• Title/Summary/Keyword: respiratory resistance

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Hemodynamic Influences of Positive End-Expiratory Pressure Ventilation in Patients with Pulmonary Insufficiency (호기말 양압호흡이 혈류역학 및 심기능에 미치는 영향)

  • 장병철
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.79-85
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    • 1985
  • The effect of graded increments in positive end-expiratory pressure [PEEP] on hemodynamics required to ventilate 8 critically ill patients is reported. Acute respiratory insufficiency was a cause of death in only one patient of drug inoxication among the 8 patients studied. The cardiac output was not changed significantly after the increment of PEEP to the level of 20 cm H2O. The heart rate was increased significantly from 15 cm H2O PEEP [P<0.01] as compared to 0 cm H2O PEEP; and the stroke volume was decreased significantly from 15 cm H2O PEEP [P<0.05]. The blood pressure was not affected at any level of PEEP, but the pulmonary artery pressure was elevated significantly at 10 cm H2O PEEP [P<0.01]. The right ventricular transmural filling pressure was not affected at the level of 10 cm H2O PEEP, but from 15 cm H2O PEEP it was increased significantly. With the increment of PEEP, the left ventricular stroke work index was decreased slightly; and at 20 cm H2O PEEP, it was decreased significantly. The right ventricular stroke work index was increased only at 10 cm H2O PEEP. The systemic vascular resistance was decreased significantly from 15 cm H2O PEEP [P<0.01].

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Clinical Analysis of Secundum Atrial Septal Defect (이차공형 심방중격결손증의 임상적 고찰)

  • 정황규
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.520-527
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    • 1987
  • Clinical analysis was performed of 89 secundum type atrial septal defect patients operated on during the period from July, 15th, 1981 to March, 1987 in the Thoracic and Cardiovascular Surgery Department of Pusan National University Hospital. Secundum type ASD was 2`I.0% among all of congenital heart diseases operated in the same period. The age distribution of patients ranged from 3 to 41 years and sex ratio, male to female was 1.23 to 1.0. Common symptoms were exertional dyspnea 64.0%, frequent upper respiratory infection 43.8%, cyanosis 10.1% and fatigue 7.9%. The mean value of cardiac catheterization data of the group of ASD combined with another cardiovascular anomalies was compared with that of only ASD group. The amount of shunt showed not statistically significant difference between two groups [P>0.05] but pulmonary arterial pressure and pulmonary vascular resistance of combined group was significantly higher than that of only ASD group [P<0.02, P<0.01]. The difference of mean hemodynamic data between the age group below 20 years and above 21 years was not statistically significant [P>0.05]. All cases were operated under cardiopulmonary bypass. Among these 51 were closed directly and 38 were applied Dacron patch. Two most common associated cardiac anomalies were pulmonary stenosis [8 cases, 9.0%] and VSD [8 cases, 9.0%]. The most frequent postoperative complication was wound infection, One patient died of low cardiac output on 10th postoperative day and the overall operative mortality was 1.1%

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Novel swine-origin H1N1 influenza (신종 H1N1 인플루엔자)

  • Lee, Jina;Lee, Hoan Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.862-868
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    • 2009
  • Since its identification in April 2009, a swine-origin H1N1 influenza A virus (S-OIV) which is a reassortment of gene segments from both North American triple-reassortant and Eurasian swine influenza has been widely spread among humans in unexpected rapidity. To date, each gene segment of the 2009 influenza A (H1N1) outbreak viruses have shown high (99.9%) neucleotide sequence identity. As of July 6, 94,512 people have been infected in 122 countries, of whom 429 have died with an overall case-fatality rate of <0.5%. Most confirmed cases of S-OIV infection have been characterized by self-limited, uncomplicated febrile respiratory illness and 38% of cases have also included vomiting or diarrhea. Standard plus droplet precautions should be adhered to at all times. Tests on S-OIV have indicated that current new H1N1 viruses are sensitive to neuraminidase inhibitors (oseltamivir). However, current less virulent S-OIV may evolve into a pathogenic strain or acquire antiviral resistance, potentially with more severe clinical consequences. Efforts to control these outbreaks would be based on our understanding of novel S-OIV and previous influenza pandemics.

