By using Siregnost FD 91 body plethysmograph. we measured thoracic gas volume (TGVe) at end of expiration in 19 healthy subjects aged 20-43 years in order to compare with functional residual capacity (FRC) measured by closed circuit method. The results obtained were as follows: 1. Mean values of TGVe and FRC were 3.395+/-0.585 liter, and 3.398+/-0.618 liter, respectively. 2. A advantage of the body physthysmographic method for measuring thoracic gas volume was that it were rapid, safe. and easy to perform, requires no gas sample for chemical analysis, and measured TGVe several times.
Functional Residual Capacity*

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation

OBJECTIVE: To measure and compare the quantitative parameters of the lungs and airways in Korean never-smokers and current or former smokers (“ever-smokers”). MATERIALS AND METHODS: Never-smokers (n = 119) and ever-smokers (n = 45) who had normal spirometry and visually normal chest computed tomography (CT) results were retrospectively enrolled in this study. For quantitative CT analyses, the low attenuation area (LAA) of LAA(I-950), LAA(E-856), CT attenuation value at the 15th percentile, mean lung attenuation (MLA), bronchial wall thickness of inner perimeter of a 10 mm diameter airway (Pi10), total lung capacity (TLC(CT)), and functional residual capacity (FRC(CT)) were calculated based on inspiratory and expiratory CT images. To compare the results between groups according to age, sex, and smoking history, independent t test, one way ANOVA, correlation test, and simple and multiple regression analyses were performed. RESULTS: The values of attenuation parameters and volume on inspiratory and expiratory quantitative computed tomography (QCT) were significantly different between males and females (p < 0.001). The MLA and the 15th percentile value on inspiratory QCT were significantly lower in the ever-smoker group than in the never-smoker group (p < 0.05). On expiratory QCT, all lung attenuation parameters were significantly different according to the age range (p < 0.05). Pi10 in ever-smokers was significantly correlated with forced expiratory volume in 1 second/forced vital capacity (r = −0.455, p = 0.003). In simple and multivariate regression analyses, TLC(CT), FRC(CT), and age showed significant associations with lung attenuation (p < 0.05), and only TLC(CT) was significantly associated with inspiratory Pi10. CONCLUSION: In Korean subjects with normal spirometry and visually normal chest CT, there may be significant differences in QCT parameters according to sex, age, and smoking history.
Female ; Forced Expiratory Volume ; Functional Residual Capacity ; Humans ; Lung* ; Male ; Reference Values ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Spirometry ; Thorax ; Tomography, X-Ray Computed ; Total Lung Capacity ; Vital Capacity

OBJECTIVES: To identify adverse health effects due to air pollution derived from a cement plant in Korea. The ventilation impairment in residents around a cement plant was compared to another group through a pulmonary function test (PFT). METHODS: From June to August of 2013, both a pre and post-bronchodilator PFT was conducted on a "more exposed group (MEG)" which consisted of 318 people who lived within a 1 km radius of a cement plant and a "less exposed group (LEG)" which consisted of 129 people who lived more than 5 km away from the same plant. The largest forced expiratory volume in a one second (FEV1) reading and a functional residual capacity (FVC) reading were recorded after examining the data from all of the usable curves that were agreed upon as valid by PFT experts of committee of National Institute of Environmental Research. The global initiative for chronic obstructive lung disease (GOLD) criteria for COPD, defined the FEV1/FVC ratio < 0.7 as the obstructive type, and the FEV1/FVC ratio >== 0.7 and FVC% predicted < 80% were as the restrictive type. The FVC% predicted value was estimated using Korean equation. We compared the proportion of lung function impairments between the MEG and the LEG by using a chi-square, and estimated the OR of obstructive and restrictive ventilation impairments by logistic regression. RESULTS: The obstructive type impairment proportion was 9.7% in the MEG, whereas it was 8.5% in the LEG. The restrictive type was 21.6% in the MEG which was more than the 12.4% of the LEG. The odds ratio (OR) of total ventilation impairment in the MEG was 2.63 (95% CI 1.50 ~ 4.61) compared to the LEG. The OR of obstructive type in the MEG was 1.60 (95% CI 0.70 ~ 3.65), the smoking history was 3.10 (CI 1.10 ~ 8.66) whereas OR of restrictive type in the MEG was 2.55 (95% CI 1.37 ~ 4.76), the smoking history was 0.75 (95% CI 0.35 ~ 1.60) after adjusting for sex and age. Level of exposure to particulate played a role in both types. However, it appeared to be a significant variable in restrictive type, while smoking history was also an important variable in obstructive type. CONCLUSION: Although this study is a limited cross-section study with a small number of subjects, ventilation impairment rate is higher in the MEG. There might be a possibility that it is due to long-term exposure to particulate dust generated by the cement plant.
Air Pollution ; Dust ; Forced Expiratory Volume ; Functional Residual Capacity ; Korea ; Leg ; Logistic Models ; Lung ; Odds Ratio ; Plants* ; Pulmonary Disease, Chronic Obstructive ; Radius ; Respiratory Function Tests ; Smoke ; Smoking ; Ventilation*

BACKGROUNDThe respiratory system changes with age and a better understanding of the changes contribute to detect and prevent respiratory dysfunctions in old population. The purpose of this study was to observe age-associated changes of pulmonary function parameters in healthy young adults and the elderly.

