• 제목/요약/키워드: Lung: pulmonary function

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The Effects of Simultaneous Pulmonary Rehabilitation during Thoracic Radiotherapy in the Treatment of Malignant Diseases

  • Choi, Myeong Geun;Lee, Hyang Yi;Song, Si Yeol;Kim, Su Ssan;Lee, Seung Hak;Kim, Won;Choi, Chang-Min;Lee, Sei Won
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.148-158
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    • 2021
  • Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. -10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). Conclusion: Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR's effects during thoracic radiotherapy.

식도암의 근치적 식도 절제술 후 폐합병증의 발생에 영향을 미치는 위험인자의 임상적 분석 (Clinical Analysis of Risk Factors in Pulmonary Complications after Curative Resection of Esophageal Cancer)

  • 최필조;정상석
    • 대한기관식도과학회지
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    • 제17권2호
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    • pp.98-103
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    • 2011
  • Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

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만성폐쇄성폐질환 환자의 폐기능 향상을 위한 호흡중재기법의 유병기간별 비교 (Comparison of Effectiveness of Breathing Intervention Program for Improvement of Pulmonary Functions according to Prevalence Period in Patients with COPD)

  • 김용남
    • The Journal of Korean Physical Therapy
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    • 제24권5호
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    • pp.355-361
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    • 2012
  • Purpose: The purpose of this study was to evaluate the effectiveness of pulmonary rehabilitation on lung function and fatigue in persons with chronic obstructive pulmonary disease (COPD). Methods: Thirty one persons with COPD participated in this study. Four groups were allocated as follows: experimental group 1 (under 10 years of the post-disease period), control group 1 (under 10 years of the post-disease period), experimental group 2 (over 10 years of the post-disease period), and control group 2 (over 10 years of the post-disease period). Results: Forced expired volume in one second (FEV1) % pred and lactic acid showed improvement in experimental group 1 and experimental group 2 after training. Control group 1 and control group 2 did not show improvement of FEV1% pred and lactic acid after training. However, FEV1% pred and lactic acid in experimental group 1 were not significantly different, compared with the experimental group. Conclusion: Results of our study suggest that implementation of a pulmonary rehabilitation program resulted in improvement of lung function and fatigue in persons with COPD not related to the post-disease period.

인삼백합탕이 알레르기와 폐손상에 미치는 영향 (An Experimental study on the effects of Insambakhab-tang on the Anti-allergic effect and Pulmonary Function of $O_3$ intoxicated Mice)

  • 오창선;감철우;박동일
    • 동의생리병리학회지
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    • 제16권3호
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    • pp.577-583
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    • 2002
  • Experimental studies were done to research the Clinical effects of Insambakhab-tang on the Anti-allergic effect and pulmonary function of O₃ intoxicated Mice. Anti-allergic effect experiment consisted of vascular permeability responses to intradermal histamine and serotonin, 48hrs homologous passive cutaneous anaphylaxis provoked by the IgE-like antibody against egg white albumin, and delayed type hypersensitivity responses to Picryl Chloride and SRBC. Pulmonary function of O₃ intoxicated Mice experimental consisted of pulmonary thromboembolism (Sodium Arachidonate-induced and ADP-induced), lung TBA value, and serum Na/sup +/, K/sup +/, Cl/sup +/ level. The results obtained as follows; 1. In the effects of Insambakhab-tang on the pulmonary thromboembolism by Sodium Arachidonic acid and ADP, Insambakhab-tang group revealed significant effect. 2. In the effects of Insambakhab-tang on the vascular permeability responses to intradermal histamine, Insambakhab-tang group revealed significant effect. 3. In the effects of Insambakhab-tang on the vascular permeability responses to intradermal serotonine, Insambakhab-tang group revealed significant effect. 4. In the 48hrs homologous passive cutaneous anaphylaxis provoked by the IgE-like antibody against egg white albumin, Insambakhab-tang group revealed significant effect. 5. In the delayed type hypersensitivity responses to Picryl Chloride, Insambakhab-tang group revealed significant effect. 6. Insambakhab-tang group revealed significant effect on decrease of the lung TBA value of lung. 7. In the effects of Insambakhab-tang on Serum Na/sup +/, K/sup +/ Level in O₃-intoxicated Mice. Insambakhab-tang group revealed none significant effect, but In the effects of Insambakhab-tang on Serum Cl/sup +/ Level in O₃-intoxicated Mice, Insambakhab-tang group revealed significant effect.

