• Title/Summary/Keyword: Expiratory volume

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Relationship between the Change in Body Weight or Body Mass Index and Pulmonary Function (체중 및 체질량지수 차이에 따른 폐 기능과의 연관성)

  • Kim, Taeyoung;Woo, Jeonghyun;Lee, Woohyun;Jo, Seonkyung;Chun, Hyejin
    • Korean journal of health promotion
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    • v.19 no.2
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    • pp.91-95
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    • 2019
  • Background: Obesity and deterioration of pulmonary function are known to increase all-cause mortality and morbidity associated with chronic diseases. Obesity is a known risk factor for decreasing pulmonary function; however, studies on the effect of changes in body weight or body mass index (BMI) on pulmonary function are rare. This study aimed to investigate the relationship between the change in body weight or BMI and the pulmonary function test (PFT) in Koreans who underwent consecutive screening at a health promotion center. Methods: We enrolled 5,032 patients who underwent consecutive screening health check-ups at a health promotion center in 2015 and 2017. The BMI was calculated as the body weight (kg) divided by the square of the height (m2) in 2015 and 2017. We analyzed the association between the change in body weight or BMI and PFT. Results: In males, PFT and changes in body weight were associated with forced expiratory volume in 1 second (FEV1) but not with changes in BMI. In females, FEV1/forced vital capacity and forced expiratory flow between 25-75% of vital capacity (FEF25-75%) were significantly associated with the changes in body weight and BMI. A correlation analysis between body weight and BMI showed a negative correlation with FEF25-75% in males. In females, FEV1/FVC and FEF25-75% were negatively correlated. Conclusions: We observed that the increase in body weight and BMI was significantly associated with pulmonary function. This finding suggests that careful monitoring of body weight and BMI may aid in maintaining proper pulmonary function, thereby, reducing mortality and morbidity.

Accuracy of Spirometry at Predicting Restrictive Pulmonary Impairment (제한성 환기장애의 진단에서 폐활량검사의 정확성)

  • Ahn, Young Mee;Koh, Won-Jung;Kim, Cheol Hong;Lim, Seong Yong;An, Chang Hyeok;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung
    • 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.

Effect of Hypothermia on the Prevention of Ventilator-Induced Lung Injury in Rats (백서에서 저체온 전처치가 환기기유발폐손상 억제에 미치는 효과)

  • Lim, Chae-Man;Hong, Sang-Bum;Koh, Youn-Suck;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.540-548
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    • 2001
  • Backgrounds : Because ventilator-induced lung injury is partly dependent on the intensity of vascular flow, we hypothesized that hypothermia may attenuate the degree of such an injury through a reduced cardiac output. Methods : Twenty-seven male Sprague-Dawley rats were randomly assigned to normothermia ($37{\pm}1^{\circ}C$)-injurious ventilation (NT-V) group (n=10), hypothermia ($27{\pm}1^{\circ}C$)-injurious ventilation (HT-V) group (n=10), or nonventilated control group (n=7). The two thermal groups were subjected to injurious mechanical ventilation for 20 min with peak airway pressure 30 cm $H_2O$ at zero positive end-expiratory pressure, which was translated to tidal volume $54{\pm}6\;ml$ in the NT-V group and $53{\pm}4\;ml$ in the HT-V group (p>0.05). Results : Pressure-volume (P-V) curve after the injurious ventilation was almost identical to the baseline P-V curve in the HT-V group, whereas it was shifted rightward in the NT-V group. On gross inspection, the lungs of the HT-V group appeared smaller in size, and showed less hemorrhage especially at the dependent regions, than the lungs of the NT-V group. [Wet lung weight (g)/body weight (kg)] ($1.6{\pm}0.1$ vs $2.4{\pm}1.2$ ; p=0.014) and [wet lung weight/dry lung weight] ($5.0{\pm}0.1$ vs $6.1{\pm}0.8$ ; p=0.046) of the HT-V group were both lower than those of the NT-V group, while not different from those of the control group($1.4{\pm}0.4$, $4.8{\pm}0.4$, respectively). Protein concentration of the BAL fluid of the HT-V group was lower than that of the NT-V group($1,374{\pm}726\;ug/ml$ vs $3,471{\pm}1,985\;ug/ml$;p=0.003). Lactic dehydrogenase level of the BAL fluid of the HT-V group was lower than that of the NT-V group ($0.18{\pm}0.10\;unit/ml$ vs $0.43{\pm}0.22\;unit/ml$;p=0.046). Conclusions : Hypothermia attenuated pulmonary hemorrhage, permeability pulmonary edema, and alveolar cellular injuries associated with injurious mechanical ventilation, and preserved normal P-V characteristics of the lung in rats.

