The Occupational Safety and Health Research Institute is currently evaluating spirometry tests used for worker health examinations by applying the 2005 American Thoracic Society (ATS) and European Respiratory Society (ERS) spirometric test standardization guide and reviewing the application of the 2019 ATS/ERS guide. To compare results obtained using the new evaluation criteria with previous results and determine whether it is appropriate to apply them to Korean workers' health examinations, we reviewed spirometry results from 325 special health examination institutions. Although evaluation criteria such as extrapolation volume, correction error, and forced inspiratory vital capacity were applied more strictly, institutions had higher reliability scores. Primarily because the acceptability and repeatability of forced expiratory volume in 1 second and forced vital capacity were judged separately, and thus, deduction width was reduced. The study shows that adopting the new evaluation criteria would reduce the possible use of inappropriate data, increase tester and doctor understanding of result selection and interpretation, increase result reliability, and reduce the testing burden.
Kim, Young-Whan;Oh, Yeon-Mok;Jung, Man-Pyo;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
Tuberculosis and Respiratory Diseases
/
v.40
no.4
/
pp.390-394
/
1993
Background: Bronchiectasis is characterized by chronic sputum production and complications such as hemoptysis and repeated infections. Even though some patients are cured by surgical resection of bronchiectatic lesions, most bronchiectasis patients can not be treated surgically because of multiple site involvement, and they are treated by medical measures such as postura1 drainage and antibiotics when indicated. Recently there have been some reports that low-dose longterm erythromycin treatment is effective on bronchiectsis, and it is well known that low-dose longterm erythromycin treatment is the treatment of choice in diffuse panbronchiolitis which is characterized by chronic sputum production and dyspnea. To evaluate the efficacy of erythromycin, we tried erythromycin on twenty five stable bronchiectasis patients for more than six months. Methods: We tried erythromycin 250 mg b.i.d. for more than 6 months. We checked respiratory symptoms, chest PA, spirometry, and side effects before treatment and after 3 and 6 months of treatment. Results: 1) 32% of the patients showed marked improvement of symptoms and PFT. 32% showed slight improvement of symptoms with little change of PFT, and 36% showed no change of symptoms and signs. 2) Analysis of the patients showing marked improvement revealed that most of them had diffuse bronchiectasis and paranasal sinus involvement. Conclusion: These results suggest that low-dose longterm erythromycin treatment can be tried on diffuse bronchiectasis patients with sinus involvement. And further studies will be followed on the mechanism of erythromycin in bronchiectasis.
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.
Kim, Kwan-Hyoung;Oh, Yong-Seok;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
Tuberculosis and Respiratory Diseases
/
v.39
no.3
/
pp.219-227
/
1992
Background: Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma. Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation. We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day). Methods: Clinical symptoms, pulmonary function test, histamine $PC_{20}$, serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide. Results: 1) Pulmonary function test; PEFR, FEV1 and FVC after 6 weeks of treatment with budesonide were higher than those before treatment. 2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide. 3) Histamine provocation; Histamine $PC_{20}$ after 6 weeks of treatment with budesonide was significantly higher than that before treatment. 4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol. Conclusion: From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious.
Frequently patients with chronic obstructive pulmonary disease have lowered arterial oxygen saturation in daytime. During sleep, they are apt to experience additional hypoxemia. These episode of nocturnal hypoxemia are usually associated with periods of relative hypoventilation. Noctunal hypoxemia may be associated with cardiac arrhythmia and with acute increase in pulmonary arterial pressure and may be implicated in the development of chronic pulmonary hypertension and cor pulmonale. We selected 14 patients with chronic obstructive pulmonary disease, 9 with emphysema dominant type and 5 with chronic bronchitis dominant type, to examine the frequency and severity of nocturnal hypoxemia and the effect of oxygen in prevention of nocturnal hypoxemia. The results were as follows; 1) On PFT, FVC, $FEV_1$, and $FEV_1$/FVC showed no significant difference between the emphysema dominant type (pink puffers, PP) and the chronic bronchitis dominant type (blue bloaters, BB). But DLCO/VA for the PP group was $45.7{\pm}15.1%$ which was significantly different from BB group, $82.4{\pm}5.6%$. 2) The daytime arterial oxygen saturation ($SaO_2$) and the lowest $SaO_2$, during sleep for the BB group were significantly lower than for the PP group. 3) The hypoxemic episodes during sleep were more frequent in BB group and the duration of hypoxemic episode was longer in BB group. 4) In both group studied, although there was a tendency for a lower L-$SaO_2$ (the lowest $SaO_2$, during sleep), an increase in hypoxemic episodes and duration as the daytime $SaO_2$, fell lower, the only parameter which showed significant correlation was daytime $SaO_2$, and the frequency of hypoxemic episodes in the PP group (r=-0.68, P<0.05). 5) In PP group, with oxygen supplementation, L-$SaO_2$, during sleep showed significant increase, and there was a tendency for the frequency of hypoxemic episodes and duration to fall but it was not significant. 6) In BB group, oxygen supplementation significantly increased the L-$SaO_2$ during sleep and also significantly decreased the frequency and duration of hypoxemic episode. From these results, we can see that oxygen supplementation during sleep can prevent the decrease in $SaO_2$ to some extent and that this effect of oxygen can be seen more prominently in the BB group.
