• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.40-47
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• 2021

Objective: The purpose of this study is to prove the reliability and validity of the Power breath K5 and to compare it with pony FX. Power breathe K5 is one type of device can assess automatically Maximum inspiratory pressure (MIP), Peak inspiratory pressure, Peak inspiratory flow (PIF). Design: Cross-sectional study. Methods: Thirty-five COPD patients participated in the test to investigate for the intra relater reliability and concurrent validity. The tests MIP, Vital capacity (VC), PIF were measured by Powerbreathe K5 and Pony Fx. Data was analyzed by intraclass correlation reliability (ICC) value and a standard error of measurement and Bland-Altman plots for reliability and pearson correlation for validity. Results: Intra rater reliability of the Powerbreathe K5 was very high at MIP (ICC=0.977 95%CI 0.956~0.989, SEM=8.665, MDC=0.295), PIF (ICC=0.966 95%CI 0.933~0.93, SEM=8.665, MDC=0.295), VC (ICC=0.949 95CI 0.902~0.974, SEM=0.042, MDC=0.116). The Powerbreath K5 was significant correlation compared with Pony Fx in assessment for MIP (r=0.971, p<0.05) and vital capacity (r=0.534, p<0.05). Conclusion: In this study, We investigated the clinical usefulness of the Powerbreath K5 in evaulating the MIP, VC and PIF with COPD patients with high reliability and validity.

• Tuberculosis and Respiratory Diseases
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• 제40권4호
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• pp.357-366
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• 1993

연구배경 : $^{99m}Tc$-DTPA의 폐청소율은 폐포상피세포의 손상도를 반영하고 일부 질환에서는 기존의 폐기능검사보다 더 예민한 것으로 알려져 있다. 흡입된 $^{99m}Tc$-DTPA의 폐청소율은 $^{99m}Tc$-DTPA가 침착되는 부위에 의해 많은 영향을 받아 체외에서 감마카메라로 폐의 방사능 소실속도를 측정하는 방법으로는 섬모운동에 의한 청소속도와 폐포상피를 통한 흡수속도를 구분 할 수 없어 전체 폐의 방사능 소실속도가 폐포상피세포의 투과성만을 반영한다고 할 수 없고 또 장시간동안 감마카메라로 촬영을 해야하는 등 방법이 복잡하다. 흡입된 $^{99m}Tc$-DTPA는 체내에서 24시간 이내에 모두 소변으로 배설되고, 첫 2시간동안 소변으로 배설되는 $^{99m}Tc$-DTPA량은 폐포상피세포를 통한 흡수속도에 의해 결정된다고 알려져 있어, 본 연구자들은 2시간과 24시간 소변내의 방사능배설량의 비를 이용하여 간편하게 폐청소율을 구하는 방법의 유용성 여부를 관찰하기 위해 본 연구를 시행하였다. 방법 : 비흡연 정상인과 미만성 간질성 폐질환환자들을 대상으로 폐기능 검사를 시행하였고 $^{99m}Tc$-DTPA를 vaporizer를 통하여 5분간 흡입후 앙와위에서 폐의 후부상을 감마카메라로 1분단위영상방식으로 30분간 컴퓨터에 수록하여 폐방사능 반감기($T_{1/2}$)를 구하였으며, 또 흡입후 2시간과 24시간 소변을 모아 2시간대 24시간 소변내 방사능배설량비를 구하여 다음과 같은 결과를 얻었다. 결과: 1) 비흡연 정상인에서 $T_{1/2}$와 2시간대 24시간 소변내 방사능배설량비간에는 통계적으로 의미있는 역상관관계가 관찰되었다(r=-0.77, p<0.05). 미만성 폐질환 환자에서 폐방사능 반감기와 2시간대 24시간 소변내 방사능배설량비간에도 역시 의미있는 역상관관계가 관찰되었다 (r=-0.63, p<0.05). 2) 미만성 간질성 폐질환 환자에서 $T_{1/2}$는 $38.65{\pm}11.63$분으로 비흡연 정상인의 $55.53{\pm}11.15$분에 비하여 통계적으로 유의하게 짧았으며, 2시간대 24시간 소변내 방사능배설량비 역시 미만성 간질성 폐질환 환자에서 $52.15{\pm}10.07%$로 비흡연 정상인의 $40.43{\pm}5.53%$에 비해 유의하게 증가되어 있었다(p<0.05). 3) $T_{1/2}$나 2시간대 24시간 소변내 방사능배설량비는 환자군에서 폐확산능과 유의한 상관관계가 없었다(p>0.05). 결론 : 이상의 결과로 $^{99m}Tc$-DTPA의 2시간대 24시간 소변내 방사능배설량비는 폐포상피세포의 투과성을 잘 반영하여 폐포상피세포의 손상정도를 반영하는 간편한 bedside 검사로 생각되며 특히, 폐포상피세포 투과성이 증가되어 있는 미만성 간질성 폐질환 환자에서 예민한 추적경사로 폐확산능과 상호보완적으호 유용하게 사용될 수 있을 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제62권5호
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• pp.382-388
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• 2007

