• Journal of Chest Surgery
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• 제54권5호
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• pp.396-399
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• 2021

A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventilation, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid administration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while communication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous immunoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

• Journal of Korean Biological Nursing Science
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• 제1권1호
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• pp.1-24
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• 1999

The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.

• 대한물리의학회지
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• 제10권1호
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• pp.15-21
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• 2015

PURPOSE: This study compared the effects of chest expansion resistance exercise (CERE) and breathing retraining (BRT) on stroke patients' chest expansion and maximal inspiratory pressure(MIP), thereby intending to present an effective intervention method for enhancing their respiratory functions. METHODS: The subjects were 30 stroke patients and randomly and equally assigned to a CERE group (10), a BRT group (10), and a control group (10). The intervention was applied to each group five times per week, 30 minutes per each time, for six weeks. A tapeline was used to measure upper and lower chest expansion and MIP prior to and after the intervention and the results were compared. RESULTS: After the intervention, the upper and lower chest expansion was considerable in the CERE group (p<.01), significant in the BRT group (p<.05) but was not significant in the control group (p>.05). According to the post-hoc test result, the upper and lower chest of the CERE group and the BRT group significantly expanded compared to that of the control group (p<.05) and the upper and lower chest of the CERE group statistically significantly expanded relative to that of the BRT group (p<.05). According to the MIP evaluation result, the CERE group saw considerable improvement (p<.01) and the BRT group underwent significant changes (p<.05), but there were no significant changes in the control group (p>.05). The post-hoc test result was that the CERE group and the BRT group saw significant improvement compared to the control group (p<.05) and the CERE group experienced statistically significant enhancement relative to the BRT group (p<.05). CONCLUSION: As an intervention for respiratory function improvement, CERE is considered effective for strengthening respiratory muscles and promoting chest expansion through manual resistance by a therapist.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.120-130
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• 2020

Objective: This study was conducted to identify the clinical usefulness, validity, and reliability of the Spirokit, a device that combines the pulmonary function test (PFT) and respiratory muscle strength (RMS) test. Design: Cross-sectional study. Methods: Forty young adults (male: 23, female: 17) participated in a PFT and a RMS test. The concurrent validity for pulmonary function was assessed by comparing data obtained from MicroQuark and the Spirokit and the agreements between the MicroRPM and the Spirokit for RMS were compared. The test-retest reliability of the Spirokit was determined by comparing data obtained from the first and second sessions. The test and retest were performed at the same time after one day for the PFT and RMS test. Validity was estimated using intraclass correlation coefficients (ICCs), and by calculating 95% limits of agreement (LoA). To estimate interrater reliability, ICCs were calculated. Results: The Spirokit showed a high agreement intra class coefficient (ICC [2, 1]): 0.978-0.999, 95% limits of agreements (95% LOA): -0.798 to 0.847 with MicroQuark. It also showed a high level of concordance ICC (2, 1): 0.992 to 0.993, 95% LOA: -9.313 to 11.169 with MicroRPM. The test-retest reliability of the Spirokit was analyzed using ICC (2, 1), and showed a high level of reliability (ICC [2,1]=0.960 to 0.998). Standard error of measurement % (SEM%) was 0.12% to 3.39%, and minimum detectable change% (MDC%) was 0.02% to 3.79%, indicating high level of reliability. Conclusions: The Spirokit is a device with high validity and reliability that can be used to simultaneously measure PFT and RMS tests.

• 대한통합의학회지
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• 제8권4호
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• pp.155-161
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• 2020

Purpose : This study was conducted to investigate the effect of positive active pressure technique and active breathing technique on lung function in healthy adults. Methods : In this study, the passive lung expansion technique and active respiration enhancement technique using an air mask bag unit were conducted in 30 normal adults to observe changes in pulmonary function with forced vital capacity (FVC), Forced expiratory volume at one second (FEV1). In order to observe the change in the level of respiratory function, we would like to investigate the peak expiratory flow (PEF) and the forced expiratory flow (FEF 25-75 %). Results : As a result of this study, there was no significant difference in comparison between the passive lung expansion technique and the active breathing enhancement technique (p>.05). The passive lung expansion technique effectively increased the effortful expiratory volume and the median expiratory flow rate of 1 second (p<.05). And the passive lung expansion technique effectively increased the effortless lung capacity and the maximum expiration flow rate (p<.05). Conclusion : The passive lung expansion technique effectively increases the range of motion of the lungs and chest cages, intrathoracic pressure, and elasticity of the lungs, and the active breathing technique increases the muscle functions such as the diaphragm and the biceps muscles. It is expected that it will be able to selectively improve the respiratory function of patients with respiratory diseases or functional limitations as it is found to be effective.

