• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.274-281
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• 2021

Background: The Korea National Health and Nutrition Examination Survey (KNHANES) is a well-designed survey to collect national data, which many researchers have used for their studies. In KNHANES, although portable spirometry was used, its reliability has not been verified. Methods: We prospectively enrolled 58 participants from four Korean institutions. The participants were classified into normal pattern, obstructive pattern, and restrictive pattern groups according to their previous spirometry results. Lung function was estimated by conventional spirometry and portable spirometry, and the results were compared. Results: The intraclass correlation coefficients of forced vital capacity (FVC) (coefficient, 9.993; 95% confidence interval [CI], 0.988-0.996), forced expiratory volume in 1 second (FEV₁) (coefficient, 0.997; 95% CI, 0.995-0.998), FEV₁/FVC ratio (coefficient, 0.995; 95% CI, 0.992-0.997), and forced expiratory flow at 25-75% (FEF25-75%; coefficient, 0.991; 95% CI, 0.984-0.994) were excellent (all p<0.001). In the subgroup analysis, the results of the three parameters were similar in all groups. In the overall and subgroup analyses, Pearson's correlation of all the parameters was also excellent in the total (coefficient, 0.986-0.994; p<0.001) and subgroup analyses (coefficient, 0.915-0.995; p<0.001). In the paired t-test, FVC, FEV₁/FVC, and FEF25-75% estimated by the two instruments were statistically different. However, FEV₁ was not significantly different. Conclusion: Lung function estimated by portable spirometry was well-correlated with that estimated by conventional spirometry. Although the values had minimal differences between them, we suggest that the spirometry results from the KNHANES are reliable.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.188-196
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• 1986

Spirometry and regional function studies using 99m-Technetium were performed preoperatively to predict postoperative pulmonary function change in 34 patients who had various pulmonary resectional procedures at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Between two months and fourteen months postoperation all the patients were reinvestigated with spirometry and clinical examination to evaluate their functional respiratory status. The postoperative obtained values, especially forced vital capacity [FVC] and forced expiratory volume in one second [FEV1] among the other parameters were compared with the postoperative predicted values. Estimated values of FVC and FEV1 derived from preoperative spirometry and quantitative perfusion lung scan correlated well with the measured postoperative values. The linear regression line derived from correlation between postoperative estimated[X] and postoperative measured[Y] values of FVC and FEV1 in all patients are as follows; 1. Y=0.76x + 0.39 in correlation of FVC [r=0.91] 2. Y=0.88x + 0.17 in correlation of FEV1 [r=0.96],br> This method of estimation was one of the best methods of predicting postoperative pulmonary function change and valuable in determining the extent of safe resection and postoperative prognosis to a poor risk patient with chronic obstructive lung disease.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.609-612
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• 1993

Studies of pulmonary function using spirometry were performed before and after pneumonectomy for inflammatory lung diseases from 1985 to 1990 at the Pusan Paik Hospital, Inje Medical College. Fifty-two patients were evaluated ; 33 tuberculosis, 17 bronchiectasis, 2 abscess, and 1 actinomycosis. All patients had preoperative and postoperative FVC, FVC[% predicted], FEV1, %FEV1, MVV and MVV[%predicted] determinations. And above datas were compared each other statistically with applying of the paired t-test. The results were obtained as follows : there were significant decreased after surgery in the values of FVC, FVC[% predicted], MVV, and MVV[% predicted], but the values of FEV1, and %FEV1 were no significant changes after surgery.

• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.108-114
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• 2010

Background: The aim was to estimate the differences between pulmonary disability grades according to the spirometry reference equations (the Korean equation and the Morris equation). Methods: Spirometry was performed on 16,916 male and 1,353 female special examination for pneumoconiosis, in the period of 2007~2009. Changes in predictive values for forced expiratory volume in one second ($FEV_1$), forced vital capacity (FVC) and $FEV_1$/FVC and in disability grade were evaluated using both equations. Results: Mean FVCs for men and women were 4,218.7 mL and 2,801.5 mL in predictive values after the application of the Korean equation, and 3,763.9 mL and 2,395.6 mL after the Morris equation, respectively. Compared with the Morris equation, the Korean equation showed 10.8% and 14.5% of excesses for men and women (p<0.001). Mean $FEV_1s$ for men and women were 3,102.5 mL and 2,107.1 mL in the Korean equation, and 2,667.8 mL and 1,699.6 mL in the Morris equation, respectively. Compared with the Morris equation, the Korean equation showed 14.0% and 19.3% of excesses for men and women (p<0.001). Men and women who showed the changes of disability grades using the Korean equation in place of the Morris equation were 23.9% (4,052/16,916) and 22.9% (311/1,353) on FVC, and 23.1% (3,913/16,916) and 10.7% (145/1,353) on $FEV_1$. Conclusion: Applying different reference equations for spirometry has resulted in changes for disability grades in special examination for pneumoconiosis.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.14.1-14.14
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• 2022

