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

This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO₂) and arterial partial pressure of carbon dioxide (PaCO₂), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO₂, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO₂, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients.
Animals ; Asthma ; Carbon Dioxide ; Cats ; Eosinophils ; Forced Expiratory Volume ; Glycosylation End Products, Advanced ; Humans ; Hydrogen-Ion Concentration ; Immunoglobulin E ; Immunoglobulins ; Inspiratory Capacity ; Lipocalins ; Lung Diseases, Obstructive ; Neutrophils ; Nitric Oxide* ; Oxygen ; Partial Pressure ; Peroxidase ; Plasma ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Surfactant-Associated Protein A ; Residual Volume ; Sputum ; Total Lung Capacity ; Vital Capacity

Tuberculous spine has high incidence in children. Many cases of the tuberculous spine are complicated by deformities of the spine and disability such as paraplegia, cardio-plumonary dysfunction, and also early death. There are now several reports on the pulmonary dysfunction due to spinal deformities such as scoliosis and kyphoscoliosis, but there are few papers on the pulmonary function of patients with the tuberculous spine and kyphosis in children. This article is a report on the study of chest excursion in 70 kyphotic children and of the pulmonary function in 10 cases of severe kyphotic patients with collapsing tuberculous spine. The following results are obtained through the study: 1) Chest excursion was evidently diminished in the cases of moderate and severe thoracic, and severe lumbar involvement. The remainders were nearly within normal limits. 2) The study revealed that the chest excursion and the radiological kyphosis has a very gradually sloped negative correlation in thoracic involvement. 3) Pulmonary function in the severe kyphotics who had the curve over 50 degree were revealed as follows; a) Over 50 percent of the cases had diminished vital capacity. That is, over-all average was 67.7 percent of normal capacity. Especially inspiratory reserve volume was diminished, it was 63.7 percent of normal. Maximum breathing capacity was 68.8 percent of normal. b) Tidal volume, timed vital capacity, minute ventilation rate and O2 consumption were within normal limits or nearly normal.
Child ; Congenital Abnormalities ; Forced Expiratory Volume ; Humans ; Incidence ; Inspiratory Reserve Volume ; Kyphosis ; Paraplegia ; Respiration ; Scoliosis ; Spine ; Thorax ; Tidal Volume ; Ventilation ; Vital 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

BACKGROUND: A lung bulla may rarely shrink as a result of an inflammation within the bulla or a closing of a bronchus involved in the inflammation process, which is termed 'autobullectomy'. The purpose of this study was to describe clinical features of patients with regressions of bullae during follow-up. METHODS: We retrospectively reviewed the cases and individuals who showed unequivocal evidence of interval regressions in a pre-existing bulla. A total of 477 cases with a bulla >5 cm in diameter were screened manually. Thirty cases with bullae that showed regression during follow-up were selected. RESULTS: Regressions of large bullae occurred in 30 of 477 cases (6.3%). The median age of those patients was 61 (range, 53~66) years and 87% of those patients were men. The main cause of a bulla was emphysema (80%). Among 30 cases, 16 cases had pneumonia in the lung parenchyma of the peribullous area. Another 7 cases had a regressed bulla accompanied by an air-fluid level within the bulla. The remaining 7 cases showed a spontaneous regression of the bulla without such events. Complete regression of a bulla occurred in 25 cases. A follow-up chest-X ray showed that in all cases except one, the bulla remained in a collapsed state after 24 months. Forced expiratory volume in one second (FEV1) improved in 3 cases and the other 2 cases had increased forced vital capacity (FVC). In addition, total lung capacity (TLC) and residual volume (RV) decreased in another 2 cases. CONCLUSION: Regression of a lung bulla occurred not only after pneumonia or the presence of air-fluid level within the bulla, but also without such episodes. The clinical course of regression of a lung bulla varied. After regression of a bulla, lung function could be improved in some cases.
Blister ; Bronchi ; Emphysema ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Inflammation ; Lung ; Male ; Pneumonia ; Pulmonary Emphysema ; Remission, Spontaneous ; Residual Volume ; Retrospective Studies ; Total Lung Capacity ; Vital Capacity

BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight ; Electric Impedance ; Forced Expiratory Volume ; Humans ; Korea ; Mortality ; Nutritional Status* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Total Lung Capacity ; Vital Capacity ; Weight Loss

