We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; < 1,000 g) or extremely preterm (EP; < 28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.
Adolescent ; Adult ; Anxiety ; Autism Spectrum Disorder ; Blood Pressure ; Bronchopulmonary Dysplasia ; Cardiovascular Diseases ; Caregivers ; Cohort Studies ; Depression ; Education ; Executive Function ; Humans ; Infant, Newborn ; Insulin ; Intelligence ; Lung ; Mental Health ; Pensions ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Ventilation ; Quality of Life ; Registries ; Reproduction ; Schizophrenia ; Survivors

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*

OBJECTIVE: To study the pulmonary function and nasal resistance characteristics of patients with chronic nose-sinusitis and nasal polyps (CRSwNP), to explore the evaluation role of nasal resistance in nasal ventilation function and the effect of endoscopic sinus surgery on pulmonary function in patients with CRSwNP. METHOD: Fifty CRSwNP patients that met the study criteria were selected . The patients were performed endoscopic surgeries according to Messerklinger surgical procedures under general anesthesia. Extent of surgery was based on preoperative CT showing the range of the lesion of disease and endoscopic findings. Perioperative treatments contained intranasal corticosteroids, cephalosporin or penicillin antibiotics, nasal irrigation and other treatments. Main outcome measures included visual analog scale (VAS), endoscopic Lind-Kennedy scores, nasal resistence, pulmonary function in patientsone week before and after surgery, three months and six months after surgery. Pulmonary function includes forced expiratory volume in one second (FEV1), forced vital capacity FEV1/FVC and peak expiratory flow (PEF). RESULT: The study found that there were significantly positive correlations among VAS score, Lund-Kennedy score and nasal resistance (P < 0.05) in CRSwNP patients, but there is a significantly negative correlation between VAS score, Lund-Kennedy score, nasal resistance and pulmonary function indexes of FEV1, FVC and PEF (P < 0.05). The VAS score, Lund-Kennedy score and nasal resistance values of CRSwNP patients were decreased significantly after comprehensive treatments with nasal endoscopic operation as the major one, the difference was statistically different (P < 0.05). And the pulmonary function indexs (FEV1, FVC, PEF) were significantly increased after surgery in CRSwNP patients. CONCLUSION The nasal resistance can objectively and reliably reflect the degree of nasal congestion and the recovery of nasal function in CRSwNP patients after endoscopic sinus surgery. The detection method of nasal resistance is simple. Functional endoscopic sinus surgery can effectively improve the pulmonary ventilation function in CRSwNP patients, providing some clinical references about the prevention and treatment of CRS related lower respiratory disease.
Administration, Intranasal ; Adrenal Cortex Hormones ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Endoscopy ; Humans ; Nasal Lavage ; Nasal Polyps ; diagnosis ; Nose ; physiopathology ; surgery ; Pulmonary Ventilation ; Respiratory Function Tests ; Rhinitis ; Sinusitis ; diagnosis ; surgery

Noninvasive Ventilation ; Positive-Pressure Respiration ; Pulmonary Heart Disease ; complications ; Silicosis ; physiopathology ; Ventricular Function, Right

Asthma is a chronic airway inflammatory disease that is characterized by symptoms such as shortness of breath, wheezing, chest tightness, and nighttime or early morning coughing, together with variable expiratory airflow limitation. Asthma is a heterogeneous disease involving various underlying processes that have been described based on causal or exacerbating factors, the pattern of airflow obstruction, severity of disease, pattern of cellular inflammation, and structural changes among patients with asthma. However, there is considerable overlap among these clinical variants, which are not correlated strongly with specific pathological processes or treatment responses. The Global Strategy for Asthma Management and Prevention 2014 (GINNA 2014) emphasizes the importance of confirming the diagnosis to minimize both under- and over-treatment with respect to the heterogeneity of asthma. To assess asthma control, it is necessary to assess not only the symptom control but also the future risks of an adverse outcome. Lung function is the most used indicator of future risk. This article reviews the treatment of adult asthma, including patients already receiving treatment according to GINA 2014 and the Health Insurance Review and Assessment Service.
Adult ; Asthma* ; Cough ; Diagnosis ; Dyspnea ; Humans ; Inflammation ; Insurance, Health ; Lung ; Pathologic Processes ; Population Characteristics ; Pulmonary Ventilation ; Respiratory Function Tests ; Respiratory Sounds ; Thorax

