• Journal of Korean Academy of Nursing
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• 제14권2호
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• pp.38-46
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• 1984

The purpose of this study was to test the effect of the structured preoperative teaching on post-operative recovery and to observe the effects of an structured preoperative teaching on the adult surgical patient's ventilatory function ability, the length of hospital stay, the number of analgesics within a 72 hour postoperative period, the length of early ambulation. The research question investigated in this study was: What would be the effects of a structured preoperative teaching upon the adult surgical patients postoperative recovery? This study was based on a sample of 40 patients who were scheduled for abdominal surgery. They were asssigned alternately to experimental and control group. Among 40 subjects, 20 were placed in the experimental group and 20 in the control group. Preoperative ventilation function testing of control and experimental subjects was done the evening before surgery and before the patient received the structured preoperative teaching. A structured preoperative teaching was given to the subjects in the exporimental group only by writer. Postoperative testing was done the 5th postoperative day. The data were collected over a period of two months, from Aug. 8 to Oct. 31, 1983. For the analysis of the data and test for the hypotheses, the t-test with mean difference was used. The results of this study regarding the four-hypotheses were as follows: 1. Experimental group which received structured preoperative eaching will have more increase to-cough and deep breathe as measured byhis forced vital capacity(FVC), forced expiratory volume 1 (FEV1), maximal voluntary volume 15 (MVV 15) than control group without structured preoperative teaching. The ventilation function ability was more increase in experimental group than in control group, the mean difference was statistically significant at 0.01 level. Hypotheses 1 was supported. 2. Experimental group with structured preoperative teaching will have more reduced the length of hospital stay than control group without structured preoperative teaching. The length of hospital stay of the experimental group and control group were 11.90 days and 16.05 days respectively. However, the difference was. not statistically significant at .05 level. Therefore the hypothese 2 was not supported. 3. Experimental group with structured preoperative teaching will have more reduce the number of analgesics within a 72 hour postoperative period than control group. The number of analgesics within a 72 hour' postoperative period of experimental group and control group were 1.65 times and 2.4 times. The difference was not statically significant at .05 level. Therefore, the hypotheses 3 was not supported. 4. Experimental group with structured preoperative. teaching will have more reduce the length of early ambulation than control group without structured preoperative teaching. The length of early ambulation of experimental group and control group were 2.2 days and 3.5 days respectively The difference was statistically signficant at 0.05 level. Thus the hypothess 4 was supported.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.175-181
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• 2002

Intermaxillary fixation and occusal splint are routine procedure for maxillofacial fracture and orthognathic surgery. When these methods could obstruct oral airway the patients who kept intermaxillary fixation and occusal splint in their mouth, are very difficult to breath after surgery. Nasal bleeding and pharyngeal edema due to nasotracheal intubation, residual effect of muscle relaxants, and anesthetic agent could be contributing factor of airway obstruction. In this study, pulmonary function test was evaluated before and after intermaxillary fixation, and intermaxillary fixation with occusal splint in 22 volunteers. The results were as follows 1. FVC, %FVC, $FEV_1$, $FEV_1%$, PEF, $PEF_{50}$, MVV without intermaxillary fixtion were 4.45L, 88%, 4.03L, 90.9%, 10.26L/s, 5.53L/s, and 136.14L/min, and with intermaxillary fixation were 3.51L, 68.67%, 3.06L, 69.39L, 6.52L/s, 3.94L/s, and 69.39L/min. The results with intermaxillary fixation and occusal splint were 2.15L, 42.41%, 1.71L, 38.81%, 2.83L/s, 1.74L/s, and 37.14L/min. 2. Compared with before and after intermaxillary fixation, all values of pulmonary function test were decreased and after intermaxillary fixation and intermaixillary fixation with occulasal splint, the results were decreased. 3. MVV and PEF were decreased significantly with interaxillary fixtion and occusal splint, and FVC was less decreased. It meant that intermaxillary fixation and occluasal splint induced reduction of respiratory flow significantly, but less reduction of respiratory volume. 4. Intermaxillary fixation and occulsal splint induced increase of airway resistance, decrease of expiratory volume and air flow. So severe respiratory difficulty could be seen to all volunteers who kept intermaxillary fixtion and occusal splint. 5. In classification of respiratory difficulty, intermaxillary fixation with occulsal splint induced complex respiratory difficulty more than intermaxillary fixation only did. From the above results, doctors who care patients kept intermaxillary fixation and occusal splint should be aware of respiratory depression caused by these treatment.

