• Tuberculosis and Respiratory Diseases
• /
• 제70권3호
• /
• pp.199-205
• /
• 2011

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

• The Korean Journal of Physiology
• /
• 제13권1_2호
• /
• pp.1-12
• /
• 1979

To evaluate the present status of physical fittness of Korean long distance runners, body fat, pulmonary functions, maximal oxygen intake and oxygen debt were measured in 5 elite marathoners (A group), 6 college student runners (B group) and 3 middle school student runners (C group). After laboratory tests, full course marathon running was performed in 2 elite marathoners during which their heart rates were monitored continuously. The results are summerized as follows: 1) Total body fat in all three groups are in the range of 13-15% of their body weight. 2) In all three groups, average values of various pulmonary functions were within the normal limits, but those of tidal volume were higher and respiratory rate were lower in comparison to normal values. These phenomena may represent respiratory adaptations against training. The average resting oxygen consumptions in A,B and C were $322{\pm}23$, $278{\pm}14$ and $287{\pm}16$m1/min, respectively. 3) In all three groups, resting blood pressures were in the normal range, but the resting heart rate was slightly lower in groups A $(56{\pm}3\;beats/min)$ and B $(64{\pm}2\;beats/min)$ and higher in group C $(82{\pm}9\;beats/min)$ in comparison to normal values. These changes in cardiovascular functions in marathoners may also represent adaptive phenomena. 4) During treadmill running the minute ventilation and oxygen consumption of the runners increased lineally with work load in all three groups. When the oxygen consumption was related to heart rate, it appeared to be a exponential function of the heart rate in all three groups. 5) The average maximal heart rates during maximal work were $196{\pm}3$, $191{\pm}3$ and $196{\pm}5\;beats/min$ for groups A,B and C, respectively. Maximal oxygen intakes were $84.2{\pm}3.3\;ml/min/kg$ in group A, $65.2{\pm}1.1\;ml/min/kg$ in group B and $58.7{\pm}0.4\;ml/min/kg$ in group C. 6) In all three groups, oxygen debts and the rates of recovery of heart rate after treadmill running were lower than those of long ditsance runners reported previously. 7) The 40 km running time in 2 elite marathoners was recorded to be $2^{\circ}42'25'$, and their mean speed was 243 m/min (ranged 218 to 274 m/min). The heart rate appeared to increase lineally with running speed, and the total energy expenditure during 40 km running was approximately 1360.2 Calories. From these it can be speculated that if their heart rates were maintained at 166 beats/min during the full course of marathon running, their records would be arround $2^{\circ}15'$. Based on these results, we may suspect that a successful long distance running is, in part, dependent on the economical utilization of one's aerobic capacity.

• Clinical and Experimental Pediatrics
• /
• 제64권10호
• /
• pp.497-503
• /
• 2021

Reading disability (dyslexia) refers to an unexpected difficulty with reading for an individual who has the intelligence to be a much better reader. Dyslexia is most commonly caused by a difficulty in phonological processing (the appreciation of the individual sounds of spoken language), which affects the ability of an individual to speak, read, and spell. In this paper, I describe reading disabilities by focusing on their underlying neurobiological mechanisms. Neurobiological studies using functional brain imaging have uncovered the reading pathways, brain regions involved in reading, and neurobiological abnormalities of dyslexia. The reading pathway is in the order of visual analysis, letter recognition, word recognition, meaning (semantics), phonological processing, and speech production. According to functional neuroimaging studies, the important areas of the brain related to reading include the inferior frontal cortex (Broca's area), the midtemporal lobe region, the inferior parieto-temporal area, and the left occipitotemporal region (visual word form area). Interventions for dyslexia can affect reading ability by causing changes in brain function and structure. An accurate diagnosis and timely specialized intervention are important in children with dyslexia. In cases in which national infant development screening tests have been conducted, as in Korea, if language developmental delay and early predictors of dyslexia are detected, careful observation of the progression to dyslexia and early intervention should be made.