연구배경: 저산소증을 동반한 COPD 환자에서 인지기능 장애를 보이는 것은 잘 알려져 있다. 그러나 저산소증이 없는 COPD 환자에서의 인지기능에 대해서는 논란의 여지가 있다. 또한, COPD 환자는 수면장애를 동반하는 것으로 알려져 있다. 저자들은 저산소증이 없는 COPD 환자들의 인지기능을 평가하고, 인지기능 장애를 가진 COPD 환자들에서 수면장애가 얼마나 나타나는지 알아보았다. 방 법: 90% 이상의 동맥혈 산소 포화도를 가진 28명의 COPD 환자를 대상으로 연구를 시행하였으며, 환자의 평균 나이는 70.7세였다. 대조군은 건강검진을 위해 내원한 33명의 건강성인을 대상으로 하였고, 대조군의 평균 나이는 69.5세였다. 모든 환자 및 대조군은 the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease(CERADK)를 이용하여 신경인지기능을 평가하였다. 결 과: COPD 환자군은 단어목록회상(p=0.03)과 단어목록재인(p=0.006) 항목에서 대조군과 비교하여 유의하게 낮은 점수를 보였다. 9명의 환자에서 유의미한 인지기능 장애를 가지고 있었으며, 이 중 7명의 환자에서 수면다원검사를 시행한 결과, 5명의 환자에서 시간당 5회 이상의 apnea-hypopnea index를 보였다. 7명의 환자에서 동맥혈 산소 포화도 감소 지수 및 평균 사지 운동 지수는 각각 3.6/시간과 38.6/시간이었다. 결 론: 이 연구는 저산소증이 없는 COPD 환자에서 언어기억 장애를 가진다는 것을 시사하며, 이렇게 인지기능 장애를 가진 COPD 환자들이 수면장애를 동반하고 있어 이에 관한 추가연구의 필요성이 제시되었다.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.323-328
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• 2008