• Physical Therapy Korea
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• 제24권2호
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• pp.27-36
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• 2017

Background: Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing. Objective: The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility. Methods: Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels. Results: The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05). Conclusion: These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

• Journal of Chest Surgery
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• 제57권5호
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• pp.460-466
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• 2024

Background: Numerous studies have investigated methods of predicting postoperative pulmonary complications (PPCs) in lung cancer surgery, with chronic obstructive pulmonary disease (COPD) and low forced expiratory volume in 1 second (FEV₁) being recognized as risk factors. However, predicting complications in COPD patients with preserved FEV₁ poses challenges. This study considered various diffusing capacity of the lung for carbon monoxide (DL_CO) parameters as predictors of pulmonary complication risks in mild COPD patients undergoing lung resection. Methods: From January 2011 to December 2019, 2,798 patients undergoing segmentectomy or lobectomy for non-small cell lung cancer (NSCLC) were evaluated. Focusing on 709 mild COPD patients, excluding no COPD and moderate/severe cases, 3 models incorporating DL_CO, predicted postoperative DL_CO (ppoDL_CO), and DL_CO divided by the alveolar volume (DL_CO/VA) were created for logistic regression. The Akaike information criterion and Bayes information criterion were analyzed to assess model fit, with lower values considered more consistent with actual data. Results: Significantly higher proportions of men, current smokers, and patients who underwent an open approach were observed in the PPC group. In multivariable regression, male sex, an open approach, DL_CO <80%, ppoDL_CO <60%, and DL_CO/VA <80% significantly influenced PPC occurrence. The model using DL_CO/VA had the best fit. Conclusion: Different DL_CO parameters can predict PPCs in mild COPD patients after lung resection for NSCLC. The assessment of these factors using a multivariable logistic regression model suggested DL_CO/VA as the most valuable predictor.

• Tuberculosis and Respiratory Diseases
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• 제46권5호
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• pp.662-673
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• 1999

Background : Pressure-controlled ventilation (PCV) is frequently used recently as the initial mode of mechanical ventilation in the patients with respiratory failure. Theoretically, because of its high initial inspiratory flow, pressure-controlled ventilation has lower peak inspiratory pressure and improved gas exchange than volume-controlled ventilation (VCV). But the data from previous studies showed controversial results about the gas exchange. Moreover, the comparison study between PCV and VCV with various inspiration : expiration time ratios (I : E ratios) is rare. So this study was performed to compare the respiratory mechanics and gas exchange between PCV and VCV with various I : E raitos. Methods : Nine patients receiving mechanical ventilation for respiratory failure were enrolled. They were ventilated by both PCV and VCV with various I : E ratios (1 : 2, 1 : 1.3 and 1.7 : 1). $FiO_2$, tidal volume, respiratory rate and external positive end-expiratory pressure (PEEP) were kept constant throughout the study. After 20 minutes of each ventilation mode, arterial blood gas, airway pressures, expired $CO_2$ were measured. Results : In both PCV and VCV, as the I : E ratio increased, the mean airway pressure was increased, and $PaCO_2$ and physiologic dead space fraction were decreased. But P(A-a)$O_2$ was not changed. In all three different I : E ratios, peak inspiratory pressure was lower during PCV, and mean airway pressure was higher during PCV. But $PaCO_2$ level, physiologic dead space fraction and P(A-a)$O_2$ were not different between PCV and VCV with three different I : E ratios. Conclusion : There was no difference in gas exchange between PCV and VCV under the same tidal volume, frequency and I : E ratio.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1267-1272
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• 2009

