Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.
Yoon, Ho Il;Park, Young Mi;Choue, Ryowon;Kang, Yeong Ae;Kwon, Sung Youn;Lee, Jae Ho;Lee, Choon-Taek
Tuberculosis and Respiratory Diseases
/
v.65
no.5
/
pp.385-389
/
2008
Background: There are reports that food deprivation causes emphysematous changes in the lungs of rats and humans. However, the meaning of this phenomenon in patients with chronic obstructive pulmonary disease has not been evaluated. The aim of this study was to determine the correlations between the caloric intake and parameters of the lung function in patients with chronic obstructive pulmonary disease. Methods: Patients with chronic obstructive pulmonary disease who had visited the respiratory clinic from March, 2006 for one year were enrolled in this study. The patients underwent pulmonary function tests, and a dietitian evaluated their nutritional intake using a food record method. Results: There was no correlation between the total caloric intake and forced vital capacity (FVC, %predicted) or forced expiratory volume in one second ($FEV_1$, %predicted). The total caloric intake showed a positive correlation with the diffusing capacity of carbon monoxide (DLCO %predicted, DLCO/VA %predicted), and a negative correlation with the total lung capacity (TLC, %predicted). Of the calories taken, only calories from protein intake correlated with the diffusing capacity of carbon monoxide (DLCO %predicted, DLCO/VA %predicted). Conclusion: The total caloric intake of patients with chronic obstructive pulmonary disease showed a positive correlation with the diffusing capacity of the lung, and a negative correlation with the total lung capacity. Further study on the linkage between the caloric intake and severity of emphysema is needed.
Amidarone is one of the most commonly prescribed anti-arrythmic agents for almost all arrythmias, whether atrial or ventricular in origin. There are several side effects associated with amiodarone therapy. These include corneal deposits, abnormal liver function tests, hyper and hypothyroidism, bluish discolorations of the skin, bone marrow suppression, coagulopathies, peripheral neuropathies, and pulmonary toxicity. Amiodarone-induced pulmonary toxicity(APT), which was first described in 1980, is potentially serious side effects that are believed to develop in 5% of patients. Doctors often assume that APT occurs only when high amiodarone doses are used for a long time, but in practice a low maintenance dose of amiodarone may also be toxic. In this report, a case of amiodarone-induced pulmonary toxicity after a long course of a low dose therapy for refractory supraventricular arrythmia is described.
The purpose of this study was to analyze the effect wool in patients with chronic obstructive pulmonary disease. The study was conducted experimentally on 53 patients with chronic obstructive pulmonary disease attending the chest diseases polyclinic of a hospital located in Erzurum. A randomized selection method was used to categorize patients into two groups; a treatment (n = 27), and a control group (n = 26). Patients in the treatment group (pre-test measurements were taken) wore wool vests for a period of three months, while patients in the control group wore cotton vests (placebo) for the same duration; post-test measurements were taken for both groups at the end of the three-month period. The Medical Outcomes Study Short Form 36, the St. George's Respiratory Questionnaire, and pulmonary function tests were used to collect data. Results concluded that there was a significant decrease (p < 0.05) in the overall score of the St. George's Respiratory Questionnaire, and the symptom, effect, and activity mean scores, while there was a significant increase (p < 0.05) in the SF-36 physical functioning, general health, bodily pain, role physical, vitality, role emotional, social functioning, mental health, physical and mental component summary mean scores of patients in the treatment group. Results of the study concluded that the symptoms, activity, disease effectiveness, and quality of life improved in patients that wore wool vests.
Background: Firefighters are required to use self-contained breathing apparatus (SCBA), which impairs ventilatory mechanics. We hypothesized that firefighters have elevated arterial $CO_2$ when using SCBA. Methods: Firefighters and controls performed a maximal exercise test on a cycle ergometer and two graded exercise tests (GXTs) at 25%, 50%, and 70% of their maximal aerobic power, once with a SCBA facemask and once with protective clothing and full SCBA. Results: Respiratory rate increased more in controls than firefighters. Heart rate increased as a function of oxygen consumption ($V_{O_2}$) more in controls than firefighters. End-tidal $CO_2$ ($ETCO_2$) during the GXTs was not affected by work rate in either group for either condition but was higher in firefighters at all work rates in both GXTs. SCBA increased $ETCO_2$ in controls but not firefighters. Conclusions: The present study showed that when compared to controls, firefighters' hypoventilate during a maximal test and GXT. The hypoventilation resulted in increased $ETCO_2$, and presumably increased arterial $CO_2$, during exertion. It is proposed that firefighters have altered $CO_2$ sensitivity due to voluntary hypoventilation during training and work. Confirmation of low $CO_2$ sensitivity and the consequence of this on performance and long-term health remain to be determined.
