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.
Journal of The Korean Society of Integrative Medicine
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v.12
no.3
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pp.25-36
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2024
Purpose : After coronavirus disease 2019 pandemic, many people around the world became aware of respiratory diseases and developed increased interest in health and exercise. As the elderly population grows larger, the prevalence of brain diseases and respiratory conditions increases. This study aimed to investigate the impact of dynamic neuromuscular stabilization (DNS) exercises on pulmonary function and electroencephalogram (EEG) findings in the elderly population. Methods : In this study, we measured the pulmonary function and performed EEG of 30 elderly individuals. The participants were randomly divided into an experimental group (n=15) and a control group (n=15). The experimental group completed a DNS exercise training protocol, while the control group performed simple exercise training. After the exercise, the pulmonary function and EEG testing were repeated, and the amounts of change within and between groups were determined. Results : In terms of pulmonary function, the experimental group's forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) increased significantly after the exercise (p<.05), while the FVC differed significantly between groups (p<.05). In terms of EEG findings, the relative alpha waves significantly decreased in the F3 region (p<.05), while the relative beta waves significantly increased in the F4 region (p<.05). The relative gamma waves increased significantly in the Fp2 and P3 regions (p<.05), while the values in the F3 region differed significantly between groups (p<.05). Conclusion : DNS exercises performed by this elderly population demonstrated significant clinical value by providing fundamental data about both pulmonary function and EEG activity.
Journal of The Korean Society of Integrative Medicine
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v.7
no.4
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pp.13-21
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2019
Purpose : The purpose of this study was to investigate the effect of abdominal muscle strengthening exercise on abdominal muscle strength and respiratory function in stroke patients. Methods : The subjects were 14 stroke patients (10 males, 4 females) hospitalized at W rehabilitation hospital in Busan City and randomly assigned to 7 exercise groups and 7 control groups. Exercise was performed in combination with an upper and lower extremity pattern of proprioceptive neuromuscular facilitation. Measurements of abdominal muscle strength and respiratory function were made before intervention and 4 weeks after intervention. Abdominal muscle strength was assessed using a digital manual dynamometer, and respiratory function was assessed by spirometry. The collected data were analyzed with a paired t-test and independent t-test and the significance level was set as α =.05. Results : The results showed that applying abdominal muscle strengthening exercise to stroke patients showed a significant increase in abdominal muscle strength and a significant difference between groups (p<.05). Maximal-effort expiratory spirogram (MES) readings were significantly increased in forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), in the exercise group, and there were a significant differences between the groups in terms of FEV1 (p<.05). Slow vital capacity (SVC) was significantly increased in vital capacity (VC), tidal volume (TV), inspiratory reserve volume (IRV), and expiratory capacity (EC), and there were significant differences between the groups in VC, TV, expiratory reserve volume (ERV), EC, and inspiratory capacity (IC) (p<.05). Conclusion : Abdominal muscle strengthening exercise was effective in the abdominal muscle strength of stroke patients, and it was confirmed to have a positive effect on the enhancement of respiratory function. Therefore, it seems that exercise programs for stroke patients with respiratory weakness should include abdominal muscle strengthening exercises.
Lee, Jong Seong;Shin, Jae Hoon;Baek, Jin Ee;Choi, Byung-Soon
Journal of Korean Society of Occupational and Environmental Hygiene
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v.29
no.3
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pp.404-413
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2019
Objectives: Chronic obstructive pulmonary disease(COPD) is an important cause of mortality in workers exposed to hazardous dust, such as crystalline silica or coal, and COPD is related to inflammation and oxidative stress in the lung. The aim of this study was to evaluate the association of oxidative stress and inflammation to COPD in retired workers exposed to mineral dust. Methods: The levels of malondialdehyde(MDA) in EBC as biomarkers for oxidative stress and C-reactive protein(CRP) and lactate dehydrogenase(LD) as biomarkers for inflammation were measured in 107 male subjects(63 pneumoconiosis and 42 COPD subjects). Results: Mean levels of EBC MDA(2.03 nmol/L vs. 4.65 nmol/L, p=0.010) and serum LD(170.3 U/L vs. 185.9 U/L, p=0.022) were significantly higher in subjects with COPD, but mean levels of serum CRP(p=0.469) did not show a statistical difference between the study groups. Level of EBC MDA was negatively correlated with ${%}FEV_1$ predicted(r=-0.279, p=0.004) and ${%}FEV_1/FVC$ ratio(r=-0.397, p<0.001). Conclusions: These results suggest that EBC is a useful biological matrix for investigation of respiratory oxidative stress. High levels of EBC MDA and serum LD are related to COPD in retired workers exposed to mineral dust.
