• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.13-20
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• 2019

PURPOSE: Sitting with crossed legs may have an effect on maintaining a healthy body posture and proper functioning of the respiratory system. Thus, this study's objective was to identify whether or not sitting with crossed legs affects the vertebral angle, chest wall mobility, the pulmonary function, and the activity of the respiratory muscles. METHODS: Thirty healthy subjects were recruited for this study (16 males and 14 females). The vertebral angle, chest wall mobility, pulmonary function, and the activity of the respiratory muscle were measured while the subjects sat in the correct posture and these factors were again measured with the subjects seated with their legs crossed. Three-dimensional motion analysis was used to determine the trunk and lumbar vertebral angles. Surface electromyography was employed to measure the sternocleidomastoid, the rectus abdominis, and the external and internal oblique abdominis muscles. A tapeline was utilized to evaluate the subjects' chest wall mobility. Spirometry was assessed to determine the forced vital capacity and forced expiratory volume in one second. Paired t-tests were then performed (p<.05). RESULTS: There were significant differences in the trunk and lumbar flexion angles, the chest wall mobility, the activity of the right external oblique muscle, and the left internal oblique abdominis muscle. However, the difference in pulmonary function did not reach statistical significance. CONCLUSION: A crossed leg posture caused slight thoracic extension and lumbar flexion, which may lead to a decrease of the chest wall mobility and also to an imbalance of the abdominal muscles. Therefore, sitting with a crossed leg posture should be avoided. Yet a crossed leg posture did not have any clinical effect on the pulmonary function of healthy people. It may be necessary to study the effects of sitting with crossed legs over an extended period of time for patients suffering with impaired respiratory function.

• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.28-31
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• 2015

A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc ($23{\times}18cm$) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.13-20
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• 2015

Background: To evaluate the effect of thoracic mobility exercise and deep breathing exercise applied to stroke patients on pulmonary function. Methods: The subjects were divided into two group. Twenty-five patients with stroke were randomly assigned to DB (deep breathing exercise) group (n=13) and TM (combination of deep breathing exercise and thoracic mobility exercise) group (n=12). During four weeks, DB group were carried out deep breathing exercises for 5~10 minutes twice a day and TM Group were carried out deep breathing exercises for 5~10 minutes and thoracic mobility exercise for 20~30 minutes twice a day. All tests were completed before and after experiment. The pulmonary functions were measured by PowerBreathe K5 (Hab International Ltd, England) and tape measure respectively. For each case, the experimental data were obtained in 4 items; average of inspiratory load, inspiratory flow speed, inspiratory flow volume and chest expansion. Results: The results of this study were as follows: 1. In DB group, the statistically significants were shown on average of inspiratory flow speed, inspiratory flow volume and chest expansion (p<.05). 2. In TM group, the statistically significants were shown on all items (p<.05). 3. There was a statistically significant difference on all items between DB group and TM group (p<.05). Conclusions: The above results revealed that DB and TM group can be used to improve pulmonary function in stroke patients. In comparison of DB and TM group, TM group was more improved. In conclude, thoracic mobility exercise helped improving function of vital capacity and chest expansion in stroke patients.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.214-220
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• 2018

Purpose: This study aimed to investigate the effect of smoking duration, smoked cigarettes per day and smoking cessation period on pulmonary function among ex-smokers: based on the 6th Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This study was analyzed using the 6th KNHANES data. Pulmonary function tests were performed on a total of 4,214 adults (> 40 years old). A total of 770 adults ex-smokers were eligible for inclusion in the final analysis. Forced vital capacity (FVC), forced expiratory volume in one second ($FEV_1$) and $FEV_1/FEV$ were measured to evaluate pulmonary function. Results: This study showed that there were significant differences in both $FEV_1$ and FVC values based on gender, age and height, among ex-smokers. $FEV_1/FVC$ significantly differed by age, height and the smoking duration prior to smoking cessation. Multiple regression analysis revealed that, $FEV_1/FVC$ accounted for 26.0% of the variance by age, height and smoking duration. There was a difference in the mean value of $FEV_1/FVC$ with or without smoking for more than 10 years. Conclusion: This study's findings show that smoking for over 10 years in an ex-smoker can lead to problems with the respiratory system. The long-term cigarette has progressive ill effects on the respiratory system.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.49-58
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• 2023

