• Journal of Chest Surgery
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• 제26권3호
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• pp.170-179
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• 1993

Three hundred consecutive adult patients having cardioaortic surgery under the cardiopulmonary bypass for a variety of cardioaortic lesions were evaluated retrospectively for postoperative hyperbilirubinemia[above 5mg/100ml].We found twenty eight patients with postoperative hyperbilirubinemia and divided them into two groups according to the postoperative day of peak s-bilirubin .Group A was the patients with a peak s-bilirubin level within three days ,and group B above three days postoperatively.Group B was divided into group S[survive] and group D[death] . We had compaired the survival & death group and observed the correlation between the decreasing tendency of postoperative s-bilirubin & the nutrition per os in group B. The incidence of postoperative hyperbilirubinemia,as defined by a s-bilirubin concentration of 5.0mg/100ml or greater,was 9.3%.The mortality rates of group A & B were 0.0% and 35.7% respectively.Important contributing factors between group A & B were the age,duration of ICU,Max.DOAB[maximum dose of catecholamine used],amount of blood transfused during or shortly after surgery and preoperative pulmonary hypertension[main pulmonary artery pressure > 30mmHg] and backward heart failure. The risking factors of group D compared to group S were as follows the age,preoperative & postoperative SGOT[serum glutamic-oxaloacetic trasaminase],postoperative total & indirect bilirubin,cardiopulmonary bypass time,duration of ICU & mechanical ventilation ,Max.DOAB,preoperative pulmonary hypertension and backward heart failure.The six patients in group B showed good correlation between the decreasing point of s-bilirubin and the starting day of oral or tube feeding.

• Tuberculosis and Respiratory Diseases
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• 제74권3호
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• pp.120-123
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• 2013

Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.

• Clinical and Experimental Pediatrics
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• 제54권5호
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• pp.192-196
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• 2011

Respiratory syncytial virus (RSV) is a main cause of hospitalization for bronchiolitis and pneumonia in infants worldwide. Children with hemodynamically significant congenital heart disease (HS-CHD), as well as premature infants are at high risk for severe RSV diseases. Mortality rates for CHD patients hospitalized with RSV have been reported as about 24 times higher compared with those without RSV infection. Recently with advances in intensive care, mortality rates in CHD patients combined with RSV have decreased below 2%. The requirements of intensive care and mechanical ventilation for CHD patients with RSV infection were still higher than those without RSV infection or with non-CHD children. RSV infection has frequently threatened CHD infants with congestive heart failure, cyanosis, or with pulmonary hypertension. As a progressive RSV pneumonitis in those infants develops, the impairment of oxygen uptake, the breathing workload gradually increases and eventually causes to significant pulmonary hypertension, even after the operation. Preventing RSV infection as much as possible is very important, especially in infants with HS-CHD. A humanized monoclonal antibody, palivizumab, has effective in preventing severe RSV disease in high-risk infants, and progressive advances in supportive care including pulmonary vasodilator have dramatically decreased the mortality (<1%). Depending on the global trend, Korean Health Insurance guidelines have approved the use of palivizumab in children <1 year of age with HS-CHD since 2009. Korean data are collected for RSV prophylaxis in infants with CHD.

• The Korean Journal of Pain
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• 제9권1호
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• pp.235-238
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• 1996

Hyperhidrosis is the distressing condition of abnormal sweating which affects the palm, sole and axillary region. Transthoracic endoscopic sympathectomy is recommended as the treatment of choice for hyperhidrosis, especially when the upper limbs are affected. We experienced a case of accidental cauterization of right azygos vein in a healthy 23 year old male during endoscopic transthoracic sympathectomy. We changed the single lumen endotracheal tube to a double lumen tube which made it easier to perform the explo-thoracotomy and bleeder ligation under one lung ventilation. Crystalloid and colloid solutions, and packed RBC were loaded during explo-thoracotomy. Monitoring showed the signs indicating pulmonary edema. Pulmonary arterial catheterization revealed global heart failure. The patient was transfered to ICU for intensive management for heart failure. On the 4th postoperative day, pulmonary edema and heart failure were cured; and the patient was extubated. But in the evening of the same day ST-segment elevation and Q-wave were noted on ECG monitoring. On the 13th postoperative day coronary angiography was performed. This revealed left apex focal hypokinesia, patent coronary artery and accidental right coronary spasm, treated by vasodilator. On the 14 day, after surgery, he was discharged to return to work.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.133-144
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• 2000

The purpose of this study was to determine whether respiratory physical therapy might increase the pulmonary function of the patients with stroke or not. Twenty patients with stroke were randomly assigned to experimental and control group. During four weeks, both groups participated in the conventional physical therapy and only the experimental group added in a program of respiratory physical therapy. Respiratory physical therapy consisted of chest mobilization, resistive ventilatory muscle training used the method of PNF technique and relaxed diaphragm breathing. Baseline and post-test measurements were made of vital capacity. inspiratory capacity, expiratory reserve volume, farced vital capacity, forced expiratory volume at one second, $FE1/FVC(\%)$ and maximal voluntary ventilation. Ater four weeks, the experimental group showed the significant improvement in VC(p<.05). FVC(p<.05), FFV1(p<.05) md MVV(p<.05). However, the controll group showed no significant differnece. As compared th the relationship of dependent variables between the experimental group and control group. experimental group showed the significant difference in VC(p<.01), FEV1(p<.05) and MVV(p<.05). These findings suggest that respiratory physical therapy can be used to improve pulmonary function in stroke patients. Also, respiratory physical therapy should be performed for at least four weeks and be followed by the continuous respiratory exercise programs.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.1-7
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• 2012