The use of fluoroquinolone in children (소아에서 fluoroquinolone 사용)

  • Hur, Jae Kyun
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1042-1046
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    • 2008
  • The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has been limited because of their potential to induce arthropathy in juvenile animals. Despite class label warnings against use in children, prescriptions for quinolone antibiotics to treat infections in children have become increasingly prevalent. The main use of fluoroquinolones in pediatrics should be, understandably, in serious life-threatening infections for which other antibiotics therapies are not effective or available. While most of the published studies failed to detect an increased rate of articular adverse effects in children treated with fluoroquinolones, an increase in the use of these compounds, particularly in community-acquired lower respiratory infections, could accelerate the emergence of multidrug-resistant (including fluoroquinolone) pneumococcal strains. This review will discus the main issues related to the use of fluoroquinolones in children, the major problems of resistance developing among these compounds, with special emphasis on the potential side effects and skilled use of these alternative potent drugs in pediatric infection.

Vitamin D status and childhood health

  • Shin, Youn Ho;Shin, Hye Jung;Lee, Yong-Jae
    • Clinical and Experimental Pediatrics
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    • v.56 no.10
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    • pp.417-423
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    • 2013
  • Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in order to enhance normal calcification of the growth plate and bone mineralization. Moreover, emerging evidence supports an association between 25-hydroxyvitamin D (25[OH]D) levels and immune function, respiratory diseases, obesity, metabolic syndrome, insulin resistance, infection, allergy, cancers, and cardiovascular diseases in pediatric and adolescent populations. The risk factors for vitamin D insufficiency or deficiency in the pediatric population are season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, low socioeconomic status, and female gender. It is recommended that all infants, children, and adolescents have a minimum daily intake of 400 IU ($10{\mu}g$) of vitamin D. Since the vitamin D status of the newborn is highly related to maternal vitamin D levels, optimal vitamin D levels in the mother during pregnancy should be maintained. In conclusion, given the important role of vitamin D in childhood health, more time spent in outdoor activity (for sunlight exposure) and vitamin D supplementation may be necessary for optimal health in infants, children, and adolescents.

Enhancement of Allergen-related Eosinophilic Airway Inflammation and Airway Hyperresponsiveness by House Dust Particles in Mice (생쥐에서 가정분진 입자로 인한 항원관련 호산구성 기도 염증과 기도 과민성의 증대)

  • Lim, Heung-Bin;Kim, Seung-Hyung
    • Journal of Korean Society for Atmospheric Environment
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    • v.24 no.3
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    • pp.321-328
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    • 2008
  • The number of patient with allergic asthma and atopy have increased in the cities of Korea steadily. In order to elucidate the primary factor, we investigated whether the house dust particles collected from an apartment of the middle classes has promoting effects of allergen-related airway inflammation and airway hyperresponsiveness. Mice were treated with 0.1 mL of 1 mg/mL of house dust particles suspension by intratracheal instillation once weekly for 10 weeks combined with ovalalbumin (OVA) sensitization. Intratracheal instillation of house dust particles and OVA sensitization caused an increase in the level of serum L-lactate dehydrogenase (LDH), immunoglobulun-E (IgE) and histamine, and an elevation in respiratory resistance. It also enhanced infiltration of eosinophils in the bronchoalveolar lavage fluid (BALF) of mice, IgE and eotaxin expression in blood, and T helper type 2 cell derived cytokine levels such as of interleukin (IL)-4, IL-13 and IL-5 in the BALF. However, it did not influence T helper type 1 cytokine such as interferon-gamma in the BALF. These results indicate that house dust particles elevate allergen-related airway inflammation and airway hyperresponsiveness in mice and may play an important role in the aggravation of asthma and atopy in Korea.

