담관암의 유일한 치료 방법은 수술로, 수술 가능성 평가가 진단 과정에 있어 매우 중요하다. 처음 진단 당시에는 원격 전이가 확인되지 않아 수술적 치료를 계획하던 중 다발성의 폐결절이 새롭게 확인되었던 원위부 총담관암 증례를 문헌고찰과 함께 보고한다. 원발 부위의 원위부 총담관암의 크기 변화는 없어 폐 전이 외의 감별진단이 필요하다고 판단하였다. 최근 COVID-19 감염력이 있던 증례로 수술 생검 결과상 최종적으로 폐 크립토코코스증으로 진단되었다.

This case report describes the pathological features of pulmonary alveolar proteinosis(PAP) in mouse. Grossly, multiple irregular yellow-grey patches were observed on the lung surface of a C57BL/6 mouse. Histopathologically, the alveolar walls were thickened by type II cell hyperplasia and cellular infiltrates, and the bronchioles and alveolar lumens were filled with amorphous eosinophilic lipoproteinaceous material. This material was positive for Periodic acid-Schiff stain. Gomori methenamine silver staining was negative. Immunohistochemical staining showed that cells in the alveolar wall and lumen were positive for surfactant protein B, chitinase-like protein-3, and CD68. As a result, PAP was diagnosed. This is a rare case of spontaneous PAP in mice, and we report the histopathological characteristics along with the literature.

Background: It is Difficult for older adults to avoid a decreased in pulmonary functions caused by aging, and these reduced functions have been shown to affect not only the quality of life, but also the rate of disease and mortality. Although massage therapy is generally applied as a treatment method for improving the musculoskeletal system, massage is also studied as a potential intervention for lung function as a complementary treatment method. Objectives: To determine the effects of massage and relaxation breathing exercise applied after a low-intensity walking exercise on pulmonary functions in older individuals. Design: Quaxi-experiment study. Methods: Twelve day care elderly were divided into a massage group (n=6) and a relaxation breathing exercise group (n=6). After performing low-intensity walking exercise twice for 7 weeks, massage intervention and relaxation breathing exercise intervention were performed, respectively. PEF, FEV1, and FVC were measured by performing lung function tests pre- and post the intervention. Results: As a result of this study, PEF and FVC were significantly increased in the pre- and post-group comparison of MG, and there was no significant difference in FEV1. There were no significant differences in all variables in the pre-post comparison of RBEG within groups. There was no significant difference in all variables in the comparison between the two groups on the intervention results. Conclusion: To conclude, pulmonary functions in older adults increased significantly after the massage intervention, although no significant difference was found in comparison to intervention with relaxation breathing exercise.

Background: Inspiratory muscle training can improve inspiratory strength and endurance through threshold loading. In addition, trunk stabilization exercises can improve trunk strength and respiratory function. Objectives: The purpose of this study is to investigate the effect of application of inspiratory muscle training and trunk stabilization exercise on pulmonary function and inspiratory muscle activation in college students. Design: Randomized controlled trials. Methods: In this study, 24 college students were randomly divided into two groups: inspiratory muscle training and trunk stabilization exercise (experimental group, n=12), and trunk stabilization exercise (control group, n=12). Inspiratory muscle activity was measured using a surface electromyography. Pulmonary function was measured using a spirometer and a peak expiratory flow meter. Results: In the experimental group, the muscle activity of both upper trapezius and latissimus dorsi muscles increased significantly after the intervention. In the experimental group, both upper trapezius muscle activity was significantly increased than in the control group. In the experimental group, all the pulmonary function significantly increased after the intervention. Conclusion: In this study, when the inspiratory muscle training was additionally applied to the trunk stabilization exercise in college students in their twenty, it was possible to improve the inspiratory muscle activity and pulmonary function.

