• Journal of Chest Surgery
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• 제14권3호
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• pp.187-194
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• 1981

Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.147-153
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• 2015

Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.

• 대한물리의학회지
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• 제9권3호
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• pp.307-314
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• 2014

PURPOSE: The purpose of this study was to investigate the effects of high intensity intermittent training on cardiopulmonary capacity in canoe and kayak paddlers. METHODS: A total of 16 canoe and kayak paddlers were participated in this study. Experimental group(n=8) was performed high-intensity intermittent training and control group(n=8) was moderate intensity training. All subjects performed a treadmill test in order to compare the difference before and after the intervention. Finishing the test, all subjects were measured to their heart rate(HR), forced vital capacity(FVC), forced expiratory volume in one second (FEV1) and forced expiratory ratio(FEV1/FVC). Recovery of heart rate(RHR) was calculated using the HR. HR and pulmonary flow values was measured before and during the intervention period per 2, 4, 6 and 8 weeks. To compare the differences over time between experimental group and the control group, used(time${\times}$group) two-way repeated measures ANOVA. One-way repeated ANOVA was performed to determine where differences over time within-group. RESULTS: One-way repeated ANOVA revealed a significant difference in the experimental and control group. In experimental group, %RHR3min and FEV1 were significantly increased after 4 weeks(p<.05). Also, %RHR1min, FVC and FEV1/FVC were significantly increased after 6 weeks(p<.05). In control group, %RHR1min, %RHR3min, FVC, FEV1 and FEV1/FVC were significantly increased after 6 weeks(p<.05). CONCLUSION: Not only moderate training but also high-intensity intermittent training contributes to cardiopulmonary capacity in canoe and kayak paddlers. Although high-intensity intermittent training is very short time, the training has high degree of efficiency. Therefore, developed this training in the future, it will be better to improve the cardiopulmonary capacity for athletes and healthy people.

• Investigative Magnetic Resonance Imaging
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• 제18권4호
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• pp.314-322
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• 2014

배경: 심장의 이완기능 이상은 비대성심근증 환자에서 흔히 발견되는 문제이다. 본 연구는 비대성심근증 환자의 심장 이완기능을 평가하는 데 있어, 승모판과 폐정맥의 유속을 이용한 MRI의 역할을 알아보고자 하였다. 방법과 결과: 승모판과 폐정맥의 유속을 이용한 위상차 MRI와 심초음파검사가 59명 (남:여 = 44:15, 평균 연령 = 51세)의 비대성심근증 환자에서 시행되었다. 49명의 환자가 심초음파검사에서 다양한 정도의 심장 이완기능 이상을 보였다; grade 1 (20명), grade 2 (27명), and grade 3 (2명). MRI로 계산한 승모판 유속인자들 (E, A, E/A ratios)은 심초음파검사로 구한 동일 인자들과 양의 상관관계를 보였다 (Pearson's r values = 0.47, 0.60, 0.75 for E, A, E/A, respectively, all P < 0.001). MRI로 폐정맥 유속정보를 이용하는 경우, pseudo-normalized pattern (8명)이 정상 충만 양상(filling pattern) (17명)과 구분될 수 있었고, 이들을 이용하여 이완기능 정도를 평가를 하는 경우, 심장 MRI가 심초음파검사와 중등도의 일치도를 보였다 (kappa value = 0.45, P < 0.001). 결론: 비대성심근증 환자에서 위상차 MRI를 이용한 심장 이완기능 평가는 임상적으로 적용 가능한 방법이며, 폐정맥 유속 분석을 추가하는 경우, 정상과 pseudo-normal을 구분하는데 유용하다.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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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.

