• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.120-123
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• 2013

Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.

• Journal of Chest Surgery
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• v.4 no.1
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• pp.25-34
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• 1971

We observed 88 csses of primary lung cancer clinically and statistically, which had been experienced at the dept. of thoracic surgery, St. Mary's Hospital, Catholic Medical College, during the period of 7 years from January, 1964 to December, 1970. The results obtained were as follows: 1) Peak incidence of age was from 5th decade to 7th decade (86.4%), the youngest being 25 and the oldest 76. The ratio of male to female was 4.9: 1. 2) Squamous cell carcinomas showed high resectability (68.7%) and short clinical duration (188 days). Adenocarcinoma and undifferentiated carcinoma showed low resectability (33.3%, 36.4%) in spite of the more shorter clinical duration(120 days, 112 days, respectively) than squamaus cell carcinoma. 3) Positivity (above class III) in brochocopic cytology was 70.3%, and 44.8% in fresh sputum cytology. 4) Other combined pulmonary diseases (emphysema. chronic bronchitis) were noted in about one half of bronchographied 66 cases and which were considered as factors to contribute ventilatory function of lung. 5) Among 88 cases, twelve cases refused operation and 34 cases(44.7%) were operated. Seventeen cases(22.3%) out of the 34 thoracotomies were resected, 7 with lobectomy and 10 with pneumonectomy and remaining 17 cases were unresectable. 6) Histopathological findiugs of resected 17 cases were squamous cell carcinomas (11 cases), adenocarcinoll1a(1 case), undifferentiated carcinumas (4 cases) and undetermined carcinoma(l case). 7) There's no opelative mortality. Among resected 17 cases, [; cases are still alive(4 years, 3 years & 2 mo, 2 yearo, 13 mo., respectively), 7 case were expired (3 of these from remote metastasis), and remaining 5 cases were unable to follow up.

• Safety and Health at Work
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• v.9 no.4
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• pp.468-472
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• 2018

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.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.377-387
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• 1996

Background : In 1980, WHO made a definition in which the term "impairment" as applied to the respiratory system is used to describe loss of lung function, "disability" the resulting diminution in exercise capacity. The measurement of pulmonary function during exercise would give us information about overall functional capacity and respiratory performance that would be lacking in tests performed at rest. We conducted this study to investigate the role of resting pulmonary function test and exercise test for assessing impairment/disability in patients with chronic airflow obstruction(CAO). Method : We studied 19 patients with CAO. The spirometry and body plethysmograph were performed in stable condition. And then patients performed a progressive incremental exercise test to a symptom-limited maximum using cycle ergometer. Patients were divided in two groups, severe and non-severe impairment, according to the resting PFTs and compaired each other. A patient was considered to be severely impaired if FVC < 50 %, FEV1 < 40 % or FEV1/FVC < 40 %. Results : 1) The airway obstruction and hypoxemia of severe impairment group were more severe and exercise performance was markedly reduced compairing to non-severe impairment group. 2) The severe impairment group showed ventilatory limitation during exercise test and the limiting symptomes ware dyspnea in 9/10 patients. 3) The impairment and disability of the patients with tuberculous destructed lung were most marked in patients with CAO. 4) The FEV1 was the most prevalent criterion for the determination of severe impairment based on resting PFTs and was the valuable best correlated to V02max(r=0.81, p < 0.001). 5) The sensitivity of exercise limits for predicting severe disability according to resting PFTs was 80 % and specificity 89 %. Conclusion : In patients with severe CAO, FEV1 is a good predictive of exercise performance and impairment measured by resting PFTs can predict a disability by exercise test.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.55-64
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• 1995

During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.239-243
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• 1996

Chest wall reconstruction Is difficult because of the physiological and anatomical functions of thoracic cavity where the thoracic cavity must be stabilized in order to prevent paradoxical motion, and adequate protection must be provided to the mediastinal structures. A 37-year-old male patient with full-thickness defect on the left anterior thoracic cavity due to traffic accident was treated. Emergency operation was performed for debridement and bleeding control, and on postoperative 25 days, chest wall reconstruction was performed as a second-stage operation. Left anterior chest wall was reconstructed with latissimus dorsi myocutaneous flap which had thoracodorsal arterial pedicle, and split-thickness skin grift from the left thigh was done. After chest wall reconstruction, spontaneous self-respiration was possible without ventilatory support. The pulmonary function test performed at postoperative 3 months revealed 80% of predicted values (FVC, FEV1.0). The postoperative result of chest wall reconstruction using latissimus dorsi myocutaneous flap was excellent anatomically, physiologically and aesthetically.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.366-373
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• 2016

Background: The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods: In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (${\geq}$3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results: Follow-up was 100% complete (mean $85{\pm}24months$). CWPM was inversely correlated with single lung VC (Spearman R=-0.72, p=0.0003), global VC (R=-0.51, p=0.02) and diaphragm excursion (R=-0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion: Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea.

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.613-620
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• 2005

Tests of ventilatory function including pulmonary diffusing capacity were made in 18, the last period pregnant women and 20 non pregnant women. During the study was from May 22 to June 4, the subject of study refered 38 women (20 student and the staff of Physical Therapy at Masan college and 18 women who were examined at Masan OO obstetrics Hospital). All the studied subjects had no clinical abnormalities of the cardiorespiratory system. Mean FVC and FEV1.0 were significantly decreased in the last pregnant women compare with that of non pregnant women. All the Other Measurements were not differ from those of non pregnant women. The results of this study were as follows. l. Pregnancy was associated with decrease in mean FVC and FEVl.0, Which at the last period pregnant women were $2.70{\pm}0.58{\iota},\;2.31{\pm}0.53{\iota}$ below the non pregnant women mean $3.03{\pm}0.33,\;2.64{\pm}0.44{\iota}$ : Both changes were statistically significant.(P<0.05) 2. The mean VC, which at the last period pregnant women was $3.15{\pm}0.45{\iota}$ below the non pregnant women mean $3.28{\pm}0.33{\iota}$ and the mean IC $2.21{\pm}0.53{\iota}$ below the non pregnant women mean $2.22{\pm}0.54{\iota}$, but the difference were not statistically significant. 3. The mean ERV, IRV were not statistically significant between non pregnant women and pregnant women. 4. The mean TV were not statistically significant between non pregnant women and pregnant women. 5. The mean FEVl.0(G) were not statistically significant between non pregnant women and pregnant women.