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A Case of Idiopathic Interstitial Pneumonia in Childhood (소아 특발성 간질성 폐렴 1례)

  • Lee, Su-Jin;Shin, Eon-Woo;Park, Eun-Young;Oh, Phil-Soo;Lee, Kon-Hee;Kim, Kwang-Nam;Shin, Ho-Seung;Lee, Il-Seung
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.327-332
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    • 2005
  • Interstitial lung disease refers to a group of pulmonary disorders characterized by inflammation of the interstitium, derangements and loss of alveolar capillary units leading to disruption of alveolar gas exchange, which induces symptoms of restrictive lung disease. Cases of interstitial pneumonia in children are uncommon and mostly have unknown causes. We have experienced an 8-year old boy who had symptoms of cyanosis, dry cough, dyspnea and abrupt weight loss. He had not been exposed to organic dusts, allergens or any other systemic disease infections. Chest radiology showed diffuse ground glass opacity in both lung fields. High resolution computed tomography(HRCT) showed multiple small patchy areas of consolidation with an underlying ground glass appearance in both lungs. The pathologic findings of lung biopsy tissue showed patchy areas of interstitial fibrosis, alveolar obliteration and nodular fibrotic areas, strongly suggesting interstitial pneumonia. No specific finding of viral inclusion or any other evidence of infection was found under electromicroscopy. We used peak flow meters to compare functional improvement. Forced expiratory volume in one second ($FEV_1$) was decreased to 25 percent of predicted value. The boy was given treatment with prednisone and showed improvements in HRCT findings after two months. He was able to tolerate easy exercise in school and showed clinical improvements after one year of follow up.

Implications of Emphysema and Lung Function for the Development of Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

  • Hong, Yoonki;Lee, Jae Seung;Yoo, Kwang Ha;Lee, Ji-Hyun;Kim, Woo Jin;Lim, Seong Yong;Rhee, Chin Kook;Lee, Sang-Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.2
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    • pp.91-97
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    • 2016
  • Background: Chronic obstructive pulmonary disease (COPD) is sometimes complicated with pneumonia, but little is known about the risk factors that promote the development of pneumonia in COPD. These risk factors were evaluated in the present study. Methods: The data of 324 patients with COPD from a prospective multi-center observational cohort with obstructive lung disease were evaluated retrospectively. To identify risk factors for the development of pneumonia in COPD, the clinical and radiological data at enrollment and the time to the first episode of pneumonia were analyzed by Cox proportional hazard analysis. Results: The median follow-up time was 1,099 days and 28 patients (8.6%) developed pneumonia. The Cox analysis showed that post-bronchodilator forced expiratory volume in one second ($FEV_1$, % of predicted) and the computed tomography (CT) emphysema extent (inspiratory V950) were independent risk factors for the development of pneumonia (post-bronchodilator $FEV_1$: hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.94-1.00; p=0.048 and inspiratory V950: HR, 1.04; 95% CI, 1.01-1.07; p=0.01). Conclusion: Emphysema severity measured by CT and post-bronchodilator $FEV_1$ are important risk factors for the development of pneumonia in COPD.

Association between Pulse Pressure and Impaired Pulmonary Function in Non-Smoking Adults (비흡연 성인에서 맥압과 폐기능 장애의 상관성)

  • Yoon, Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.119-127
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    • 2020
  • According to previous studies, an impaired pulmonary function is associated with arterial stiffness (AS). The pulse pressure (PP) is an important predictor of AS, but the association of an impaired pulmonary function with the PP is unclear. Therefore, this study assessed the associations between the PP and the predicted forced vital capacity (predicted FVC) and predicted forced expiratory volume in one second (predicted FEV1) in Korean non-smoking adults. The data obtained from 6,857 adults during the 2013~2015 Korean National Health and Nutrition Examination Survey were analyzed. After adjusting for the related variables, the ORs of restrictive pulmonary disease (RPD, the predicted FVC<80.0% with FEV1/FVC≥70.0%) using the normal PP group (PP≤60 mmHg) as a reference group was significant for the high PP group (PP>60 mmHg; 1.337 [95% confidence interval (CI), 1.049~1.703]). In addition, the ORs of obstructive pulmonary disease (OPD, FEV1/FVC<70.0%) using the normal PP group as a reference group were significant for the high PP group (1.339 [95% CI, 1.093~1.642]). In conclusion, a high PP is positively associated with both RPD and OPD in Korean non-smoking adults.

Spirometry and Bronchodilator Test

  • Sim, Yun Su;Lee, Ji-Hyun;Lee, Won-Yeon;Suh, Dong In;Oh, Yeon-Mok;Yoon, Jong-seo;Lee, Jin Hwa;Cho, Jae Hwa;Kwon, Cheol Seok;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.105-112
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    • 2017
  • Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

Prediction Equations for FVC and FEV1 among Korean Children Aged 12 Years (체중 잔차를 이용한 12세 아동의 정상 폐기능 예측식)