• 대한물리의학회지
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• 제17권2호
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• pp.95-100
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• 2022

PURPOSE: The purpose of this study was to compare the effect of depending on the location of applying chest expansion resistance exercise on the respiratory muscle strength stroke patients, and to suggest more effective interventions to improve respiratory function in stroke patients in clinical practice. METHODS: A total of 30 subjects were selected and divided into two groups, and chest cage extension resistance exercise was applied to the sternum and rib cage, respectively, and performed for 4 weeks, 3 times a week, for 20 minutes. In order to compare the general characteristics of the study subjects and the homogeneity of the group, the pre-experimental values were analyzed using the independent sample t-test. Paired-sample t-test was used for pre-post value comparison of maximum inspiratory pressure and maximum expiratory pressure in each group. Statistical significance was set to .05. RESULTS: Both the sternum application group and the rib cage application group showed a significant difference in the maximum inspiratory pressure according to the intervention. Also, there was a statistically significant difference in the maximum expiratory pressure in the sternum application group. CONCLUSION: As breathing exercise is important for stroke patients, based on the results of this study, if therapists perform sternal extension resistance exercise or rib extension resistance exercise according to the patient's condition and environment, it can help the breathing function of stroke patients.

• Journal of Chest Surgery
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• 제13권4호
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• pp.490-494
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• 1980

Myasthenia gravis is a neuromuscular disorder manifested by fatigability and weakness of voluntary muscles. The basic defect in the myasthenia is reduction of available acetylcholine receptors at neuromuscuiar junctions by an autoimmune attack. Removal of the thymus gland now play an Important role in the management of this disease. We have two experiences of thymectomy for myasthenic patients. The 31-year-old housewife(J.H) was admitted to the Taegu Presbyterian Medical Center because of bilateral ptosis, mastication and swallowing difficulties. The presence of thymoma was strongly suggested by roentgenographic studies. A 99.8 gm thymoma was removed completely by total thymectomy. On the 2nd postoperative day respiratory failure developed. Tracheostomy was performed and ventilatory assist was given for 3 days. The patient was completely recovered with antichollestrase drug only. C.N. was 17-year-old girl who has the symptoms of bilateral ptosis and diplopia for 3 years. Tensilon test was positive and antichollnestrase was given for several months, but the patient showed no improvement. After thymectomy she was free from myasthenic symptoms with out anticholinestrase drug.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.98-107
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• 2002

Multifocal motor neuropathy (MMN) is a chronic immune-mediated peripheral myelinopathy. The major clinical features include slowly progressive, painless, and asymmetric weakness, usually of distal limb muscle. Early in the course of the disease, weakness is not necessarily associated with muscle atrophy, owing to the initial primary involvement of peripheral myelin. Chronic progressive weakness is often associated with some degree of concurrent axonal loss and subsequent muscle atrophy. Sensory symptoms are usually mild or absent, and involvement of cranial and respiratory muscles is rare. The findings of multifocal motor conduction block, abnormal temporal dispersion, and focal conduction slowing at segments not at risk for common entrapment or compression injury, associated with normal sensory conduction studies along the same segments, are the hallmark electrophysiologic features of MMN. The slow progression and absence of upper motor neuron signs are the major clinical points that separate MMN from amyotrophic lateral sclerosis. The role of GM1 antibodies, found in high titers in 22~84% of MMN patients, remains uncertain. The contention that MMN is an autoimmune disorder is largely based on the often dramatic improvement in symptoms following the administration of intravenuos immunoglobulin or cyclophosphamide.

• 대한후두음성언어의학회지
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• 제5권1호
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• pp.22-28
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• 1994

Previous studies reveal that in English there is no EMG evidence fur the feature tense-lax distinction. The technique of electro-myography(EMG) was used to see if the existing claim holds true, particularly in unstressed syllable. It was found that in unstressed syllable, the peak EMG amplitude from the orbicularis oris superior muscle was significantly greater in /p/ than in /b/, while in stressed syllable this difference was negligible. It was hypothesized that in stressed syllable, /p/ and /b/ may be differentiated by the EMG activities from a muscle other than the orbicularis oris superior muscle, e.g. the respiratory muscles relating to 'aspiration' or depressor anguli oris muscle. In Korean, there was a clear labial gestures for the feature tense-lax distinction. The phoneme-sensitive manifestation of stress and some possible reasons for the inter-speaker variability in the data and the variability within a given speaker were discussed.