Toll-like Receptor 2 유전자의 Microsatellite 유전자 다형성과 만성폐쇄성폐질환 발생과의 연관성 결여 (Lack of the Association between Microsatellite Polymorphism in Toll-like Receptor 2 Gene and Development of COPD)

  • 이희석;이혜원;김덕겸;고동석;박근민;황용일;이상민;유철규;김영환;한성구;심영수;임재준
    • Tuberculosis and Respiratory Diseases
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    • 제58권4호
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    • pp.367-374
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    • 2005
  • 연구배경 : 장기간 흡연을 하는 사람의 10-20%에서만 COPD가 발생한다는 사실은 COPD의 발생에 유전적 인자가 관여함을 시사한다. 최근 surfactant protein A가, COPD의 병인에 중요한 역할을 하는 것으로 알려진 MMP-9의 분비를 TLR2를 통해 증가시킨다고. 그러므로 COPD의 병인에 TLR2이 역할을 할 수 있을 것이라는 가정 아래, TLR2 유전자의 intron II에 존재하는 Guanine-Thymine (GT)의 반복으로 이루어진 유전자다형성과 한국인에서의 COPD의 발생과의 연관성을 규명하고자 하였다. 방 법 : 흡연력이 있는 남자 COPD 환자와 정상 폐기능을 보이는 남자 흡연자를 대상으로 하여, TLR2 유전자의 intron II의 GT 반복횟수를 확인하였다. 그 GT 반복이 3상성의 분포를 보여 이들을 다시 세 개의 맞섬 유전자 아형으로 분류하여 분석하였다. (12-16회 GT 반복: 짧은 아형; 17-22회 반복: 중간 아형; 23-27회 반복: 긴 아형) 결 과 : 각각의 맞섬유전자 아형의 분포는 125명의 COPD군과 144명의 대조군 사이에 유의한 차이는 없었다(P=0.75). 또한 각각의 맞섬유전자 아형의 유무에 따른 유전형의 빈도도 두 군간의 차이는 관찰할 수 없었다. 결 론 : TLR2 유전자의 intron II에 존재하는 GT 반복으로 이루어진 유전자다형성은 한국인에서 COPD의 발생과 연관되어 있지 않다.

Relation of Pulmonary Function Impairment and Coronary Artery Calcification by Multi-detector Computed Tomography in Group Exposed to Inorganic Dusts

  • Lee, Won-Jeong;Shin, Jae Hoon;Park, So Young
    • Tuberculosis and Respiratory Diseases
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    • 제74권2호
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    • pp.56-62
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    • 2013
  • Background: The purpose of this study was to evaluate the relationship of pulmonary function impairment (PFI) and coronary artery calcification (CAC) by multi-detector computed tomography (MDCT), and the effect of pneumoconiosis on CAC or PFI. Methods: Seventy-six subjects exposed to inorganic dusts underwent coronary artery calcium scoring by MDCT, spirometry, laboratory tests, and a standardized questionnaire. CAC was quantified using a commercial software (Rapidia ver. 2.8), and all the subjects were divided into two categories according to total calcium scores (TCSs), either the non-calcified (<1) or the calcified (${\geq}1$) group. Obstructive pulmonary function impairment (OPFI) was defined as forced expiratory volume in one second/forced vital capacity ($FEV_1$/FVC, %)<70, and as $FEV_1$/FVC (%){\geq}70 and FVC<80 for restrictive pulmonary function impairment (RPFI) by spirometry. All subjects were classified as either the case (profusion${\geq}1/0$) or the control (profusion${\leq}0/1$) group by pneumoconiosis findings on simple digital radiograph. Results: Of the 76 subjects, 35 subjects (46.1%) had a CAC. Age and hypertension were different significantly between the non-calcified and the calcified group (p<0.05). Subjects with pneumoconiosis were more frequent in the calcified group than those in the non-calcified group (p=0.099). $FEV_1$/FVC (%) was significantly correlated with TCSs (r=-0.316, p=0.005). Subjects with OPFI tended to increase significantly with increasing of TCS (4.82, p=0.028), but not significantly in RPFI (2.18, p=0.140). Subjects with OPFI were significantly increased in the case group compared to those in the control group. Conclusion: CAC is significantly correlated with OPFI, and CAC and OPFI may be affected by pneumoconiosis findings.