SETDB1 mediated FosB expression increases the cell proliferation rate during anticancer drug therapy

  • Na, Han-Heom;Noh, Hee-Jung;Cheong, Hyang-Min;Kang, Yoonsung;Kim, Keun-Cheol
    • BMB Reports
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    • v.49 no.4
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    • pp.238-243
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    • 2016
  • The efficacy of anticancer drugs depends on a variety of signaling pathways, which can be positively or negatively regulated. In this study, we show that SETDB1 HMTase is down-regulated at the transcriptional level by several anticancer drugs, due to its inherent instability. Using RNA sequence analysis, we identified FosB as being regulated by SETDB1 during anticancer drug therapy. FosB expression was increased by treatment with doxorubicin, taxol and siSETDB1. Moreover, FosB was associated with an increased rate of proliferation. Combinatory transfection of siFosB and siSETDB1 was slightly increased compared to transfection of siFosB. Furthermore, FosB was regulated by multiple kinase pathways. ChIP analysis showed that SETDB1 and H3K9me3 interact with a specific region of the FosB promoter. These results suggest that SETDB1-mediated FosB expression is a common molecular phenomenon, and might be a novel pathway responsible for the increase in cell proliferation that frequently occurs during anticancer drug therapy.

Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension (폐동맥고혈압 동반여부에 따른 폐동정맥루의 치료)

  • Huh, Yun Jeong;Kim, Jeong Tae;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.216-220
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    • 2005
  • Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

Pathological findings of paraquat poisoning in mice, rats and rabbits (마우스, 랫트 및 토끼에서 paraquat 중독의 병리학적 관찰)

  • Lee, Suk-joo;Cho, Sung-whan
    • Korean Journal of Veterinary Research
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    • v.34 no.2
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    • pp.339-347
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    • 1994
  • This study was carried out to investigate the pathological changes with paraquat(1.1'-dimethyl-4.4'-dipyrildiylium dichloride) administered by intraperitoneally, orally, skin applied in mice, rats and rabbits. Results were obtained as follows; In 2 days after paraquat administration clinical signs anorexia, depression, tachypnea, and tachycardia, respiratory failure, coma and death were observed in mice, rats and rabbits. Compared toxicity of paraquat with mouse were observed toward to paraquat that resistance was strong than rats and rabbits. Also, mortality of skin application were found the low than intraperitoneal and high than oral administration. In the case of gross observation were appear lips moisture in orally administered rats and rabbits by skin application. Lung of all laboratory animals were observed congestion and haemorrhage, swelling or atrophy. In the case of microscopic findings were severe congestion and haemorrhage, interstitial pneumonia of lung. Congestion and haemorrhage of liver, congestion and haemorrhage, renal tubule epithelium necrosis of kidney were observed in mice, rats and rabbits. Skin application group of mice, rats and rabbits showed infiltration of inflammatory cells and folliculitis of epidermis and dermis. Also, in oral administration group showed congestion and haemorrhage, tachment, necrosis of alimentary tract mucosa.

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Analysis of Obesity and Sarcopenia among COPD Patients in Korea (한국 COPD 환자의 비만도와 근감소증 분석)

  • Jekal, Yoonsuk
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.3
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    • pp.604-612
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    • 2020
  • The purpose of this study is to analyze the level of obesity and sarcopenia among chronic obstructive pulmonary disease(COPD) patients in Korea. The current study recruited 75 patients with COPD who visited the department of respiratory medicine at J University Hospital in J-do. Height, body weight, waist circumference, and hip circumference were measured, and body composition, muscle strength, and flexibility were assessed. The levels of obesity were classified with body mass index(BMI), waist-hip circumference ratio(WHR) and percent body fat, and sarcopenia was classified with the value of skeletal muscle mass and muscle strength by Asian Working Group for Sarcopenia. In results, it was found that the level of obesity was very high as 43% by BMI, 88% by WHR, and 64% by percent body fat. The lower level of muscle strength was 15.50% in males and 23.50% in females. The lower level of muscle mass was 24.10% in males and .00% in females. Males who had one sarcopenia factors were 22.40%, and females were 23.50%, respectively. Males with sarcopenia were 6.90%, and females were .00%. In conclusion, regular resistance exercise is essential not only for the development of motor skills, but also for the normalization of skeletal muscle function and prevention of muscle dystrophy among COPD patients.