Fundamental verification to establish evidences among pulmonary rehabilitation.

1) 为了通过改变历史上假定的呼吸模式来检查呼气式马力呼吸 (PLB) 对支气管扩张和呼吸效率改善的影响，在 PLB 期间测量了 10 名健康受试者的通气力学。我们在 2004 年 ATS 会议上报告了 PLB 期间的呼吸阻抗和鼻咽闭合情况，并提交发表。此外，还在患有慢性阻塞性肺病的患者中进行了测量。结果显示PLB期间发生了各种变化，这些结果将在日本呼吸护理学会2005年和美国胸科医师学会2005年报告并提交。计划在 PLB 期间进行脑电图研究，以检查对健康受试者和慢性阻塞性肺病患者呼吸困难感觉的影响。我们即将完成脑电图阿尔法波频率分析的数据获取。目前，分析正在进行中。关于心电图 R-R 变化的数据也在 PLB 期间进行研究，但尚未完成。2）我们新开发了“死腔负荷系统”，用于测量胸部理疗前后呼吸肌的耗氧量。该系统可以在不影响功能残气量的情况下测量耗氧量，适合慢性阻塞性肺病患者。该系统已经申请了专利。初步研究已经完成，将在胸部理疗前后的COPD患者中开始测量。3）我们尝试研究肋间肌的组织氧饱和度，以探讨呼吸肌训练的最佳负荷。但由于技术困难，我们决定将评估目标改为呼吸辅助肌并继续进行实验。4）由于医院的问题，无法在PLB期间使用电子束CT拍摄肺部图像。初步图像已发表在《新英格兰医学杂志》上。正在与滋贺医科大学开展联合项目，利用电子束 CT 研究 PLB 期间的支气管扩张效应。较少的

1)To examine the effects of Pursed hp breathing (PLB) on broncho-dilation and improvement of respiratory efficiency by changing respiratory pattern which have been historically assumed, ventilatory mechanics was measured in 10 healthy subjects during PLB. We reported respiratory impedance and nasopharyngeal closure during PLB at ATS meeting 2004 and submitted for publication. Further, the measurements were also performed in the patients with COPD. The results showed various changes during PLB, which will be reported at Japanese Society for Respiratory Care 2005 and American College of Chest Physicians 2005, and will be submitted. EEG study during PLB were planned to examine the effects on dyspnea sensation in healthy subjects and patients with COPD. We almost finished to obtain the data to performm frequency analysis of EEG alfa-wave. Currently, the analysis is undergoing. The data concerning R-R variation in ECG is also being studied during PLB, but not finished, yet.2)We newly develo … More ped "Dead space loading system" to measure oxygen consumption of respiratory muscle before and after chest physiotherapy This system allows to measure the oxygen consumption without influence of functional residual capacity, and is suited for patients with COPD. A patent was already applied for the system. The preliminary studies were done, and the measurement will be started in the patients with COPD before and after chest physiotherapy.3)We tried to study tissue oxygen saturation in intercostals muscles to investigate the optimal load for respiratory muscle training. However, because of technical difficulties, we decided to change the target of the assessment to respiratory accessory muscles and to continue to do experiments.4)It became impossible to take image of the lung during PLB using electron-beam CT because of the problem in the Hospital. The preliminary images were already published in New England Journal of Medicine. Joint projects to study bronch-dailating effects during PLB using electron-beam CT is under processing with Shiga Medical University. Less