• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.163-175
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• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.202-209
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• 2011

Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.374-379
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• 2005

Background : The single-breath carbon monoxide diffusion capacity (DLCO) and the per unit alveolar volume (KCO; $D_LCO/VA$) gave discordant values when there was an abnormal alveolar volume (VA). However, the clinical significance of the discordant values in patients with airflow limitation has not been examined. This study investigated the $D_LCO$ and KCO changes after improving the airflow limitation. Methods : The baseline $D_LCO$ and KCO with lung volume were measured in patients with an airflow obstruction. The effective alveolar volume was measured using the single-breath $CH_4$ dilution method. The patients divided into two groups according to the baseline values: (1) increased KCO in comparison with the $D_LCO$ (high discordance) (2) decreased or not increased KCO in comparison with the $D_LCO$ (low discordance). The diffusion capacity and lung volume were measured after treatment. Results : There was no significant difference in the baseline lung volumes including the $FEV_1$ and FVC between the two groups. The $FEV_1$ and FVC were significantly increased in the high discordance group compared with the low discordance group after treating the airflow limitation. The $D_LCO$ and alveolar volume were significant higher in the high discordance group compared with the low discordance group while the TLC was not. Conclusion : The discordance between the $D_LCO$ and KCO could be translated into an airflow reversibility in patients with an airflow limitation.

• Journal of the Korean Applied Science and Technology
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• v.37 no.4
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• pp.699-710
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• 2020

The purpose of this study was to investigate the effect of combined exercise on lung function, blood vitamin D, calcium and bone metabolism hormones in elderly women who are over 65 years by dividing them into a combined exercise group(n=13), control group(n=17). The combined exercise program included 60-minutes sessions 3times each week. Aerobic exercise intensity was 40-50%HRR(RPE 12-13) for 1-4 week, 50-60%HRR(RPE 13-14) for 5-8 week, and 60-70%HRR(RPE 14-15) for 9-12 week and resistance exercise intensity was set at OMNI-RES 3-4 for 1-4 week, OMNI-RES 5-6 for 5-8 week, OMNI-RES 7-8 for 9-12 week. As a result, lung function indicated that FEV₁ showed an interaction effect between group and time and FVC/FEV₁ levels significantly increased in combined exercise group. Blood vitamin D showed an interaction effect between group and time, also, significantly increased in combined exercise group and control group. Calcium showed an interaction effect between group and time, and significantly decreased in control group. Bone metabolism hormones indicated that both calcitonin and osteocalcin showed an interaction effect between group and time, osteocalcin significantly decreased in control group. For the following this conclusion, elderly women can be improved their lung function through 12 weeks combined exercise and also mitigate the blood vitamin D but there was no meaningful results of calcium and bone metabolism hormones.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.298-305
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• 2016

Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.317-326
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• 1999

Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.

• The Journal of the Convergence on Culture Technology
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• v.6 no.2
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• pp.341-348
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• 2020

This research is to find out which position is more effective on exercise. This study compared paricipants in their twenties on sitting position & standing position doing abdominal breathing of their respiration & abdominal muscle activation for 4 weeks. In sitting position, FEV1 was the biggest after breathing exercise. In standing position, the gap was biggest between the FEV1 & forced expiratory flow before and after the exercise. In standing and supine position, Lt. rectus abdominis before exercise and Rt. rectus abdominis after exercise muscle activities were the biggiest. Both posture exercise of repeated measure of analysis result, before and after the exercise of the rectus abdomonis muscle and external oblique muscle were not difference in both muscle activity(p>.05). Left Musculus obliquus externus abdominis before and after physical exercise, it's showed a meaningful difference(p<0.05). Before and after exercise, saw a meaningful difference the efforts of FEV1/FVC(p<0.05). The left external oblique abdominis muscle showed the most muscle activity in the supine position before/after exercising, the efforts expiratory showed the lowest muscle activity.The results from the repeated measures ANOVA regarding to before/after the volume and muscle activity, it showed significant difference between at the right rectus abdominis muscle(p<.05). This study finally gathered data about the muscle activity according to the position. This could be used to find in what position the abdominal breath exercise is the post effective & a new treatment for the patients who has worsened respiration function.