Background: This study aims to examine the useful- ness of the portable spirometer "The Spirokit" as a clinical diagnostic device through technology introduction, precision test, and correction. Design: Technical note Methods: "The Spirokit" was developed using a propeller-type flow rate and flow rate measurement method using infrared and light detection sensors. The level of agreement between the Pulmonary Waveform Generator and the measured values was checked to determine the precision of "The Spirokit", and the correction equation was included using the Pulmonary Waveform Generator software to correct the error range. The analysis was requested using the ATS 24/26 waveform recognized by the Ministry of Food and Drug Safety and the American Thoracic Society for the values of Forced Voluntary Capacity (FVC), Forced Expiratory Volume in 1second (FEV1), and Peak Expiratory Flow (PEF), which are used as major indicators for pulmonary function tests. All tests were repeated five times to derive an average value, and FVC and FEV1 presented accuracy and PEF presented accuracy as the result values. Results: FVC and FEV1 of 'The Spirokit' developed in this study showed accuracy within ± 3% of the error level in the ATS 24 waveform. The PEF value of 'The Spirokit' showed accuracy within the error level ± 12% of the ATS 26 waveform. Conclusion: Through the results of this study, the precision of 'The Spirokit' as a clinical diagnosis device was identified, and it was confirmed that it can be used as a portable pulmonary function test that can replace a spirometer.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.122-136
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• 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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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.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.175-184
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• 2022

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), FEV₁/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV₁ were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z₅), total airway resistance (R₅), central airway resistance (R₂₀), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X₅, X₂₀) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.167-171
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• 2014

Background: In Korea, patients with destroyed lung due to tuberculosis (TB) account for a significant portion of those affected by chronic pulmonary function impairment. The objective of our research was to evaluate the efficacy of inhaled tiotropium bromide in TB destroyed lung. Methods: We compared the effectiveness of inhaled tiotropium bromide for 2 months between pre- and post-treatment pulmonary function tests performed on 29 patients with destroyed lung due to TB. Results: The mean age of the total number of patients was $63{\pm}9$ years, where 15 patients were male. The pre-treatment mean forced expiratory volume in 1 second ($FEV_1$) was $1.02{\pm}0.31L$ ($44.1{\pm}16.0%$ predicted). The pre-treatment mean forced vital capacity (FVC) was $1.70{\pm}0.54L$ ($52.2{\pm}15.8%$ predicted). Overall, the change in $FEV_1%$ predicted over baseline with tiotropium was $19.5{\pm}19.1%$ (p<0.001). Twenty patients (72%) got better than a 10% increase in $FEV_1$ over baseline with tiotropium, but one patient showed more than a 10% decrease in $FEV_1$. Overall, the change in FVC% predicted over baseline with tiotropium was $18.5{\pm}19.9%$ (p<0.001). Seventeen patients (59%) experienced greater than a 10% increase in FVC over baseline with tiotropium; 12 (41%) patients had stable lung function. Conclusion: The inhaled tiotropium bromide therapy may lead to improve lung functions in patients with TB destroyed lung. However, the long-term effectiveness of this treatment still needs to be further assessed.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.3
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• pp.207-211
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• 2005

Body index is known as it affects pulmonary function tests (PFT), so it has been used with predictive formula and nomogram in terms of sex, age, height, etc. Body indices as body weight, body mass index (BMI), and body surface area (BSA) might also affect PFT, so that we have analyzed the correlations between body indices and forced expiratory volume in one second ($FEV_1$), and have done multiple regression analysis to see how body indices affect $FEV_1$. We confirmed that $FEV_1$ had positive correlations with height (r=0.49, p<0.01), body weight (r=0.37, p<0.01), and BSA (r=0.47, p<0.01), inverse correlation with age (r=-0.45, p<0.01), but no correlation with BMI. We found that the 41.9% of $FEV_1$ was diverged from height, age and BSA. Therefore, BSA definitely needs to be considered with predictive formula and nomogram in PFT.