Purpose: The purpose of this study was to examine the effects of inhalation and exhalation exercise combined with upper extremity proprioceptive neuromuscular facilitation pattern on two spirometry values: forced volume vital (FVC) and peak expiratory flow (PEF). Methods: Thirty-two healthy adults were divided into two groups: 1) a combined group, which performed upper extremity D2 flexion pattern (shoulder flexed/abducted/external rotated, forearm supinated, wrist radial deviated, and finger extended) during exhalation and D2 extension pattern (shoulder extended/adducted/internal rotated, forearm pronated, wrist ulnar deviated, and finger flexed) during inhalation; and 2) reverse combined group, which performed the D2 flexion pattern during inhalation and the D2 extension pattern during exhalation. The inverse application of upper extremity movements during inhalation and exhalation induced selective resistance or assistance on respiration. FVC and PEF were measured at two time points, before and after four weeks. Results: In both groups, the pre-post intervention comparison showed significant increases in FVC and PEF (p < .05). In the between-groups comparison, the reverse combined group showed a significantly higher PEF than the combined group at four weeks post intervention (p < 0.05). Conclusion: The combined respiration exercise with reverse PNF upper extremity patterns using selective resistance showed an effective increase in PEF in healthy adults. Clinicians and researchers might consider using selective resistance as a widely applicable and cost-effective option for respiratory rehabilitation planning.
Background : Reduced lung compliance and increased lung resistance are the primary lung mechanical abnormalities in acute respiratory distress syndrome (ARDS). Although there is little information regarding the mechanisms responsible for the increases in the respiratory resistance of ARDS, bronchodilators have been frequently administered in mechanically ventilated ARDS patients. To determine the effect of a bronchodilator on the respiratory mechanics depending on the level of applied positive end-expiratory pressure (PEEP), the changes in the respiratory mechanics by salbutamol inhalation was measured under the variable PEEP level in patients with ARDS. Materials and Methods : Fifteen mechanically ventilated paralyzed ARDS patients (14 of male, mean age 57 years) were enrolled in this study. The respiratory system compliance, and the maximum and minimum inspiratory resistance were obtained by the end-inspiratory occlusion method during constant flow inflation using the CP-100 pulmonary monitor (Bicore, Irvine, CA, USA). The measurements were performed at randomly applied 8, 10 and 12 cm $H_2O$ PEEP before and 30 mins after administrating salbutamol using a meter-dose-inhaler (100ug${\times}$6). Results : 1) The maximum inspiratory resistance of the lung was higher than the reported normal values due to an increase in the minimal inspiratory resistance & additional resistance. 2) The maximum inspiratory resistance and peak airway pressure were significantly higher at 12cm $H_2O$ of PEEP compared with those at 10cm $H_2O$ of PEEP. 3) Salbutamol induced a significant decrease in the maximum and the minimum inspiratory resistance but no significant change in the additional resistance only was observed at 12cm $H_2O$ of PEEP(from $15.66{\pm}1.99$ to $13.54{\pm}2.41$, from $10.24{\pm}2.98$ to $8.04{\pm}2.34$, and from $5.42{\pm}3.41$ to $5.50{\pm}3.58cm$$H_2O$/L/sec, respectively). 4)The lung compliance did not change at the applied PEEP and salbutamol inhalation levels. Conclusion : The bronchodilator response would be different depending on the level of applied PEEP despite the increased respiratory resistance in patients with ARDS.
Sohyun Kang;Soomin Kim;Ji Soo Kim;Gayoung Lee;Annisa Utami Rauf;Kraichat Tantrakarnapa;Shih-Chun Candice Lung;Kiyoung Lee
Journal of Environmental Health Sciences
/
v.50
no.4
/
pp.267-273
/
2024
Background: During the coronavirus pandemic, masks played a critical role in preventing respiratory infections. While the performance of masks such as KF-certified masks and N95 masks was evaluated and managed by the authorities, the performance of common masks was not. Objectives: This study aimed to evaluate the performance of uncertified masks in four Asian countries against certification standards (Korean KF80, KF94, and US N95). Methods: Thirty uncertified mask products from Indonesia, 20 from South Korea, 26 from Taiwan, and 30 from Thailand were purchased to perform performance evaluations. The uncertified masks included disposable dental masks, cloth masks, and children's masks. Filtration efficiency and inhalation airflow resistance tests were conducted according to Korean KF80, KF94, and US N95 protocols. Results: None of the 106 identified masks complied with the KF94 standard. A few complied with the KF80 standard: four from Indonesia, four from South Korea, 13 from Taiwan, and 16 from Thailand. Some of the masks met the N95 standard: one from Indonesia, three from South Korea, two from Taiwan, and one from Thailand. Conclusions: Since many uncertified masks did not comply with performance standards, wearing them might not have provided sufficient protection. Performance of uncertified masks could provide critical information for next pandemic management.