Background: Although spirometry results can be interpreted differently depending on the reference equation used, there are no established criteria for selecting reference equations as part of the special health examinations for Korean workers. Thus, it is essential to examine the current use of reference equations in Korea, quantify their impact on result interpretation, and propose reference equations suitable for Korean workers, while also considering the environmental conditions of special health examination facilities. Methods: The 213,640 results from the special health examination database were analyzed to identify changes in the ratio of measured values to reference values of lung capacity in Korean workers with changes in age or height, and changes in the agreement of interpretations with the reference equation used. Data from 238 organizations that participated in the 2018-2019 quality control assessment by the Korea Occupational Safety and Health Agency were used to identify the spirometer model and reference equations used in each special health examination facility. Results: Korean special health examination facilities used six reference equations, and the rate of normal or abnormal ventilatory diagnoses varied with the reference equation used. The prediction curve of the Global Lung Function Initiative 2012-Northeast Asian (GLI2012) equation most resembled that of the normal group, but the spirometry model most commonly used by examination facilities was not compliant with the GLI2012 equation. With a scaling factor of 0.95 applied to the Dr. Choi equation, the agreement with the GLI2012 equation was > 0.81 for men and women. Conclusions: We propose the GLI2012 equation as reference equation for spirometry in Korean workers. The GLI2012 equation exhibited the most suitable prediction curve against the normal lung function group. For devices that cannot use the GLI2012 equation, we recommend applying a scaling factor of 0.95 to the Dr. Choi equation.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.302-309
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• 2012

Background: Korean regression models for spirometric reference values are different from those of Americans. Using spirometry results of Korean adults, goodness-of-fits of the Korean and the USA Caucasian regression models for forced vital capacity (FVC) and forced expiratory volume in one second ($FEV_1$) were compared. Methods: The number of study participants was 2,360 (1,124 males and 1,236 females). Spirometry was performed under the guidelines of the American Thoracic Society and the European Respiratory Society. After excluding unsuitable participants, spirometric data for 729 individuals (105 males and 624 females) was included in the statistical analysis. The estimated FVC and $FEV_1$ values were compared with those measured. Goodness-of-fits for Korean and USA Caucasian models were compared using an F-test. Results: In males, the expected values of FVC and $FEV_1$ using the Korean model were 12.5% and 5.7% greater than those measured, respectively. The corresponding values for the USA Caucasian model were 3.5% and 0.6%. In females, the difference in FVC and $FEV_1$ were 13.5% and 7.7% for the Korean model, and 6.3% and 0.4% for the USA model, respectively. Goodness-of-fit for the Korean model regarding FVC was not good to the study population, but the Korean regression model for $FEV_1$, and the USA Caucasian models for FVC and $FEV_1$ showed good fits to the measured data. Conclusion: These results suggest that the USA Caucasian model correlates better to the measured data than the Korean model. Using reference values derived from the Korean model can lead to an overestimation regarding the prevalence of abnormal lung function.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.230-242
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• 2005