• Tuberculosis and Respiratory Diseases
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• v.69 no.3
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• pp.177-183
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• 2010

Background: Smoking reduces pulmonary function and induces various lung diseases. Recently, the rate of emphysema detection has increased due to lung cancer screening with low-dose chest computed tomography (CT). The purpose of this study was to evaluate changes in lung function associated with emphysema in healthy smokers. Methods: One hundred and ninety one healthy smokers, who had undergone a low-dose chest CT (LDCT) scan as part of lung cancer screening and had revisited the health center after a median 23.9 months' time, were recruited into this study. The severity of emphysema was calculated by the direct observation of a radiologist and a pulmonologist indipendently. Longitudinal changes in lung function according to emphysema based on LDCT and type of smoker was analyzed. Results: Of the participants in this study, 25% of healthy smokers had emphysema, which was mild in severity, in older patients (p=0.003) and in heavy smokers (p<0.001). $FEV_1/FVC$ and FEF25-75% were decreased in current smokers with emphysema (p=0.001 and p=0.009, respectively) and without emphysema (p=0.001 and p=0.042). Although lung function was not decreased in ex-smokers without emphysema, $FEV_1/FVC$ and FEF25-75% were decreased in ex-smoker with emphysema (p=0.020 and p=0.010). Conclusion: Upon examination with LDCT, the prevalence of emphysema was higher in healthy smokers was than in non-smokers. Lung function was diminished in smokers with emphysema, in spite of former smoker.

• Phonetics and Speech Sciences
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• v.6 no.3
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• pp.49-56
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• 2014

This research compared the features of respiration and phonation between practical musicology students and general male students, according to their smoking status. Participants of this research are 15 practical musicology male students attending ${\bigcirc}{\bigcirc}$ university and 16 general ${\bigcirc}{\bigcirc}{\bigcirc}$ university students. The participants, both non-smokers and smokers with 5-years of smoking history have no history of voice disease in any case and have normal cognitive functions. The results indicated that, first, there is not a notable difference in the respiratory activity status(FVC, FEV1, FEV1/FVC), regardless of major and smoking status. In MPT, even though there is no significant difference in accordance with their majors, considering smoking status, the smoker group was shorter than non-smoker group significant difference statistically (p<.01). Second, the divisions of participants' major did not show significant difference in Fo, jitter, shimmer, and NHR in the vowel prolongation task. However, the smoker group showed a significantly higher degree of jitter and shimmer than the non-smoker group (p<.05) as Fo and NHR shows no difference. In the case of VRP, maximum frequency and frequency range of the practical group are significantly higher than normal group statistically (p<.001). Moreover, although the difference of the minimum frequency shown at the statistic is not significant, practical group showed a higher tendency of frequency than normal group (p=.051). In conclusion, even though there is no difference in respiratory activity between the smoker group and non-smoker group, the MPT of the smoker group is shorter than that of non-smoker group. In addition, the smoker group showed a higher degree of jitter and shimmer than the non-smoker group. MPT is related to the valve action of vocal fold that passes through the glottis. Thus, it is interpreted that the smoker group has a lower quality of voice and valve action of the vocal fold. Also, the practical group has a higher degree of maximum frequency and frequency range than the normal group. This research can function as basic data for vocal characteristics for the majors in relation to the voice-specializing.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.540-547
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• 1993

Backgrounds: The measurement of volume of isoflow has been considered as a sensitive test for detecting small airway diseases showing normal pulmonary function in a routine pulmonary function test. To evaluate the functions of small airway among dust exposed workers, the changes of volume of isoflow were measured and its applicability of managing early stage pneumoconiosis patients was studied. Method: The subjects were 67 male, pneumoconiosis with small opacity and FEV1>80%, FEV1/FVC>75% in spirometry and the controls were 20 male, no dust-exposed office workers. The maximal epiratory volume curves after inhalation of indoor air and $He-O_2$ gas mixtures were measured and ${\Delta}V_{max50},\;{\Delta}V_{max75},\;V_{iso}V/VC$ between the dust exposed and control workers were compaired. Results: 1) There were no significant differences between two group in ${\Delta}V_{max50}$ and ${\Delta}V_{max75}$. But the ratio of $V_{iso}V/VC$ of the subjects was siginificantly higher than that of the control (p<0.01). This study confirms that $V_{iso}V/VC$ is a very useful index in early detection of small airway dysfunction. 2) The ratio of $V_{iso}V/VC$ of the subjects was signigicantly different between only smoker group and mixed group(smoker and nonsmoker). It suggestes that smoking is an important cousative factor of small airway dysfunction. 3) As the profusion of the chest X-ray increased, the rartio of $V_{iso}V/VC$ increased, but no significant difference of $V_{iso}V/VC$ was found between categories of pneumoconiosis. The categories of pneumoconiosis and small airway dysfunction may not be related. 4) No significant relationship was established between the duration of work and the ratio of $V_{iso}V/VC$. Conclusions : It is concluded that the measurement of $V_{iso}V/VC$ is useful to detect small airway dysfuction of early stage pnuemoconiosis patents with small opacities but showing normal pulmonary function in a routine pulmonary function test.