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.
The purpose of this study was to confirm the relevance of dental health capacity and pulmonary function status. The subjects of this study were adults aged 40 years and older, who participated in pulmonary function and oral examinations. The data used for this study were raw data from the sixth Korea National Health and Nutrition Examination Survey (2013~2015). Statistical analysis was performed by analysis of complex sample survey data. The results were as follows: First, restrictive and obstructive patterns were more prevalent among males than females. They were even worse in older subjects. Approximately 67% of smokers had obstructive pattern. Second, there was a relevance between dental health capacity and pulmonary function status. The functioning teeth index, number of present teeth, and number of sound teeth (ST), which are indicators of dental health, declined with decreased pulmonary function. The number of missing teeth (MT) increased as the pulmonary function deteriorated (p<0.05). Third, the relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience was statistically significant in the tissue health (T-health) index and ST among non-smokers. The relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience was statistically significant (p<0.05) for the T-health index, ST, and MT among smokers. However, there was no relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience and adjusting confounding variables. In conclusion, there was a relevance between dental health capacity and pulmonary function status after confounding variables were adjusted. However, there was no relevance between dental health capacity and pulmonary function status after stratifying the life-long smoking experience and adjusting confounding variables.
The objective of the study which utilised population based data was to determine the respiratory condition of elementary school children in Gangneung. From October 9th to December 14th, 2006, Pulmonary Function Tests (PFT) including Forced Vital Capacity (FVC) and Forced Expiratoy Volume in I Second $(FEV_1)$ were conducted on the target group of children using a spirometer. The prevalence of asthmatic symptoms was 29.8% among boys and 39.6% among girls. By using logistic regression, we found that family history of allergic rhinitis (OR=3.90, CI=1.05-14.51), experience of allergic conjunctivitis (OR=4.67, CI=1.54-14.16) and atopic dermatitis (OR=2.86, CI=1.17-7.05) significantly increased the asthmatic symptoms. Also, a family history of asthma and food allergy were associated with asthmatic symptoms. In relation to housing and environmental risk factors, residences under the ground (OR=3.59, CI=1.35-9.51) and big-size dolls (OR=2.71, CI=0.86-8.53) significantly increased the prevalence of asthmatic symptoms. For PFT, above four families, exposure of passive smoking and pets significantly reduced FVC in both groups (p<0.05). In girls, a big-size doll was significantly associated with decreased lung function (FVC and $FEV_1$). In boys, using bed significantly reduced $FEV_1$. Also, the risk of asthmatic symptoms was found to increase when the house has been built for 5 years or more, the house is close to a road $({\leq}100m)$, a gas/Kerosene heater or carpet is utilized within the house. However, their differences were not significant. It is concluded that genetic factor such as a family history of respiratory disease, allergic symptoms and housing risk factor are related to asthmatic symptoms. These results were worth noting because the findings will help address risk factors related respiratory symptoms especially in relation to housing and environment.
Journal of Korean Academy of Fundamentals of Nursing
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v.19
no.1
/
pp.16-22
/
2012
Purpose: The purpose of this study was to identify Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second ($FEV_1$), $FEV_1$/FVC according to obesity in young adult women. Method: Height, weight, body mass index (BMI), and percent body fat (PBF) were obtained by using bioelectrical impedance analysis. Neck circumference (NC), waist circumference (WC) and spirometric values (FVC, $FEV_1$, $FEV_1$/FVC) were obtained for 135 women college students who were healthy and non smokers. Results: Mean BMI and PBF were $21.8kg/m^2$ and 30.5%. Obesity prevalence according to BMI and PBF were respectively 13.3%, and 50.9%. Lean body mass (LBM) was positively correlated with FVC, $FEV_1$, and PBF was negatively correlated with FVC, $FEV_1$ and $FEV_1$/FVC. FVC and $FEV_1$ of the underweight or obese group were lower than those of normal weight group. Conclusion: PBF, but not BMI, is negatively associated with pulmonary function in women college students.
Kim, Hyeon-Tae;Lee, Sang-Moo;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik
Tuberculosis and Respiratory Diseases
/
v.40
no.3
/
pp.250-258
/
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.
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