OBJECTIVE: To determine the effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion. METHODS: Sixty 70-85 year old patients, ASA class II or III, undergoing spinal fusion were randomly assigned into 2 groups (30 in each group): a protection mechanical ventilation group (group P) and a conventional mechanical ventilation group (group C). Low VT and low level positive end expiratory pressure (PEEP) mechanical ventilation were applied in group P (VT=6mL/kg, RR=12-18 b/min, I:E=1:2, PEEP=10 cmH2O, alveolar recruitment performed once every 15 min), while traditional ventilation was used in group C ( VT=10-12 mL/kg, RR=12 b/min, I:E=1:2). Arterial blood samples were taken and pH, PaO2, PaCO2, PaO2/FiO2, A-aDO2, HR, SBP, DBP and CVP were recorded before the operation (T0), 1 h after tracheal intubation (T1), tracheal extubation immediately (T2), 1 h after tracheal extubation (T3), 1 d, 2 d, and 3 d after the operation (T4, T5, and T6). The pulmonary complication was also examined 1 d after the operation. RESULTS: At T1, T2, T3, T4 and T5, PaO2 and PaO2/FiO2 in group P were higher than those in group C, but A-aDO2 in group P was lower than that in group C. Five patients had bronchitis, 5 had hyoxemia, and 3 had atelectasis in group C, but 2 bronchitis in group P. The incidence of pulmonary complication was 43.3% in group C and 6.6% in group P. There was no significant difference in HR, SBP, DBP and CVP between the 2 groups. CONCLUSION Lung protection mechanical ventilation improves the arterial oxygenation and accelerates the recovery of respiratory functions in elderly patients after spinal fusion operation, with no influence on hemodynamics.
Aged ; Aged, 80 and over ; Anesthesia, General ; Female ; Humans ; Hypoxia ; prevention & control ; Male ; Positive-Pressure Respiration ; methods ; Postoperative Complications ; prevention & control ; Pulmonary Ventilation ; Respiration, Artificial ; methods ; Respiratory Function Tests ; Spinal Fusion ; methods

This paper presents a new gas flow measurement system, which works by calorimetric sensors and DSP wavelet transform signal processing. The system is achieved by specific hardware including flow sensors, voltage amplifier, A/D converter, DSP, heat control circuits as well as supporting software and algorithm. The main advantages of the scheme include its high precision, stable performance and high noise rejection. It can be applied to especially under small tidal volume and low-flow conditions.
Equipment Design ; Pulmonary Ventilation ; Respiratory Function Tests ; instrumentation ; Rheology ; Wavelet Analysis

The aim of the present study was to evaluate the relation between fat mass (FM), fat free mass (FFM) and ventilatory function in children and adolescents. 1 174 healthy children and adolescents (583 males and 591 females) aged 10-18 years were selected from Heilongjiang Province through random sampling by means of questionnaire and physical examination, and measured for height, weight, waist to hip ratio (WHR), FM, FFM and ventilatory function. The data were analyzed by means of independent-samples t test, Pearson correlation analysis and multi-factors regression analysis. Regardless of sex, an independent positive correlation was found (P<0.001) between age and FFM index (FFMI). FM index (FMI) correlated negatively with age in males (P<0.001), but positively with age in females (P<0.001). Regardless of sex, FFMI correlated positively with forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25% of forced vital capacity (FEF25%), FEF50%, and maximal mid-expiratory flow (MMEF) (P<0.05), while negatively with FEV1/FVC (P<0.01). FFMI was correlated positively with FEF75% in males (P<0.05), but not correlated in females. In males, FMI correlated negatively with FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and MMEF (P<0.05), but not correlated with FVC. No correlation was found between the ventilatory function indices and FMI in females. Except FEV1/FVC and FEF75% in males, the effect of FFMI in predicting ventilatory function was higher than FMI regardless of sex. Moreover, the predicting effect of FFMI was higher in males than that in females. Growth spurt of lung function occurred in the ages of 12-15 years in males, while in the ages of 12, 13 and 18 years in females. During the period of growth spurt of lung function, regardless of sex, the effect of FFMI in predicting the lung function was higher than that of age. In conclusion, regardless of sex, FFMI correlates positively with ventilatory function, as a reflection of muscle mass. The effect of FFM in predicting ventilatory function is higher in males than that in females. FM correlates negatively with ventilatory function in males, but not in females. The rapid growth of height and FFM are possibly the main reasons for growth spurt of lung function.
Adipose Tissue ; anatomy & histology ; physiology ; Adolescent ; Body Composition ; physiology ; Body Mass Index ; Child ; Female ; Humans ; Male ; Pulmonary Ventilation ; physiology ; Respiratory Function Tests

