• Title/Summary/Keyword: circulation frequency

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A Study on Flow Characteristics around Foot to Investigate Principle of Underwater Exercise for Rheumatoid Arthritis Patients (류마티스 관절염 환자의 수중운동 원리 규명을 위한 발 주위 유동 특성 연구)

  • Choi, Ji-Hyun;Park, Sung-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.403-410
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    • 2021
  • There are positive effects, such as pain reduction, when rheumatism patients exercise in water, but the cause of the pain reduction is unclear, and research on this is inadequate. This study examined the flow of the surface of the foot and the principles of pain relief. Unsteady simulations were conducted to analyze the flow, which was performed by repeatedly setting the movement of the foot raising and descending three times. Pressure fluctuations and frequencies were analyzed by designating pressure points at the painful location. The results showed that a positive and negative pressure of approximately ±500Pa was applied overall. A pressure of approximately ±2000Pa was applied when the direction of movement was changed. A frequency of approximately 35 to 80Hz was generated in the area where rheumatoid arthritis pain frequently occurs. The effects of reducing pain could be predicted when continuous pressure fluctuations and frequencies are applied repeatedly to the painful location, blood circulation promotion. The results could be used as basic data to understand the principles of aquatic exercise and support the development of underwater exercise programs and developing related medical equipment.

Analysis of the Characteristics of Biophilic Design in 『Soswaewon 48 Yeong』 (『소쇄원 48영』에 나타난 바이오필릭 디자인 특성분석)

  • Lee, Hyung-Sook;Choi, Mi-Seon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.4
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    • pp.58-66
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    • 2022
  • Biophilic design is an approach that attempts to connect people with nature to promote health, recovery and restoration processes. The purpose of this study was to systematically analyze restorative factors and characteristics of Soswaewon by applying a biophilic design analysis framework. To this end, a biophilic design classification system was established and content analysis and frequency analysis were conducted for 『Soswaewon 48 Young』. the ratio of plant words including bamboo, pine, and plum was the highest, and words related to dynamic water flow or interaction with water as well as various water types such as streams, waterfalls, and ponds were also high. appeared in rank. In addition, multisensory factors, seasonal changes, microclimatic factors, emotional elements that allow people to indirectly experience nature were expressed in various ways. The space layout and circulation provide opportunities to appreciate and experience the rich sensory resources of Soswaewon. In conclusion, this study confirmed the healing and restorative value of Soswaewon from the perspective of biophilic design, and it needs further research on the restorative factors of traditional spaces.

The Survey of Dentists: Updated Knowledge about Basic Life support and Experiences of Dental Emergency in Korea

  • Cho, Kyoung-Ah;Kim, Hyuk;Lee, Brian Seonghwa;Kwon, Woon-Yong;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.17-27
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    • 2014
  • Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.

적취(積聚) 처방(處方)에 대(對)한 문헌적(文獻的) 고찰(考察)

