• Clinical and Experimental Pediatrics
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• v.53 no.8
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• pp.795-800
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• 2010

Purpose: B cell-activating factor (BAFF) is a tumor-necrosis factor (TNF) superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is observed in naive cells as well as in effector/memory T cells. We aimed to explore whether BAFF in sputum is expressed at elevated levels in asthmatic airways and associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. Methods: One hundred and fifty-four asthmatic children and 98 healthy children were enrolled in the study. Sputum supernatants were collected and sputum BAFF and eosinophil cationic protein (ECP) levels were measured. We performed pulmonary function tests and methacholine challenge tests, while measuring total eosinophil count, total serum IgE, and serum ECP in all subjects. Results: Asthmatic children had significantly higher levels of BAFF in induced sputum [26.50 (10.50-100.27) pg/mL] compared to healthy children [18.32 (7.68-44.63) pg/mL; $P$=0.011]. Sputum BAFF positively correlated with sputum eosinophils (${\gamma}$=0.406, $P$<0.001) and sputum ECP (${\gamma}$=0.789, $P$<0.001). Significant negative correlations were found between sputum BAFF and FEV1 (${\gamma}$=-0.291, $P$<0.001) or post-bronchodilator FEV1 (${\gamma}$=-0.334, $P$<0.001), whereas nonsignificant correlations were found between sputum BAFF and bronchial hyperresponsiveness, serum eosinophil count, and serum ECP. Conclusion: These findings suggest that BAFF may play a role in childhood asthma, and BAFF levels in sputum could be a supportive marker that represents airway inflammation, especially eosinophilic inflammation.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.8 no.2
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• pp.509-515
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• 2004

Pulmonary function tests are widely used to diagnose and determine patients' therapy in clinic. And it was also applied in the research of the physiology and dynamics for lung disease. Among the pulmonary function tests, spirometry is the most easy and economic test. Spirometers are medical instruments that measure the instantaneous rate of volume flow of respired Bas. The mechanical spirometer was mostly used in the past. Up to the present, the most popular method of spirometer is the differential pressure technique with which change in the volume of flow are transferred to change in pressure. This kind of instrument suffers from several limitations, pressure drop, difficulty in maintenance and short period of calibration. Therefore, this study has begun to implement ultrasound spirometer, which is free of pressure loss and has wide range, focusing on the flow measurement technique and diagnostic algorithm.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.536-545
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• 1998

Background: The studies on prediction equations of pulmonary function parameters for adults in Korea have been performed in a reference population mainly consisted of young and middle ages. So they included a relatively few elderly who conducted pulmonary function test frequently in clinic. We established prediction equations of pulmonary function parameters for healthy adults over 50 years old in rural area and compared this results with those of other studies. Therefore we attempted to consider normative values of pulmonary function tests for elderly in Korea. Method: Five hundred thirty-three women and men over 50 years old in rural area were participated. A "healthy" subgroup of 110 women and 32 men were identified by excluding those who had conditions that negatively influenced pulmonary function. We derived prediction equations for FVC, $FEV_1$ and $FEV_1%$ by multiple linear regression method from their age, heights and weights in each sex. Results: Prediction equations for FVC and $FEV_1$ in each sex were derived as follows Male; FVC (L)=0.02488Height(cm)-0.0269Age(years)+0.493 $FEV_1(L)$=0.01874Weight(kg)-0.0282Age(years)+2.906 Female; FVC(L)=0.02160Height(cm)-0.0192Age(years)-0.0125 $FEV_1(L)$=0.01720Height(cm)-0.0194Age(years)+0.3890 Prediction equations for $FEV_1%$ were not derived because $FEV_1%$ didn't have statistically significant terms. Comparing Predicted values that were calculated by substitution into the equations of various studies of mean values of age, heights and weights from this study, FVC and $FEV_1$ values in men of this study were lower than those of other studies. In women, FVC and $FEV_1$ values of this study were as similar as or lower than those of the study conducted for healthy elderly blacks in U.S.A respectively. Conclusion: We have got prediction equations of pulmonary function parameters which were driven from forced expiratory spirogram in adults over 50 years old in rural area. Predicted values of this study were lower than those of other studies which were conducted in Korea. So we consider that the study for spirometry reference values for elderly Korean using the method compatible with ATS recommendation need to be conducted more frequently forward.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.250-258
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• 1993

Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.1
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• pp.51-57
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• 2023

PURPOSE: Recently, the proportion of respiratory diseases has been increasing worldwide, and deaths from respiratory diseases in Korea are increasing. Maintaining a healthy respiratory function is a crucial factor in preventing respiratory diseases. There are various ways to improve respiratory function, such as respiratory muscle and aerobic exercises. In other countries, respiratory muscle exercise is performed using a respiratory resistance mask, but such research is insufficient in Korea. Therefore, this paper proposes a respiratory exercise program using a respiratory resistance mask. METHODS: This study was conducted by dividing healthy adults in their 20s into a treadmill exercise + respiratory resistance mask group and a treadmill exercise group into an experimental group and a control group. The changes in the subject's physical function before and after exercise were confirmed by cardiopulmonary exercise and pulmonary function tests. RESULTS: As a result of the study, the experimental and control groups increased their physical function significantly (p < .05). On the other hand, when the increase rate according to the group was confirmed, the increase rate of the experimental group was higher. CONCLUSION: Based on this study, it is necessary to develop a respiratory exercise program using respiratory exercise tools such as a respiratory resistance mask and provide it easily to various subjects.

• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.199-205
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• 2011

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.234-241
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• 2020

Background: The fractional exhaled nitric oxide (FENO) test is useful in asthma patients. However, a few studies on its usefulness in chronic obstructive pulmonary disease (COPD) patients have been reported. We analyzed the FENO level distribution and clinical characteristics according to the FENO level in COPD patients. Methods: From December 2014 to June 2019, COPD patients who underwent pulmonary function and FENO tests at Chonnam National University Hospital were retrospectively evaluated for FENO, comorbidities, asthma history, blood eosinophil, and pulmonary function test. The high FENO group was defined as those with FENO level>25 parts per billion (ppb). Results: A total of 849 COPD patients (mean age, 70.3±9.4 years) were included. The mean forced expiratory volume at 1 second was 66.5±21.7% and the mean FENO level was 24.3±20.5 ppb. Patients with FENO ≤25 ppb were 572 (67.4%) and those with FENO >25 ppb were 277 (32.6%). Blood eosinophil percentage was significantly higher (4.2±4.8 vs. 2.7±2.5, p<0.001) in patients with the high FENO group than the low FENO group. The high FENO group revealed a significantly higher frequency of patients with blood eosinophil percentage >3% (46.9% vs. 34.8%, p=0.001) and asthma history (25.6% vs. 8.6%, p<0.001) than the lower FENO group. Asthma history, blood eosinophil percentage >3%, and positive bronchodilator response (BDR) were independent risk factors for the high FENO level (adjusted odds ratio [aOR], 3.85; p<0.001; aOR, 1.46; p=0.017; and aOR, 1.57, p=0.034, respectively) in the multivariable analysis. Conclusion: The FENO level distribution varied in COPD patients and the mean FENO value was slightly elevated. Asthma history, eosinophil percent, and positive BDR were independent risk factors for the high FENO level.

• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.73-79
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• 2018

Background: Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS. Methods: This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted. Results: A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p<0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD. Conclusion: Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.458-472
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• 1987

A heart supplies bloods of about 15, 000 liters to each human organ in a day. A normal function of heart valves is necessary to this act of heart. The disease of heart valve develops to a narrowness of a closure, resulting in an abnormal circulation of bloods. In an attempt to eliminate the affliction of heart valves, the operation method to repair with artificial heart valves has been developed and saved numerous patients over past 30 years. This replacement operation has been performed since early 1960`s in Korea, but all the artificial heart valves used are imported from abroad with very high costs until recent years. The artificial heart valve using pyrolytic carbon has been developed at KAIST, which was proved to be stable in the mechanical performance and durability. Therefore, the in viva performance of this valve was examined through animal tests. The artificial heart valves used in this study are tilting disc type valves, in which the disc were made of graphite coated with pyrolytic carbon and the cages were made of titanium. In viva testings of these valves were performed in 12 dogs, in which right ventriculo-pulmonary arterial [Croup I] or inter-aortic [Croup IV] valved conduit was implanted using polytetrafluoroethylene conduits containing KAIST valve and aortic valve [Group II] or pulmonary valve [Croup III] was replaced by a KAIST valve with a 21mm or 19mm tissue annulus diameter. In group I and II, pre-and post-operative transvalvular pressure gradient was measured and compared with other prosthetic valves. During post operative period laboratory examination was performed including hemoglobin, hematocrit, red cell count, white cell, lactic acid dehydrogenase and platelet. The eight surviving dogs were sacrificed and autopsy was performed at 2, 6, and 8 weeks. KAIST valve has low transvalvular gradient and relatively high orifice area. Average ventriculo-aortic peak systolic transvalvular gradient was 14 mmHg in 21 mm valve and 19 mmHg in 19 mm valve. The valve has slight intravascular hemolysis effect. Thrombogenic effect of low polishing quality and eddy currents around small orifice is high. The valve has vulnerability of disc movement. These animal tests suggest that the improvement of the heart valve design, surface polishing state and prescription methods.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.259-266
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• 1993

Background: To evaluate the risk factor of pneumothorax (PNX) which is the most common complication of CT-guided needle aspiration of the lung, we have examined the frequency of PNX according to the presence of obstructive ventilatory impairment determined by pulmonary function tests. Methods: A comparative study of analysis of forecd expiratory volume and folw-volume curves, and determinations of diffusing capacity taken before procedure were made between each 16 cases with PNX and controls with no PNX. Each of the control group was matched for sex, age, height, and size and depth of lesion with the former. Results: 1) In comparison of vital capacity and parameters derived from forced expiratory volume curve between two groups, VC and FVC were not significantly different, whereas $FEV_1$, $FEV_1$/FVC%, and FEF25-75% showed a significant decrease in the PNX gorup. Also, in the PNX group, all the observed values of parameters analyzed from flow-volune curve were siginificantly reduced in the PNX group compared with those in the control group. 2) The diffusing capacity tended to decrease along with varying individual differences in the PNX group. 3) Patients who had obstructive ventilatory impairment according to the results of pulmonary function tests experienced a twofold increase in the frequency of PNX and a sixfold increase in the frequency of chest tube drainage for treatment of PNX compared with those whose results were normal. Conclusion: These findings suggest that the exact evaluation of obstructive lung disease determined by pulmonary function test be considered assessing a pastient's risk for PNX in the patients who will take the CT-guided needle aspiration of the lung.