• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.587-590
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• 2009

천식환자의 폐활량 측정 및 관리는 정기적으로 검사되어 관리될 필요가 있는 매우 중요한 관리 항목이다. 본 연구는 천식환자의 폐활량을 정기적으로 관리할 수 있도록 PC-기반 폐활량기를 이용한 천식환자의 폐활량 측정 및 관리 시스템의 설계 및 구현에 관한 연구이다. 폐활량 검사는 크게 3종류 구성되며, 본 연구는 노력성 폐활량 검사(Forced Vital Capacity Test)를 1차적으로 설계 및 구현 방법을 제안하였다. FVC 검사의 목적은 폐질환의 진단, 중증도 그리고 치료효과 판정, 기관지 천식의 진단 및 관리, 수술시 마취방식의 결정 등으로 무엇보다 정확한 검사와 정기적인 검사를 필요로 하는 중요한 검사이다. FVC 검사는 검사과정에서 천식환자에게 많은 노력을 필요로 하는 힘든 검사로서 검사자의 도움이 필수적이므로 폐활량 검사 프로그램 개발에 있어 고려되어 알고리즘이 효율적으로 개발되어야 한다. 본 시스템은 휴대형 폐활량기(Spirometer)를 PC에 연결하고, 폐활량을 측정할 수 있도록 구성되었고, 검사 내용은 PC의 DB에 저장하고, 추후에 정기적으로 서버의 DB로 전송함으로서 보다 더 폭넓은 관리를 가능하도록 하며 천식환자는 서버가 제공하는 웹 사이트를 이용함으로서 자신의 건강관리를 가능하도록 구성된다. FVC 검사 프로그램은 정확한 검사와 편리한 사용자 인터페이스를 제공하도록 설계 및 구현하였고 따라서 자체 개발된 폐활량기를 PC-기반 프로그램으로 제어 가능함으로서 추후 다양한 임상실험의 데이터 확보, 기능의 확장과 성능의 개선을 할 수 있고, 좀 더 편리하고, 정확한 폐활량측정이 가능 할 것이다.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.230-242
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• 2005

Background : Spirometry should be compared with the normal predictive values obtained from the same population using the same procedures, because different ethnicity and different procedures are known to influence the spirometry results. This study was performed to obtain the normal predictive values of the Forced Vital Capacity(FVC), Forced Expiratory Volume in 1 Second($FEV_1$), Forced Expiratory Volume in 6 Seconds($FEV_6$), and $FEV_1/FVC$ for a representative Korean population. Methods : Based on the 2000 Population Census of the National Statistical Office of Korea, stratified random sampling was carried out to obtain representative samples of the Korean population. This study was performed as a part of the National Health and Nutrition Survey of Korea in 2001. The lung function was measured using the standardized methods and protocols recommended by the American Thoracic Society. Among those 4,816 subjects who had performed spirometry performed, there was a total of 1,212 nonsmokers (206 males and 1,006 females) with no significant history of respiratory diseases and symptoms, with clear chest X-rays, and with no significant exposure to respiratory hazards subjects. Their residence and age distribution was representative of the whole nation. Mixed effect models were examined based on the Akaike's information criteria in statistical analysis, and those variables common to both genders were analyzed by regression analysis to obtain the final equations. Results : The variables affecting the normal predicted values of the FVC and $FEV_6$ for males and females were $age^2$, height, and weight. The variables affecting the normal predicted values of the $FEV_1$ for males and females were $age^2$, and height. The variables affecting the normal predicted values of the $FEV_1/FVC$ for male and female were age and height. Conclusion : The predicted values of the FVC and $FEV_1$ was higher in this study than in other Korean or foreign studies, even though the difference was < 10%. When compared with those predicted values for Caucasian populations, the study results were actually comparable or higher, which might be due to the stricter criteria of the normal population and the systemic quality controls applied to the whole study procedures together with the rapid physical growth of the younger generations in Korea.

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.601-612
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• 2005