• Tuberculosis and Respiratory Diseases
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• 제40권3호
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• pp.283-291
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• 1993

연구배경 : 장기간의 저농도 산소요법은 저산소혈증을 가진 만성폐쇄성폐질환 환자들의 생존율을 향상시킬 뿐만 아니라 삶의 질을 향상시킨다. 저자들은 재택산소요법을 시행하는 환자의 실태를 알아보고 효과적인 개선책을 알아보기 위하여 추적관찰중인 환자 26예에 대한 임상적 관찰을 하였다. 방법 : 대상환자는 경북대학병원 호흡기내과에서 진료를 받고 있는 환자 가운데 가정에서 장기간의 저농도 산소요법을 시행하고 있는 남자 18명 여자 8명 이었으며 재택산소요법을 시행하기전에 신체적 특성과 병력, 폐기능검사, 심전도, 동맥혈가스 및 말초 혈액검사 소견들과 사용중인 산소용기의 종류, 하루에 흡입하는 시간, 투여산소의 농도, 그리고 사용기간 및 문제점 등에 대해서 조사하였다. 결과 : 원인질환은 만성폐쇄성폐질환 14예, 중증폐결핵의 후유증 9예, 기관지확장증 2예 그리고 특발성 폐섬유증 1예였다. 산소치료의 시행동기는 폐성심이 21예, 운동시 호흡곤란 및 심한 환기장애 4예, 그리고 수면중 산소포화도가 90%미만인 경우가 1예였다. 치료시작전의 동맥혈가스소견의 평균치는 $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg 및 $SaO_2$ 87.7% 였으며 폐활량의 평균치는 VC 2.05 L, $FEV_1$ 0.92 L, $FEV_1$/FVC% 51.9%였다. 사용중인 산소용기는 산소탱크를 사용하는 경우가 19예, 산소농축기를 사용하는 경우가 1예, 산소탱크와 액화산소를 함께 사용하는 경우가 2예, 그리고 산소탱크와 휴대용산소를 함께 사용하는 경우 4예였다. 산소사용 기간은 1년 미만이 3예, 1년에서 2년이 15예, 3년에서 5년이 6예 그리고 9년, 10년 동안 산소요법을 시행한 경우도 각각 1예씩 있었다. 산소농도는 전예에서 2.5L/min 이하를 사용하고 있었고 하루 사용시간은 10예 만이 15시간 이상을 사용하였고 대부분이 짧은 시간 동안만 산소를 사용하고 있었다. 결론 : 효과적인 산소투여를 위해서는 환자 및 주위의 사람들에게 장기간의 저농도 산소요법에 대한 교육이 필요하며 편리하게 사용할 수 있는 산소용기의 구입을 위한 제도적 뒷받침이 필요하다.

• Tuberculosis and Respiratory Diseases
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• 제58권2호
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• pp.160-166
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• 2005

연구배경 : 최근 국내에서도 만성폐질환을 가진 저산소증 환자에게 재택산소요법이 증가하고 있으나 그 실태는 잘 알려져 있지 않다. 이에 한 대학병원 호흡기내과에서 재택산소요법을 처방 받은 환자들의 실태를 알아보고자 하였다. 방 법 : 2000년 1월부터 2003년 8월까지 서울아산병원 호흡기내과에서 재택산소요법을 처방 받은 환자들을 대상으로 의무기록 검토와 설문조사를 시행하였다. 산소를 중단한 4명의 환자는 제외하였다. 결 과 : 총 86명의 환자가 산소요법을 처방받았고, 2000년 이후로 매년 빈도가 증가되는 추세였다.남/녀비는 52/34명, 평균연령은 61.3세였다. 환자들의 기저질환으로 만성폐쇄성폐질환 29명, 결핵파괴폐 18명, 기관지확장증 15명, 간질성폐질환 12명, 척추후측만증 7명 등으로 다양한 질환을 보였다. 산소 처방 당시 평균 53명의 폐기능 소견은 $FEV_1/FVC$ 비 $58.4{\pm}25.2%$, FVC $54.5{\pm}17.1$ (% pred.), $FEV_1$ $41.7{\pm}20.6$ (% pred.)로 측정되었다. 산소요법은 1.5 L/min에서 시작하여 평균 14.5시간 동안 사용하였다. 산소 처방 당시 동맥혈 산소농도는 77.7 mm Hg, 동맥혈 이산화탄소농도는 49.6 mm Hg 정도로 조절하였다. 전체 환자 중에서 가정간호사 방문이나 맥박산소측정기로 집에서 산소포화도를 모니터링 하는 경우는 16.5%에 불과하였고 대부분의 환자는 외래 방문시 시행하는 동맥혈가스분석이나 증상에 따라 산소량을 조절하였다. 재택산소치료를 하는 환자들의 3년 생존율은 56%였고 고탄산혈증을 가지는 환자에서 더 좋은 예후를 보였다. 결 론 : 재택산소치료는 다양한 폐질환 환자에게 시행되고 있고, 점차 빈도도 증가하고 있어 효율적인 관리 체계의 확립을 위한 보험제도의 개선이 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.24-29
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• 2012