METHODSA cross-sectional study was conducted among 600 male and female subjects aged 19 to 92 years. The subjects were divided into three groups by age: young adult (19 - 39 years), middle-aged adult (40 - 59 years), and the elderly (≥ 60 years). The pulmonary function was measured with routine examination methods and 13 parameters including vital capacity (VC), residual volume (RV), functional residual capacity (FRC), total lung capacity (TLC), RV/TLC, forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), FEV(1)/FVC, peak expiratory flow (PEF), forced expiratory flow at 25% of FVC exhaled (FEF(25)), forced expiratory flow at 50% of FVC exhaled (FEF(50)), diffusion capacity of the lung for carbon monoxide (D(L)CO), and specific diffusion capacity of CO (KCO) were collected and analyzed. Changes in pulmonary function parameters among the pre-elderly and elderly subjects, especially the aging influence on FEV(1)/FVC and RV were studied further.

RESULTSTen pulmonary function parameters including VC, FVC, FEV(1), FEV(1)/FVC, PEF, FEF(25), FEF(50), TLC, D(L)CO and KCO decreased significantly with age in both male and female subjects (P < 0.01). RV and RV/TLC were increased with age (P < 0.01). FRC remained stable during aging. Except FRC, the linear relationship was significant between age and other pulmonary function parameters. In the pre-elderly and elderly subjects, RV had a non-significantly increasing tendency with age (P > 0.05), and FEV(1)/FVC did not change significantly with age (P > 0.05).

CONCLUSIONTotal pulmonary function was declined with advancing age, but FRC was stable, and the increasing tendency of RV and decreasing tendency of FEV(1)/FVC obviously slowed down in the pre-elderly and elderly subjects.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aging ; physiology ; Cross-Sectional Studies ; Female ; Forced Expiratory Volume ; Functional Residual Capacity ; Humans ; Lung ; physiology ; Male ; Middle Aged ; Vital Capacity ; Young Adult

PURPOSE: Aim of this study is to obtain the normal values of pulmonary function test (PFT) in newborn babies according to their postconceptional age and to detect changes in PFT values of neonatal lung diseases including respiratory distress syndrome and meconium aspiration pneumonia. METHODS: PFT was performed in 60 newborn babies who were admitted in the neonatal intensive care unit and newborn nurseries of Inje University Sanggye Paik Hospital from 2002. 11. 1. to 2003. 10. 31. The PFT data of 20 respiratory distress syndrome (RDS) and 20 meconium aspiration pneumonia patients during the same period were analyzed and compared with normal values of similar postconceptional age group to find what kind of changes in PFT values occur in patient groups. PFT values including compliance (C), resistance (R), functional residual capacity (FRC), tidal volume (TV), percent volume to peak flow (%V-PF) were measured. RESULTS: 1) In PCA 30-32 week newborns, C:1.22+/-0.43 (mL/cmH2O), R:0.12+/-0.07 (cmH2O/mL/sec), FRC:20.9+/-12.7 (mL/kg), TV:7.1+/-3.6 (mL/kg), In PCA 33-36 week newborns, C:1.81+/-0.76 (mL/cmH2O), R:0.09+/-0.04 (cmH2O/mL/sec), FRC:23.3+/-14.1 (mL/ kg), TV:7.3+/-4.3 (mL/kg). In PCA 37-42 week newborns, C:2.08+/-0.57 (mL/cmH2O), R:0.08+/-0.06 (cmH2O/mL/sec), 28.3+/-13.4 (mL/kg), TV:8.5+/-4.1 (mL/kg). 2) In RDS patients of PCA 30-36 week, C:0.08+/-0.02 (mL/cmH2O), FRC:12.3+/-4.3 (mL/kg), %V-PF:0.27+/-0.11. These values were significantly decreased comparing with normal PFT values of newborns with similar postconceptional age (P<0.05). CONCLUSIONS: Lung compliance and FRC of normal newborns increased with increase of their postconceptional age. In RDS patients compliance, FRC and %V-PF were significantly decreased comparing with normal newborns with similar postconceptional age.
Compliance ; Functional Residual Capacity ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Lung Compliance ; Lung Diseases ; Meconium Aspiration Syndrome ; Nurseries ; Passive Cutaneous Anaphylaxis ; Pneumonia ; Reference Values* ; Respiratory Function Tests* ; Tidal Volume