Objective: Patients with chronic obstructive pulmonary disease (COPD) may experience reduced physical activity and quality of life (QoL) due to decreased pulmonary function. The purpose of this study was to investigate the level of pulmonary function, physical activity, and QoL of COPD patients. Design: Cross-sectional observational study. Methods: This study examined the published data of the Korea National Health and Nutrition Examination Survey in 2015-2019. Among 39,759 subjects who participated for 5 years, data from 151 patients diagnosed with COPD were analyzed separately. For the pulmonary function, the results of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV6, forced expiratory flow 25-75%, and peak expiratory flow were observed. Physical activity was identified as frequency and duration. For the QoL, EQ-5D-3L evaluation results were examined, and the frequency and index of the Korean version were investigated. Results: In pulmonary function, all variables were found to be lower than age and weighted matched normal values. COPD patients showed to perform very low levels of high/medium physical activity and sitting time was confirmed to be more than 8 hours a day. In QoL, it was found that the highest reporting rate of some problems was the "pain and discomfort" and "mobility". Conclusions: It was found that COPD patients showed that the prevalence of circulatory disease was relatively high, lowered pulmonary function, and QoL. These can be improved through regular physical activity, and it is thought that this can be achieved through optimization of pulmonary rehabilitation.
Background: Bronchial reactivity is known to be a component of airway hyperresponsiveness, a cardinal feature of asthma, with bronchial sensitivity, and is increments in response to induced doses of bronchoconstrictors as manifested by the steepest slope of the dose-response curve. However, there is some controversy regarding methods of measuring bronchial reactivity and clinical impact of such measurements. The purpose of this study was to evaluate the clinical significance and assess the clinical use by analyzing the relationship of the bronchial sensitivity, the clinical severity and the changes in pulmonary function with bronchial reactivity. Method: A total of 116 subjects underwent a methacholine bronchial provocation test. They were divided into 3 groups : mild intermittent, mild persistent, moderate and cough asthma. Severe patients were excluded. Methacholine PC20 was determined from the log dose-response curve and PC40 was determined by one more dose inhalation after PC20. The steepest slope of log dose-response curve, connecting PC20 with PC40, was used to calculate the bronchial reactivity. Body plethysmography and a single breath for the DLCO were done in 43 subjects before and after methacholine test. Results: The average bronchial reactivity was 38.0 in the mild intermittent group, 49.8 in the mild persistent group, 61.0 in the moderate group, and 41.1 in the cough asthma group. There was a weak negative correlation between PC20 and bronchial reactivity. A heightened bronchial reactivity tends to produce an increased clinical severity in patients with a similar bronchial sensitivity and basal spirometric pulmonary function. There were significant correlations between the bronchial reactivity and the initial pulmonary function before the methacholine test in the order of sGaw, Raw, $FEV_1$/FVC, MMFR. There were no correlations between the bronchial sensitivity and the % change in the pulmonary function parameters after the methacholine test. However, there were significant correlations between the bronchial reactivity and the PEF, $FEV_1$, DLCO. Conclusion: There was weak significant negative correlation between the bronchial reactivity and the bronchial sensitivity, and the bronchial reactivity closely reflected the severity of the asthma. Accordingly, measuring both the bronchial sensitivity and the bronchial reactivity can be of assistance in assessing of the ongoing disease severity and in monitoring the effect of therapy.
Background: Mixed obstructive and restrictive pattern of spirometry can not be concluded in the presence of true restrictive disorders because pure obstructive disorders can also show reduced vital capacity. However, it is not known how many patients with mixed spirometric pattern really have restrictive disorders in Korea whose pattern of pulmonary diseases is somewhat different from foreign countries. To answer this question, I performed this study and tried to answer it according to diseases in addition. Method: Test results from 413 patients who undergone both spirometry and lung volume measurements on the same visit from August 1, 1998 to July 31, 1999 were included. Spirometry data were classified as mixed obstructive-restrictive pattern when spirometry showed '$FEV_1/FVC$<70% (<65% if age$\geq$60)' and FVC<80% of predicted value'. TLC by the method of nitrogen washout was considered as gold standard to diagnose restrictive disorders in which TLC is less than 80% of predicted value. Results: Out of 404 patients who could be evaluated, 58 had mixed pattern of spirometry. 58 patients were suffered from airway diseases(39 patients) such as COPD(22 patients, 38%), asthma(11, 19%), bronchiectasis (6,10%), and sequelae of pulmonary tuberculosis(15, 26%) or other diseases(4,7%). Only 18 out of 58(31%) were confirmed to have true restrictive disorders by TLC. The proportion of true restrictive disorders was different according to diseases, 20.5%(8/39patients) in patients with airway diseases and 53.3%(8/15) with sequelae of pulmonary tuberculosis(p<0.05). Conclusion: Many patients whose spirometry showed mixed pattern didn't have restrictive disorders but had pure obstructive disorders. This was true for more patients with airway diseases. Therefore it would be prudent that lung volume be tested to diagnose restrictive disorders in patients with mixed spirometric pattern.