• 한국임상수의학회지
• /
• 제36권1호
• /
• pp.42-45
• /
• 2019

Thromboelastography (TEG) analysis consists of ${\alpha}$, G, K, MA, and R types of values and tests the effectiveness of blood clotting, which can be assessed for platelet function, clotting strength, and fibrinolysis. Canine heartworm diseases caused by Dirofilaria immitis, a vascular nematode, can lead to hyperfibrinolysis and hypercoagulation. In this study, G and MA values showed a statistically significant decrease over time after treatment of heartworm disease. Additionally, the ${\alpha}-value$ showed a high correlation with G, K, MA, and R values. The G value showed a high correlation with K and MA values, while The K value showed a high correlation with MA and R values. This study clearly found a gradual decrease in G and MA values in dogs with heartworm disease over time, both before and after treatment. This suggests that the clot formation time is longer and that the intensity of clot formation is lowered and may improve the risk of thromboembolism in dogs with heartworm disease.

• Annals of Clinical Neurophysiology
• /
• 제21권1호
• /
• pp.30-35
• /
• 2019

Background: Postural tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance symptoms associated with a heart rate increment of greater than 30 beats/min, usually up to 120 beats/min, on head-up tilt test. Symptoms related to POTS are usually light-headedness, palpitations and tremor, but syncope can also occur. The pathophysiology of POTS is heterogeneous and its prognosis is uncertain. Methods: We prospectively evaluated patients who met the criteria for POTS, at baseline and follow-up, using composite autonomic symptom scores and autonomic tests to assess the autonomic function. We compared the clinical and autonomic test results between baseline and follow-up. Results: Sixty-eight patients met the inclusion criteria for POTS and forty-five patients were ultimately followed up for at least 1 year after baseline. The patients were predominantly young females (84%), with a mean age of 21 years. Most patients showed improved orthostatic symptoms and more than a quarter of patients had no longer met the criteria for POTS at follow-up. Conclusions: Most patients had a benign outcome in that they could resume their daily activities without great limitations. Our results demonstrated a relatively favorable prognosis in most patients with POTS.

• Safety and Health at Work
• /
• 제9권4호
• /
• pp.468-472
• /
• 2018

Background: Firefighters are required to use self-contained breathing apparatus (SCBA), which impairs ventilatory mechanics. We hypothesized that firefighters have elevated arterial $CO_2$ when using SCBA. Methods: Firefighters and controls performed a maximal exercise test on a cycle ergometer and two graded exercise tests (GXTs) at 25%, 50%, and 70% of their maximal aerobic power, once with a SCBA facemask and once with protective clothing and full SCBA. Results: Respiratory rate increased more in controls than firefighters. Heart rate increased as a function of oxygen consumption ($V_{O_2}$) more in controls than firefighters. End-tidal $CO_2$ ($ETCO_2$) during the GXTs was not affected by work rate in either group for either condition but was higher in firefighters at all work rates in both GXTs. SCBA increased $ETCO_2$ in controls but not firefighters. Conclusions: The present study showed that when compared to controls, firefighters' hypoventilate during a maximal test and GXT. The hypoventilation resulted in increased $ETCO_2$, and presumably increased arterial $CO_2$, during exertion. It is proposed that firefighters have altered $CO_2$ sensitivity due to voluntary hypoventilation during training and work. Confirmation of low $CO_2$ sensitivity and the consequence of this on performance and long-term health remain to be determined.

