The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.
In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.
The detrimental impact of air pollution as a result of frequent exposure to fine particles posed a global public health risk mainly to the pulmonary disorders in pediatric and geriatric population. Here, we reviewed the current literature regarding the role of ginseng and/or its components as antimicrobials, especially against pathogens that cause respiratory infections in animal and in vitro models. Some of the possible mechanisms for ginseng-mediated viral inhibition suggested are improvements in systemic and mucosa-specific antibody responses, serum hemagglutinin inhibition, lymphocyte proliferation, cell survival rate, and viral clearance in the lungs. In addition, ginseng reduces the expression levels of proinflammatory cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-5, IL-6, IL-8) and chemokines produced by airway epithelial cells and macrophages, thus preventing weight loss. In case of bacterial infections, ginseng acts by alleviating inflammatory cytokine production, increasing survival rates, and activating phagocytes and natural killer cells. In addition, ginseng inhibits biofilm formation and induces the dispersion and dissolution of mature biofilms. Most clinical trials revealed that ginseng, at various dosages, is a safe and effective method of seasonal prophylaxis, relieving the symptoms and reducing the risk and duration of colds and flu. Taken together, these findings support the efficacy of ginseng as a therapeutic and prophylactic agent for respiratory infections.
Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.
The increase in size and numbers of general hospitals in the process of conspicuous development of modem medicine has been accompanied by a serious increase in hospital acquired infections. Hospital aquired infections cause pain and discomfort, may threaten life, adds an economic burden, and delays recovery and return to society. Even though respiratory hospital infection rates resulting for tracheostomy and respiratory inhalation therapy, may be low, they are serious because of their bad prognosis and high mortality rates. This study was designed to assess certain aspects of respiratory infections of patients with a tracheostomy and thus provide baseline data for further research related to preventive or therapeutic nursing interventions. The specific objectives were to determine the incidence of colonization in the trachea, clinical signs, type of colonized bacteria and sensitivity to antibiotics. Data were collected from July 1 to December 10, 1989 at two university Hospital in Seoul. Subjects were 20 patients with a tracheostomy admitted to the Intensive Care Unit or Cerebral Vascular Accident Center. Clinical signs related to respiratory infection were observed using a checklist based on previous study outcomes. Bacterial culture, sensitivity test to antibiotics, WBC counts and chest X-ray were also performed. Cultures were done on the day of tracheostomy, and on the third, fifth and seventh day. Cultures were then done on seventh days after the first colonization. The results were as follows : 1. The incidence of bacteria colonization in a week was 90%(18 patients) 50% (10/20 patients) on the day of tracheostomy, 70%(7/10 patients) on the third day, and 0% on the fifth day, and 33%(1/3 patient) on the seventh day. 3 of 18 patients (16.7%) were colonies of mixed growth isolated. 2. The observed clinical signs related to respiratory infection were high fever 38.9%(7 patients), prulent secretion 16.7%(12 patients) and infiltration seen on chest X-ray 33.3%(6 patients). 3. The total number of types of bacteria isolated among the 18 subjects was 21 ; gram negative 71.4%, gram postive 28.6%. The dominant bacteria type was Staphylococcus aureus(5 cases) for gram(equation omitted) and Pseudomonas aeruginosa(3 cases), Klebsiella (4 cases), Enterobacter(3 cases) for gram (equation omitted). The results of culture on 7th day after the first colonization, 6 cases showed same type of bacteria, 3cases showed different type of bacteria and 1 cases showed no growth. 4. The sensitivity tests to antibiotics showed that Pseudomonas aeruginosa and Staphylococcus were strongly resistant to most kinds of antibiotics, but Klebsiella and the rest of gram negative bacteria were moderately sensitive to antibiotics.
Objectives: This study was designed to analyze the treatment effects of Eunhwayeongyo-tang through retrospective chart reviews. We also checked the correlation between each pair of variables of the symptoms and curative rates of patients with cough. Methods: Thirty-three patients with cough who had satisfied the selection criteria were retrospectively reviewed through their basic medical records, nasal endoscopy, and questionnaires about cough on their first and second visits. The questionnaires used were "The questionnaire on clinical symptoms of cough & sputum", Leicester Cough Questionnaire Korean Version (LCQ-K), Total Nasal Symptom Scores (TNSS), Visual Analog Scale (VAS), and "Cold-heat patterns". The improvement rate, calculated by "The questionnaire on clinical symptoms of cough & sputum" was considered to be clinically effective if reduction of symptoms scored more than 30%. The state of nasopharyngeal mucosa was assessed to categorize the cold-heat patterns of the upper respiratory tract and for diagnosis. Results: According to this study, cough and sputum improved by $57.22{\pm}37.76%$. Most patients (76%) improved significantly after $12.18{\pm}6.59days$ of taking Eunhwayeongyo-tang. The cure rates of 26 patients among the 33 patients were judged as effective. All the mean scores of the questionnaires and the anterior nasal cavity states were significantly improved on the patients' second visits. After $18.39{\pm}15.68days$, 30 patients were completely cured and ended treatment. The nasopharyngeal mucosa states of all patients were categorized as heat patterns. Conclusions: The conditions of the patients with nasopharyngitis significantly improved after taking Eunhwayeongyo-tang. All of the patients had pharyngitis or rhinitis. The cold-heat pattern of nasopharyngeal mucosa was a significant indicator of upper respiratory inflammation diagnosis.