목 적 : 천식은 하부기도의 만성 염증으로 정의될 수 있으며, 기관지과민성은 천식의 병태생리적인 특징이다. 하부기도를 직접적으로 평가할 수는 없지만 최대호기중간유량(forced expiratory flow between 25 and 75 percent, $FEF_{25-75}$)이 하부기도의 직경을 비교적 잘 반영하는 것으로 알려져 있다. 본 연구에서는 1초간호기량(forced expiratory volume in 1 second, $FEV_1$)과 $FEF_{25-75}$를 이용하여 얻어진 이들의 차이(difference between $FEV_1$ and $FEF_{25-75}$, DFF)와 비(ratio between $FEV_1$ and $FEF_{25-75}$, RFF)를 분석하여 기관지과민성과의 연관성을 알아보고자 하였다. 방 법 : 만 6세에서 15세 사이의 583명을 대상으로 하였다. 전체 대상자에서 폐기능 검사, 메타콜린 흡입 유발시험을 시행하였고, 혈액 내 호산구수, 혈청 총 IgE 농도, 혈청 ECP 농도를 측정하였다. 메타콜린 흡입 유발시험으로 얻어진 $PC_{20}$을 기준으로 기관지과민성 양성군($PC_{20}$>16 mg/mL)과 음성군($PC_{20}=16mg/mL$)을 정의하였으며, 그 중증도에 따라 4군으로(Group 1: <1 mg/mL; Group 2: 1-4 mg/mL; Group 3: 4-16 mg/mL; Group 4: >16 mg/mL, by American Thoracic Society, 1999) 분류하여 분석하였다. 결 과 : DFF는 기관지과민성 양성군에서 4.0 (-6.0-13.0), 음성군에서 -5 (-18.0-6.0)로 양성군에서 음성군에 비해 유의하게 높게 나타났다 (P<.001). RFF도 기관지과민성 양성군에서 1.07 (0.93-1.21), 음성군에서 0.95 (0.84-1.07)로 양성군에시 음성군과 비교하여 의미있게 높았다(P<.001). 또한 기관지과민성 중증도에 따라 나눈 4군 사이에서도 DFF (P<.001)와 RFF (P<.001) 모두 유의한 차이를 나타내었다. $PC_{20}$은 DFF ($\gamma$=0.337, P< .001) 및 RFF ($\gamma$=0.337, P<.001)와 의미있는 음의 상관 관계를 보였다. 결 론 : $FEF_{25-75}$를 이용하여 얻어진 DFF와 RFF는 기관지과민성과 밀접한 연관성을 보였고 이를 반영하는 지표가 될 수 있는 가능성을 보여주었다.

• The Korean Journal of Physiology
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• 제9권2호
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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)

• Korean Journal of Radiology
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• 제25권7호
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• pp.673-683
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• 2024

Objective: To evaluate the role of visual and quantitative chest CT parameters in assessing treatment response in patients with severe asthma. Materials and Methods: Korean participants enrolled in a prospective multicenter study, named the Precision Medicine Intervention in Severe Asthma study, from May 2020 to August 2021, underwent baseline and follow-up chest CT scans (inspiration/expiration) 10-12 months apart, before and after biologic treatment. Two radiologists scored bronchiectasis severity and mucus plugging extent. Quantitative parameters were obtained from each CT scan as follows: normal lung area (normal), air trapping without emphysema (AT without emph), air trapping with emphysema (AT with emph), and airway (total branch count, Pi10). Clinical parameters, including pulmonary function tests (forced expiratory volume in 1 s [FEV1] and FEV1/forced vital capacity [FVC]), sputum and blood eosinophil count, were assessed at initial and follow-up stages. Changes in CT parameters were correlated with changes in clinical parameters using Pearson or Spearman correlation. Results: Thirty-four participants (female:male, 20:14; median age, 50.5 years) diagnosed with severe asthma from three centers were included. Changes in the bronchiectasis and mucus plugging extent scores were negatively correlated with changes in FEV1 and FEV1/FVC (ρ = from -0.544 to -0.368, all P < 0.05). Changes in quantitative CT parameters were correlated with changes in FEV1 (normal, r = 0.373 [P = 0.030], AT without emph, r = -0.351 [P = 0.042]), FEV1/FVC (normal, r = 0.390 [P = 0.022], AT without emph, r = -0.370 [P = 0.031]). Changes in total branch count were positively correlated with changes in FEV1 (r = 0.349 [P = 0.043]). There was no correlation between changes in Pi10 and the clinical parameters (P > 0.05). Conclusion: Visual and quantitative CT parameters of normal, AT without emph, and total branch count may be effective for evaluating treatment response in patients with severe asthma.