OBJECTIVEBody plethysmography is a typical method to measure functional residual capacity (FRC) and airway resistance (Raw). The aim of the study was to test the feasibility of measuring lung function with the body plethysmography in young children with acute lower respiratory tract infection (ALRI) by evaluating changes and prognosis of lung function for infants with ALRI with or without wheezing via body plethysmograph.

METHODPulmonary function tests (PFTs) were performed by using body plethysmography in 444 children with ALRI, aged 1-36 months, to assess their tidal breathing parameters such as ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE), plethysmographic functional residual capacity (FRCP), FRCP per kilogram (FRCP/kg), specific effective airway resistance (sReff), effective airway resistance (Reff), Reff per kilogram (Reff/kg), etc. According to whether there was wheezing or not, children who had ALRI with wheezing were classified as Group-W, or without wheezing as Group-N. Changes or correlations of tidal breathing parameters and plethysmographic parameters were compared.One hundred and three contemporaneous healthy controls aged 1-36 months underwent the same tests for comparison. And 36 wheezing children accepted PFTs at follow-up in recovery phase.

RESULTMean values of TPTEF/TE in Group-W,Group-N and the Control respectively were (20.5 ± 6.7)%,(22.8 ± 6.5)%,(34.6 ± 5.0)% (F = 110.500, P < 0.001), while VPTEF/VE respectively were (23.0 ± 6.3)%,(25.2 ± 6.8)%,(34.5 ± 4.2)% (F = 107.800, P < 0.001). Compared to the Control,Group-W and Group-N had significantly higher values of FRCP (226 vs. 176 vs. 172 ml, χ(2) = 64.870, P < 0.001), FRCP/kg(24.40 vs.17.80 vs.17.60 ml/kg,χ(2) = 68.890, P < 0.001), sReff(1.00 vs. 0.52 vs. 0.46 kPa·s,χ(2) = 75.240, P < 0.001), Reff (3.90 vs.2.74 vs.2.20 kPa·s/L, χ(2) = 36.480, P < 0.001) and Reff/kg [0.42 vs. 0.29 vs.0.22 kPa·s/(L·kg), χ(2) = 29.460, P < 0.001]. Although 25 (12.8%) wheezing children with ALRI had normal values of tidal breathing parameters, they already had increased FRCP, FRCP /kg, sReff, Reff and Reff/kg (t = 2.221, 1.997, 2.502, 2.587, 2.539, all P < 0.05). Values of FRCP and Reff in infants caught ALRI were inversely correlated to that of TPTEF/TE and VPTEF/VE (P < 0.05); 36 children with wheezing who accepted PFTs at follow-up had shown significant decline in the specific parameters of plethysmography such as FRCP, FRCP/kg, sReff, Reff and Reff/kg (Z = -1.999, -2.195, -2.038, -1.823, -2.054, all P < 0.05), while no improvement in the main parameters of tidal breathing such as TPTEF/TE.

CONCLUSIONMeasuring lung function with the body plethysmography in young children with ALRI is feasible. FRC and Raw, as special lung function testing parameters of body plethysmography, were sensitive indicators reflecting impairment of lung function in infants with ALRI (especially for children caught ALRI with wheezing) and shows significant correlation with parameters from lung function testing via tidal breathing. Therefore plethysmography is worthy of clinical promotion.

Airway Resistance ; physiology ; Case-Control Studies ; Child, Preschool ; Female ; Functional Residual Capacity ; physiology ; Humans ; Infant ; Lung ; physiopathology ; Male ; Plethysmography, Whole Body ; Respiratory Function Tests ; Respiratory Sounds ; diagnosis ; physiopathology ; Respiratory Tract Diseases ; diagnosis ; physiopathology ; Tidal Volume