This study explores the effects of facemasks on respiratory, thermoregulatory, cardiovascular responses during exercise on a treadmill and at rest. Five male subjects (25.8 ± 0.8 y, 171.8 ± 9.2 cm in height, 79.8 ± 28.1 kg in weight) participated in the following five experimental conditions: no mask, KF80, KF94, KF99, and N95. Inhalation resistance was ranked as KF80 < KF94 < N95 < KF99 and dead space inside a mask was ranked as KF80 = KF94 < N95 < KF99. The surface area covered by a mask was on average 1.1% of the total body surface area. The results showed no significant differences in body core temperature, oxygen consumption (VO2), carbon dioxide production (VCO2), heart rate or subjective perception among the five experimental conditions; however, cheek temperature, respiratory ventilation and blood pressure were greater for KF80 or KF94 conditions when compared to KF99 or N95 conditions (p<0.05). The differences among mask conditions are attributed to the dead space or specific designs (cup type vs pleats type) rather than the filtration level. In addition, the results suggest that improving mask design can help mitigate respiratory resistance from increased filtration.
Background: Bronchial asthma is a complex disease, which is characterized by spontaneous exacerbations of airway obstruction and persistent bronchial hyperresponsiveness. Animal models have fallen short of reproducing the human disease, particularly in mimicking the spontaneous and persistent airflow obstruction that characterized in asthma. In animals, airflow obstruction is usually assessed by measuring airflow resistance during tidal breathing under such invasive technique as tracheostomy and anesthesia. A noninvasive technique for measuring pulmonary function in small animals is needed to evaluate long-term changes in lung function during the course of experimentally produced disease without sacrificing the animal. Purpose: The purpose of this study was to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness (AR) to inhaled methacholine in nonanethetized, unrestrained guinea pigs. Method: Guinea pig model of asthma was sensitized by subcutaneous injection with ovalbumin and challenged by inhalation of aerosolized ovalbumin(1% wt/vol ovlabumin). Airflow obstruction of conscious guinea pig was measured as specific airway resistance (airway resistance $\times$ thoracic gas volume). Airway resistance and thoracic gas volume of conscious guinea pig were assessed by body plethysmography before challenge and at regular intervals for as long as 30 minutes after challenge. AR to aerosolized methacholine of asthma group was compared with that of control group in body plethysmography. Result: Asthma model<> developed in 13 (65%) among 20 guinea pigs, in which early responses occurred in the airways after the exposure to inhalation with ovalbumin. Airway challenge with ovalbumin caused increase in specific airway resistance, which peaked at 6 minutes and amounted to a $231.5{\pm}30.4%$ increase from baseline. AR to aerosolized methacholine of asthma model increased significantly compared with control group. Conclusion: These results have showed a useful animal model to evaluate early bronchoconstrcition after allergen challenge and airway responsiveness in nonanethetized, unrestrained guinea pigs.
Asbestos is widely used in the textile, asbestos cement, construction products, friction material, paper products, insulation products, chemical and plastic products because of its heat resistance, flexibility, tensile strength, and texturability. It is now generally recognized that longterm and excessive inhalation of asbestos dust causes asbestosis, lung cancer, malignant mesothelioma and malignancies in other organs such as cancer of gastrointestinal tract, leukemia, lymphoma. Although eighty thousand tons of asbestos has been annually consumed since 1979 in korea, it has not been reported asbestos and lung cancer by asbestos dust so far, while a case of mesothelioma was officially diagnosis as a occupational disease at 1993. We experienced firstly a case of asbestosis and lung cancer caused simultanously by occupational asbestos exposure 11 years, which was confirmed by chest x-ray, pulmonary function test, chest CT and HRCT, bronchoalveolar lavage, and gallium scan. And so We present a case of asbestosis, pleural effusion and lung cancer with a review literature.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.27
no.4
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pp.283-290
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2017
Objectives: This study aimed to evaluate the relationship between filter replacement and filter performance change in particulate filters used in the workplace. Methods: Three types of particulate respirator filters are mainly used in the workplaces. These were tested against the filter performance safety certification standard for dust masks established by the Ministry of Employment and Labor(MoEL). Used filters were collected to test their performance, such as filter pressure drop, efficiency, and quality factors. All these factors were evaluated by a filter tester. To compare filter performance between used and new ones, the same kinds of new filters were also tested together under the same procedures. Results: A total of 270 used filters were collected for testing. The main reasons to replace the filters were difficulty in breathing(46.2%), dirty/odor influx(19.7%), and a combination of factors(26.7%). The pressure drop for two special class groups was significantly different(new filters: $20.72{\pm}3.33mmH_2O$; used filters: $24.70{\pm}5.26mmH_2O$, p<0.0001). In the case of penetration, new filter groups indicated $0.0032{\pm}0.0040%$, while that of the used filters was $0.0596{\pm}0.1187%$. The quality factor for the used filters($0.34{\pm}0.09$) significantly decreased compared to the new filters($0.53{\pm}0.08$) (p<0.0001). Conclusions: Filter performance including pressure drop, penetration, and the quality factor was evaluated and compared between new and used filters in the workplace. The results showed that general filter performance deteriorated more for change of pressure drop, penetration and the quality factor.
