• Title/Summary/Keyword: Respiratory mechanics

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Respiratory Responses during Exercise in Self-contained Breathing Apparatus among Firefighters and Nonfirefighters

  • Hostler, David;Pendergast, David R.
    • Safety and Health at Work
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    • v.9 no.4
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    • pp.468-472
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    • 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.

Reference values for respiratory system impedance using impulse oscillometry in school-aged children in Korea (학동기 소아에서 impulse oscillometry system로 측정한 폐기능 정상치)

  • Wee, Young Sun;Kim, Hyoung Yun;Jung, Da Wun;Park, Hye Won;Shin, Yoon Ho;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.862-867
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    • 2007
  • Purpose : The impulse oscillometry (IOS) is applicable to young children because it requires minimal cooperation and a non-invasive method to measure the mechanics of respiratory system. This study aimed to develop the reference values in school-aged children in Korea, using IOS which is a modification of forced oscillation technique (FOT). Methods : Measurements were performed in 92 previously untrained healthy children, aged 7 to 12 years old, using IOS. We analyzed the relationships between the data about their age, height, weight, body surface area (BSA), body mass index (BMI) and the result of IOS using the linear regression test. Results : The success rate of IOS was 92.4%. Stepwise multiple regression of resistance of respiratory system (Rrs) and reactance of respiratory system (Xrs) in natural form for age, height, weight, BSA, BMI showed that height was the most significant predictor and altogether of 5 variables explained the Rrs and Xrs most. Our regression equations at multiple frequencys were comparable to published reference values, especially about the Rrs obtained at 5 Hz. Conclusion : IOS is a feasible method to measure the respiratory resistance in untrained children. We got the reference values using IOS and it seems to be useful to diagnose a variety of respiratory diseases.

The PIV measurements on the respiratory gas flow in human airway (호흡기 내 주기적 공기유동에 대한 PIV 계측)

  • Kim, Sung-Kyun;Chung, Seong-Kyu
    • 한국가시화정보학회:학술대회논문집
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    • 2005.12a
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    • pp.93-98
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    • 2005
  • The mean and RMS velocity field of the respiratory gas flow in tile human airway was studied experimentally by particle image velocimetry(PIV). Some researchers investigated the airflow for the mouth breathing case both experimentally and numerically. But it is very rare to investigate the airflow of nose breathing in a whole airway due to its geometric complexity. We established the procedure to create a transparent rectangular box containing a model of the human airway for PIV measurement by combination of the RP and the curing of clear silicone. We extend this to make a whole airway including nasal cavities, larynx, trachea, and 2 generations of bronchi. The CBC algorithm with window offset (64*64 to 32*32) is used for vector searching in PIV analysis. The phase averaged mean and RMS velocity distributions in Sagittal and coronal planes are obtained for 7 phases in a respiratory period. Some physiologic conjectures are obtained. The main stream went through the backside of larynx and trachea in inspiration and the frontal side in expiration. There exist vortical motions in inspiration, but no prominent one in expiration.

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Odor Thresholds and Breathing Changes of Human Volunteers as Consequences of Sulphur Dioxide Exposure Considering Individual Factors

  • Kleinbeck, Stefan;Schaper, Michael;Juran, Stephanie A.;Kiesswetter, Ernst;Blaszkewicz, Meinolf;Golka, Klaus;Zimmermann, Anna;Bruning, Thomas;Van Thriel, Christoph
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.355-364
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    • 2011
  • Objectives: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning, although localized effects in the upper airways can be expected. This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. Methods: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender. Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of $SO_2$. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. Results: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/$m^3$. Conclusion: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.

Sternal defect reconstruction using a double-barrel vascularized free fibula flap: a case report

  • Gravina, Paula Rocha;Chang, Daniel K.;Mentz, James A.;Dibbs, Rami Paul;Maricevich, Marco
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.498-502
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    • 2021
  • Total and subtotal sternectomy oncological defects can result in large deficits in the chest wall, disrupting the biomechanics of respiration. Reviewing the current literature involving respiratory function and rib motion after sternectomy, autologous rigid reconstruction was determined to provide the optimal reconstructive option. We describe a novel technique for sternal defect reconstruction utilizing a double-barrel, longitudinally oriented, vascularized free fibula flap associated with rib titanium plates fixation. Our reconstructive approach was able to deliver a physiological reconstruction, providing rigid support and protection while allowing articulation with adjacent ribs and preservation of chest wall mechanics.