• Clinical and Experimental Pediatrics
• /
• 제46권6호
• /
• pp.585-590
• /
• 2003

목 적 : 심혈관계 자율신경 기능이상은 청소년기 당뇨병 환자의 7.7-28%에서 동반되며, 당뇨병성 자율신경병증은 심장 교감 신경계 이상으로 인한 돌발성 부정맥 및 돌연사를 초래할 수 있는 것으로 보고되었다. 본 연구는 소아 및 청소년기 당뇨병 환자에서 심혈관계 자율신경 기능이상의 빈도 및 이에 영향을 미치는 인자들을 파악하여 당뇨병성 자율신경병증의 조기진단 및 치료에 도움이 되고자 시행하였다. 방 법 : 8-26세의 1형 당뇨병 환자 80명(남자 27명, 여자 53명)과 2형 당뇨병 환자 12명(남자 4명, 여자 8명)을 대상으로, 발살바 동작시 R-R 간격의 변화(발살바 비), 심호흡시 심박수의 변화, 기립시 R-R 간격의 변화(30 : 15 비), 기립성 저혈압의 4가지 항목에 대하여 검사를 시행하여 환자의 연령, 유병기간, 당화혈색소, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와의 연관성을 분석하였다. 결 과 : 검사 당시 연령 및 평균 유병기간은 1형과 2형 당뇨병 환자간에 의미있는 차이가 없었으나, 당뇨병의 발병연령은 2형에서 더 높았다. 체질량지수는 1형에 비해 2형에서 의미있게 높았으며, 혈압 및 당화혈색소는 두 군간에 차이가 없었다. 1형 당뇨병 환자의 22.5%에서 조기, 8.7%에서 중등도, 1.3%에서 심한 자율신경병증에 해당하였으며, 2형의 경우 16.7%에서는 조기, 8.3%에서 중등도, 8.3%에서 심한 자율신경병증에 해당하였다. 전체적으로, 심혈관계 자율신경 기능 이상은 1형의 32.5%에서, 2형의 33.3% 에서 나타나 빈도에 있어서 두 군간에 차이는 보이지 않았다. 1형에서는 발살바 비와 유병기간 간에 의미있는 상관관계가 있었으며, 2형에서는 발살바 비와 연령, 심호흡시 심박수 변화와 당화혈색소, 그리고 기립성 저혈압과 유병기간 간에 의미있는 상관관계가 관찰되었다. 1형과 2형 당뇨병 환자 전체를 대상으로 시행한 로지스틱 회귀분석상, 연령(OR=1.133(1.003-1.279), P<0.05) 및 유병기간(OR=1.148(1.009-1.307), P<0.05)만이 자율신경 기능 이상의 의미있는 예측인자로 나타났으며, 당화혈색소, 혈압, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와는 관련이 없었다. 검사항목 중 발살바 비는 31.5%의 환자에서, 심호흡시 심박수의 변화는 41.3%의 환자에서 경계역 또는 이상소견을 보인 반면, 30 : 15 비 및 혈압변화는 각각 14.1%, 9.8%에서 경계역 또는 이상소견을 보였다. 발살바 비(OR=0.001(0.000-0.083), P<0.01)와 심호흡시 심박수의 변화(OR=0.840(0.754-0.934), P<0.01)는 자율신경 기능이상 유무에 의미있게 영향을 미쳤으나, 30 : 15 비 및 기립성 저혈압은 영향을 미치지 못하였다. 결 론 : 심혈관계 자율신경 기능이상은 소아 및 청소년 당뇨병 환자의 32.6%에서 동반되었으며, 중등도 이상의 뚜렷한 자율신경 기능이상도 10.8%에서 관찰되었다. 혈당 조절이 양호한 환자에서도 자율신경계 합병증의 가능성은 배제할 수 없으며 연령 및 유병기간이 증가할수록 그 위험은 더욱 증가하였다. 소아 및 청소년기 당뇨병 환자에서 자율신경 기능검사시, 발살바 비와 심호흡시 심박수의 변화가 가장 유용한 검사 항목으로 사료된다.

