• Title/Summary/Keyword: 폐 환기능

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Significance Evaluation of Lung Volume and Pulmonary Dysfunction (폐용적과 폐기능 환기장애에 대한 유의성 평가)

  • Ji-Yul Kim;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.767-773
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    • 2023
  • To In this study, we sought to evaluate related factors affecting lung volume and their significance in pulmonary function and ventilation disorders. As experimental subjects, 206 normal adult men and women who underwent a low-dose chest CT scan and a spirometry test were selected at the same time. The experimental method was to measure lung volume using lung CT images obtained through a low-dose chest CT scan using deep learning-based AVIEW. Measurements were made using the LCS automatic diagnosis program. In addition, the results of measuring lung function were obtained using a spirometer, and gender and BMI were selected as related factors that affect lung volume, and significance was evaluated through an independent sample T-test with lung volume. As a result of the experiment, it was confirmed that in evaluating lung volume according to gender, all lung volumes of men were larger than all lung volumes of women. he result of an independent samples T-test using the respective average values for gender and lung volume showed that all lung volumes were larger in men than in women, which was significant (p<0.001). And in the evaluation of lung volume according to BMI index, it was confirmed that all lung volumes of adults with a BMI index of 24 or higher were larger than all lung volumes of adults with a BMI index of less than 24. However, the independent samples T-test using the respective average values for BMI index and lung volume did not show a significant result that all lung volumes were larger in BMI index 24 or higher than in BMI index less than 24 (p<0.055). In the evaluation of lung volume according to the presence or absence of pulmonary ventilation impairment, it was confirmed that all lung volumes of adults with normal pulmonary function ventilation were larger than all lung volumes of adults with pulmonary ventilation impairment. And as a result of the independent sample T-test using the respective average values for the presence or absence of pulmonary ventilation disorder and lung volume, the result was significant that all lung volumes were larger in adults with normal pulmonary function ventilation than in adults with pulmonary function ventilation disorder (p <0.001). Lung volume and spirometry test results are the most important indicators in evaluating lung health, and using these two indicators together to evaluate lung function is the most accurate evaluation method. Therefore, it is expected that this study will be used as basic data by presenting the average lung volume for adults with normal ventilation and adults with impaired lung function and ventilation in similar future studies on lung volume and vital capacity testing.

Normal Lung Ventilation/Perfusion Scintigraphy in Miniature Pigs (미니돼지에서 정상 폐 환기/관류 신티그라피)

  • Kim, Se-Eun;Han, Ho-Jae;Shim, Kyung-Mi
    • Journal of Life Science
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    • v.20 no.11
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    • pp.1725-1728
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    • 2010
  • Miniature pigs are widely used in experiments related to pulmonary disease because of their similarities with humans. However, there are not enough data about normal lung function in miniature pigs. Thus, in this study, we investigated normal lung function in miniature pigs with lung ventilation/perfusion scintigraphy and evaluated the availability of this method. Three male miniature pigs weighing 30-35 kg were used. After general anesthesia, ventilation scintigraphy was performed with 100 MBq of $^{99m}Tc$-pertechnetate (${O_4}^-$), after which perfusion scintigraphy was performed with intravenous injection of $^{99m}Tc$-macro aggregated albumin (MAA). The functional contribution of the right lung was about 55%, and left lung was about 45%, similar to humans. Lung ventilation/perfusion scintigraphy was very useful in evaluating the normal lung function of miniature pigs because it was a non-invasive procedure (no tissue damage was involved), took a short time and was easy to perform. In conclusion, miniature pigs are similar to humans in functional contributions of the lung, and this method will be helpful in future pulmonary disease studies involving miniature pigs.

A Study on the Correlation between Lung Ventilation Scan using Technegas and Pulmonary Function Test in Patients with COPD (Technegas를 이용한 폐환기 검사와 폐기능 검사의 상관관계에 관한 고찰)

  • Kim, Sang-Gyu;Kim, Jin-Gu;Baek, Song-EE;Kang, Chun-Koo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.45-49
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    • 2019
  • Purpose Lung Ventilation Scan(LVS) images directly inhaled radiation gas to evaluate lung ventilation ability. Therefore, it is influenced by various factors related to inhalation, including number of breaths, respiratory duration, respiration rate, and breathing method. In actual LVS examinations, it is difficult for objectify the patient's ability to inhale, and there is currently no known index related to inhalation. Therefore, this study confirms the correlation between counts per second(cps) in LVS and the results of pulmonary function test(PFT) and evaluate its usefulness as an objective indicator of inhalation. Materials and Methods From October 2010 to September 2018, 36 Chronic Obstructive Pulmonary Disease(COPD) patients who had both LVS and PFT were classified by severity(Mild, Moderate, Severe). LVS was performed by creating Technegas with Vita Medical's Technegas Generator and inhaling it to the patient. LVS images were acquired with Philips's Forte equipment., and PFT used Carefusion's Vmax Encore 22. The correlation between the cps measured by setting the region of interest(ROI) of both lungs on the LVS and the forced vital capacity(FVC), forced expiratory volume in one second($FEV_1$), $FEV_1/FVC$ of the results of PFT was compared and analyzed. Results We analyzed the correlation between cps of LVS using Technegas and the results of PFT by classifying COPD patients according to severity. Correlation coefficient between $FEV_1/FVC$ and cps was Severe -0.773, Moderate -0.750, and Mild -0.437. The Severe and Modulate result values were statistically significant(P<0.05) and Mild was not significant(P=0.155). On the other hand, the correlation coefficient between FVC and cps was statistically significant only in Mild and it was 0.882(P<0.05). Conclusion According to the study, we were able to analyze correlation between cps of LVS using Technegas and the results of PFT in COPD Patients. Using this result, when performing a LVS, the results of PFT can be used as an index of inhaling capacity. In addition, it is thought that it will be more effective for the operation of the exam rooms.

