• Title/Summary/Keyword: respiratory and cardiovascular system

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Molecular genetics of congenital central hypoventilation syndrome and Haddad syndrome

  • Lee, Jae-Ho;Kim, Dae-Kwang
    • Journal of Genetic Medicine
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    • v.11 no.1
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    • pp.11-15
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    • 2014
  • Congenital central hypoventilation syndrome (CCHS) is a disorder of the autonomic nervous system characterized by a decreased response to hypercarbia. CCHS is frequently associated with congenital megacolon; the combination is called Haddad syndrome. CCHS is associated with dysfunction in respiratory features of the autonomic nervous system and with other disorders, including facial deformities, cardiovascular symptoms, and tumors. Patients with CCHS frequently have a mutation in the homeobox protein 2b (PHOX2B) gene. Most mutations involve heterozygous expansion of alanine repeats (GCN). Interestingly, a higher polyalanine repeat number is associated with a more severe clinical phenotype. To clarify the role of PHOX2B in disease pathogenesis, we introduce and review the clinical and molecular features of CCHS and Haddad syndrome.

Skeletal Muscle Dysfunction in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 골격근 기능 이상)

  • Kim, Ho-Cheol;Lee, Gi-Dong;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.3
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    • pp.125-139
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    • 2010
  • Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.

Pulseless electrical activity during general anesthesia induction in patients with amyotrophic lateral sclerosis

  • You, Tae Min;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.235-240
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    • 2017
  • Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia. We report a case of PEA during the induction of general anesthesia in a patient with ALS who presented for dental treatment and discuss the causes of PEA and necessary considerations for general anesthesia in patients with ALS.

Preserved Respiratory Function after Reconstruction of a Large Chest Wall Defect

  • Kim, Yu Jin;Kim, Yoon Ji;Lee, Jae-Ik
    • Archives of Reconstructive Microsurgery
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    • v.24 no.1
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    • pp.28-31
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    • 2015
  • A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc ($23{\times}18cm$) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

A Case of Pulmonary Eosinophilic Granuloma Involving Mediastinal Lymph Node (종격동 임파절 침범을 동반한 폐 호산구성 육아종 1예)

  • Kwak, Seung-Min;Kim, Se-Kyu;Shin, Dong-Hwan;Chung, Kyung-Young;Jang, Joong-Hyun;Lee, Hong-Lyeol;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.424-430
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    • 1993
  • Pulmonary eosinophilic granuloma or histiocytosis X is a chronic interstitial lung disease characterized by proliferations of Langerhans cells and, therefore, not truly histiocytosis. Both histiocytes and Langerhans cells are believed to be related to the mononuclear phagocyte system. In Eosinophilic granuloma, extra-pulmonary such as mediastinal or hilar lymph nodes involvement is very rare in adult. We report a case of young man with eosinophilic granuloma involving lung and anterior mediastinal lymph node simultaneously which is confirmed by open thoracotomy.

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AUTONOMIC MECHANISMS OF AN ACUTE STRESS RESPONSE DURING WORD RECOGNITION TASK PERFORMANCE WITH INTENSE NOISE BACKGROUND (백색소음하의 단어재인검사 수행에 따른 자율신경계 스트레스 반응)

  • ;;;Estate Sokhadze
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 1999.03a
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    • pp.127-132
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    • 1999
  • Cardiovascular, respiratory and electrodermal responses to acute stress episodes modeled by combined presentation of intense white noise and performance of word recognition task with noise background were studied in 15 college students. Experimental procedure consisted in sessions with white noise, word recognition task presentation with noise background and test with noise background. Recorded physiological variables were analyzed in terms of their sensitivity to detect activation of sympathetic and parasympathetic branches of autonomic nervous system and thus reflect autonomic arousal level during shout-term stress-inducing experimental manipulations. It was shown that performance of effortful mental task with noise background elicited significant physiological responses typical for active coping behavior, namely electrodermal arousal and increased cardiovascular activity. this response profile was more profound as compared to white noise only or attending task in noise background. However, all physiological responses were mostly phasic, without long-term tonic changes, since almost all variables recovered to their initial baseline levels, suggesting that dominant autonomic mechanisms in transient acute stress episodes were of parasympathetic nature (withdrawal in stress with subsequent activation in restoration period), while sympathetic contribution was not long-lasting. Nevertheless, increased number of stressors and their longer exposure may result in higher profile of tonic sympathetic arousal and reduced functional role of vagal mechanisms in autonomic balance regulation.