  • Mun, Gu;Jo, Seong-Gak
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.2 no.1
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    • pp.113-160
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    • 1996
  • Cancer is one of the most important cause of death. So recently, investigation of cancer progress prosperously all over the world. Cancer in the present medicine correspond to You-Am, Sin-Am, Young-Soon, Sel-Gyun, Sil-Young, Young-Lyoo, Seg-Je, Seg-Young, Seg-Ha, Jerk-Chui(積聚), Jing-Ha, Oel-Gyek, Ban-Oui, Bi-Gi, Bok-Lyang, Jang-Dan, Hyen-Bek in the oriental medicine. Among these, generally Jerk-Chui(積聚) is expressed to cancer. So to develop of new drugs of cancer in the present medicine, bibliographic investigation of mass-prescriptions was studied in the oriental medicine-books. According to the bibliographic study of Jerk-Chui-prescriptions, the results run as follows. 1. According to the analyses of three hundred sixty eight Jerk-Chui-prescriptions in the twenty-seven kinds of literature, the frequency number of the used drugs were Pericarpium Citri Nobilis Viride 140 times, Pericarpium Citri Reticulatae 135 times, Rhizoma Scirpi 124 times, Radix Aucklandie 115 times, Rhizoma Zedoariae 114 times, Cortex Magnoliae Officinalis 111 times, Radix Glycyrrhizae 106 times, Rhizoma Zingiberis 100 times, Rhizoma Coptidis 94 times, Radix Ginseng 93 times, Poria 86 times, Rhizoma Pinelliae 85 times, Semen Arecae 83 times, Rhizoma Cyperi 82 times, Radix Angelicae Sinensis 80 times, Rhizoma Atractylodis 74 times, Massa Fermentata Medisinalis 67 times, Radix Et Rhizoma Rhei 66 times, Fructus Aurantii 62 times, Fructus Hordei Genninatus 55 times, Conex Cinnamomi 54 times, Fructus Evodiae 51 times, Fructus Aurantii Immaturus 49 times, Fructus Crataegi 49 times, Rhizoma Cnidii 46 times, Radix Platycodi 44 times, Semen Tiglii 44 times, Radix Aconiti 43 times, Fructus Amoni 38 times, Semen Raphani 37 times, Radix Aconiti Praeparata 36 times, Radix Scutellariae 35 times, Pericarpium Zanthoxyli 35 times, Rhizoma Corydalis 33 times, Rhizoma Acori Graminei 31 times, Carapax Amydae 31 times, Fructus Foeniculi 31 times, Semen Persicae 30 times, Radix Bupleuri 30 times. 2. The frequency number of the most imponant used drugs in the Jerk-Chui-prescriptions were Rhizoma Coplidis 41 times, Rhizoma Scirpi 35 times, Radix Et Rhizoma Rhei 31 times, Pericarpium Citri Reticuiatae 30 times, Rhizoma Zedoariae 27 times, Rhizoma Cyperi 22 times, Cortex Magnoliae Officinalis 22 times, Rhizoma Atraclylodis 22 times, Pericarpium Citri Nobilis Viride 21 times, Rhizoma Pinelliae 20 times, Semen Arecae 20 times, Fructus Crataegi 18 times, Rhizoma Zingiberis 17 times, Carapax Amydae 16 times, Semen Pharbitidis 13 times, Poria 12 times, Radix Angelicae Sinensis 10 times, Semen Persicae 10 times, Fructus Evodiae 10 times, Radix Aeoniti 10 times, Radix Glycyrrhizae 9 times, Massa Fennenlata Medisinalis 9 times, Fructus Aurantii 9 times, Fructus Hordei Genninatus 8 times, Radix Aueklandie 8 times, Rhizoma Atractylodis 8 times, Radix Bupleuri 8 times, Radix Ginseng 7 times, Semen Raphani 7 times, Radix Astragali 7 times, Cortex Cinnamomi 6 times, Fructus Aurantii Immaturus 6 times, Rhizoma Cnidii 6 times, Radix Aconiti Praeparata 5 times, Fructus Foeniculi 5 times, Lacca Sinica Exsiccata 5 times, Radix Aconiti 5 times, Rhizoma Zingiberis 5 times. 3. The clinical-botanic classifications of the used drugs in the Jerk-Chui-prescriptions were regulating the flow of Qi drugs, warm-heating drugs, promoting blood circulation drugs, killing mass drugs, resolving drugs, purgative drugs, Qi and blood tonics drugs, heat clearing drugs, removing dampness by promoting diures is drugs, phlegm eliminating drugs, allaying pain drugs. 4. According to the nature and taste in the drugs, warm and heating recipes were used most, heatclearing recipes were used a few times assistantly. 5. The Jerk-Chui-prescription used frequently was Bun-Don-Tang, which was used 13 times ; Bok-Oyang-Hoan 12 times, Bi-Gi-Hoan(肥氣丸) 12 times, Sik-Boon-Hoan 12 times, A-Uie-Hoan 12 times, Bi-Gi-Hoan 12 times, Dai-Cil-Gi-Tang 8 times, San-Cuie-Tang 8 times, Guye-Gyen-Tang 6 times, On-Baig-Won 5 times, So-Jek-Jeng-Ouen-San 5 times, Jin-In-Hoa-Cel-Tang 5 times, Byel-Gab-San 5 times, Sng-Hong-Hoan 5 times, Ji-Sil-San 4 times, So-A-Oie-Hoan 4 times, Hyang-Rng-Hoan 4 times.