본 연구는 복직근의 기능적 전기자극이 경직형 뇌성마비 아동의 1회 호흡용적과 폐활량 등의 호흡능력과 복직근의 근육활동에 미치는 영향을 알아보기 위해서 대구 시내 OO특수학교에 재학 중인 14세 이상 16세 미만의 경직형 사지 뇌성마비 아동 6명(남자 3, 여자 3)을 대상으로 하여 복직근에 1회 20분. 주 3회씩 총 6주간 기능적 전기자극을 적용하였다. 기능적 전기자극의 적용 6주 전과, 직전에 두 번의 사전 검사와 적용 후 사후 검사를 실시하였다. MP30(Biopack, USA)을 이용하여 폐활량과 예측치 폐활량 백분율, 1회 호흡용적을 검사하였으며 Table면전극 근전도(Noraxon, USA)를 이용하여 복직근의 근육 활동량을 측정하였다. 분석결과는 다음과 같다. 1. 복직근의 기능적 전기자극 적용 6주 전과 직전의 폐활량은 유의한 차이가 없었으나, 적용 후의 폐활량은 적용 전에 비해 유의한 증가를 나타내었다(p<0.05). 2. 복직근의 기능적 전기자극 적용 6주 전과 직전의 예측치 폐활량 백분율은 유의한 차이가 없었으나, 적용 후의 예측치 폐활량 백분율은 적용 전에 비해 유의한 증가를 나타내었다(p<0.05). 3. 복직근의 기능적 전기자극 적용 6주 전과 직전의 1회 호흡용적은 유의한 차이가 없었으나, 적용 후의 1회 호흡용적은 적용 전에 비해 유의한 증가를 나타내었다(p<0.05). 4. 복직근의 기능적 전기자극 적용 6주 전과 직전의 복직근의 활동 값은 유의한 차이가 없었으나 적용 후의 복직근의 활동 값은 적용 전에 비해 유의한 증가를 나타내었다(p<0.05). 이상의 결과를 종합해 볼 때 6주간의 복직근의 기능적 전기자극이 경직형 뇌성마비 아동에 있어서 복직근의 근력을 강화시킴으로써 폐활량과 1회 호흡 용적 등의 호흡능력을 향상시킴을 확인할 수 있었다.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.330-337
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• 2003

Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.4
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• pp.276-283
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• 2023

The Occupational Safety and Health Research Institute is currently evaluating spirometry tests used for worker health examinations by applying the 2005 American Thoracic Society (ATS) and European Respiratory Society (ERS) spirometric test standardization guide and reviewing the application of the 2019 ATS/ERS guide. To compare results obtained using the new evaluation criteria with previous results and determine whether it is appropriate to apply them to Korean workers' health examinations, we reviewed spirometry results from 325 special health examination institutions. Although evaluation criteria such as extrapolation volume, correction error, and forced inspiratory vital capacity were applied more strictly, institutions had higher reliability scores. Primarily because the acceptability and repeatability of forced expiratory volume in 1 second and forced vital capacity were judged separately, and thus, deduction width was reduced. The study shows that adopting the new evaluation criteria would reduce the possible use of inappropriate data, increase tester and doctor understanding of result selection and interpretation, increase result reliability, and reduce the testing burden.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.836-842
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• 1999

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.

• Tuberculosis and Respiratory Diseases
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• v.62 no.4
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• pp.276-283
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• 2007

Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.8 no.2
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• pp.509-515
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• 2004

Pulmonary function tests are widely used to diagnose and determine patients' therapy in clinic. And it was also applied in the research of the physiology and dynamics for lung disease. Among the pulmonary function tests, spirometry is the most easy and economic test. Spirometers are medical instruments that measure the instantaneous rate of volume flow of respired Bas. The mechanical spirometer was mostly used in the past. Up to the present, the most popular method of spirometer is the differential pressure technique with which change in the volume of flow are transferred to change in pressure. This kind of instrument suffers from several limitations, pressure drop, difficulty in maintenance and short period of calibration. Therefore, this study has begun to implement ultrasound spirometer, which is free of pressure loss and has wide range, focusing on the flow measurement technique and diagnostic algorithm.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.521-530
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• 1994

Background : The past studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. Methods We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respitatory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. Result : 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with $FEV_1$/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with $FEV_1$ and $FEV_1$/FVC. Conclusion : We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.1
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• pp.29-36
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• 2023

This study proposes a spirometry reference equation suitable for Asian migrant workers undergoing special health examinations. The study participants were divided according to their region: Central Asia, Northeast Asia, and South Asia Pacific. We confirmed results of the spirometry analysis of migrant workers and the interpretation consistency between the prediction equations. Based on this data, we propose a reference equation suitable for domestic migrant workers and suggest a scaling factor applicable to the spirometer wherein the reference equation is not easily applicable. The kappa-values obtained for men and women, respectively, between the global lung function initiative 2012 (GLI2012)-Southeast Asian and the Southeast Asian equations were 0.819 and 0.770, between the GLI2012-Southeast Asian and the South Asian equations were 0.881 and 0.866, and between the GLI2012-Northeast Asian and the Central Asian equations were 0.831 and 0.833. We propose applying the GLI2012-Northeast Asian equation for Northeast Asian and Central Asian countries, whereas the GLI2012-Southeast Asian equation was found to be more suitable for predicting Southeast Asian and South Asian populations. For spirometry, we recommend applying a scaling factor of 0.87 to the Dr. Choi equation, wherein the GLI2012-Southeast Asian equation is not applicable.