  • Kang, Jong-Won;Sung, Joo-Hon;Cho, Soo-Hun;Ju, Yeong-Su
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.1
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    • pp.60-64
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    • 1999
  • Objectives. Changes in lung function are frequently used as biological markers to assess the health effects of criteria air pollutants. We tried to formulate the prediction models of pulmonary functions based on height, weight, age and gender, especially for children aged 12 years who are commonly selected for the study of health effects of the air pollution. Methods. The target pulmonary function parameters were forced vital capacity(FVC) and forced expiratory volume in one second(FEV1). Two hundreds and fifity-eight male and 301 female 12-year old children were included in the analysis after excluding unsatisfactory tests to the criteria recommended by American Thoracic Sosiety and excluding more or less than 20% predicted value by previous prediction equations. The weight prediction equation using height as a independent variable was calculated, and then the difference of observed weight and predicted weight (i.e. residual) was used as the independent variable of pulmonary function prediction equations with height. Results. The prediction equations of FVC and FEV1 for male are FVC(ml) = $50.84{\times}height(cm)+7.06{\times}weight$ residual 4838.86, FEV1(ml) = $43.57{\times}height(cm)+3.16{\times}weight$ residual - 4156.66, respectively. The prediction equations of FVC and FEV1 for female are FVC(ml) = $42.57{\times}height(cm)+12.50{\times}weight$ residual - 3862.39, FEV1(ml) = $36.29{\times}height(cm)+7.74{\times}weight$ residual - 3200.94, respectively.

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Influence of Environmental Exposures on Patients with Chronic Obstructive Pulmonary Disease in Korea

  • Hong, Yoonki;Lim, Myoung Nam;Kim, Woo Jin;Rhee, Chin Kook;Yoo, Kwang Ha;Lee, Ji-Hyun;Yoon, Ho Il;Kim, Tae-Hyung;Lee, Jin Hwa;Lim, Seong Yong;Lee, Sang Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.226-232
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    • 2014
  • Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and results from environmental factors and genetic factors. Although cigarette smoking is a major risk factor, other environmental exposures can influence COPD. The purpose of this study is to investigate the clinical characteristics of COPD according to the history of environmental exposure. Methods: The study population comprised of 347 subjects with COPD who were recruited from the pulmonary clinics of 14 hospitals within the Korean Obstructive Lung Disease Study Group. We classified environmental exposures according to history of living near factory, and direct exposure history to firewood or briquette. According to living environmental exposures, we compared the frequency of respiratory symptoms, pulmonary function, quality of life, exercise capacity, and computed tomography phenotypes. Results: Thirty-one subjects (8.9%) had history of living near factory, 271 (78.3%) had exposure history to briquette, and 184 (53.3%) had exposure history to firewood. Patients with history of living near a factory had a significantly longer duration of sputum, while patients with exposure to firewood tended to have lower forced expiratory volume in one second, and patients with exposure to briquette tended to have lower six minute walk distance. Conclusion: COPD subjects with the history of living near factory had more frequent respiratory symptoms such as sputum. Our data suggest that environmental exposure may influence clinical phenotype of COPD.

Association of Specific Immunoglobulin E to Staphylococcal Enterotoxin with Airway Hyperresponsiveness in Asthma Patients

  • Kim, Seong Han;Yang, Seo Yeon;You, Jihong;Lee, Sang Bae;You, Jin;Chang, Yoon Soo;Kim, Hyung Jung;Ahn, Chul Min;Byun, Min Kwang;Park, Hye Jung;Park, Jung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.295-301
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    • 2016
  • Background: Specific immunoglobulin E (IgE) sensitization to staphylococcal enterotoxin (SE) has been recently considered to be related to allergic disease, including asthma. Despite studies on specific IgE (sIgE) to SE and its relationship to asthma diagnosis and severity, the association of sIgE to SE with airway hyperresponsiveness (AHR) remains unclear. Methods: We enrolled 81 asthma patients admitted to the Severance Hospital in Korea from March 1, 2013, to February 28, 2015 and retrospectively reviewed the electronic medical records of the enrolled subjects. The serum levels of sIgE to SE (A/B) of all subjects was measured using the ImmunoCAP 250 (Phadia) system with SE-sIgE positive defined as >0.10 kU/mL. Results: The SE-sIgE level was not significantly correlated with asthma severity (forced expiratory volume in 1 second [$FEV_1$], $FEV_1$/forced vital capacity, sputum eosinophils, and serum eosinophils), whereas the SE-sIgE level in patients with positive AHR ($mean{\pm}standard$ error of the mean, $0.606{\pm}0.273kU/mL$) was significantly higher than that in patients with negative AHR ($0.062{\pm}0.015kU/mL$, p=0.034). In regression analysis, SE sensitization (sIgE to SE ${\geq}0.010kU/mL$) was a significant risk factor for AHR, after adjustment for age, sex, $FEV_1$, and sputum eosinophils (odds ratio, 7.090; 95% confidence interval, 1.180-42.600; p=0.032). Prevalence of SE sensitization was higher in patients with allergic rhinitis and non-atopic asthma patients, as compared to patients without allergic rhinitis and atopic asthma patients, respectively, but without statistical significance. Conclusion: SE sensitization is significantly associated with AHR.