BACKGOUND: The effect of anesthetic techniques, such as closed circuit anesthesia (CCA) using semiclosed circuit system and semiclosed circuit anesthesia (SCCA), on the work of breathing has not been studied yet in detail. This study was purposed to compare the work of breathing according to anesthetic technique (CCA, SCCA). METHODS: Thirty patients were assigned to receive either SCCA group or CCA group (n = 15). Anesthesia was induced with propofol 2 mg/kg with 2% lidocaine 1 ml. Two percents isoflurane with O2 and N2O 2 L/min were given for 10 min to patients initially to wash in functional residual capacity and the breathing circuits. In SCCA group, anesthesia was maintained with 2% isoflurane in O2 2 L/min and N2O 2 L/min throughout the surgery. In CCA group, O2 was reduced to 200 ml/min and N2O to 100 ml/min with isoflurane vaporizer setting adjusted to 4% for anesthesia maintenance. When the operation was ended, the vaporizer setting of isoflurane deceased to zero and then O2 was increased to 4 L/min for the arousal of the patient. We measured the inspiratory/expiratory concentration of isoflurane, end-tidal CO2, the hemodynamic parameters, the change of airway pressure, the work of breathing, and compliance at anesthetic induction and emergence in both groups. RESULTS: There were no significant differences in the inspiratory/expiratory concentrations of isoflurane, the hemodynamic parameters, end-tidal CO2, airway pressure, the work of breathing and compliance between the groups. CONCLUSIONS: CCA using semiclosed circuit system does not increase the work of breathing compared to SCCA.
Anesthesia ; Anesthesia, Closed-Circuit* ; Arousal ; Compliance ; Functional Residual Capacity ; Hemodynamics ; Humans ; Isoflurane ; Lidocaine ; Nebulizers and Vaporizers ; Propofol ; Respiration ; Work of Breathing*

OBJECTIVETo study the development of pulmonary function of healthy children between 1-48 months.

METHODSA total of 295 healthy children at ages of 1-48 months were classified into 7 groups according to their age, i.e., 1-2 months, 3-4 months, 5-7 months, 8-12 months, 13-24 months, 25-36 months, and 37- 48 months. Pediatric pulmonary function laboratory type 2600 (Sensor Medics Corporation USA) was used to detect tidal flow volume curve, which can partially replace the maximum expiratory flow volume curve and reflect airway ventilation function. Passive expiratory flow volume technique was used to examine respiratory system static compliance and total airway resistance. Open nitrogen washout method was used to measure functional residual capacity.

RESULTSThe values of tidal, peak tidal expiratory flow, and respiratory system static compliance functional residual capacity increased with the increasing age and were significantly different among the 7 groups. However, respiratory rate and total airway resistance decreased with the increased age. The value of each parameter of tidal flow volume curve was stable during 1-48 months.

CONCLUSIONSThis study displayed the developmental characteristics of pulmonary function of healthy children at ages of 1-48 months, which is useful to observe the changes of pulmonary function in respiratory diseases.

Age Factors ; Child, Preschool ; Female ; Functional Residual Capacity ; Humans ; Infant ; Lung ; physiology ; Male ; Peak Expiratory Flow Rate

Atelectasis can impair arterial oxygenation and decrease lung compliance. However, the effects of atelectasis on endotoxemic lungs during ventilation have not been well studied. We hypothesized that ventilation at low volumes below functional residual capacity (FRC) would accentuate lung injury in lipopolysaccharide (LPS)-pretreated rats. LPS-pretreated rats were ventilated with room air at 85 breaths/min for 2 hr at a tidal volume of 10 mL/kg with or without thoracotomy. Positive end-expiratory pressure (PEEP) was applied to restore FRC in the thoracotomy group. While LPS or thoracotomy alone did not cause significant injury, the combination of endotoxemia and thoracotomy caused significant hypoxemia and hypercapnia. The injury was observed along with a marked accumulation of inflammatory cells in the interstitium of the lungs, predominantly comprising neutrophils and mononuclear cells. Immunohistochemistry showed increased inducible nitric oxide synthase (iNOS) expression in mononuclear cells accumulated in the interstitium in the injury group. Pretreatment with PEEP or an iNOS inhibitor (1400 W) attenuated hypoxemia, hypercapnia, and the accumulation of inflammatory cells in the lung. In conclusion, the data suggest that atelectasis induced by thoracotomy causes lung injury during mechanical ventilation in endotoxemic rats through iNOS expression.
Animals ; Blood Pressure ; Carbon Dioxide/blood ; Cardiac Output ; Combined Modality Therapy ; Endotoxemia/*complications/immunology/pathology ; Functional Residual Capacity ; Immunohistochemistry ; Leukocytes, Mononuclear/pathology ; Lipopolysaccharides/pharmacology ; Lung/enzymology/pathology/physiopathology ; Lung Compliance ; Lung Volume Measurements ; Male ; Neutrophils/pathology ; Nitric Oxide Synthase Type II/metabolism ; Oxygen/blood ; Positive-Pressure Respiration/*adverse effects ; Pulmonary Atelectasis/*etiology/pathology/*therapy ; Rats ; Rats, Sprague-Dawley ; Thoracotomy/*adverse effects