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Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function (호흡기능장애와 관련된 간호진단의 타당도 조사)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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Preliminary Study on the MR Temperature Mapping using Center Array-Sequencing Phase Unwrapping Algorithm (Center Array-Sequencing 위상펼침 기법의 MR 온도영상 적용에 관한 기초연구)

  • Tan, Kee Chin;Kim, Tae-Hyung;Chun, Song-I;Han, Yong-Hee;Choi, Ki-Seung;Lee, Kwang-Sig;Jun, Jae-Ryang;Eun, Choong-Ki;Mun, Chi-Woong
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.131-141
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    • 2008
  • Purpose : To investigate the feasibility and accuracy of Proton Resonance Frequency (PRF) shift based magnetic resonance (MR) temperature mapping utilizing the self-developed center array-sequencing phase unwrapping (PU) method for non-invasive temperature monitoring. Materials and Methods : The computer simulation was done on the PU algorithm for performance evaluation before further application to MR thermometry. The MR experiments were conducted in two approaches namely PU experiment, and temperature mapping experiment based on the PU technique with all the image postprocessing implemented in MATLAB. A 1.5T MR scanner employing a knee coil with $T2^*$ GRE (Gradient Recalled Echo) pulse sequence were used throughout the experiments. Various subjects such as water phantom, orange, and agarose gel phantom were used for the assessment of the self-developed PU algorithm. The MR temperature mapping experiment was initially attempted on the agarose gel phantom only with the application of a custom-made thermoregulating water pump as the heating source. Heat was generated to the phantom via hot water circulation whilst temperature variation was observed with T-type thermocouple. The PU program was implemented on the reconstructed wrapped phase images prior to map the temperature distribution of subjects. As the temperature change is directly proportional to the phase difference map, the absolute temperature could be estimated from the summation of the computed temperature difference with the measured ambient temperature of subjects. Results : The PU technique successfully recovered and removed the phase wrapping artifacts on MR phase images with various subjects by producing a smooth and continuous phase map thus producing a more reliable temperature map. Conclusion : This work presented a rapid, and robust self-developed center array-sequencing PU algorithm feasible for the application of MR temperature mapping according to the PRF phase shift property.

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Preliminary Study on the Development of a Platform for the Optimization of Beach Stabilization Measures Against Beach Erosion III - Centering on the Effects of Random Waves Occurring During the Unit Observation Period, and Infra-Gravity Waves of Bound Mode, and Boundary Layer Streaming on the Sediment Transport (해역별 최적 해빈 안정화 공법 선정 Platform 개발을 위한 기초연구 III - 단위 관측 기간에 발생하는 불규칙 파랑과 구속모드의 외중력파, 경계층 Streaming이 횡단표사에 미치는 영향을 중심으로)

  • Chang, Pyong Sang;Cho, Yong Jun
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.31 no.6
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    • pp.434-449
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    • 2019
  • In this study, we develop a new cross-shore sediment module which takes the effect of infra-gravity waves of bound mode, and boundary layer streaming on the sediment transport into account besides the well-known asymmetry and under-tow. In doing so, the effect of individual random waves occurring during the unit observation period of 1 hr on sediment transport is also fully taken into account. To demonstrate how the individual random waves would affect the sediment transport, we numerically simulate the non-linear shoaling process of random wavers over the beach of uniform slope. Numerical results show that with the consistent frequency Boussinesq Eq. the application of which is lately extended to surf zone, we could simulate the saw-tooth profile observed without exception over the surf zone, infra-gravity waves of bound mode, and boundary-layer streaming accurately enough. It is also shown that when yearly highest random waves are modeled by the equivalent nonlinear uniform waves, the maximum cross-shore transport rate well exceeds the one where the randomness is fully taken into account as much as three times. Besides, in order to optimize the free parameter K involved in the long-shore sediment module, we carry out the numerical simulation to trace the yearly shoreline change of Mang-Bang beach from 2017.4.26 to 2018.4.20 as well, and proceeds to optimize the K by comparing the traced shoreline change with the measured one. Numerical results show that the optimized K for Mang-Bang beach would be 0.17. With K = 0.17, via yearly grand circulation process comprising severe erosion by consecutively occurring yearly highest waves at the end of October, and gradual recovery over the winter and spring by swell, the advance of shore-line at the northern and southern ends of Mang-Bang beach by 18 m, and the retreat of shore-line by 2.4 m at the middle of Mang-Bang beach can be successfully duplicated in the numerical simulation.