단순 디지털 촬영과 저선량 CT의 폐기종 소견으로부터 폐쇄성 폐기능 장애 위험 비교 (Evaluation of Obstructive Pulmonary Function Impairment Risks in Pulmonary Emphysema Detected by Low-Dose CT: Compared with Simple Digital Radiography)

  • 이원정;이정오;최병순
    • Tuberculosis and Respiratory Diseases
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    • 제71권1호
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    • pp.37-45
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    • 2011
  • Background: Pulmonary emphysema (PE) is major cause of obstructive pulmonary function impairment (OPFI), which is diagnosed by spirometry. PE by high resolution CT is known to be correlated with OPFI. Recently, low dose CT (LDCT) has been increasingly used for screening interstitial lung diseases including PE. The aim of this study was to evaluate OPFI risks of subjects with PE detected by LDCT compared with those detected by simple digital radiography (SDR). Methods: LDCT and spirometry were administered to 266 inorganic dust exposed retired workers, from May 30, 2007 to August 31, 2008. This study was approved by our institutional review board and informed consent was obtained. OPFI risk was defined as less than 0.7 of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), and relative risk (RR) of OPFI of PE was calculated by multiple logistic regression analysis. Results: Of the 266 subjects, PE was found in 28 subjects (10.5%) by LDCT and in 11 subjects (4.1%) by SDR; agreement was relatively low (kappa value=0.32, p<0.001). FEV1 and FEV1/FVC were significantly different between PE and no PE groups determined by either SDR or LDCT. The differences between groups were larger when the groups were divided by the findings of SDR. When PE was present in either LDCT or SDR assays, the RRs of OPFI were 2.34 and 8.65, respectively. Conclusion: LDCT showed significantly higher sensitivity than SDR for detecting PE, especially low grade PE, in which pulmonary function is not affected. As a result, the OPFI risks in the PE group by LDCT was lower than that in the PE group by SDR.

Systemic White Blood Cell Count as a Biomarker Associated with Severity of Chronic Obstructive Lung Disease

  • Koo, Hyeon-Kyoung;Kang, Hyung Koo;Song, Pamela;Park, Hye Kyeong;Lee, Sung-Soon;Jung, Hoon
    • Tuberculosis and Respiratory Diseases
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    • 제80권3호
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    • pp.304-310
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    • 2017
  • Background: Chronic obstructive pulmonary disease (COPD), is a chronic inflammatory disorder. We evaluated whether white blood cell (WBC) count, is associated with the severity of COPD, independent of other inflammatory conditions, such as metabolic syndrome. Methods: The WBC counts were compared between 1227 COPD patients and 8679 non-COPD adults older than 40. The relationships between the WBC count, lung function, and symptoms score in COPD patients, were determined, using general linear regression analyses. Results: The WBC count was negatively associated with forced vital capacity (FVC, L), FVC (% predicted), forced expiry volume in one second ($FEV_1$, L), and $FEV_1$ (% predicted) in COPD patients. Additionally, the WBC count was independently associated with the quality of life measure, by EQ5D-index score. However, this relationship between WBC count, and disease severity, was not significant in current smokers, because of the confounding effect of smoking, on the WBC count. Conclusion: The WBC count is associated with current smoking status and COPD severity, and a risk factor for poor lung function, and quality of life, especially in non-currently smoking COPD patients. The WBC count can be used, as an easily measurable COPD biomarker.

결핵성 파괴폐의 흉부 전산화단층촬영 소견 및 폐기능과의 상관관계 (CT Radiologic Findings in Patients with Tuberculous Destroyed Lung and Correlation with Lung Function)

  • 채진녕;정치영;심상우;노병학;전영준
    • Tuberculosis and Respiratory Diseases
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    • 제71권3호
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    • pp.202-209
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    • 2011
  • Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.

Medical Imaging and Nuclear Molecular Imaging Probes for Pulmonary Fibrosis Diagnosis

  • Heesu Ahn;Yong Jin Lee
    • 대한방사성의약품학회지
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    • 제8권2호
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    • pp.103-111
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    • 2022
  • Idiopathic pulmonary fibrosis (IPF) is a progressive disease caused by some risk factors, including smoking, viral infection, toxic substances, and radiation, that decline lung function of fresh oxygen and blood delivery throughout the body. Patients with pulmonary fibrosis have suffered from breathing and cough and the average survival rate is only 3 years after diagnosis. Therefore, it is significant to diagnose IPF and start treatment in enough time. Usually, lung biopsy is available to diagnose localized pulmonary fibrotic sites directly. However, it is insufficient to visualize whole lung tissue, and also it has a risk of infection for patients. In the clinic, medical imaging systems can diagnose pulmonary fibrosis non-invasively without infection. In this review, we introduce current medical imaging systems used to diagnose pulmonary fibrosis, including CT, MRI, and nuclear medicine. Further, we introduce several molecular imaging probes targeting specific biomarkers which are expressed in pulmonary fibrosis. Through this paper, it is expected that it would be helpful to understand the latest knowledge and research trends on pulmonary fibrosis diagnostic imaging.