Inspiratory Flow Rate for the Evaluation of Bronchodilator in Patients with COPD (만성폐쇄성폐질환 환자에서 기관지확장제 흡입에 대한 흡기환기지표의 반응)

  • Baik, Jae-Joong;Park, Keon-Uk;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.342-350
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    • 1995
  • Background: Although there are improvements of clinical symtoms after bronchodilator inhalation in COPD patients, it has been noted that there was no increase of $FEV_1$ in some cases. $FEV_1$ did not reflect precisely the improvement of ventilatory mechanics after bronchodilator inhalation in these COPD patients. The main pathophysiology of COPD is obstruction of airway in expiratory phase but in result, the load of respiratory system is increased in inspiratory phase. Therefore the improvement of clinical symptoms after bronchodilator inhalation may be due to the decrease of inspiratory load. So we performed the study which investigated the effect of bronchodilator on inspiratory response of vetilatory mechanics in COPD patients. Methods: In 17 stable COPD patients, inspiratory and expiratory forced flow-volume curves were measured respectively before bronchodilator inhalation. 10mg of salbutamol solution was inhaled via jet nebulizer for 4 minutes. Forced expiratory and inspiratory flow-volume curves were measured again 15 minutes after bronchodilator inhalation. Results: $FEV_1$, FVC and $FEV_1$/FVC% were $0.92{\pm}0.34L$($38.3{\pm}14.9%$ predicted), $2.5{\pm}0.81L$($71.1{\pm}21.0%$ predicted) and $43.1{\pm}14.5%$ respectively before bronchodilator inhalation. The values of increase of $FEV_1$, FVC and PIF(Peak Inspiratory Flow) were $0.15{\pm}0.13L$(relative increase: 17.0%), $0.58{\pm}0.38\;L$(29.0%) and $1.0{\pm}0.56L$/sec(37.5%) respectively after bronchodilator inhalation. The increase of PIF was twice more than $FEV_1$ in average(p<0.001). The increase of PIF in these patients whose $FEV_1$ was not increased after bronchodilator inhalation were 35.0%, 44.0% and 55.5% respectively. Conclusion: The inspiratory parameter reflected improvement of ventilatory mechanics by inhaled bronchodilater better than expiratory parameters in COPD patients.

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Muscle Fatigue Analysis Based on Electromyography Signals for The Evaluation of Low-Level Laser Therapy (저출력 레이저의 치료 효과 규명을 위한 근전도 신호의 피로도 해석 연구)

  • Kim, Ji-Hyun;Choi, Hyo-Hoon;Youn, Jong-In
    • Journal of Biomedical Engineering Research
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    • v.32 no.4
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    • pp.319-327
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    • 2011
  • Skeletal muscle fatigue is defined as a 'any reduction in the maximal capacity to generate force or power output', and is the reduction of oxygen consumption and by-product of metabolism. For the muscle fatigue therapy, low level laser has been introduced that leads the mitochondrial respiratory and attributes the muscle fatigue recovery. This study analyzed the muscle fatigue signals from electromyography(EMG) during low-level laser therapy (LLLT). Healthy subjects performed voluntary elbow flexion-extension excercise and received placebo LLLT and active LLLT using a 830 nm laser diode. Then, EMG were measured for the evaluation of muscle fatigue. The acquired EMG data were analyzed with median frequency and short time fourier transform methods. The results showed that the LLLT had a significant symptomatic relief of muscle fatigue based on the EMG frequency analysis. Therefore, the muscle fatigue analysis with EMG signals can be applied to quantitative evaluation for the monitoring of LLLT effects.

Could Natural Products Confer Inhibition of SARS-CoV-2 Main Protease? In-silico Drug Discovery

  • Mohamed-Elamir F Hegazy
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2020.12a
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    • pp.14-14
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    • 2020
  • In December 2019, the COVID-19 epidemic was discovered in Wuhan, China, and since has disseminated around the world impacting human health for millions. Herein, in-silico drug discovery approaches were utilized to identify potential candidates as Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) inhibitors. We investigated several databases including natural and natural-like products (>100,000 molecules), DrugBank database (10,036 drugs), major metabolites isolated from daily used spices (32 molecules), and current clinical drug candidates for the treatment of COVID-19 (18 drugs). All tested compounds were prepared and screened using molecular docking techniques. Based on the calculated docking scores, the top ones from each project under investigation were selected and subjected to molecular dynamics (MD) simulations followed by molecular mechanics-generalized Born surface area (MM-GBSA) binding energy calculations. Combined long MD simulations and MM-GBSA calculations revealed the potent compounds with prospective binding affinities against Mpro. Structural and energetic analyses over the simulated time demonstrated the high stabilities of the selected compounds. Our results showed that 4-bis([1,3]dioxolo)pyran-5-carboxamide derivatives (natural and natural-like products database), DB02388 and Cobicistat (DB09065) (DrugBank database), salvianolic acid A (spices secondary metabolites) and TMC-310911 (clinical-trial drugs database) exhibited high binding affinities with SARS-CoV-2 Mpro. In conclusion, these compounds are up-and-coming anti-COVID-19 drug candidates that warrant further detailed in vitro and in vivo experimental estimations.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

The Changes of Cuff Pressure from Endotracheal Intubation for Long-term Mechanical Ventilation (장기간 기계호흡 환자에서 기관내 관의 기낭압의 변화)

  • Jung, Bock-Hyun;Park, Whan;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.156-165
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    • 2002
  • Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.