• Title/Summary/Keyword: 폐용적

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Effect of Posture on the Distribution of Pulmonary Ventilation in Patients with Increased Closing volume (폐쇄용적(Closing Volume)이 증가된 만성 폐질환 환자에서 체위에 따른 폐환기량의 변화)

  • Kim, Young-Tae;Kim, Mee-Kyung;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Ryu, Jin-Sook;Lee, Myung-Hae;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.631-637
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    • 1993
  • Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.

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Tracheobronchial Stenosis due to Malrotation of the Heart -A case report - (심장의 이상 회전으로 유발된 기관기관지의 협착 1예)

  • Kim Jin Sun;Choi Seon Uoo;Lee Hoseok;Yang Ji-Hyuk;Jun Tae-Gook
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.863-865
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    • 2005
  • We experienced tracheobronchial stenosis caused by malrotation of the heart in a 3-year-old girl. Malrotation of the heart is induced by the decreased right lung volume, which was the result of right lung hypoplasia and herniation of the left thoracic cavity. We corrected the right lung volume and location of the heart to treat tracheobronchial stenosis.

Importance of Carbon Monoxide Transfer Coefficient (KCO) Interpretation in Patients with Airflow Limitation (기류제한 환자의 일산화탄소확산능 해석에서 폐용적 보정의 의의)

  • Seo, Yong Woo;Choi, Won-Il;Lee, Jeong Eun;Park, Hun Pyo;Ko, Sung Min;Won, Kyoung Sook;Keum, Dong Yoon;Lee, Mi-Young;Jeon, Young June
    • 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.

Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea (우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정)

  • Song, Eun Hee;Oh, Yeon Mok;Hong, Sang Bum;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Kim, Tae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.218-226
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    • 2006
  • Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.

An Implementation of ARM 920T Processor-based Ultrasonic Spirometer and Improvement of Its Sensitivity (ARM 920T 프로세서 기반의 초음파 폐활량계 구현 및 감도 향상 연구)

  • Lee, Cheul-Won;Kim, Young-Kil
    • Journal of the Korean Society for Nondestructive Testing
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    • v.25 no.4
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    • pp.268-273
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    • 2005
  • The spirometer is a medical device that measures the instantaneous velocity of the respiratory gas flow capacity. It is used for testing the condition of the lung and patient monitoring. It measures the absolute capacity difference that includes the flow capacity signal. In this paper, by using an ultrasound sensor that reduce+ the error caused by the inertia and pressure it has improved the transmission and receiving signal. This has enabled patients with weak respiratory to use the spirometer. Also, by using the ARM 920T Processor, a precise and prompt detection system was implemented.

An Implementation of the embedded hardware system based Ultrasonic Spirometer and Improvement of Its Sensitivity (임베디드 하드웨어 시스템 기반의 초음파 폐활량계 구현 및 감도 향상 연구)

  • Lee, Cheul-Won;Kim, Young-Kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • v.9 no.2
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    • pp.417-420
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    • 2005
  • The spirometer is a medical device that measures the instantaneous velocity of the respiratory gas flow capacity. It is used for testing the condition of the lung and patient monitoring. It measures the absolute capacity difference that includes the flow capacity signal. In this paper, by using an ultrasound sensor that reduce the error caused by the inertia and pressure it has improved the transmission and receiving signal. This has enabled patients with weal respiratory to use the spirometer. Also, by using the embedded hardware system, a precise and prompt detection system was implemented.

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Change of Lung Volumes in Chronic Obstructive Pulmonary Disease Patients with Improvement of Airflow Limitation after Treatment (치료 후 기류제한이 호전된 만성폐쇄성폐질환 환자에서 폐용적의 변화)

  • Park, Hun Pyo;Park, Soon Hyo;Lee, Sang Won;Seo, Yong Woo;Lee, Jeong Eun;Seo, Chang Kyun;Kwak, Jin Ho;Jeon, Young June;Lee, Mi Young;Chung, In Sung;Kim, Kyung Chan;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.143-147
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    • 2004
  • Background : It is important to predict the exercise capacity and dyspnea, as measurements of lung volume, in patients with COPD. However, lung volume changes in response to an improvement in airflow limitation have not been explored in detail. In the present study, it is hypothesized that lung volume responses might not be accurately predicted by flow responses in patients with moderate to severe airflow limitations. Methods : To evaluate lung volume responses, baseline and follow up, flow and lung volumes were measured in moderate to severe COPD patients. The flow response was defined by an improvement in the $FEV_1$ of more than 12.3%; lung volume changes were analyzed in 17 patients for the flow response. Results : The mean age of the subjects was 66 years; 76% were men. The mean baseline $FEV_1$, $FEV_1$/FVC and RV were 0.98L (44.2% predicted), 47.5% and 4.65 L (241.5%), respectively. The mean follow up duration was 80 days. The mean differences in the $FEV_1$, FVC, TLC and RV were 0.27 L, 0.39 L, -0.69 L and -1.04 L, respectively, during the follow up periods. There was no correlation between the delta $FEV_1$ and delta RV values(r=0.072, p=0.738). Conclusion : To appropriately evaluate the lung function in patients with moderate to severe airflow limitations; serial lung volume measurements would be helpful.

A Case of Bilateral Lung Volume Reduction Surgery in Severe Emphysema (심한 폐기종 환자에서의 양측성 폐용적 감축술 1예)

  • Kang, Nam-Young;Park, Jae-Seuk;Lee, Myeung-In;Ha, Dong-Yeol;Jee, Young-Koo;Lee, Kye-Young;Kim, Keun-Yeol;Seo, Pil-Weon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.630-635
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    • 1998
  • Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.

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