ABSTRACT
Spirometry measures the forced expiratory volumes and flows. In patients with neuromuscular disease, these are altered since there is some respiratory muscle involvement. The usefulness of this test is based on the interpretation of the shape of the flow / volume loop and values of spirometric variables. In patients with neuromuscular disease, Forced Vital Capacity is the most used especially for its prognosis value.
La espirometría mide volúmenes y flujos espiratorios forzados. En los pacientes con enfermedad neuromuscular (ENM) estos se ven alterados debido al compromiso muscular respiratorio. La utilidad de este examen se basa en la interpretación de la forma de la curva flujo/volumen y los valores de las variables espirométricas. En los pacientes con ENM la Capacidad Vital Forzada es la más utilizada ya que otorga valor pronóstico.
Subject(s)
Humans , Maximal Expiratory Flow-Volume Curves/physiology , Neuromuscular Diseases/physiopathology , Maximal Expiratory Flow Rate/physiology , Respiratory Muscles/physiopathology , Spirometry , Vital CapacityABSTRACT
With the world standardization of inhaled steroids for bronchial asthma, the principle of Kampo medicine has changed from treatment for asthma attack to the prevention of it. The number of severe adult patient cases has decreased, and the number of <i>hojinzai</i> (kidney tonic) users has increased. The number of weaker children has increased, and the number of <i>hohizai</i> (spleen tonic) users has increased. Kampo medicine was not equal to inhaled steroids for the treatment of bronchial asthma, because the number of patients treated with Kampo medicine, having more than one year without an attack, was only 10% to 20%, and this figure would be lower, with inhaled steroids.<br>Nevertheless, Kampo medicine has had a great effect, on patients with milder symptoms, who do not require inhaled steroids, and well as those patients uncontrollable even with inhaled steroids. The Saiboku-to and Maozai groups, including Sho-sei-ryu-to and Ma-kyo-kan-seki-to, are good for milder patients. It is advisable to first check the immediate reaction of Maozai group users, following its administration in the clinic for treating attacks. The Hojinzai group, including Hachimi-jio-gan and Bakumi-jio-gan-ryo, are good for patients with the severe asthma or chronic obstructive pulmonary disease. An increase in the peak-flow rate of these patients with Hachimi-jio-gan might be related to activation of dehydroepiandrosterone, although the mechanism is unknown. Moku-boi-to is indicated for those patients with complicated heart failure.
ABSTRACT
Kampo treatment for respiratory diseases on the traditional standard including some care reports lectured. To find adequate Kampo prescription for each patient, it need to discriminate what is the cause of the symptoms, throat, nose, chest or low respiratory function. Some patients whose obstructive feeling at throat was improved by the adiministration of Hange-koboku-to, was introduced. Anxiety at throat was an important sign for its indication in these patients. This prescription was also applicated to sleep-disordered breathing. On treatment for chronic rhinitis that caused respiratory symptoms the pulse diagnosis was an important technique for the diagnosis of stasis of body fluids. Kampo treatment for common cold, chronic bronchitis, bronchial asthma and interstitial pneumonia were told as chest diseases. Kampo prescriptions for chronic bronchitis were classified by the characteristics of cough (dry or wet) and Kyo-Jitsu (asthenia or robust). Pediatric asthma patients who respond to the prescriptions with tonic effect including Sho-kenchu-to, was considered to increase recently. A case with interstital pneumonia improved with Bukuryo-kyonin-kanzo-to, was introduced and adequate Kampo prescription for this disease was discussed with some previous reports. Hachimi jio-gan increased peak flow rate of asthmatic patients with low respiratory function and the difference of indication to Bakumi-jio-gan-ryo was discussed.
ABSTRACT
PURPOSE: Peak urinary flow rate is a widely used parameter in the diagnosis and evaluation of treatment erect of BPH because of its objectiveness and non-in vasiveness. The peak urinary flow rate, however is different with each voided volume in the same patient and tends to decrease even in an asymptomatic man with increasing ages. Therefore we need an adjusted peak urinary flow rate corresponding with the age and voided volume. This adjusted peak urinary flow rate can be used to evaluate the voiding function more easily in the same patient periodically or In the different patient of various voided volume and ages. MATERIALS AND METHODS: Data on age, volume voided and peak urinary flow rate were accumulated from 216 male aged from 10 to 80 who were free of voiding symptoms. All combinations of peak urinary flow rate, age and volume voided were tested for equation of bet fit by the least squares method with search for the equation providing least residual standard deviation with SAS package. RESULTS: When the peak urinary flow rate is defined as a function of age and voided volume, the equation is Q=35.01+0.086A-0.0031A2-1612/V(Q: peak urinary flow rate, A: age, V: voided volume). At the point of population means for volume voided(247.5ml) arid age(35.2) the reference peak urinary flow rate was 27.7m1/sec. Adjusted peak flow rate can be obtained by subtracting the difference between the measured and expected peak flow rate(expected minus measured) from the reference peak flow rate. To make the adjusted peak flow rate obtained easily with measured peak flow rate, age and voided volume nomogram that incorporates the equation has been designed. In our nomogram an adjusted peak flow rate 1.3 standard deviation below mean should be considered suspicious for obstruction. CONCLUSIONS: Nomogram for adjusted peak flow rate that incorporates the age, voided volume and measured peak flow rate would be satisfactory for clinical use.
Subject(s)
Humans , Male , Diagnosis , Least-Squares Analysis , NomogramsABSTRACT
PURPOSE: The present study was performed to assess whether the subjective information of the international prostate symptom score(I-PSS) correlated with prostate volume and uroflowmetric findings and could predict the degree of flowmetric impairment. MATERIALS AND METHODS: To establish the relationship among I-PSS, uroflowmetric findings, and prostate volume, we surveyed community-based samples of 600 men over the age 50. The questionnaire of Korean version of I-PSS was shared and self completed. The flow rate was measured by a portable device with at least more than a voided volume of 100, then the prostate volume was estimated by transrectal ultrasonography. The participants were categorized as obstructed or non-obstructed according to the uroflowmetric findings. The I-PSS and all individual components were compared with peak flow rate, average flow rate, and prostatic volume, and to the uroflowmetric categories. The I-PSS severity categories(mild 0-7, moderate 8-19, and severe> or =20) were also compared to the uroflowmetric assorted groups. RESULTS: Mean age of the 600 men was 64.3 years(ranging 50-88 years), and 37.7%, 40.7%, and 21.6% of them had mild, moderate, and severe symptoms, respectively. 164 men(27.3%) had uroflowmetrically impaired flow rate set on the basis of 10ml/s. Subject age was significantly associated with I-PSS, peak flow late, and prostatic volume. Significant correlation was found in any I-PSS parameters with uroflowmetric findings, but no correlation with prostate volume. I-PSS severity groups, when compared to the uroflowmetric groups, showed a statistically significant relationship. When the multivariate linear regression analysis was applied to determine the variable, which best predicted uroflowmetric obstruction, age was the most significant predictor of the uroflowmetric findings. CONCLUSIONS: I-PSS correlated with objective data from the uroflowmetry. Although I-PSS has been known to be neither an accurate tool nor specific for the diagnosis of BPH, it may be useful to evaluate and predict the severity of uroflowmetric impairment.