Background: Generally, rounded shoulders may occur when an individual habitually takes a relaxed, slouched posture. Although various studies on the round shoulder exist, studies on the effect of improvement of thoracic mobilization on the round shoulder are insufficient. Objectives: To investigate the effect of thoracic mobilization on round shoulders and pulmonary capacities. Design: Randomized controlled trials. Methods: Twenty subjects were randomly allocated into an exercise group (n=10) and a mobilization group (n=10). To quantify the round shoulder before and after the intervention, the distance between the acromion and the table surface was measured, and the pulmonary capacities were also measured. The intervention program was conducted twice a week for 6 weeks. The exercise group performed corrective exercise, and the mobilization group performed both corrective exercise and thoracic mobilization. Results: The round shoulder in both groups was significantly decreased (P<.05), and the pulmonary capacities were significantly improved (P<.05). However, there was no significant difference between the two groups (P>.05). Conclusion: The combination of corrective exercise with stretching and strengthening exercises led to the improvement of round shoulders and pulmonary capacities, no additional benefits were detected with thoracic mobilization.

Background: The circuit exercise program is a continuous method that combines complex training types and is an exercise method that is performed to improve performance by improving basic physical strength such as strength, agility, endurance and muscular endurance. Objectives: To examine the effect of exercise program on pulmonary function of professional volleyball players. Design: Randomized controlled trial. Methods: 22 professional volleyball players were divided into two groups of 11 each. A high intensity interval exercise program and circuit exercise program were performed twice a week for 45 minutes for 4 weeks. Results: The changes in pulmonary function in professional volleyball players were significantly different pre and post the intervention in both groups and the interval exercise program group showed a more significant difference before and after the intervention in Forced Expiratory Volume in 1 Second (FEV1) and Forced Expiratory Volume in 1 Second/Forced Vital Capacity (FEV1/FVC) (P<.05). In addition, there was also a significant difference in FEV1 and FEV1/FVC between two groups (P<.05). Conclusion: The interval exercise program group was effective in improving pulmonary function for professional volleyball players.

A cat who is a 15-year-old and spayed female visited an animal clinic with severe coughing symptoms. Since the cat’s coughing symptoms had worsened from the age of 10 and X-rays showed a bronchial pattern in the lungs, it was diagnosed as Chronic Obstructive Pulmonary Disease (COPD). She received three injections of stem cells isolated from the amniotic membrane on days 0, 7, and 23. Although there was no improvement in the clinical findings on the x-ray, the number of coughing was significantly reduced. In addition, even after long-term follow-up post treatment for a month, she was stable with almost no coughing.

본 연구의 목적은 한국 대학생들의 기초체력과 신체활동량이 폐기능과 상관관계가 있는지를 분석하고, 성별에 따른 차이를 검증하는데 있다. 건강한 참여자 312명(남성 150명[평균연령: 19.29±1.72세], 여성 160명[평균연령: 19.05±1.17세])은 신체조성, 기초체력, 신체활동량 설문지, 그리고 노력성폐활량 (FVC)과 1초간 강제호기량(FEV1)의 폐기능 검사를 수행하였다. 연구결과, 남학생의 폐기능은 우악력과 좌악력, 그리고 배근력과 관련이 있었고, 여학생의 폐기능은 모든 기초체력 하위 요인과 관련이 있었다. 또한 여성의 폐기능은 중강도 신체활동량과 관련이 있는 반면 남성의 폐기능은 신체활동량의 모든 하위 요인과 관련이 있었다. 본 연구의 주요 발견은 폐기능을 개선하기 위해서 남학생은 신체활동량을 증가시키고, 여학생은 기초체력을 향상시킬 필요가 있음을 제안한다. 대학생들의 폐기능을 유지하고 개선시키기 위해서는 폐기능 관련 인자에 대한 성별의 차이를 이해하고, 성별에 맞는 교육적 노력이 필요할 것이다.

Background: Individuals with forward head posture (FHP) have neck pain. To correct the FHP, a posture correction band is commonly used. However, we do not know the posture correction band influenced the pulmonary function in individuals with FHP. Objects: This study aimed to elucidate the effects of the posture correction band on the pulmonary function in young adults with neck pain and FHP and to monitor how the pulmonary function changed over time. Methods: Twenty subjects with chronic neck pain and forward head posture were recruited. Subjects performed pulmonary function test four times: before, immediately, and 2 hours after wearing the postural band, and immediately after undressing the postural band. Vital capacity (VC), forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume at one second (FEV1) were measured. The modified Borg dyspnea scale was used to measure each subject’s responses to the posture correction band. The mixed-effect linear regression was used to the effect of the posture correction band over time. Results: There were no significant differences in VC, FVC, PEF, FEV1 values over time (p > 0.05), although all values slightly decreased after applying posture correction band. However, the score of the modified Borg scale significantly changed after wearing the postural bands (p < 0.05), indicating the subject felt discomfort with posture correction band during breathing. Conclusion: Because the posture correction band did not change the pulmonary function over time, but it induces psychological discomforts during breathing in people with FHP. Therefore, this posture correction band can be used for FHP realignment after discussion with the subjects.

