• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.628-635
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• 1999

Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.47-53
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• 2019

PURPOSE: This study measured the external pressure on abdomen during maximal inspiration. The study determined the correlation between the diaphragmatic contraction pressure and the lung capacities to verify whether or not the measured pressure values can represent diaphragmatic contractility. METHODS: The study included 32 healthy subjects (16 males and 16 females). The researchers fabricated their own diaphragmatic pressure belt (DiP Belt) to measure DCP. DiP Belt device was fixed on the front of the abdomen and the diaphragmatic contractility was measured during maximal inspiration. The lung capacities were measured using a portable digital spirometer device (Pony Fx, COSMED, Italy). A digital spirometer is a device that is used to test the flow of air entering and exiting the lungs. RESULTS: DCP showed significant positive correlations with vital capacity (VC), inspiratory reserve volume (IRV) and inspiratory capacity (IC). Among values of lung capacities, IC showed especially strong positive correlations with the DCP (r =.714, p<.010). For the males, DCP showed significant positive correlations with IRV and IC, and DCP showed significant negative correlation with the expiratory reserve volume (ERV). For the females, DCP showed significant positive correlation with tidal volume (VT), but any significant correlation was not found with any of the other values of lung capacities. CONCLUSION: DCP showed high correlations with IRV and IC associated with inspiratory capacity. Therefore, The DiP Belt can be looked upon as a simple device that is very useful for measuring diaphragmatic contractility.

• Journal of Life Science
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• v.20 no.3
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• pp.437-443
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• 2010

This study was designed to examine the aerobic capacity and ventilatory response during an incremental exercise in elite high school cyclists. Twelve boys ($17{\pm}1\;yr$, $175{\pm}5\;cm$, $70{\pm}9\;kg$) participated in anthropometric measurements, incremental exercise testing, and pulmonary function tests. During incremental exercise testing using a cycle ergometer, their maximal oxygen uptake ($VO_2max$), maximal power output, ventilation, ventilatory equivalents for oxygen ($V_E/VO_2$) and carbon dioxide ($V_E/VCO_2$), respiratory rate, and tidal volume were measured. Time variables such as inspiratory time (Ti), expiratory time (Te), breathing time (Tb), and inspiratory duty cycle (Ti/Tb), as well as inspiratory flow rate ($V_T$/Ti) were assessed. Pulmonary function of vital capacity (FVC), forced expiratory volume in one second ($FEV_1$), $FEV_1$/FVC, and peak expiratory flow were evaluated. Their $VO_2max$, maximal heart rate, and Wmax were $57.5{\pm}3.9\;ml{\cdot}kg^{-1}{\cdot}min^{-1}$, $194.1{\pm}8.6\;beat{\cdot}min^{-1}$, and 452 W, respectively. $VO_2max$ was not related to any anthropometric parameters. Most ventilatory variables progressively increased with exercise intensity. As intensity increased, Ti, Tb, Tb decreased while Ti/Tb was maintained. Below an intensity of 250 W, height, weight, body mass index, and body surface were highly correlated with $V_T$/Ti and Ti/Tb (p<0.05). Collectively, $VO_2max$ appeared to be lower than adult cyclists, suggesting a different pattern of ventilatory control as age advances. Morphological characteristics were not related to $VO_2max$ in the population. Time variables of ventilatory response seemed to be related only at an exercise intensity level of less than 250 W. $V_T$/Ti may be related to exercise endurance capacity, but Ti/Tb was similar to adult cyclists.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.548-557
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• 1993

Background: Bronchiectasis is a irreversible disease, a lot of cases of which are associated with chronic bronchitis, pulmonary emphysema and bronchial asthma due to chronic recurrent pulmonary infection. Therefore, pulmonary functions in bronchiectasis may also vary with associated diseases or involved segments. Methods: For the evaluation of ventilatory dynamics in bronchiectasis with respect to the pathoanatomic types of bronchiectasis and the degree of dyspnea, a total of 93 cases comprising 45 cases of tubular, 30 saccular and 18 mixed type of bronchiectasis whose clinical diagnosis was confirmed by bronchography were analyzed retrospectively. They were also divided into two groups: those with Hugh-Jones dyspnea grade 1 & 2 (group I) and those with Hugh-Jones dyspnea grade 3 & 4 (group II). Pulmonary functions tested in this study were analyses of curves of forced expiratory volume and flow-volume, and determinations of maximal voluntary ventilation and closing volumes. Results: The results were as follows; 1) The vital capacity and parameters reflecting expiratory flow rate except PEF were significantly reduced in saccular and mixed type than that in tubular type of bronchiectasis. 2) In saccular and mixed type, the maximal voluntary ventilation tended to decrease while CV/VC tended to increase. 3) As the degree of dyspnea became serious, the involved segments were progressively increased. In contrast, ventilatory functions were significantly reduced in proportion to the severity of dyspnea. Conclusion: These findings suggest that in bronchiectasis, there be obstructive ventilatory impairment combined with mild restrictive ventilatory impairment, which becomes more prominent in saccular and mixed type and also as the degree of dyspnea progresses.