Fourteen patients underwent surgical resection of bullae between February, 1987 and June, 1990 via median sternotomy. Twelve patients had spontaneous pneumothorax with previous history of pneumothorax on the contralateral side or visible bullae on chest X-ray films. Two patients had bullous emphysema. The duration of operation and admission, frequency and amount of analgesic administered for pain control, pulmonary function test [FEV1, FVC, MVV] and the amount of bleedings were compared with six cases of staged unilateral thoracotomy. The results were as follows: 1. All patients were male. 2. Mean follow up period was 13.5 month and no recurrence of pneumothorax are noted after the operation. 3. Median sternotomy showed shortened admission days than thoracotomy. [12.4$\pm$2.7, 15.6$\pm$3.1 days] 4. Significantly shortened anesthetic time in median sternotomy than thoracotomy [121$\pm$21, 184$\pm$33 minutes] 5. Median sternotomy required less injection of analgesics than thoracotomy. [6.5$\pm$2.7, 13.5$\pm$3.1 ampules] 6. Bleeding amount and PFT showed no differences. 7. Complications were prolonged air leakage for more than 7 days [2 patients], transient elevation of SGOT and SGPT[2 patients], and wound infection[1 patient]
Eleven cases of pulmonary resection had been performed for pulmonary aspergilloma in the department of thoracic and cardiovascular surgery, School of Medicine, Kyungpook National University from August 1984 to July 1988. The patients were consisted of six males and five females and were evenly distributed from third decade to sixth decade. Hemoptysis was usually presenting symptom [72.2%] and the variable was the interval between symptom onset to surgical resection, which was ranged from few months to several years In the plane chest films, intracavitary fungus balls were noted in five cases [5/11] and upper lobe involvements were seven cases [7/11]. Aspergillus fumigatus was identified preoperatively in three cases among the eight cases of sputum culture. Mean preoperative FVC and FEV 1.0 values were in normal range. Eleven pulmonary resections were done by eight lobectomies, two segmentectomies and one pneumonectomy. The lesion was superimposed upon old tuberculosis in eight patients, in one upon bronchiectasis and in two upon tuberculous bronchiectasis. Five complications appeared postoperatively which included ARDS [1 case] bleeding [2 cases], persistent air leak[1 case], and dead space [1 case].
Objective : Respiratory muscle weakness and decreased chest mobility has been suggested to result from the deconditioning that accompanied activity level in chronic elderly stokes. The benefits of respiratory exercise programmes on exercise capacity and muscle strength in hemiplegia. This study aimed to determine the effects of selective inspiratory and expiratory muscles training and chest mobility exercise on patients with strokes to establish if an improved exercise capacity can be obtained in patients that are not limited in their daily activities. Methods & Intervention : Twelve patients were assigned to the intensive respiratory exercise group participated in a measures design that evaluated the subjects with pre-treatment and post-treatment. Thirteen subjects who were assigned to a control group received training with breathing exercise and resistance exercise of skeletal muscles. The subjects performed spirometry then undertook a 6-week programme of respiratory muscle and chest mobility training. Training for the two groups was carried out 2 times a week for 6 weeks. Measurements and Results : Spirometry(Forced Vital Capacity: FVC and Closed Circuit Spiromety: CCS) and thoracic mobility were measured before and after the 6 weeks. The experimental group improved significantly compared to control group in FVC, $FEV_1$, MVV, IRV and ERV, and upper chest wall expansion(p<0.05). No significant improvement was seen in thoracic mobility or lung function in control group(p>0.05). Conclusion : The major findings in this study were that a intensive 6week exercise programme of resistive breathing and chest mobility in patients with hemiplegia led to an increase in lung capacity. The resistive breathing exercise programme used here resulted in a significant increase in the chest excursion during breathing.
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