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

• 한국안전학회지
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• 제12권2호
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• pp.119-132
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• 1997

According to the construction environmental changes due to the trend of large scale and complicated building construction, many construction methods(such as : TOPDOWN )are more often used. However, it is pointed out that occupational pulmonary diseases, reduction of the machinery lifetime and productivity caused to be narrow visual field and collision between the workers. Therefore, this study is mainly dealing with the views of productivity and safety improvement in order to improve work efficiency and to insure the safety in underground construction environment.

• 대한물리의학회지
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• 제12권4호
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• pp.29-37
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• 2017

PURPOSE: This study investigated the immediate effect of inspiratory muscle training with whole-body vibration on the pulmonary function of subacute stroke patients. METHODS: All participants (n=30) were allocated to the following groups: (1) the inspiratory muscle training group with whole-body vibration (n=10), wherein the patients received inspiratory muscle training with whole-body vibration comprising 3minutes of vibration per session and respiratory training of 30 times and 2 sessions for one day. (2) the inspiratory muscle training group with visual feedback (n=10), wherein the patients received inspiratory muscle training with visual feedback. (3) the inspiratory muscle training group (n=10), wherein the patients received inspiratory muscle training. RESULTS: After the experiment, the inspiratory muscle training group with whole-body vibration exhibited significantly higher forced vital capacity, forced expiratory volume at 1 second, peak inspiratory flow rate, maximal inspiratory pressure, and chest expansion (p<.05), compared to the other groups. Inspiratory muscle training group with whole-body vibration had significantly higher peak expiratory flow rate and maximal voluntary ventilation than the other groups (p<.05). CONCLUSION: These results show that pulmonary function, maximal inspiratory pressure, and chest expansion were significantly better in the inspiratory muscle training group with whole-body vibration than in the other groups. Thus, this treatment will help recovery of pulmonary function in stroke patients.

• The Korean Journal of Physiology and Pharmacology
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• 제17권5호
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• pp.463-468
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• 2013

Acute hypoxia induces contraction of pulmonary artery (PA) to protect ventilation/perfusion mismatch in lungs. As for the cellular mechanism of hypoxic pulmonary vasoconstriction (HPV), hypoxic inhibition of voltage-gated $K^+$ channel (Kv) in PA smooth muscle cell (PASMC) has been suggested. In addition, our recent study showed that thromboxane $A_2$ ($TXA_2$) and hypoxia-activated nonselective cation channel ($I_{NSC}$) is also essential for HPV. However, it is not well understood whether HPV is maintained in the animals exposed to ambient hypoxia for two days (2d-H). Specifically, the associated electrophysiological changes in PASMCs have not been studied. Here we investigate the effects of 2d-H on HPV in isolated ventilated/perfused lungs (V/P lungs) from rats. HPV was almost abolished without structural remodeling of PA in 2d-H rats, and the lost HPV was not recovered by Kv inhibitor, 4-aminopyridine. Patch clamp study showed that the hypoxic inhibition of Kv current in PASMC was similar between 2d-H and control. In contrast, hypoxia and $TXA_2$-activated $I_{NSC}$ was not observed in PASMCs of 2d-H. From above results, it is suggested that the decreased $I_{NSC}$ might be the primary functional cause of HPV disappearance in the relatively early period (2 d) of hypoxia.

• 대한물리의학회지
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• 제11권4호
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• pp.71-78
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• 2016

PURPOSE: The purpose of this study was to investigate which treadmill walking training mode is more effective strategy for improving pulmonary function of persons with chronic stroke. METHODS: Twenty-one chronic stroke patients were allocated and randomly to an experimental group (treadmill training with randomized speed control, n=11) and a control group (treadmill training without speed change, n=10). All participants received 30 minutes of neurodevelopmental treatment. In addition, the two groups performed treadmill training for 20 minutes each time with or without speed change. Speed change was applied 40%, 50%, 60%, 70% of Heart Rate Reserve. All the exercise programs lasted six weeks, with five times per week. Pulmonary function was assessed before and after exercise program by using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV). RESULTS: In the both groups, FEV1 was significantly increased after training (p<.05). Compared to the control group, the experimental group showed 11.9% larger amount of change (p<.05). In the experimental group, FVC and MVV were significantly increased after training (9.9%, 7.6%, respectively) (p<.05). But in the control group, there was no significant difference in the FVC and MVV after training. CONCLUSION: Treadmill training with randomized speed control will be a better positive rehabilitation program than treadmill training without speed change to improve pulmonary function in persons with chronic stroke.