The purpose of this study was to identify the effects of music therapy on anxiety of cesarean section wemen. The research design was a nonequivalent control group non-synchronized design. The subjects of this study were 65 cesarean section wemen scheduled for surgery. The study was conducted from October 15, 1999 to January 5, 2000. Two groups consisted of subjects assigned : one the experimental group(33 wemen), and the other the control group(32 wemen). The music therapy was performed 3 times to experimental group just before surgery day, on surgery day. The level of anxiety was measured by State Anxiety Inventory, blood pressure, pulse rate, respiratory rate. The data were analyzed using descriptive statistics, $x^2-test$, t-test, Repeated measures of ANCOVA. The results of study were as fellows : 1) State anxiety scores were significantly different between the experimental group and the control group after music therapy. 2) Systolic blood pressures and diastolic blood pressures were significantly different between the experimental group and the control group after music therapy. 3) Pulse rates were significantly different between the experimental group and the control group after music therapy. 4) Respiratory rates were significantly different between the experimental group and the control group after music therapy. According to these results, music therapy can be regarded as an effective nursing intervention that relieves anxiety of cesarean section wemen.
This study was peformed to examine the effect of muscle relaxation training on patients with insomnia complaint. The subjects were selected those who have taken poor sleep below 240-300 minutes. per day, between 16-15ages, without organic brain syndroms. Using the Budzinski's muscle relaxation training tapes the patients have been gotten the muscle relaxation training daily during four weeks and examined the state anxiety with Spielberger's Trait-State Anxiety Scale, and investigated Sleep amounts, Blood pressure, Pulse rates, Respiratory rates before and after the muscle relaxation training. The results were as follow : 1. The mean of the State anxiety after the muscle relaxation training(41.8$\pm$6.4) was significantly lower than that of before training (54.2$\pm$7.0) (p<0.001). 2. The mean of systolic blood pressure after the training (114.$\pm$7.8mmHg) was significantly lower than that of before training (139.0$\pm$9.8) (P<0.001). 3. The mean of Pulse rate after the traing (89.2$\pm$3.0) was significantly lower than that of before training (103.9$\pm$7.4) (P<0.001). 4. The mean of Respiratory rate after the training(18.6$\pm$1.0) was significantly lower than that of before training(22.8$\pm$1.3) (P<0.001). 5. The mean of Sleep amount after the muscle relaxation training (459.8$\pm$52.4 minutes) was significantly increased than that of before training (287.3$\pm$30.3) (P<0.001).
This study was carried out to evaluate the effects of doxapram after medetomidine treatment. Twenty dogs were sedated with medetomidine(0.04mg/kg IM) Ten dogs were injected doxapram(2mg/kg IV) as a experimental group and ten dogs were injected with saline(5$m\ell$ IV) as a control group in twenty minutes after the injection of medetomidine. Recovery time, heart rate, respiratory rate, body temperature. blood chemistry, electrocardiogram findings (ECG) were recorded. The results obtained were as follows ; 1. Medetomidine revealed fast and excellent sedative effect. 2. Recovery time was shorted by doxapram(p<0.01) 3. Respiratory rates were decreased significantly by medetommidine, but increased remarkably after the injection of doxapram and them decreased gradually and revealed normal levels(p<0.01). 4. Herts rates were decreased significantly by medetomidine but increased remarkably after the injection of doxapram and then decreased gradually and revealed normal levels(p<0.01). 5. Body temperature were increased slightly and then decreased by medetomldine and in experimental group revealed with higher levels than those of control group(p<0.01) 6. Arrhythmias were observed after the injection of medetomidine, but relieved after the injection of doxapram . There was no another change on electrocardiograms.
This study was carried out to evaluate the effects of yohimbine on medetomidine sedation. Twenty dogs were sedated with medetomidine(0.04mg/kg, IM). Twen쇼 minutes after the injection, ten dogs were injected with saline(0.1mg/, IV)for the control group and the others were injected wi yohimbine(0.1mg/kg, IV)for the experimental group. Onset, recovery time, respiratory rate, body temperature, blood chemistry, electrocardiogram(ECG) finding were recorded. The results obtained were summarized as follows; 1. Onset of the sedation was fast and favorable. 2. Recovery time was shorted significantly by yohimbine treatment(p<0.01). 3. Respiratory rates were decreased significantly, but increased to normal level after the yohimblne treatment(p<0.01). 4. Heart rates were decreased significantly; but increased to normal level after the yohimbine treatment(p<0.01). 5. Body temperatures of dogs in the experimental group revealed higher level than those of control group(p<0.01). 6. Arrythmias were observed in both groups but relieved to normal after the yohimbine treatment. 7. Blood chemistry values were not changed significantly by medetomidine and yohimbine treatment. 8. These results showed that yohimbine is an excellent antagonist of medetomidine.
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