Comparison of Single-Breath and Intra-Breath Method in Measuring Diffusing Capacity for Carbon Monoxide of the Lung (일산화탄소 폐확산능검사에서 단회호흡법과 호흡내검사법의 비교)

  • Lee, Jae-Ho;Chung, Hee-Soon;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.555-568
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    • 1995
  • Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

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Comparison of Inhalation Scan and Perfusion Scan for the Prediction of Postoperative Pulmonary Function (수술후 폐기능 변화의 예측에 대한 연무 흡입스캔과 관류스캔의 비교)

  • Cheon, Young-Kug;Kwak, Young-Im;Yun, Jong-Gil;Zo, Jae-Ill;Shim, Young-Mog;Lim, Sang-Moo;Hong, Sung-Woon;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.111-119
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    • 1994
  • Background: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. $^{99m}Tc$-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared $^{99m}Tc$-DTPA radioaerosol inhalation scan with $^{99m}Tc$-MAA perfusion scan in predicting postoperative lung function. Method: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneurnonectomy $FEV_1$=Preop $FEV_1x%$ of total function of lung to remain Postlobectomy $FEV_1$=Preop $FEV_1{\times}$(% of total 1-function of affected lung${\times}$$\frac{Number\;of\;segments\;to\;be\;resected}{Number\;of\;segments\;of\;affected\;lung})$ Results: 1) The inhalation scan showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.86, 0.72, 0.87 respectively). 3) Among three parameters, $FEV_1$ showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. Conclusion: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function a1though the former showed a better correlation in FVC.

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Correlation Between High-Sensitive Collimator and Quantitave Analysis in Lung Ventilation SPECT (폐 환기 SPECT에서 고감도 Collimator와 정량분석의 상관관계)

  • Kim, Jung-Soo;Kim, Sang-Hyun
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.89-99
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    • 2015
  • This study investigated the correlation between the characteristics of collimator in accordance with the efficiency of detecting photon signals and the quantitative analysis of the lung function, thereby assessing the possibility of clinically applying high sensitivity lung ventilation SPECT. From March to May, 2014, 10 subjects in normal volunteers underwent an ultra high resolution, high resolution and high sensitivity collimator planar scan and SPECT. The experiment showed that compared with the collimator scan, the quantitative analysis results were significant (p=0.89), and compared to the high resolution collimator SPECT, the time was reduced by 4.9 fold. Therefore, the lung ventilation SPECT that had not been used due to an undermined effectiveness can offer usefulness when clinically applied if a high sensitivity collimator is used since the quality and quantity of information and the duration of scan time all offer an improvement.

Correlation of Tracheal Cross-sectional Area with Parameters of Pulmonary Function in COPD (만성 폐쇄성 폐질환에서 기관의 단면적과 폐기능지표와의 상관관계)

  • Lee, Chan-Ju;Lee, Jae-Ho;Song, Jae-Woo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.628-635
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    • 1999
  • Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

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Effects of Leukocyte Depleted Priming Solution on Cardiopulmonary Edema by Extracorporeal Circulation (백혈구제거 혈액성 충진액이 체외순환 후 심폐부종에 미치는 영향)

