The Relationship of VO2Max/Min in cardiopulmonary exercise test and fat distribution / 결핵

BACKGROUND: Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate (VO2) compared to non-obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. METHODS: Maximal exercise capacity was represented by maximam maximum oxygen uptake and VO2 max in the cardiopulmonary test. Obesity, total fat content and abdominal obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers(male 22, female 20) were evaluated. RESULTS: 1) Weight to height ratio(mean±SD) was 110%±14.9% in men and 100±11.1% in women. 2) Fat ratio(mean±SD) was 23.3±5.2% in men and 27.55±3.9% in woman. 3) Waist to hip ratio(mean±SD) was 0.85±0.04 in men and 0.8±0.03 in woman. 4) In men, VO2max/min/Kg was negatively correlate with obesity, fat ratio, and abdominal fat distribution. 5) In woman, VO2max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. CONCLUSION: Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.

Immediate of effects of cigarette smoking on exercise in young adult smokers / 결핵

BACKGROUND: Although the long term adverse effects of cigarette smoking on health are well known, the acute possible detrimental effects of smoking on pulmonary or cardiovascular function, especially when these systems are stressed by the metabolic demands of exercise, have not been well studied. The purpose of this study is to .determine the acute action of cigarette smoking on cardiopulmonary function under stress.' METHOD: Twenty-one healthy smoking subjects were studied. Before exrecise testing, history taking, physical examination and baseline studies, including CBC, chest PA, PFT and EKG, were done. The subjects performed an incremental bicycle exercise test to exhaustion on two occasions, one without smoking and the other after smoking 5 cigarettes/h for 2 hours. All indices of P.F.T and bicycle ergometry were compared between before and after smoking. RESULTS: 1. VO2max and O2 pulse showed significant decrease in smoking day. 2. Although there were no significant differences, anaerobic threshold showed a tendency of decrease and HRmax showed that of increase in smoking day. 3. P.F.T. and respiratory indices showed no significant change in smoking day. CONCLUSION: Cigarette smoking has immediate adverse effect, especially on the cardiovascular system rather than the respiratory system. These results would be due to the effect of elevated HbCO and/or impaired blood flow iii response to the exercise stimulus.

The Long-term Follow-up Study of Therapeutic Effects of 8 French Catheter for Spontaneous Pneumothorax / 결핵

BACKGROUND: Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces(PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. METHODS: From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. RESULTS: The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Their was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was 6.2+/-3.8 days, which was significantly shorter than that of chest tube group in SP, 9.1+/-7.5 days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p= 0.041 ; one-tailed, p=0.053 ; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. CONCLUSION: Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.