• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.13-18
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• 2018

Bronchodilator therapy is central to the management of chronic obstructive pulmonary disease and are recommended as the preferred treatment by the Global Obstructive Lung Disease Initiative (GOLD). Long acting anti-muscarinics (LAMA) and long acting ${\beta}_2$ agonists (LABA) are both more effective than regular short-acting drugs but many patients remain symptomatic despite monotherapy with these drugs. Combination therapy with LAMA and LABA increases the therapeutic benefit while minimizing dose-dependent side effects of long-acting bronchodilator therapy. The TOviTO programme has investigated the benefits of treatment with a combination of tiotropium and olodaterol administered via a single inhaler. Tiotropium+olodaterol $5/5{\mu}g$ significantly improved forced expiratory volume in 1 second ($FEV_1$) area under the curve from 0 to 3 hours, trough $FEV_1$ health status and breathlessness versus the mono-components and placebo. Tiotropium+olodaterol $5/5{\mu}g$ also increased endurance time and reduced dynamic hyperinflation during constant work rate cycle ergometry. On the basis of these and other studies the 2017 GOLD report recommends escalating to dual bronchodilator therapy in patients in groups B and C if they remain symptomatic or continue to have exacerbations and as initial therapy for patients in group D.

• 국제물리치료학회지
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• 제7권2호
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• pp.1006-1010
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• 2016

This study aimed to examine the effects of thoracic cage mobilization on the respiratory function, spinal curve and spinal movement in patients with restrictive lung diseases. The subjects were ten community-dwelling elderly with a restrictive lung diseases when measured using a spirometer($FEV1/FVC{\leq}65%$, FVC<80%). They received an intervention over an eight-week period: three times a week and for 30 minutes a day. SPSS for Windows(ver. 19.0) was used to analyze all the collected data. Independent t-tests were used to examine changes before and after the intervention. The study's results showed statistically significant improvement(p<.05) in forced expiratory volume in 1 second(chage rate: .$24{\pm}.25$), thoracic curve(chage rate: $-2.50{\pm}2.76$), lumbar curve(chage rate: $-.80{\pm}1.32$), thoracic flexion(chage rate: $2.10{\pm}1.52$), thoracic extension(chage rate: $-2.00{\pm}1.25$), lumbar flexion(chage rate: $2.40{\pm}3.13$) and lumbar extension(chage rate: $-1.30{\pm}1.42$). The results of this study suggest that the thoracic cage mobilization contribute to improve pulmonary function in patients with restrictive lung disease.

• 대한임상검사과학회지
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• 제37권3호
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• pp.207-211
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• 2005

Body index is known as it affects pulmonary function tests (PFT), so it has been used with predictive formula and nomogram in terms of sex, age, height, etc. Body indices as body weight, body mass index (BMI), and body surface area (BSA) might also affect PFT, so that we have analyzed the correlations between body indices and forced expiratory volume in one second ($FEV_1$), and have done multiple regression analysis to see how body indices affect $FEV_1$. We confirmed that $FEV_1$ had positive correlations with height (r=0.49, p<0.01), body weight (r=0.37, p<0.01), and BSA (r=0.47, p<0.01), inverse correlation with age (r=-0.45, p<0.01), but no correlation with BMI. We found that the 41.9% of $FEV_1$ was diverged from height, age and BSA. Therefore, BSA definitely needs to be considered with predictive formula and nomogram in PFT.

• 기본간호학회지
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• 제18권1호
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• pp.19-27
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• 2011

Purpose: This study was conducted to develop a respiratory nursing program using recorder playing for patients with asthma and to determine the effects of the program. Method: Participants were 26 patients with asthma (experimental group: 13, control group: 13). The experimental group participated in the respiratory nursing program for six months from April, to October, 2007. Content included playing a recorder, group education about asthma, and educational messages including cellular phone messages. The control group received usual care during the six months. Results: In this research the respiratory nursing program using recorders was developed in 3 stages: initial stage, advanced stage, and wrap up stage. Compared to the control group, fatigue status in the experimental group improved significantly as well as level of forced expiratory volume in 1 second. However significant differences were found in sleep status, mood, or quality of life. Conclusions: These results suggest that this respiratory nursing program for symptom management of patients with asthma led to improvements in self care activity. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented over a transition period.

