• 대한물리의학회지
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• 제17권1호
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to investigate the effect of the resistance respiratory muscle exercise with transcutaneous electrical nerve stimulation (TENS) on the respiratory muscle tone and pulmonary function of stroke patients. METHODS: Twenty stroke patients were divided into the TENS group (n = 7), placebo TENS group (n = 7), and control group (n = 6), and each intervention was performed on the three groups 5 times a week for 4 weeks. The assessment was carried out by measuring changes in the muscle tone of the latissimus dorsi and abdominal external obliques, and pulmonary function. RESULTS: In this study, the TENS group and the placebo TENS group had significant increases in the paretic side latissimus dorsi muscle tone, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). There was no significant difference in changes in respiratory muscle tone between the three groups. The pulmonary function was significantly different between the three groups, and it was observed from the results of the post-hoc test that FVC showed a significant increase in the TENS group and the placebo TENS group compared to the control group. CONCLUSION: Through this study, it was found that the respiratory muscle resistance exercise was more effective as a method to increase respiratory muscle tone and pulmonary function in stroke patients than combined transcutaneous electrical nerve stimulation.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.187-198
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• 1996

The industrial use of MMMF(man-made mineral fibers), has been increasing, particularly since the banning of most asbestos products. Fibrous minerals can cause health abnormalities currently associated with occupational exposure to glass fiber. This study was conducted to evaluate health risks of glass fiber manufactory workers within the country. We examined questionaries, physical examination including auscultation, chest x-ray, pulmonary function test for 488 male workers, to go through their dermal itching symptoms and respiratory evaluation. we had the results as follows. 1. In 45% of the workers itching had been expressed at their entrance. At that time we was investigating, 18.5% had itching, and most of them complained it when they fall asleep and night. The Sequent itching site is waist and groin, upper and lower extremity in order, and it had been expressed mainly during summer and winter. 2. As the results of ventilatory functions test, 6.0% were obstructive type, 1.0% were restrictive type. So, glass fiber exposures should be controlled or elimination by protective devices in the workplace. 3. The means of FVC, $FEV_1,\;FEV_1%$ were in normal range. As the comparison of ventilatory functions by age groups, MMF was decreased significantly for the group, 50 years old and more than other groups. And the comparison by the serving periods at glass fiber producing factory, MMF was decreased for the workers had worked for $11\sim15$ years. Therefore, MMF be more sensitive index in the evaluation of ventilatory impairments caused by glass fiber workers.

• 성인간호학회지
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• 제20권1호
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• pp.163-175
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• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• Tuberculosis and Respiratory Diseases
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• 제71권3호
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• pp.202-209
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• 2011

Background: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. Methods: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. Results: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second ($FEV_1$), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and $FEV_1$, % predicted (B=-0.050, p=0.022). Conclusion: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.

• Tuberculosis and Respiratory Diseases
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• 제59권4호
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• pp.374-379
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• 2005

배 경 : 폐확산능 ($D_LCO$)과 폐용적을 보정한 확산계수($D_LCO/VA$; KCO)는 폐포용적이 비 정상적인 경우 차이가 생긴다. 그러나, 기류제한으로 비 정상적인 폐포용적을 가지는 환자에서 이러한 차이의 의미는 연구되지 않았다. 본 연구는 기류제한이 있는 환자에서 기류제한의 호전에 따른 폐확산능과 확산계수의 변화를 연구하고자 한다. 방 법 : 기류제한이 있는 환자에서 기저 폐기능과 더불어 폐확산능을 측정하고, 일회호흡 $CH_4$ 희석법으로 폐포용적을 측정하였다. 기저치에 따라서 환자는 다음의 두 군으로 나누었다. 확산계수(예측치에 대한 백분율)와 확산능(예측치에 대한 백분율)의 비가 115%를 넘는 경우를 고차이군으로 하였고, 115% 미만인 경우를 저차이군으로 하였다. 기류제한을 치료 한 후 폐기능검사와 폐확산능을 반복해서 측정하였다. 결 과 : 고차이군과 저차이군의 기저 폐기능은 유의한 차이가 관찰되지 않았다. 두 군 모두 확산계수의 예측치에 대한 백분율은 평균 113%와 100%로 정상범위였다. 치료 후 추적 폐기능에서 $FEV_1$과 FVC는 저차이군에 비해 고차이군에서 증가하였다. 고차이군에서 치료 후 측정한 폐기능은 기저치에 비해 폐확산능과 폐포용적은 증가하였으나 저차이군에서는 유의한 차이는 관찰되지 않았다. 전폐용적과 잔기량은 치료 전후에 양군 모두에서 유의한 차이가 관찰되지 않았다. 결 론 : 기류제한이 있는 환자에서 확산계수는 정상 범위에 있지만 확산능이 감소한 경우 확산능이 감소하지 않은 환자에 비해 가역적인 기류폐색이 클 것으로 예측할 수 있다.