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Clinical Nursing Survey of the Patients in the Intensive Care Unit (중환자실(I.C.U.)환자에 관한 임상 간호학적 관찰 -중환자실 임상 간호 교육을 위한 기초조사-)

  • 모경빈;최영희;김문실
    • Journal of Korean Academy of Nursing
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    • v.9 no.2
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    • pp.73-83
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    • 1979
  • The objectives of this study have been conducted to establish effective clinical teaching program to I.C.U in terms of proper assignment of the clients for the students, proper rotation schedule, priorities in critical nursing problems and selection of the teaching and learning. We have analyzed statistically 1,850 patients who have been admitted during a period from January 1977 to October 31 1979 in Ewha Woman's University Hospital. The results are as follows: 1. The proportion to the total inpatients number was 6.5% and mortality rate was 16.3%. 2. The average hospitalized days were 5.8 days in I.C.U and the total death was occured from 1 st hospital day to 5th hospital day. So it shows a certain difficulties for clinical experiences of the senior students in I.C.U. 3. In the age of the death, 41.3% of the patients were in the 41-60 year age group. It shows highest mortality rate in socially active and productive age groups. 4. The mortality rates of the departments of the medicine was 18.7%, general surgery 18.5%, and neurosurgery 14.7%. 5. The number of patients admitted to the department of neurosystem was 30.6%, cardiovascular system 22.6%, respiratory system 11.1 % and urinary system 2.9%. 6. On utilizing instruments and machine for diagnosis and client's assessment in I.C.U, they have utilized everything a usual. But they never utilize angiogram and cardiac catheterization in cardiovascular system, and retroperitoneal pneumography in the urologic system. Further more we would recommend as follows 1. In consideration of the average hospital days and the date of death, the rotation program for clincal experience need to be adjusted as continuing practice program in apposite to current alternative practice program for comprehensive nursing care. 2. Socioeconomic needs for the patient's families and himself should be emphasized by the students in addition to physical needs. 3. Course content for critical care might be built up in considering of core disease centered nursing problems. 4. The diagnostic procedures and client's assessment items which could not experience in our university hospital by the students might be considered and refilled as filled trips to another hospital and visual aids.

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Screening of Anti-atherosclerotic Effect of Lonicera Flower by Antioxidative and Anti-thrombotic Mechanism (Lonicera Flower의 항산화활성과 LDL 산화 억제효과 및 혈전용해능에 관한 연구)

  • Ju, Shin-Tak;Lee, Min-Ja;Lee, Hye-Sook;Jung, Hyun-Jung;Kim, Hyuck;Kim, Jai-Eun;Park, Sun-Dong;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.6
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    • pp.1509-1517
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    • 2008
  • The flowers and buds of Lonicera Flower (LF), are used in Korean herbal medicine for latent-heat-clearing, antipyretic, detoxicant and anti-inflammatory ailments. This plant is used worldwide for the treatment of many types of inflammatory disease including respiratory infections, diabetes mellitus, rheumatoid arthritis and play an important role in immune reaction. These pharmaceutical effects of LF looks like to be related to its antioxidant capacity and phytochemicals containing in LF. In this study, the antioxidant activity of extract from LF was studied in vitro methods by measuring the antioxidant activity by TEAC, measuring the scavenging effects on reactive oxygen species (ROS) [superoxide anion, hydroxyl radical] and on reactive nitrogen species (RNS) [nitric oxide and peroxynitrite] as well as measuring the inhibitory effect on $Cu^{2+}$ induced human LDL oxidation and the inhibitory effect on collagen induced platelet aggregation. The LF extracts were found to have a potent scavenging activity, as well as an inhibitory effect on LDL oxidation and on platelet aggregation. In conclusion, the LF extracts have anti-oxidative and anti-atherosclerotic effects in vitro system, which can be used for developing pharmaceutical drug against oxidative stress and atherosclerosis.

Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.683-693
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    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

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Concept Analysis: Deconditioning (개념분석: 쇠약 (Deconditioning))

  • Kim, In-Ja;So, Hee-Young;Kim, Sook-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.12 no.1
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    • pp.5-15
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    • 2009
  • Purpose: The purpose of this study was to explore the concept of deconditioning within the field of nursing allied health sciences. Method: The concept analysis method described by Walker and Avant(1995) was used. Critical attributes, antecedents, consequences, and empirical referents were identified. Also model, borderline, contrary and related cases were proposed. Results: The definition of concept 'deconditioning' was a decrease in the function of general system that occured after long periods of immobility and might be marked by frail upon return to normal conditions. The attributes of deconditioning were as follows; 1) the deconditioning was caused by lengthening of physical inactivity; 2) the deconditioning state was resulted by respiratory system, cardiovascular system, musculoskeletal system, hematologic system and generalized manifestation; 3) the deconditioning state could be reconditioned. 4) The reinforced functions by exercise could be compromised by physical inactivity. Conclusion: Deconditioning is important concept in nursing practice since it occurs commonly in any patients who lack physical activity for long time and affects many aspects of clinical outcomes, but it could be reversible by nurses' efforts.

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