Evaluation of Indoor Air Quality in a Department of Radiation Oncology Located Underground (지하에 위치한 방사선종양학과에서의 실내공기 질 평가)

  • Kim, Won-Taek;Shin, Yong-Chul;Kang, Dong-Mug;Ki, Yong-Kan;Kim, Dong-Won;Kwon, Byung-Hyun
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.243-252
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    • 2005
  • Purpose: Indoor air quality (IAQ) in the radiation treatment center which is generally located underground is important to the health of hospital workers and patients treated over a long period of time. this study was conducted to measure and analyze the factors related to IAQ and subjective symptoms of sick building syndrome, and to establish the causes influencing IAQ and find a solution to the problems. Methods and Materials : Self administrated questionnaire was conducted to check the workers' symptoms and understanding of the work environment. Based on a preliminary investigation, the factors related to IAQ such as temperature, humidity, fine particulate. carbon dioxide, carbon monoxide, formaldehyde, total volatile organic compounds (TVOC), and radon gas were selected and measured for a certain period of time in specific sites where hospital workers stay long in a day. And we also evaluated the surrounding environment and the efficiency of the ventilating system simultaneously, and measured the same factors at the first floor (outdoor) to compare with outdoor all quality, All collected data were assessed by the recommended standard for IAQ of the domestic and international environmental organizations. Results: Hospital workers were discontented with foul odors, humidity and particulate. They complained symptoms related to musculo-skeletal system, neurologic system, and mucosal-irritatation. Most of the factors were not greater than the recommended standard, but the level of TVOC was third or fourth times as much as the measuring level of some offices in the United States. The frequency and the amount of the ventilating system were adequate, however, the problem arising in the position of outdoor-air inlets and indoor-air outlets involved a risk of the indraft of contaminated air. A careful attention was a requirement in handling and keeping chemical substances including a developing solution which has a risk of TVOC emissions, and repositioning the ventilating system was needed to solve the contaminated-air circulation immediately Conclusion We verified that some IAQ-related factors and inadequate ventilating system could cause subjective symptoms in hospital workers. The evaluation of IAQ was surely needed to improve the underground working environments for hospital workers and patients. On the basis of these data, from now on, we should actively engage in designs of the department of radiation oncology or improvement in environments of the existing facilities.

A Characteristics of Visual Narrative Expression in Garden Design - Focused on the Taehwagang Garden Show 2018 - (정원디자인에 나타난 시각적 서술의 표현특성 - 2018 태화강 정원박람회 작품을 대상으로 -)

  • Kwon, Jin-Wook
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.37 no.3
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    • pp.108-118
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    • 2019
  • Appreciating gardens in garden show has its meaning in appreciating concepts and ideas of artists, hidden inside of garden, as formative arts, as well as the beauty of the nature. This study is aimed to understand the intension of artists in visual expression through formative media in the gardens by assessing structure of visual narrative in the space with 20 artworks among the ones presented in 2018 Taehwagang Garden Show. The formative structure is delivered as contents and forms through formative media and formative language. Thus, for analysis on the artworks, the researcher assessed expressive characteristics of the media, through visual and space language, that forms the formative structure in the contest of narrative structure expressed in the gardens and findings of the analysis are as follows. First, for intertextuality obtained through media image, most of the artworks delivered message through 'figure image.' This means, the concept is delivered as 'affinity of actual objects' through the media and associated 'meaning and meaning action' are expected. Second, the characteristics of signs to show symbolism in the gardens were categorized into 'icon'. 'index' and 'symbol'. The results showed that most of the artworks expressed common characteristics between image and meaning, using 'icon' and 'symbol'. Third, as space formation components, based on formative principles, the components of 'dominant' and 'subordinate' roles were defined as the key components for meaning delivery. Also, it was understood that 'space configuration with overlapped image' and 'space configuration with transparency' were adopted to strengthen conceptional layers. Forth, for space occupation types, there were mostly central hall type, corridor type and passage space type and for open space type, the entire space area was conceptualized, instead of certain object. The circulation line was defined in the frequency order of circular type, pass type and return type. The study on the expressive characteristics of visual narrative in garden design is meaningful as it could build base data for the method of spatial design for visual development of concepts in the future.

Dysfunction of Autonomic Nervous System in Patients with Chronic Obstructive Pulmonary Diseases (만성 폐쇄성 폐질환 환자의 자율신경 장애)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.317-326
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    • 1999
  • Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.

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