}]${\times}BSA$ $(m^2)$ MBC=[0.189+{$0.029{\times}Age(years)$}]${\times}Ht$ (cm) For male, MMF= [0.544+{$0.066{\times}Age(years)$}]${\times}Ht$ (cm) For female, MMF=[0.416+{$0.064{\times}Age(years)$}]${\times}Ht$ (cm)

• Science of Emotion and Sensibility
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• v.22 no.1
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• pp.15-22
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• 2019

The purpose of this study is to develop a strain sensor based on a nanoweb by applying electrical conductivity to a polyurethane nanoweb through the use of Graphene. For this purpose, 1% Graphene ink was pour-coated on a polyurethane nanoweb and post-treated with PDMS (Polydimethylsiloxane) to complete a wearable strain sensor. The surface characteristics of the specimens were evaluated using a field emission scanning electron microscope (FE-SEM) to check whether the conductive material was well coated on the surface of the specimen. Electrical properties of the specimens were measured by using a multimeter to measure the linear resistance of the specimen and comparing how the line resistance changes when 5% and 10% of the specimens are tensioned, respectively. In order to evaluate the performance of the specimen, the gauge factor was obtained. The evaluation of the clothing was performed by attaching the completed strain sensor to the dummy and measuring the respiration signal according to the tension using MP150 (Biopac system Inc., USA) and Acqknowledge (ver. 4.2, Biopac system Inc., U.S.A.). As a result of the evaluation of the surface characteristics, it was confirmed that all the conductive nanoweb specimen were uniformly coated with the Graphen ink. As a result of measuring the resistance value according to the tensile strength, the specimen G, which was treated with just graphene had the lowest resistance value, the specimen G-H had the highest resistance value, and the change of the line resistance value of the specimen G and the specimen G-H is increased to 5% It is found that it increases steadily. Unlike the resistance value results, specimen G showed a higher gauge rate than specimen G-H. As a result of evaluation of the actual clothes, the strain sensor made using the specimen G-H measured the stable peak value and obtained a signal of good quality. Therefore, we confirmed that the polyurethane nanoweb treated with Graphene ink plays a role as a breathing sensor.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.99-106
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• 1998

Background: Bronchial asthma is a complex disease, which is characterized by spontaneous exacerbations of airway obstruction and persistent bronchial hyperresponsiveness. Animal models have fallen short of reproducing the human disease, particularly in mimicking the spontaneous and persistent airflow obstruction that characterized in asthma. In animals, airflow obstruction is usually assessed by measuring airflow resistance during tidal breathing under such invasive technique as tracheostomy and anesthesia. A noninvasive technique for measuring pulmonary function in small animals is needed to evaluate long-term changes in lung function during the course of experimentally produced disease without sacrificing the animal. Purpose: The purpose of this study was to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness (AR) to inhaled methacholine in nonanethetized, unrestrained guinea pigs. Method: Guinea pig model of asthma was sensitized by subcutaneous injection with ovalbumin and challenged by inhalation of aerosolized ovalbumin(1% wt/vol ovlabumin). Airflow obstruction of conscious guinea pig was measured as specific airway resistance (airway resistance $\times$ thoracic gas volume). Airway resistance and thoracic gas volume of conscious guinea pig were assessed by body plethysmography before challenge and at regular intervals for as long as 30 minutes after challenge. AR to aerosolized methacholine of asthma group was compared with that of control group in body plethysmography. Result: Asthma model<> developed in 13 (65%) among 20 guinea pigs, in which early responses occurred in the airways after the exposure to inhalation with ovalbumin. Airway challenge with ovalbumin caused increase in specific airway resistance, which peaked at 6 minutes and amounted to a $231.5{\pm}30.4%$ increase from baseline. AR to aerosolized methacholine of asthma model increased significantly compared with control group. Conclusion: These results have showed a useful animal model to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness in nonanethetized, unrestrained guinea pigs.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1039-1046
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• 1998

Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

• 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.