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

Smoking can be a significant cause of lung diseases and reduced respiratory functions. Among soldiers, smoking may have a negative impact on their health (physical strength) and well being. Information on differences in the respiratory functions of smokers and nonsmokers in the military services and the effects of the smoking duration and amount (i.e., the number of cigarettes smoked per day) would be useful. This study investigated smoking durations and smoking amounts among young male soldiers (N = 61). The forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and forced expiratory volume in 1 sec/forced vital capacities (FEV1/FEC) were measured FVC, FEV1, or FEV1/FEC of smokers and nonsmokers were not significantly different, and FVC and FEV1 were inversely proportional to smoking duration. Besides, the number of cigarettes smoked per day was not correlated with respiratory functions. These findings may be attributed to the effect of the strenuous physical activity (e.g., military drills) undertaken by soldiers on their respiratory functions. Despite the lack of evidence for a difference in the respiratory functions of smokers and nonsmokers, this study recommends ongoing respiratory function management through smoking cessation programs and respiratory physiotherapy to manage the respiratory functions of Korean smoking soldiers.

The purpose of present study was to investigate the effect of kinesio taping on pulmonary function in stroke patients using manual wheelchairs. Twenty stroke patients were divided into a wood chair group (WCG, n=10), a wheelchairs group (WG, n=10), and a kinesio taping with wheelchairs group (KWG, n=10). Taping with wheelchairs group was applied kinesio taping on back muscles (vertical paraspinal strips and oblique strips). All three groups were trained in upright seated posture for 30 minutes. Pulmonary function tests were performed with forced expiratory volume in one second, forced vital capacity and peak expiratory flow as spirometer. There was a significant increase in forced expiratory volume in one second and forced vital capacity only in KWG. The results of this study demonstrate that kinesio taping has an immediate effect on the improvement of pulmonary function in stroke patients using manual wheelchairs.

Background: Progressive muscle weakness is aggravated not only in the skeletal muscles but also in the respiratory muscles in many patients with neuromuscular diseases (NMD). Inspiratory muscle training (IMT) has been reported as therapy for pulmonary rehabilitation to improve respiratory strength, endurance, exercise capacity, and quality of life, and to reduce dyspnea. Objects: The purpose of this study was to determine the effect of playing harmonica for 5 months on pulmonary function by assessing the force vital capacity (FVC), peak cough flow (PCF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV) in patients with NMD. Methods: Six subjects with NMD participated in this study. The subjects played harmonica once a week for 2 hours at a harmonica academy and twice a week for 1 hour at home. Thus, training was performed thrice a week for 23 weeks. The examiner assessed pulmonary function by measuring FVC in the sitting and supine positions and PCF, MIP, MEP, and MVV in the sitting position at the beginning of training and once a month for 5 months. Results: Both sitting and supine FVC significantly increased after playing harmonica (p=.042), as did MIP (p=.043) and MEP (p=.042). Conclusion: Playing harmonica can be used as an effective method to improve pulmonary function in patients with NMD.

This study aimed to determine the effect of McKenzie lumbar support on pulmonary function in Stroke patients. Twenty subjects (n=20) were divided into two groups: a McKenzie lumbar support group (MLS group=10), a control group (n=10). Pulmonary function was performed to assess its effectiveness. A spirometer was used to measure the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF). The intervention was conducted for four weeks. In the MLS group, FEV1, FVC, and PEF were increased after McKenzie lumbar support. (p<0.05), while no significant differences in the variables were found in the control group (p>0.05). There were no significant differences in variables between the MLS group and the control group (p>0.05). Our findings suggest that applying Mckenzie lumbar support may be an alternative maneuver to improve pulmonary function in stroke patients.

Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman’s Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

The aim of the study was to investigate the effects of incentive spirometry and Ujjayi breathing technique on the pulmonary function of smokers. Subjects were individuals who had a smoking habit of at least a year. Subjects were randomly divided into 3 groups: the incentive spirometry group (n=8), Ujjayi breathing technique (n=9), and a group applying both incentive spirometry as well as Ujjayi breathing technique (n=8). Each intervention was performed twice a day, 5 times a week, for a total of 8 weeks whereupon the change in pulmonary function was evaluated. A spirometer was used to measure FVC, FEV1, and FEV1/FVC. The survey used for this study included the Fagerström Test of Nicotine Dependence (FTND) and the Shortness of Breath Questionnaire (SOBQ). Study results for the comparison within groups showed that in the group that performed both the incentive spirometry and Ujjayi breathing technique, FEV1 improved with statistical significance (p<.05). Furthermore, within this comparison the FEV1/FVC improved with statistical significance. Comparison amongst the groups showed no statistically significant differences in all areas. Following, to effectively increase pulmonary function in young adult smokers, both incentive spirometry and Ujjayi breathing technique should be employed together.

Background: Abdominal bracing exercise (ABE) and abdominal hollowing exercise (AHE) improve the lumbar flexibility and pulmonary function in various patients, yet the efficacy of ABE or AHE have not yet been evaluated. Objects: The purpose of this study was to compare the lumbar flexibility and pulmonary function during both ABE and AHE in healthy adults. Methods: The study included 40 healthy adults, who were randomly divided into the experimental group and control group, each with 20 subjects. All subjects performed ABE (experimental group) and AHE (control group). The lumbar flexibility such as trunk flexion test (sitting and standing position) and schober test and pulmonary function such as the spirometer including forced vital capacity (FVC) and force expiratory volume in one second (FEV1) and chest circumference measurement (middle and lower chest) were measured, respectively. Two-way repeated analysis of variance was used to compare the lumbar flexibility and pulmonary function, respectively. Results: No significant effects of lumbar flexibility were observed on trunk flexion test from the sitting position (P=.478) and standing position (P=.096) in the ABE than in the AHE. However, the length of ABE was longer significantly than it of AHE (P=.024). No significant effects of lung function were observed on the FVC (P=.410) and FEV1 (P=.072) in the ABE group than in the AHE group. And also, no significant effects of chest circumference measurement were observed on the inspiration (P=.468) and expiration (P=.563) in middle chest circumference and inspiration (P=.104) and expiration (P=.346) in lower chest circumference. Conclusion: This study indicated that the ABE is only more effective in lumbar flexibility by lumbar length difference than AHE in healthy adults.

The purpose of the study was to determine the effect of joint mobilization with respiratory muscle taping on pulmonary function and chest expansion ability in patients with chronic stroke. Thirty subjects (n=30) were randomly divided into three groups: a joint mobilization group (n=10), a respiratory muscle-taping group (n=10), and a joint mobilization with respiratory muscle-taping group (n=10). Measurements for pulmonary function and chest expansion were performed to assess its effectiveness. A spirometer was used to measure the pulmonary function, and a tape measure was used to assess the chest expansion. In the joint mobilization group, peak expiratory flow (PEF) was increased. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and upper and lower chest expansion were also increased. All of variables of respiratory muscle-taping group also were increased. FEV1 and FVC were significantly different between joint mobilization with respiratory muscle-taping and respiratory muscle-taping group. The results of the present study suggest that mobilization with respiratory muscle taping increase the pulmonary function and chest expansion.

The purpose of this study was to compare the effects of respiratory exercise on cardiopulmonary function and muscle activity of rectus abdominis in smokers and non-smokers with elderly people. All the participants were older than 65 years, and twenty non-smokers, and twenty smokers participated. Non-smokers and smokers were randomly divined into 10 feedback breathing exercises (FBE) and a balloonblowing exercise (BBE) group. The FBE and the BBE were performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1), forced expiratory volume at one second/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and vital capacity (VC) were measured as pulmonary function. EMG was used to measure the activity of the rectus abdominis. In the FBE and BBE groups, FEV1 was significantly lower in non-smokers compared to smokers at two and four weeks (p<.05), FEV1/FVC, PEF and VC were significantly lower in non-smokers compared to smokers to pre-test, two weeks, four weeks and six weeks (p<.05). Muscle activity of rectus abdominis was significantly difference in the BBE group at pre-test, two weeks, four weeks, and six weeks (p<.05). These results suggest that respiratory exercise was effective in improving pulmonary function and rectus muscle activity.