• Journal of Chest Surgery
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• 제29권9호
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• pp.1017-1022
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• 1996

늑골골절을 입은 환자들은 심한 흉통으로 괴로워하며 이 통증은 기침, 심호흡과 기도세척을 방해하여 결국 무기폐와 호흡부전등을 초래할 수 있다. 통증의 완화는 환자를 편하게 해주고 효과적인 물리요법으로 객담배출을 용이하게한다. 늑골골절 환자에서 경막외 신경차단의 효과를 측정하기 위하여 20명의 환자를 대상으로 경막외 진통제을 투여한 10명은 실험군, 진통제를 근육주사한 10명은 대조군으로 정하 여 통증호소와 운동장애의 정도, 말초동맥혈 산소분압 및 폐기능(FRC, FEVI)의 변화를 입원직후와 경막외 진통제투여 시작후 12, 24시간 및 3일, 5일 그리고 7일째에 각각측정조사 하였다. 신경차단군에서 통증호소와 운동장애의 정도는 감소하였고 동맥혈 산소치는 약간 증가하였으나 의의가 없었으며 FRC와 FEVI는 유의하게 증가하였다. 경막외 신경차단의 부작용은가벼웠으며 쉽게 치료되었다. 위의결과로 저자들은 늑골골절 환자에서 경막외 신경차단에 의한진통법이 동통완화효과와 폐기능 향상에 괄목할만한 효과을 나타내므로 이의 임상적 이용이 바람직하다고 생각한다.

• Tuberculosis and Respiratory Diseases
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• 제74권2호
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• pp.56-62
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• 2013

Background: The purpose of this study was to evaluate the relationship of pulmonary function impairment (PFI) and coronary artery calcification (CAC) by multi-detector computed tomography (MDCT), and the effect of pneumoconiosis on CAC or PFI. Methods: Seventy-six subjects exposed to inorganic dusts underwent coronary artery calcium scoring by MDCT, spirometry, laboratory tests, and a standardized questionnaire. CAC was quantified using a commercial software (Rapidia ver. 2.8), and all the subjects were divided into two categories according to total calcium scores (TCSs), either the non-calcified (<1) or the calcified (${\geq}1$) group. Obstructive pulmonary function impairment (OPFI) was defined as forced expiratory volume in one second/forced vital capacity ($FEV_1$/FVC, %)<70, and as $FEV_1$/FVC (%){\geq}70 and FVC<80 for restrictive pulmonary function impairment (RPFI) by spirometry. All subjects were classified as either the case (profusion${\geq}1/0$) or the control (profusion${\leq}0/1$) group by pneumoconiosis findings on simple digital radiograph. Results: Of the 76 subjects, 35 subjects (46.1%) had a CAC. Age and hypertension were different significantly between the non-calcified and the calcified group (p<0.05). Subjects with pneumoconiosis were more frequent in the calcified group than those in the non-calcified group (p=0.099). $FEV_1$/FVC (%) was significantly correlated with TCSs (r=-0.316, p=0.005). Subjects with OPFI tended to increase significantly with increasing of TCS (4.82, p=0.028), but not significantly in RPFI (2.18, p=0.140). Subjects with OPFI were significantly increased in the case group compared to those in the control group. Conclusion: CAC is significantly correlated with OPFI, and CAC and OPFI may be affected by pneumoconiosis findings.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.141-145
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• 2018