• 재활복지
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• v.21 no.1
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• pp.233-252
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• 2017

The purpose of this study is to investigate the influence on respiration, oral motor and articulation using wind-instrument centered music therapy for patients with cervical cord injury who need continuous train of respiratory muscle. Three patients with cervical cord injury who needed continuous training of respiratory muscle were selected and post data was analyzed. The harmonica using both exhalation and inspiration was selected as an wind-instrument. Each session was taken 30 ~ 40 minutes, once a week from total 6 weeks with small group. Material about every session's work was provided for individual to maintain practice after program. Oral motor and articulation test was done to assess reflecting features of maximal expiratory flow and wind-instrument of factor related breath. Maximal expiratory flow has increased by average 25ml more, articulation has increased by 3.16 points more and the movement of oral motor has increased 11.67 points more than pre-test from the analyzation. In the comparison of the details, the increase of oral motor function was confirmed from scores on the jaw and tongue except for the lips. Based on the results of this study, this study suggests that wind-instrument centered music therapy will be a practical and effective intervention for respiratory rehabilitation in patients with cervical cord injury.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.61 no.9
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• pp.1350-1357
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• 2012

Medical system for personal health management recently changes its paradigm from hospital service to self home care based on ubiquitous technology for healthcare anywhere at any time. The present study developed a wireless bio-signal measurement system for patients to self manage pulmonary disease and benign prostate hyperplasia(BPH), both of which are chronic diseases with increasing frequency in modern society. Velocity-type respiratory air flow transducer adapted to develop respiratory module for pulmonary disease management was simplified in structure to measure uni-directional flow since most important diagnostic parameters are evaluated on the expiratory flow signal only. Standard weight measurement technique was introduced to obtain urinary flow signal for BPH management. Three load cell signals were acquired for averaging to minimize noise, followed by accuracy evaluation. Transmission and receiver modules were also developed with user program for wireless communication. Averaged relative errors were 2.05 and 1.02% for respiratory volume and maximal flow rate, respectively, and the relative error was 2.17% for urinary volume, demonstrating that both modules enabled very accurate measurements. Wireless communication distance was verified within 15m, long enough for home care application. The present system allows the user to select a necessary measurement module on a particular health demand and to immediately provide the self-test results, thus better quality health care would be possible.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.3
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• pp.65-73
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• 2014

Purpose: The purpose of this study was to identify the effect of a kinesio tape on inspiratory muscle training(IMT) to improve muscle strength, endurance and pulmonary function. Methods: Healthy 20 males were divided into IMT group (control group) and IMT with tape group (experimental group). The same IMT program was applied to both groups using the Respifit S for four weeks, three times a week, a total 12 times. To exprimental group, kinesio tape was applied on the inspiratory agonist diaphragm and the accessory inspiratory muscle scalene, sternocleidomastoid, pectoralis minor. The inspiratory pulmonary muscle strength was measured by the maximal inspiratory pressure (PI max) and minute volume (MV) using the Respifit S and the pulmonary function were measured peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in 1sec (FEV1), FEV1/FVC using the Spirometer and compared before and after. Results: Results showed that the PI max in the two groups increased significantly and experimental group increased more effectively than that of control group. However, only MV showed a significant increase in experimental group but was not significantly different between the two groups. PEF and FEV1/FVC are significantly increased in both groups, but they did not make much difference between two groups, and the FVC for the two groups did not increase significantly. FEV1 increased significantly only with control group, but did not make a difference with experimental group. Conclusion: These result show that the PI max value for experimental group increased significantly than that of control group. Therefore kinesio tape maximizes inspiratory muscle exercise effect on muscle strength improvement. However, because of the short experimental period and difficulty in subject control, increase values of the others did not show a significant difference. In other words, kinesio tape did not show maximizing the inspiratory muscle exercise effect to improve endurance and pulmonary function.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.43-57
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• 1995

In order to study the effect of welding fume exposure upon the pulmonary function test, we examined 131 shielded arc welding workers, and 152 $CO_2$ arc welding workers as cases and 177 control workers for their general characteristics, and forced vital capacity (FVC), forced expiratory volume in one second $(FEV_{1.0})$, forced expiratory volume in one second as a percent of FVC $(FEV_{1.0}%)$, and maximal mid-expiratory flow (MMF) were obtained from the spirogram. In shielded arc welding group and $CO_2$ arc welding group, FVC, $FEV_{1.0},\;FEV_{1.0}%$, and MMF were significantly decreased than control group, especially marked in the MMF finding. The distribution of workers below normal range was as follows. in the shielded arc welding group, 2 workers(1.5%) for FVC, 17 workers(13.0%) for $FEV_{1.0}$, 5 workers(3.8%) for $FEV_{1.0}%$, 28 workers(21.4%) for MMF, and in the $CO_2$ arc welding group, 3 workers(2.0%) for FVC, 25 workers(16.4%) for $FEV_{1.0}$, 8 workers(5.3%) for $FEV_{1.0}%$, and 37 workers(24.3%) for MMF, and significant increase by exposure duration was found in MMF. The distribution of workers who had ventilation impairment was as follows: 5 workers(3.8%) for obstructive type, 2 workers(1.5%) for restrictive type in the shielded arc welding group, and 7 workers(4.6%) for obstructive type, 2 workers(1.3%) for restrictive type, and 1 worker(0.6%) was combined type of the $CO_2$ arc welding group. In the respect of these results, the significant pulmonary function and ventilatory impairment were observed in welding fume exposed workers who had not abnormal finding in chest X-ray, and MMF considered as the most sensitive pulmonary function index by welding fume exposure. Therefore even if it is hard to doing pulmonary function test in the first health examination of workers according to the Industrial Safety Health Act in the welding fume exposure workers, it is desirable to consider doing PFT. Also evaluating the ventilation impairment, it is necessary, to observe the change of MMF that marker of effort-independent portion.