The aim of this study was done to assess the association of lung function with insulin resistance (IR), systemic inflammation, and metabolic syndrome (MetS). In 9,581 apparently healthy non-smoking male adults, pulmonary function, fasting glucose, insulin, lipid profiles and serum high-sensitivity C-reactive protein (hs-CRP) levels were measured, and homeostatic model assessment (HOMA) was used to assess IR. The presence of MetS was defined according to the AHA/NHLBI criteria. The prevalence of MetS was 19.3%. The odds ratio of MetS for restrictive ventilatory pattern was 1.55 (95% confidence interval, 1.12-2.14), and that for obstructive ventilatory pattern was 1.39 (0.66-2.94) after adjustment for confounders. When subjects were divided in 4 groups according to quartiles of FVC or FEV1 (% predicted [pred]), HOMA-IR significantly increased as the FVC or FEV1 (% predicted [pred]) decreased. Individuals in the lowest FVC or FEV1 quartile had the highest hs-CRP level. Prevalence of MetS increased as FVC or FEV1 (% predicted [pred]) quartiles decreased. The abdominal obesity, hs-CRP and HOMA-IR were the independent predictors for the lowest FVC and FEV1 (% predicted [pred]) even after adjustment for confounders. These results indicate that MetS, IR, and systemic inflammation are important risk factors for reduced lung function in nonsmoking Korean males.
Adult ; C-Reactive Protein/analysis ; Forced Expiratory Volume/physiology ; Glucose/metabolism ; Humans ; Inflammation/complications/*physiopathology ; Insulin/blood ; *Insulin Resistance ; Male ; Metabolic Syndrome X/complications/*physiopathology ; Middle Aged ; Obesity/complications ; Odds Ratio ; Pulmonary Ventilation/*physiology ; Republic of Korea ; Respiratory Function Tests ; Risk Factors ; Vital Capacity/physiology

BACKGROUND/AIMS: Chronic obstructive pulmonary disease (COPD) is characterized by an incompletely reversible airflow limitation. Pulmonary function test (PFT) has been considered the gold standard test for diagnosis and severity evaluation in COPD. However, PFT by spirometry does not provide information about exercise performance in COPD patients. Therefore, the present study was performed to compare pulmonary function determined by spirometry with exercise function determined by cardiopulmonary exercise test (CPET) for grading of COPD. METHODS: A total of 105 patients with airway obstruction were examined. The patients' mean age was 65 years, and the mean smoking history was 27 pack-years. The patients underwent spirometry and CPET. The results were analyzed by categorical statistical comparison, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society guidelines. RESULTS: The two methods agreed on the classification of only 44 patients (42%). Of the remaining patients, 21 (20%) were found to be less severe according to CPET than according to PFT, whereas 40 (38%) were more severe. Those who were more severe according to CPET had significantly low maximal minute ventilation, low anaerobic threshold, low oxygen pulse, and high breathing reserve. CONCLUSIONS: The present study revealed the large disagreement between the results of resting and exercise pulmonary function tests, and therefore suggests the need for a novel approach or guideline. Additional cardiological evaluation may be needed in patients classified as more severe according to CPET, who are assumed to have a greater degree of impairment of cardiovascular function.
Airway Obstruction ; Anaerobic Threshold ; Bacterial Toxins ; Exercise Test ; Humans ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Respiration ; Respiratory Function Tests ; Smoke ; Smoking ; Spirometry ; Ventilation