Since pulmonary function testing was first described by Hutchinson in 1846, this technic has been developed by many physiologists and applied to clinical fields for eviluation of cardiopulmonary status in order to improve diagnosis and treatment of cardiopulmonary diseases. The normal values of the lung volumes and capacities, maximal midexpiratory flow, maximal breathing capacity and forced expiratory volume and time in 120 (male-60, female-60) normal Korean adults by using a Gaensler-Collins bronchospirometer are presented. The results were as follows: 1. The vital capacity of the normal Korean adult was 4191+/-451ml. for males and 2685+/-375 ml. for females. 2. The ratio of inspiratory capacity to vital capacity for males was 66+/- 9% and for females 70+/- 7%, but that of expiratory reserve volume to vital capacity for males was 34+/-9% and for females was 30+/-7%. The ratio of inspiratory capacity to vital capacity of normal Korean adults is slightly lower than that of whites, while that of expiratory reserve volume to vital capacity of normal Korean adults is slightly higher than that of whites. 3. The maximal breathing capacity of males was 95+/- 171/min. and that of females 61+/-141/min. 4. The maxima mid-expiratory flow for males was 266+/- 711/min. and for females 176+/- 421 /min. The maximal mid-expiratory time of males was 0. 497+/- 0.145 second and that of females 0. 479+/- 0. 128 second.
Adult* ; Diagnosis ; Expiratory Reserve Volume ; Female ; Forced Expiratory Volume ; Humans ; Inspiratory Capacity ; Lung ; Male ; Maximal Voluntary Ventilation ; Reference Values ; Respiratory Function Tests ; Vital Capacity

Changes in the respiratory system caused by aging generally include structural changes in the thoracic cage and lung parenchyma, abnormal findings on lung function tests, ventilation and gas exchange abnormalities, decreased exercise capacity, and reduced respiratory muscle strength. Decreased respiratory system compliance caused by reduced elastic recoil of the lung parenchymaand thoracic cage is related to decreased energy expenditure by the respiratory system. Lung function, as measured by 1-second forced expiratory volume and forced vital capacity (FVC), decreases with age, whereas total lung capacity remains unchanged. FVC decreases because of increased residual volume and diffusion capacity also decreases. Increased physiological dead space and ventilation/perfusion imbalance may reduce blood oxygen levels and increase the alveolar-arterial oxygen difference. More than 20% decrease in diaphragmstrength is thought to beassociated withaging-related muscle atrophy. Ventilation per minute remains unchanged, and blood carbon dioxide concentration does not increase with aging. However, responses to hypoxia and hypercapnia are decreased. Exercise capacity also decreases, and maximum oxygen consumption decreases by >1%/year. Consequence of these changes, many respiratory diseases occur with aging. Thus, it is important to recognize these aging-related respiratory system changes.
Aging* ; Anoxia ; Carbon Dioxide ; Compliance ; Diffusion ; Energy Metabolism ; Forced Expiratory Volume ; Hypercapnia ; Lung ; Muscular Atrophy ; Oxygen ; Oxygen Consumption ; Residual Volume ; Respiratory Function Tests ; Respiratory Muscles ; Respiratory System* ; Total Lung Capacity ; Ventilation ; Vital Capacity

Lung Volumes and alveolorespiratory function were studied in 30 cases of pure or predominat mitral stenosis in slightly to moderately compromized state, and the results were compared with those in the normal controls. In patients with mitral stenosis, there was a singnificant reduction in the vital capcity and the total lung capacity, whereas the residual volume and its ratio to the total lung capacity were significantly increased. The distribution of inspired gas was uneven as reflected by increase in the lung clearnace index and in the slope of phase III of the single breath nitrogen washout curve. The alvelolar arterial oxygen tension gradient and the physiological dead space were singinificantly increased despite a singinificant decrease in the arterial carbon dioxide tension. The diffusing capacity was also reduced in some cases.
Carbon Dioxide ; Humans ; Lung* ; Mitral Valve Stenosis* ; Nitrogen ; Oxygen ; Residual Volume ; Total Lung Capacity

PURPOSE: To evaluate the usefulness of spiral CT in the measurement of lung volumes. MATERIALS AND METHODS: Fifteen healthy volunteers were studied by both spirometer and spiral CT at full inspiration and expiration inorder to correlate their results, including total lung capacity (TLC), vital capacity (VC) and residual volume(RV). 3-D images were reconstructed from spiral CT, and we measured lung volumes at a corresponding CT window range ; their volumes were compared with the pulmonary function test (paired t-test). RESULTS: The window range corresponding to TLC was from -1000HU to -150HU (p=0.279, r=0.986), and for VC from -910HU to -800HU (p=0.366,r=0.954) in full-inspiratory CT. The optimal window range for RV in full-expiratory CT was from -1000HU to -450HU (p=0.757, r=0.777), and TLC-VC in full-inspiratory CT was also calculated (p=0.843, r=0.847). CONCLUSION: Spiral CT at full inspiration can used to lung volumes such as TLC, VC and RV.
Healthy Volunteers ; Imaging, Three-Dimensional ; Lung* ; Respiratory Function Tests ; Tomography, Spiral Computed* ; Total Lung Capacity ; Vital Capacity