Purpose:We examined the ability of preschool aged children to meet the American Thoracic Society (ATS) and European Resiratory Society (ERS) goals for spirometry quality and tried to find out the major factor for improving the rate of success of spiromety test in this age group. Methods:Spirometry was performed in 2-6 aged 155 children with chronic cough or suspicious asthma with the recording of maneuver quality measures of forced expiratory time, end-of-test volume, back-extrapolated volume (Vbe), and forced vital capacity (FVC), as well as flow-volume curve. The subjects were tested several times and the two best results in each subject were selected. All criteria for quality control were suggested by ATS/ERS guidelines. The criteria for starting of the test was Vbe <80 mL and Vbe/FVC <12.5%. The criteria for repeatability of the test was that second highest FVC and FEV1 are within 100 ml or 10% of the highest value, whichever is greater. For the criteria for termination of the test for preschool aged children, we evaluated the flow-volume curve Results:As getting older, the success rate of spirometry increased and rapidly increased after 3 years old. Total success rate of the test was 59.4% (2 years old - 14.3%, 3 years old - 53.7%, 4 years old - 65.1%, 5 years old - 69.7%, 6 years old- 70.8%). The percentage of failure to meet the criteria for starting the test was 6.5%, repeatability of the test was 12.3% and end of the test was 31%. There was a significant difference only in age between success group and failure group. Evaluating the quality control criteria of previous studies, the success rate increased with age. Conclusion:About 60% of preschool aged children met ATS/ERS goals for spirometry test performance and the success rate was highly correlated with age. It is clearly needed that developing more feasible and suitable criteria for quality control of spirometry test in preschool aged children.

• Clinical and Experimental Pediatrics
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• 제45권5호
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• pp.588-595
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• 2002

Purpose : The incidence of obesity has increased in Korea recently. Obesity leads to higher risks of hypertension, hyperlipidemia and insulin resistance. It also leads to risks of respiratory complications. This study was performed to see the effects of obesity on children's pulmonary functions and on developed bronchospasm after exercise loading according to their obesity degrees. Methods : 257 obese children and 150 non-obese children were enrolled. Obese children were divided into 3 groups by the obesity degrees. Pre- and post-exercise loading $FEV_1$(forced expiratory volume at one second), FVC(forced vital capacity) and PEFR(peak expiratory flow rate) were checked in all subjects. The percent predicted values of each parameter was compared according to obesity degrees and the differences between pre-exercise and post-exercise values. Results : The percent predicted value of $FEV_1$, FVC decreased only in the severe obesity group compared with those in the control group. However percent predicted PEFR declined according to obesity degrees. The percent predicted value of $FEV_1$, FVC and PEFR after exercise loading were much lower than those before exercise loading in all groups. Conclusion : As the degree of obesity was higher, the percent predicted value of pulmonary function was lower. And after exercise loading, as the degree of obesity was higher, the reduction of percent predicted value of pulmonary function was larger. Therefore the pulmonary function in obese children must be observed carefully. Further studies on the effects of pulmonary functions in obese children are necessary.

• The Journal of the Convergence on Culture Technology
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• 제6권2호
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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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• 제45권2호
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• pp.351-359
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• 1998

Background: The effects of exercise on pulmonary function are complex and have been the subject of many investigations. But, there has been disputes about the effect of exercise on spirometric parameters and there is no study about the effect of exercise on IOS(Impulse Oscillometry)parameters. IOS, a new method of pulmonary function test, is based on the relationship between the pressure and flow oscillation which is produced by applying sinusoidal pressure oscillation to the respiratory system via the mouth. Method: Fifty-nine young adults without respiratory symptoms were divided into three groups according to degree of exercise(hard exercise group: mean exercise time is over three hours per week at least for the last one month, light exercise group : between thirty minutes to three hours, nonexercise group : less than thirty minutes) and undertaken pulmonary function test(simple spirometry and IOS). Results: The effects of exercise on spirometric parameters; percentage of predictive value of forced vital capacity(FVC % pred) was higher in hard exercise group than nonexercise group(hard exercise group: $102.4{\pm}14.8$, nonexercise group: $93.7{\pm}9.9$, p=0.017), but there was no significant difference in percentage of predicted value of forced expiratory volume in one second(FEV 1 % pred) and percentage of predicted value of forced expiratory flow 50% (FEF 50% pred) between groups. The effects of exercise on IOS parameters: Reactance at 5Hz(X5) was significantly lower in hard exercise group than nonexercise group(hard exercise group: $-0.166{\pm}0.123hPa/1/s$, nonexercise group: $-0.093{\pm}0.036hPa/1/s$, p=0.006) but there was no significant difference in central resistance(Rc), peripheral resistance(Rp), resonance frequency(RF) and resistance at 5Hz, 20Hz between groups. Conclusion: Hard exercise increased FVC % pred on spirometric parameters and decreased reactance at 5Hz(X5) on IOS parameters.

• Phonetics and Speech Sciences
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• 제11권3호
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• pp.69-76
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• 2019

This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.