Kim, Yun Seong;Park, Byung Gyu;Lee, Kyong In;Son, Seok Man;Lee, Hyo Jin;Lee, Min Ki;Son, Choon Hee;Park, Soon Kew
Tuberculosis and Respiratory Diseases
/
v.43
no.4
/
pp.558-570
/
1996
Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.
Background: During hot environment work tasks with whole-body enclosed anti-bioaerosol suit, the combined effect of heavy sweating and exhaled hot humid air may cause the N95 medical respirator to saturate with water/sweat (i.e., water-blocking). Methods: 32 young male subjects with different body mass indexes (BMI) in whole-body protection (N95 medical respirator + one-piece protective suit + head covering + protective face screen + gloves + shoe covers) were asked to simulate waste collecting from each isolated room in a seven-story building at 27-28℃, and the weight, inhalation resistance (Rf), and aerosol penetration of the respirator before worn and after water-blocking were analyzed. Results: All subjects reported water-blocking asphyxia of the N95 respirators within 36-67 min of the task. When water-blocking occurred, the Rf and 10-200 nm total aerosol penetration (Pt) of the respirators reached up to 1270-1810 Pa and 17.3-23.3%, respectively, which were 10 and 8 times of that before wearing. The most penetration particle size of the respirators increased from 49-65 nm before worn to 115-154 nm under water-blocking condition, and the corresponding maximum size-dependent aerosol penetration increased from 2.5-3.5% to 20-27%. With the increase of BMI, the water-blocking occurrence time firstly increased then reduced, while the Rf, Pt, and absorbed water all increased significantly. Conclusions: This study reveals respirator water-blocking and its serious negative impacts on respiratory protection. When performing moderate-to-high-load tasks with whole-body protection in a hot environment, it is recommended that respirator be replaced with a new one at least every hour to avoid water-blocking asphyxia.
Background: Heliox is known to decrease $PaCO_2$ in patients with increased airway resistance by increasing minute ventilation and reducing work of breathing(WOB). Besides these effect, heliox is expected to decrease functional anatomic dead space owing to improvement of peak expiratory flow rate(PEFR) and enhancement of gas distribution. We investigated whether heliox can decrease $PaCO_2$ even at the same minute ventilation (VE) and WOB with $N_2-O_2$ to speculate the effect of the heliox on the anatomic dead space. Material and Method: The subjects were 8 mechanically ventilated patients with asthma or upper airway obstruction(M : F=5 : 3, $68{\pm}10$years) who were under neuromuscular paralysis. The study was consisted of three 15-minutes phases: basal $N_2-O_2$ heliox and washout Heliox was administered via the low pressure inlet of servo 900C, and respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). To obtain the same tidal volume(Vt) in heliox phase, the Vt on monitor was adjusted by the factor of relative flow rate of heliox to $N_2-O_2$. Dead space was calculated by Bohr equation. Results: 1) Vt, VE, peak inspiratory pressure(PIP) and peak inspiratory flow rate(PIFR) were not different between $N_2-O_2$ and heliox. 2) PEFR was higher on heliox($0.52{\pm}0.19$L/sec) than $N_2-O_2$($0.44{\pm}0.13$L/sec)(p=0.024). 3) $PaCO_2$(mmHg) were decreased with heliox($56.1{\pm}14.1$) compared to $N_2-O_2$($60.5{\pm}15.9$)(p=0.027). 4) Dead space ventilation(%) were decreased with heliox($73{\pm}9$ with $N_2-O_2$ and $71{\pm}10$ with heliox)(p=0.026). Conclusion: Heliox decreased $PaCO_2$ even at the same VE and WOB with $N_2-O_2$, and the effect was considered to be related with the reduction of anatomic dead space.
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