Background: Measurement of peak expiratory flow rate (PEFR) in a follow-up examination for a chronic airway disease is useful because it has the advantages of being a simple measurement and can be repeated during examination. The aim of this study was to examine the annual decrease of PEFR in asthma and chronic obstructive pulmonary disease (COPD) patients and to confirm the factors which influence this decrease. Methods: From May, 2003 to September, 2010, the annual decrease of PEFR was obtained from asthma and COPD patients attending an outpatient pulmonary clinic. PEFR was measured using a Mini-Wright peak flow meter (Clement Clarke International Ltd. UK), and we conducted an analysis of factors that influence the change of PEFR and its average values. Results: The results showed an annual decrease of $1.70{\pm}12.86$ L/min the asthmatic patients and an annual decrease of $10.3{\pm}7.32$ L/min in the COPD patients. Age and $FEV_1$ were the predictive factors influencing change in asthma, and $FEV_1$ and smoking were the predictive factors influencing change in COPD. Conclusion: We confirmed the annual decreasing PEFR in patients with chronic airway disease and identified factors that work in conjunction with $FEV_1$ to influence the change.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.175-181
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• 2002

Intermaxillary fixation and occusal splint are routine procedure for maxillofacial fracture and orthognathic surgery. When these methods could obstruct oral airway the patients who kept intermaxillary fixation and occusal splint in their mouth, are very difficult to breath after surgery. Nasal bleeding and pharyngeal edema due to nasotracheal intubation, residual effect of muscle relaxants, and anesthetic agent could be contributing factor of airway obstruction. In this study, pulmonary function test was evaluated before and after intermaxillary fixation, and intermaxillary fixation with occusal splint in 22 volunteers. The results were as follows 1. FVC, %FVC, $FEV_1$, $FEV_1%$, PEF, $PEF_{50}$, MVV without intermaxillary fixtion were 4.45L, 88%, 4.03L, 90.9%, 10.26L/s, 5.53L/s, and 136.14L/min, and with intermaxillary fixation were 3.51L, 68.67%, 3.06L, 69.39L, 6.52L/s, 3.94L/s, and 69.39L/min. The results with intermaxillary fixation and occusal splint were 2.15L, 42.41%, 1.71L, 38.81%, 2.83L/s, 1.74L/s, and 37.14L/min. 2. Compared with before and after intermaxillary fixation, all values of pulmonary function test were decreased and after intermaxillary fixation and intermaixillary fixation with occulasal splint, the results were decreased. 3. MVV and PEF were decreased significantly with interaxillary fixtion and occusal splint, and FVC was less decreased. It meant that intermaxillary fixation and occluasal splint induced reduction of respiratory flow significantly, but less reduction of respiratory volume. 4. Intermaxillary fixation and occulsal splint induced increase of airway resistance, decrease of expiratory volume and air flow. So severe respiratory difficulty could be seen to all volunteers who kept intermaxillary fixtion and occusal splint. 5. In classification of respiratory difficulty, intermaxillary fixation with occulsal splint induced complex respiratory difficulty more than intermaxillary fixation only did. From the above results, doctors who care patients kept intermaxillary fixation and occusal splint should be aware of respiratory depression caused by these treatment.

• Journal of Chest Surgery
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• 제16권4호
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• pp.539-546
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• 1983

Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.