Background : Spirometry should be compared with the normal predictive values obtained from the same population using the same procedures, because different ethnicity and different procedures are known to influence the spirometry results. This study was performed to obtain the normal predictive values of the Forced Vital Capacity(FVC), Forced Expiratory Volume in 1 Second($FEV_1$), Forced Expiratory Volume in 6 Seconds($FEV_6$), and $FEV_1/FVC$ for a representative Korean population. Methods : Based on the 2000 Population Census of the National Statistical Office of Korea, stratified random sampling was carried out to obtain representative samples of the Korean population. This study was performed as a part of the National Health and Nutrition Survey of Korea in 2001. The lung function was measured using the standardized methods and protocols recommended by the American Thoracic Society. Among those 4,816 subjects who had performed spirometry performed, there was a total of 1,212 nonsmokers (206 males and 1,006 females) with no significant history of respiratory diseases and symptoms, with clear chest X-rays, and with no significant exposure to respiratory hazards subjects. Their residence and age distribution was representative of the whole nation. Mixed effect models were examined based on the Akaike's information criteria in statistical analysis, and those variables common to both genders were analyzed by regression analysis to obtain the final equations. Results : The variables affecting the normal predicted values of the FVC and $FEV_6$ for males and females were $age^2$, height, and weight. The variables affecting the normal predicted values of the $FEV_1$ for males and females were $age^2$, and height. The variables affecting the normal predicted values of the $FEV_1/FVC$ for male and female were age and height. Conclusion : The predicted values of the FVC and $FEV_1$ was higher in this study than in other Korean or foreign studies, even though the difference was < 10%. When compared with those predicted values for Caucasian populations, the study results were actually comparable or higher, which might be due to the stricter criteria of the normal population and the systemic quality controls applied to the whole study procedures together with the rapid physical growth of the younger generations in Korea.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.405-411
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• 2007

Background: The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. Methods: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and $FEV_1$ ($dFEV_1$) from prebronchodilator spirometry. Analyses included the distribution of dFVC and $dFEV_1$, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spiro-metric variability. Results: About 95% of subjects were able to reproduce FVC and $FEV_1$ within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. Conclusion: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.

• PNF and Movement
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• v.18 no.2
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• pp.297-303
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• 2020

Purpose: The purpose of this study was to examine the effects of inhalation and exhalation exercise combined with upper extremity proprioceptive neuromuscular facilitation pattern on two spirometry values: forced volume vital (FVC) and peak expiratory flow (PEF). Methods: Thirty-two healthy adults were divided into two groups: 1) a combined group, which performed upper extremity D2 flexion pattern (shoulder flexed/abducted/external rotated, forearm supinated, wrist radial deviated, and finger extended) during exhalation and D2 extension pattern (shoulder extended/adducted/internal rotated, forearm pronated, wrist ulnar deviated, and finger flexed) during inhalation; and 2) reverse combined group, which performed the D2 flexion pattern during inhalation and the D2 extension pattern during exhalation. The inverse application of upper extremity movements during inhalation and exhalation induced selective resistance or assistance on respiration. FVC and PEF were measured at two time points, before and after four weeks. Results: In both groups, the pre-post intervention comparison showed significant increases in FVC and PEF (p < .05). In the between-groups comparison, the reverse combined group showed a significantly higher PEF than the combined group at four weeks post intervention (p < 0.05). Conclusion: The combined respiration exercise with reverse PNF upper extremity patterns using selective resistance showed an effective increase in PEF in healthy adults. Clinicians and researchers might consider using selective resistance as a widely applicable and cost-effective option for respiratory rehabilitation planning.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.338-344
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• 1991

If the postoperative pulmonary function can be predicted in the patients undergoing pneumonectomy for lung cancer preoperatively, it will be helpful for identifying them as high or low risk candidates. Perfusion lung scan and spirometry were performed in 12 patients with lung cancer pre-operatively and the predicted postoperative Vital Capacity, FVC, FEV1.0, FEF25 - 75% and MVV were estimated by multiplying the preoperative values by the percentage of perfusion of the nonsurgical lung. Three months postoperation the patients were reinvestigated with spirometry and the obtained values were compared with the predicted values. The linear regression lines derived from the correlation between predicted values [X] and observed values [Y] were as follows; VC; R=0.532, Y=0.48X+1.28, P=0.075 FVC; R=0.566, Y=O 54X+1.15, P=0.055 FEV1.0; R=0.832, Y=0.68X+0.70, P=0.001 FEF25 ~ 75%; R=0.781, Y=0.68X+0.54, P=0.003 MVV; R=0.718, Y=0.67X+34.75, P=0.009 The prediction of postoperative FEV1.0, FEF25 ~ 75% and MVV in lung cancer patients undergoing pneumonectomy appear to be valid for evaluating preoperative pulmonary function.