• Environmental Analysis Health and Toxicology
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• 제14권1_2호
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• pp.21-33
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• 1999

A large number of studies have indicated associations between the impairment of respiratory health and exposure to ambient air pollutants such as ozone (O$_3$) , nitrogen dioxide (NO$_2$) , sulfur dioxide(SO$_2$) , particulate matters (PM$\_$10/). To evaluate this associations, we used the pulmonary function tests (peak expiratory flow rate : PEFR) by mini-wright peak flow meter and counting neutrophils in the nasal lavage (NL) as biomarker. From 15 June to 16 July 1998, for the workers in the highway tollgates, PEFR and NL were measured three times daily and twice per week. and association between the level of air pollutants and PEFR and NL were analyzed using the multiple regression model and the poisson regression model respectively. The results indicated that the effects of all measured air pollutants (SO$_2$, NO$_2$, O$_3$, PM$\_$10/) were not significantly associated with the value of PEFR. On the other side, SO$_2$, NO$_2$, PM$\_$10/ were significantly associated with the number of neutrophils in NL. The increase in SO$_2$, NO$_2$of 10ppb and in PM$\_$10/ of 10$\mu\textrm{g}$/m$^3$was associated with 24%, 21%, 35% increases in neutrophil counts. But the ozone exposure was not associated with NL.

• Tuberculosis and Respiratory Diseases
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• 제42권3호
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• pp.400-406
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• 1995

저자들은 개흉폐조직검사상 확진된 DAD가 병발된 다발성근염환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제43권4호
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• pp.651-656
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• 1996

저자 등은 입원 당시 전이성 암 또는 원발성 폐암의 방사선학적 소견을 보인 환자의 진단과정 중에 우리가 흔히 보는 형태가 아닌 유육종증 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제11권4호
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• pp.516-522
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• 1978

In spite of recent improvement of the medical and surgical treatments, there are many significant problems in the management of thoracic empyema. This is a clinical analysis of 49 cases of thoracic empyema who underwent lung decortication for a period of 6 years and 5 months extending from May, 1972 to Aug. 1975. The following results were obtained: Male to female ratio was 2. S to 1. The age ranged between Sand 69, bnt was mostly 2r.d and 5th decade. The underlying diseases were pulmonary tuberculosis (30 cases, 61. 1 SO, , ), posttraumatic hemothorax (7 cases, 14.396). pneumonia (6 cases, 12.2%), lung abscess (2 cases, 4.2%), paragonimiasis (2 cases, 4.2%). spontaneous pneumothorax (1 case, 2.1%), and unknown origin (1 case, 2.1%). In 13 cases (26.5%), positive bacterial growth on culture was reported. There were single infection in 11 cases and mixed infection in 2 cases. The organisms grown were Staphylococcus, alpha-hemolytIc Streptococcus, Alkaligenes fecalis, Escherichia coli, Pseudomonas, SerratIa, Enterobacter agglomerans, and Enterococcus in order of frequency. Staphylococcus, Streptococcus, and Serratia were sensitive to several different kinds of antibiotics. But Pseudomonas, Escherichia co:i, and Enterococcus were sensitive to only one or two antibiotics. Leukocytosis was observed In acute empyema, but not in chronic empyema. Hemoglobin and hematocrit were all within normal limits. Preoperative liver function tests were within normal limits in most of the cases. In 49 cases, lung decortication alone was performed in 40 cases (S1. 696), and for the remaining 9 cases (1S. 4%), additional surgical procedures were necessary, i. e., lobectomy (6cases). partial thoracoplasty (2 cases), and lobectomy & partial thoracoplasty (1 cases). The results of lung decortication in thoracic empyema were goed. 38 cases (77.5%) healed with no complication, and 10 cases (20.4%) were complicated by bleeding, wownd infection, pleural infection, chondritis, and psychosis. These complications resolved ultimately leaving no sequelae. One death was recorded (2.1%), and the causes of death were postoperative pleural infection, sepsis and hepatic insufficiency.