• 한국응용과학기술학회지
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• 제37권4호
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• pp.699-710
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• 2020

본 연구는 복합운동이 여성노인의 폐기능, 혈중 비타민 D, 칼슘 및 골대사호르몬에 미치는 영향을 구명하기 위해 만 65세 이상 여성노인을 대상으로 운동군(n=13), 대조군(n=17)으로 구분하여 주 3회, 회당 60분의 복합운동을 실시하였다. 유산소 운동 강도는 1-4주는 40-50%HRR(RPE 12-13), 5-8주는 50-60%HRR(RPE 13-14), 9-12주는 60-70%HRR(RPE 14-15)의 강도로 설정하였고 저항 운동 강도는 1-4주는 OMNI-RES(3-4), 5-8주는 OMNI-RES(5-6), 9-12주는 OMNI-RES(7-8)강도로 설정하였다. 그 결과 폐기능 중 FEV₁은 그룹×시기 간 상호작용 효과가 나타났고 운동군의 FVC/FEV₁이 유의하게 증가하였다. 비타민 D는 그룹×시기 간 상호작용 효과가 나타났고, 운동군과 대조군 모두 유의하게 증가하였다. 칼슘은 그룹×시기 간 상호작용 효과가 나타났으며 대조군이 유의하게 감소하였다. 골대사호르몬 중 칼시토닌과 오스테오칼신은 그룹×시기 간 상호작용 효과가 나타났고, 오스테오칼신은 대조군이 유의하게 감소하였다. 따라서 본 연구의 결과를 통해 12주간의 복합운동이 여성노인의 신체활동을 활발하게 하여 폐기능을 개선하고 혈중 비타민 D의 결핍을 완화할 수 있다고 생각되지만 칼슘 및 골대사호르몬에서는 유의미한 결과를 나타내지 못하였다.

• 한국임상약학회지
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• 제26권4호
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• pp.298-305
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• 2016

Background: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. Methods: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. Results: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction ($FEV_1$, $FEV_1/FVC$). Conclusion: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

• Tuberculosis and Respiratory Diseases
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• 제46권3호
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• pp.317-326
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• 1999

연구목적: 호흡기에 대한 자율신경 기능도 기도 및 혈관의 평활근, 접막하선의 점액분비. 기관지 순환 혈류조절, 비만 세포의 염증 반응에 관계되는 매개물의 분비등 매우 다양하게 나타나며 이들 자율신경 장애는 기도 폐쇄의 원인으로 작용한다. 천식은 자율신경계 이상이 원인으로 작용하고 특히 부교감신경 기능 항진이 중요한 원인으로 알려져 있다. 저자들은 심혈관계와 호흡기 자율신경 지배가 공통적으로 일어난다는 사실을 기초로 비관혈적이고 안정한 심혈관 지율신경 검사를 실시하여 만성 폐쇄성 폐질환 환자에서 자율신경 장애유무를 알아보았다. 방 법: 대상은 영남대학교 의과대학 부속병원에서 만성 폐쇄성 폐질환으로 진단 받은 환자 20명과 건강진단 센터에서 건강한 것으로 판정 받은 비슷한 나이의 20명을 대조군으로 하였다. 만성 폐쇄성 폐질환은 American Thoracic Society의 정의를 따랐으며 허혈성 심장질환, 부정맥, 당뇨병, 중심성 및 말초성 신경질환 등과 같은 자율신경계에 영향을 미칠 수 있는 질환이 동반된 경우는 제외하였다. 자율신경검사는 Ewing과 Clarke의 방법을 사용하였으며 모든 대상에서 동맥혈 가스분석과 폐기능 검사를 동시에 실시하였다. 결 과: 만성 폐쇄생 폐질환 환자는 건강한 사랑에 비하여 빈번하게 자율신경 장애가 동반되어 있었으며 만성 폐쇄성 폐질환 환자에서 교감신경 장애보다 부교감신경 장애가 더 뚜렷하였다. 만성 폐쇄성 폐질환은 질병 이환 기간이 길거나, 흡연량이 많거나, 폐기능 검사상 $FEV_1$ 및 FVC 감소 정도가 심할수록 그리고 저산소혈증이 심한 경우에 자율신경 장애가 심하였으나 연령, 만성폐쇄성 폐질환의 종류 및 동맥혈 이산화탄소 분압과는 차이가 없었다. 결 론: 만성 폐쇄성 폐질환은 부교감신경 장애가 동반되어 있으며, 부교간신경 장애는 만성 폐쇄성 폐질환의 정도가 심할수록 더 뚜렷하게 나타났다. 이러한 부교감신경 장애는 만성 폐쇄성 폐질환의 원인으로 작용하기보다는 질병의 진행으로 인한 자율신경계의 기능 저하로 생각된다.