Purpose: Changes in the curvature of the vertebral columns of elderly women with increasing age causes various side effects and disorders. Therefore, this study was conducted to evaluate the effectiveness of the 8-figure scapular brace to improve pulmonary function and balance ability based on lung capacity and foot pressure by increasing the vertebral curvature. Methods: Seventeen elderly women with a forward head posture were selected. Women were asked to wear the 8-figure scapular brace and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured, as were changes in foot pressure. Measurements were conducted three times each and the mean values were used for subsequent analyses. For static evaluation, we used the paired t-test to identify differences between pre and post values. Results: There was no significant difference in FEV1 and FVC before and after use of the brace (p>0.05); however, there was a significant decrease in forefoot pressure and an increase in rearfoot pressure following application of the brace (p<0.05). Conclusion: Application of the 8-figure scapular brace to correct vertebral curvature in elderly women influenced pressure distribution change from immediate effect body arrange of cervical and thoracic. However, wearing the 8-figure scapular brace may interfere with expansion of the chest and therefore respiratory muscle activity. Accordingly, it is necessary to apply appropriate treatment when wearing a scapular brace and to allow a sufficient intervention period while also providing therapeutic interventions such as posture correction or respiration training.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.167-171
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• 2014

Background: In Korea, patients with destroyed lung due to tuberculosis (TB) account for a significant portion of those affected by chronic pulmonary function impairment. The objective of our research was to evaluate the efficacy of inhaled tiotropium bromide in TB destroyed lung. Methods: We compared the effectiveness of inhaled tiotropium bromide for 2 months between pre- and post-treatment pulmonary function tests performed on 29 patients with destroyed lung due to TB. Results: The mean age of the total number of patients was $63{\pm}9$ years, where 15 patients were male. The pre-treatment mean forced expiratory volume in 1 second ($FEV_1$) was $1.02{\pm}0.31L$ ($44.1{\pm}16.0%$ predicted). The pre-treatment mean forced vital capacity (FVC) was $1.70{\pm}0.54L$ ($52.2{\pm}15.8%$ predicted). Overall, the change in $FEV_1%$ predicted over baseline with tiotropium was $19.5{\pm}19.1%$ (p<0.001). Twenty patients (72%) got better than a 10% increase in $FEV_1$ over baseline with tiotropium, but one patient showed more than a 10% decrease in $FEV_1$. Overall, the change in FVC% predicted over baseline with tiotropium was $18.5{\pm}19.9%$ (p<0.001). Seventeen patients (59%) experienced greater than a 10% increase in FVC over baseline with tiotropium; 12 (41%) patients had stable lung function. Conclusion: The inhaled tiotropium bromide therapy may lead to improve lung functions in patients with TB destroyed lung. However, the long-term effectiveness of this treatment still needs to be further assessed.

• 대한물리의학회지
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• 제8권4호
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• pp.489-496
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• 2013

PURPOSE: The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk test, 6minute walk test) between pre and post in the experimental group. In comparison of two group, experimental group was significant different pulmonary function(FVC, FEV1, MVV) and gait ability(6minute walk test) than control group. but, There was no significant difference of the gait ability(10m walk test). CONCLUSION: This study showed experimental group can be used to improve pulmonary function and gait ability than control group. These findings suggest that the respiratory muscle strengthening training effect on pulmonary function and gait ability for rehabilitation in patients with subacute stroke.

• Journal of Chest Surgery
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• 제49권6호
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• pp.456-460
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• 2016

Background: Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide ($CO_2$) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy. Methods: Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using $CO_2$ gas and group without using $CO_2$ gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence. Results: The improvement of forced expiratory volume at 1 second in the group using $CO_2$ gas and the group not using $CO_2$ gas was $22.46{\pm}11.27$ and $21.08{\pm}5.39$ (p=0.84). The improvement of forced vital capacity 3 months after surgery was $16.74{\pm}10.18$ (with $CO_2$) and $15.6{\pm}0.89$ (without $CO_2$) (p=0.03). During follow-up ($17{\pm}17$ months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred. Conclusion: Thoracoscopic plication under single lung ventilation using $CO_2$ insufflation could be an effective, safe option to flatten the diaphragm.