  • Kim, Si-Hoon;Kim, Young-Du;Jin, Ung;Jo, Keon-Hyun
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.704-710
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    • 2001
  • Background: Extracorporeal circulation using pump-oxygenator is an inevitable process to keep vital sign during cardiac arrest for open heart surgery. However, the diversion of blood through nonendothelialized channels appears to stimulate inflammatory response, and leukocyte activation may lead to cardiopulmonary edema. Our study evaluated the effect of leukocyte-induced cardiopulmonary edema using three different pump-oxygenator priming solutions; non-hemic crystalloid solution ; leukocyte-depleted homologous blood; non leukocyte-depleted homologous blood in priming solutions. Material and Method: Each different priming solution was used on five dogs, and the effect of leukocyte-induced cardiopulmonary edema during cardiopulmonary bypass(CPB) was evaluated. For each dog after 2 hours of exracorporeal circulation and another 4 hours of post-pump period, the dog was sacrificed and its heart and lung tissues were obtained for measuring Wet/Dry ratio. Arterial $O_2$partial pressure(PaO$_2$) and $CO_2$partial pressure(Pa$CO_2$) were checked. For the evaluation of ventilatory function, $CO_2$partial pressure difference between arterial blood (Pa$CO_2$) and exhaled air(Et$CO_2$) was measured. Result: 1. No significant difference was seen in arterial PaO$_2$and Pa$CO_2$among groups. 2. Ventilatory function evaluated by Pa$CO_2$and Et$CO_2$showed no significant difference between non-hemic and blood-mixed priming solution (P<0.05). 3. Cardiac and lung Wet/Dry ratios were remarkedly lower in the leukocyte-depleted group. There was no significant difference between the non-hemic and blood-mixed groups. Conclusion: Based upon this result, we concluded that the leukocyte depletion from homologous blood of CPB priming solution has a beneficial effect in reducing cardiopulmonary edema compared with non leukocyte-depleted or crystalloid priming solutions.

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Lung Volumes and Diffusing Capacity in Bronchiectasis: Correlation with the Findings of High Resolutional CT (기관지확장증의 흉부고해상전산화단층촬영소견과 폐기량 및 폐확산능과의 관계)

  • Kim, Yeon-Jae;Park, Jae-Yong;Won, Jun-Hee;Kim, Chang-Ho;Kang, Duk-Sik;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.489-499
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    • 1999
  • Background: The patient with bronchiectasis may have obstructive ventilatory impairment combined with mild restrictive ventilatory impairment due to fibrosis of surrounding lung parenchyme and pleural adhesions caused by chronic recurrent pulmonary infections. Since hyperinflation or emphysematous change can be occured in bronchiectasis, pulmonary functions such as lung volumes and diffusing capacity may also vary with associated emphysema. Methods: For the evaluation of lung volumes and diffusing capacity in bronchiectasis with respect to the anatomic types and severity of bronchiectasis, a total of 40 cases comprising 24 cases of tubular, and 16 cystic type of bronchiectasis were analyzed retrospectively. Correlation between lung functions and extent of bronchiectasis or associated emphysema detected in HRCT were also evaluated. Results: Vital capacity(VC) tended to decrease in cystic type than in tubular type. As the severity of bronchiectasis became serious, the VC were significantly reduced, whereas the total lung capacity(TLC), residual volume(RV) and its ratio to the total lung capacity(RV/TLC) had no significant difference. Lung clearance index(LCI) was significantly increased in cystic type than in tubular type, whereas the slope of phase III in single breath nitrogen curve($\triangle$N2/L) was not significantly changed regard to the type and severity of bronchiectasis. DLCO and DLCO/VA reflecting diffusing capacity were significantly decreased in cystic type and also as the severity of bronchiectasis became serious. The correlation coefficient of VC, DLCO and LCI with the extent of bronchiectasis were -0.322, -0.339 and 0.487, respectively, whereas other parameters were not significantly correlated with the extent of bronchiectasis. VC and DLCO correlated negatively with the extent of emphysema while RV, RV/TLC, LCI and $\triangle$N2/L correlated positively. Conclusion: These findings suggest that the reduction of VC and diffusing capacity or uneven distribution of inspired gas in bronchiectasis are related to both the extent of bronchiectasis and associated emphysema while increased residual volume be related to the extent of associated emphysema alone.

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The Effects of Walking-Support Program on the Pulmonary Ventilatory Functions of Elders Following Upper-abdominal Surgery (수술 후 보행지지 프로그램이 노인 상복부 수술환자의 폐 환기능 회복에 미치는 효과)

  • Park, Hyoung-Sook;Kim, Nam-Hee;Kim, Eun-Sim
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.2
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    • pp.214-222
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    • 2009
  • Purpose: The purpose of this study was to evaluate the effects of a walking-support program on the pulmonary ventilatory functions of elderly people who had undergone upper-abdominal surgery. Method: The study was a quasi-experimental research design. There were 26 partcipants who were admitted for upper-abdominal surgery to P University Hospital in B city. Walking exercise education was provided individually to the experimental group the day before their operation and 20 minutes a day for five days after the surgery using the 'Walking Exercise Guide Document'. Pulmonary ventilatory function was with FVC (Forced Vital Capacity), PEF (Peak Expiratory Flow), FEVI (Forced Expiratory Volume in 1 Second), FER (Forced Expiratory Ratio), Oxygen Saturation, and VAS (Visual Analog Scale). Results: The objective indexes of pulmonary ventilatory function were not significantly different between the two groups, but the subjective index was significantly different. Conclusion: With the above results, the walking support program could be an effective nursing intervention for improving pulmonary ventilatory function of surgical patients.

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