Woo, Duck Soo;Seol, Won Jong;Kyung, Sun Young;Lim, Young Hee;An, Chang Hyeok;Park, Jeong Woong;Jeong, Sung Hwan;Lee, Jae Woong
Tuberculosis and Respiratory Diseases
/
v.55
no.5
/
pp.478-487
/
2003
Background : There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). Method : Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF. Results : The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients(M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups($202.5{\pm}58.5$ vs $163.7{\pm}47.3pg/ml$, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group. Conclusion : These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.
Background: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this study is to observe the clinical course of untreated sarcoidosis. Methods: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, $FEV_1$, DLco) were evaluated every 3mooths compared between corticosteroid treated(n=5) and non-treated(n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test(2) worsening in the degree of dyspnea(3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. Results: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved(13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. Conclusion : These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.
The purpose of this study was to investigate the effects of the regular Upright Body Type Excercise on posture, muscle strength of leg, lung capacity and depression of people with mental illness. The subjects of this study were recruited from B mental health center (5 years and more mental illness patients, n=19) located in P city. For the exercise group, They were carried out the Upright Body Type Excercise Program during 8 weeks (60 min/time, 3 times/week). They were randomly divided into two groups. Exercise group (n=10) and Control group (n=9). And also, they were agreed with consent forms before the experiments. Research results were as follows. Through the upper body type exercise, there was significantly difference in PEF and FEV1/FVC in the trained group. And also, there was much improved in depression level in the trained group. The change of melancholy feeling before and after the program was not statistically significant. However, because of limitations of sampling size due to the peculiarities of the program participants, in consideration of the limit of statistical validation exists clearly, intended to better understand the subjective experience of attendees, qualitative analyzing(qualitative research) was carried out in parallel. It was conducted a deep interview only person accepted among program participants, thematic analysis, subject analysis tasks to be subdivided by classifying by considering the semantic units of what participants expressed, was thus carried out. It found that the degree of melancholy feeling of mental disorders who participated in the Upright Body Typed Exercise Program was reduced. The course of the experience of change in depression appered the three subjects and six sub-themes such as "the start of the change", "interest of the program", "recognition of the need of the body’s health", "physical health promotion", "recovery of physical function", "negative change of habits (attitude)", "reduction of sense of depression", "confidence that it is possible to", "hope for the future". Therefore, upper body type exercise is much helpful in lung capacity and mental health of people with mental illness. So, this type of exercise mostly needed in the people with mental illness group than the other group for the quality of life.
Background: Sleeve lobectomy for lung cancer in close proximity to or involving the carina is widely accepted. Operative morbidity and mortality rates, recurrence, and survival rates have varied considerably across studies. Materials and Methods: From March of 2005 to July of 2010, sleeve lobectomy was performed in 19 patients and pneumonectomy was performed in 20 patients. In this paper, the results of sleeve lobectomy and pneumonectomy for patients with lung cancer will be compared and evaluated. Results: There were no postoperative complications in either group, but there was one mortality in the pneumonectomy group. There was better preservation of pulmonary function in the sleeve lobectomy group than the pneumonectomy group (p=0.066 in FVC, p=0.019 in FEV1). The 3-year survival rates were 46.7% in the sleeve lobectomy group and 54.5% in the pneumonectomy group (p=0.505). The 3-year disease-free survival rates were 38% in the sleeve lobectomy group and 45.8% in the pneumonectomy group (p=0.200). Conclusion: Sleeve lobectomy for lung cancer showed low mortality, low bronchial anastomotic complication rates, and good preservation of pulmonary function.
As BTX-A, which has been known to be the most effective treatment for ADSD, is not effective in treating vocal tremors, voice assessment must be employed to perform differential diagnosis of SD and vocal tremor in an accurate fashion. In this study, the characteristics of vocal changes after botulinum toxin injection were compared by analyzing the voice characteristics resulting from the presence of vocal tremors using objective analysis devices, with the aim of helping to provide prognoses and to determine remedial effects in clinical cases comprising patients with adductor spasmodic dysphonia accompanied by voice tremors. Respiratory function tests, aerodynamic analysis, electroglottography (EGG), acoustic analysis, auditory perception tests, and K-VHI had been conducted at intervals of four, eight, and twelve weeks before and after injection, targeting a group of 17 ADSD female patients (a ADSD group of four with vocal tremor and a ADSD group of 13 without voice tremor). For average FVC and FEV1, the T group showed statistically significant low averages compared with the NT group, whereas the T group showed statistically significant high average ATRI compared with the NT group. In addition, the T group showed a statistically significant Fatr, lower than that of the NT group. For the ADSD group of patients with voice tremor, their vocal tremor remained unchanged despite noticeable decrease in wringing voices. In other words, as the vocal tremor and wringing voices are two distinctive features, there is a need for the two features to be targeted separately for differential diagnosis.
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