• 문화기술의 융합
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• 제6권2호
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• pp.341-348
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• 2020

본 연구의 목적은 4주간 20대 성인에게 앉은자세와 누운자세에 따른 복식호흡운동을 적용하였을 때 호흡기능과 배근육의 근활성도를 비교하여 어떤 자세에서의 운동이 효과적인지 알아보고자 하였다. 기립자세에서는 호흡운동 후 일초량이 가장 큰 수치를 보였고 누운자세에서는 호흡운동 전 일초량과 1초간노력성날숨량이 가장 크게 나타났다. 두자세의 복식호흡운동 전후 일초량과 날숨량 분산분석결과 운동전일초량, 운동후일초량, 운동전1초간날숨량, 운동후1초간날숨량 모두 유의한 차이를 보이며, 두 자세에서 복식호흡 전후 차이를 알 수 있었다. 기립자세, 누운자세에서 운동전에는 왼쪽 복직근, 운동후에는 오른쪽 복직근이 가장 높은 근활성도를 보였다. 두 자세 운동의 반복측정한 분산분석 결과 운동 전과 후의 양쪽 복직근과 외복사근은 근활성도 모두 차이를 보이지 않았다(p>.05). 기립자세에서 운동 전과 후에 왼쪽 외복사근이 유의한 차이를 보였고(p<0.05), 운동전과 후 FEV1/FVC와 노력성 호기량이 유의한 차이를 보였다(p<0.05). 운동 전과 후 왼쪽 외복사근이 누운자세에서 가장 높은 근활성도를 보였고 노력성 호기량은 가장 낮은 근활성도를 보였다. 운동 전과 후 호흡량 및 근활성도의 반복측정된 분산분석 결과에서 오른쪽 복직근에서 유의한 차이를 보였다(p<.05). 이를 통해 앉은 자세와 비스듬히 누운자세 두가지 자세에서 복식호흡 운동을 적용 하였을 때 호흡기능과 배근육의 근활성도 전,후를 비교하기 위해서는 두가지 자세에서의 운동 전,후 호흡과 근활성도 평가가 필요하고 평가에 따라서 어떤 자세에서의 운동이 더 효과적인지 알 수 있었다. 추후 연구에서는 좀 더 세분화되고 정확한 호흡기능과 근활성도를 알아보는 다양한 연령대의 사람들에게 장기간의 중재를 통해 파악하는 연구가 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.177-183
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• 2010

Background: Smoking reduces pulmonary function and induces various lung diseases. Recently, the rate of emphysema detection has increased due to lung cancer screening with low-dose chest computed tomography (CT). The purpose of this study was to evaluate changes in lung function associated with emphysema in healthy smokers. Methods: One hundred and ninety one healthy smokers, who had undergone a low-dose chest CT (LDCT) scan as part of lung cancer screening and had revisited the health center after a median 23.9 months' time, were recruited into this study. The severity of emphysema was calculated by the direct observation of a radiologist and a pulmonologist indipendently. Longitudinal changes in lung function according to emphysema based on LDCT and type of smoker was analyzed. Results: Of the participants in this study, 25% of healthy smokers had emphysema, which was mild in severity, in older patients (p=0.003) and in heavy smokers (p<0.001). $FEV_1/FVC$ and FEF25-75% were decreased in current smokers with emphysema (p=0.001 and p=0.009, respectively) and without emphysema (p=0.001 and p=0.042). Although lung function was not decreased in ex-smokers without emphysema, $FEV_1/FVC$ and FEF25-75% were decreased in ex-smoker with emphysema (p=0.020 and p=0.010). Conclusion: Upon examination with LDCT, the prevalence of emphysema was higher in healthy smokers was than in non-smokers. Lung function was diminished in smokers with emphysema, in spite of former smoker.