• The Korean Journal of Physiology
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• v.9 no.2
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• pp.7-15
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• 1975

The maximum breathing capacity (MBC) and the maximum mid-expiratory flow rate (MMF) are widely used in evaluation of the ventilatory function, among various parameters of pulmonary function. The MBC volume is the amount of gas which can be exchanged per unit time during maximal voluntary hyperventilation. Performance of this test, unlike that of single breath maneuvers, is affected by the integrity of the respiratory bellows as a whole including such factors are respiratory muscle blood supply, fatigue, and progressive trapping of air. Because of this, the MBC and its relation to ventilatory requirement correlates more closely with subjective dyspnea than does any other test. The MMF is the average flow rate during expiration of the middle 50% of the vital capacity. The MMF is a measurement of a fast vital capacity related to the time required for the maneuver and the MMF relates much better to other dynamic tests of ventilatory function and to dyspnea than total vital capacity, because the MMF reflects the effective volume, or gas per unit of time. Therefore, it is important to have a prediction formula with one can compute the normal value for the subject and the compare with the measured value. However, the formulas for prediction of both MBC and MMF of the Korean children and adolescents are not yet available in the present. Hence, present investigation was attempt to derive the formulas for prediction of both MBC and MMF of the Korean children and adolescents. MBC and MMF were measured in 1,037 healthy Korean children and adolescents (1,035 male and 1,002 female) whose ages ranged from 8 to 18 years. A spirometer (9L, Collins) was used for the measurement of MBC and MMF. Both MBC and MMF were measured 3times in a standing position and the highest values were used. For measurement, the $CO_2$ absorber and sadd valve were removed from the spirometer in order to reduce the resistance in the breathing circuit and the subject was asked to breathe as fast and deeply as possible for 12 seconds in MBC and to exhale completely as fast as possible after maximum inspiration for MMF. During the measurement, investigator stood by the subject to give a constant encouragement. All the measured values were subsequently converted to values at BTPS. The formulas for MBC and MMF were derived by a manner similar to those for Baldwin et al (1949) and Im (1965) as function of age and BSA or age and height. The prediction formulas for MBC (L/min, BTPS) and MMF (L/min, BTPS) of the Korean children and adolescents as derived in this investigation are as follows: For male, MBC=[41.70+{$2.69{\times}Age(years)$}]${\times}BSA$ $(m^{2})$ MBC=[0.083+{$0.045{\times}Age(years)$}]${\times}Ht$ (cm) For female, MBC=[45.53+{$1.55{\times}Age(years)$}]${\times}BSA$ $(m^2)$ MBC=[0.189+{$0.029{\times}Age(years)$}]${\times}Ht$ (cm) For male, MMF= [0.544+{$0.066{\times}Age(years)$}]${\times}Ht$ (cm) For female, MMF=[0.416+{$0.064{\times}Age(years)$}]${\times}Ht$ (cm)

• Journal of Chest Surgery
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• v.29 no.9
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• pp.951-958
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• 1996

Bet een November 1991 and December 1993, twelve patients (Male: 2, Female: 10) who had mitral valve disease without primary pulmonary disease underwent mitral valve replacement. The pulmonary function test (PFT) was performed preoperatively and postoperatively (mean, 9 months after operation). Mitral valve replacement was indicated for mitral stenosis in 9 patients and for mitral insufficiency in 3 patients. Preoperative WHh functional class were 111 in 11 patients and class rV in 1 patient. Postoperatively, ten patients (83 %) were classified into NYHA functional class 1. There was a significant decrease in cardiothoracic ratio (CTR) postoperatively (p< 0.05). The pulmonary function before operation was low compared with predicted values in vital capacity (VC) and forced mid-expiratory flow (FEF 25∼75 %). The FEF 25%-75% and maximal voluntary ventilation (MW) were low compared with predicted values postoperatively. There was no significant difference in the pulmonary function before an after op- eration. Twelve patients were divided into 2 groups according to the early postoperative NYHA functional class. In class I group, the postoperative pulmonary function was significantly improved in 6 parameters (RV, FRC, TLC, FEVI , FEVI /FVC, and FEF 25∼75%), but in class ll group, there was no significant change in the pulmonary function after operation.