• 생물정신의학
• /
• 제18권3호
• /
• pp.141-147
• /
• 2011

Objectives The purpose of this study is to evaluate the relationship between the severity of white matter changes (WMC), risk factors and cognitive domains, including executive function profiles. Method Forty nine subjects over 55 years with subjective memory complaints were assessed with MRI and neuropsychological tests. The WMC were assessed by MRI T2-FLAIR images and divided into 3 groups of mild vs. moderate vs. severe and 2 groups of mild-moderate vs. severe by using Mantyla's criteria and Fazeka's criteria. The risk factors were examined in hypertension, heart disease history and chemistry Lab. Medical conditions which affect to cognitive dysfunction and definite dementia were also excluded. Results Comparing 3 groups, hypertension was identified as a risk factor of the WMC. Comparing 2 groups, total cholesterol and LDL were identified for as the risk factor of WMC. The severity of WMC was significantly associated with cognitive disturbances and their main effect on cognition was working memory and inhibition. Conclusion The risk factors of the WMC in the elderly were hypertension, hyperlipidemia. The severity of WMC appears to be associated with executive dysfunction in the elderly.

• 생물정신의학
• /
• 제13권2호
• /
• pp.103-109
• /
• 2006

Objective : Associations of vascular risk/disease or apolipoprotein E ${\varepsilon}4$(APOE4) with geriatric depression has been unclear at a population level. This study aimed to evaluate whether there would be interactions of vascular risk/disease and APOE4 on depression in a Korean elderly population. Methods : 732 community residents aged 65 or over were assessed for depression(GMS), information on vascular risk/disease(reported stroke, transient ishemic attack, heart disease, hypertension, diabetes, smoking), examinations for vascular risk/disease(blood pressure, blood tests for glucose and lipid profiles, body size), APOE genotypes, demographic characteristics(age, gender, education), physical health, and cognitive function(MMSE). Results : Previous stroke and lower level of high density lipoprotein(HDL) cholesterol were significantly associated with geriatric depression independent of demographic characteristics, physical illnesses, and cognitive function. These associations were statistically significant only in those with APOE4, although the interaction terms didn't reach to statistical significance. Conclusion : Associations between vascular risk/disease and geriatric depression might be more prominent in those with APOE4. However further research would be needed to clarify this issue.

• Yonsei Medical Journal
• /
• 제59권9호
• /
• pp.1138-1142
• /
• 2018

This study aimed to analyze the impact of sleep deprivation (SD) on cardiac, hemodynamic, and endothelial parameters and to determine whether these are sustained with increased periods of SD. The study included 60 healthy men (mean: age $31.2{\pm}6.3years$; body mass index $24.6{\pm}2.6kg/m^2$). Hemodynamic parameters, parameters of myocardial contractility, spectral analysis of heart rate (HR) and blood pressure (BP) variability, and the sensitivity of arterial baroreflex function were evaluated. Biochemical tests were performed to assess L-arginine (L-Arg) and asymmetric dimethylarginine (ADMA) levels in reflection of endothelial nitric oxide synthase ability. Measurements of cardiovascular system parameters were obtained at 9 a.m. (baseline) on the first day of the study and 9 a.m. (24-h SD), 1 p.m. (28-h SD), and 5 p.m. (32-h SD) on the second day. Blood samples for evaluating biochemical parameters were obtained at baseline and after 24-h SD. ANOVA Friedman's test revealed a significant effect for time in relation to HR (${\chi}^2=26.04$, df=5, p=0.000), systolic BP (${\chi}^2=35.98$, df=5, p=0.000), diastolic BP (${\chi}^2=18.01$, df=5, p=0.003), and mean BP (${\chi}^2=28.32$, df=5, p=0.000). L-Arg and ADMA levels changed from $78.2{\pm}12.9$ and $0.3{\pm}0.1$ at baseline to $68.8{\pm}10.2$ and $0.4{\pm}0.1$ after 24-hr SD, respectively (p=0.001, p=0.004). SD in healthy men is associated with increases in BP, which appear to occur after 24 hours of SD and are maintained over increasing periods of SD. The observed hemodynamic changes may have resulted due to disordered vascular endothelial function, as reflected in alterations in L-Arg and ADMA levels.