Earticle

Oxidative stress has been suggested to play a role in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study aimed to investigate a link between malondialdehyde (MDA) levels, pulmonary function, and cardiac autonomic control in patients with COPD. Plasma levels of MDA, heart rate variability, and pulmonary function were mea-sured in 50 clinically stable COPD patients and 50 normal male controls. COPD patients exhibited lower means of the standard deviations of all normal to normal (NN) intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), and high frequency (HF). Nevertheless, they presented great-er low frequency (LF) and low frequency/high frequency ratio (LF/HF ra-tio) in supine and head-up tilt positions than controls (P<0.001). More-over, a negative correlation between MDA levels with SDNN (P<0.001) and a positive correlation with LF (P<0.01) and LF/HF ratio (P<0.05) were observed in both positions. In COPD patients, plasma MDA levels were 2.3 times greater than controls (4.33±2.03 μM vs. 1.89±0.39 μM, P<0.001), and they were inversely correlated with forced vital capacity, forced expiratory volume in 1 sec, midexpiratory flow, and peak expira-tory flow (P<0.001). Our findings suggest a potential role for oxidative stress in impaired cardiac autonomic control and clinical relevance of plasma MDA levels as a predictor of severity of COPD in COPD patients.

The aim of this study was to examine whether a high-volume compared to low-volume resistance exercise session acutely impairs lung func-tion. Fourteen males (age 23.8±6.5 years) with resistance training expe-rience participated in this study. Participants completed two resistance training protocols (high- and low-volume) and a control session (no ex-ercise) with the sequence randomised. High- and low-volume sessions involved 5 sets (5-SETS) and 2 sets (2-SETS), respectively of 10 repeti-tions at 65% one-repetition maximum for each exercise (bench press, squat, seated shoulder press, and deadlift) with 90-sec recovery be-tween sets. Lung function was evaulated pre- and postsession and re-spiratory gases were measured during the recovery between sets of exercises. An increase in the ratio of forced expiratory volume in 1 sec (FEV1) to forced vital capacity was found following the 5-SETS com-pared to 2-SETS (P=0.033). There was a significant reduction in inspira-tory capacity following 5-SETS compared to control session (P=0.049). No other lung function parameter was affected postsession. During training sessions, the squat and deadlift required greater ventilatory de-mands compared to the bench press and shoulder press (P<0.001). Across most exercises during 5-SETS compared to 2-SETS, there was a lower end-tidal CO2 partial pressure. Across most exercises during 5-SETS compared to 2-SETS there was a lower end-tidal CO2 partial pressure (PETCO2) (P≤0.013), although there were no other differences in physiological responses between the sessions. The findings tend to suggest that the ventilatory and respiratory muscle demands of a stren-uous resistance exercise session are not great enough to acutely im-pair indices of lung function.

The aim of this study was to compare the respiratory muscle thickness, lung function and thoracic cage mobility in a 20s male adults according to smoking status. Forty-seven healthy males aged 20-29 participated in this study. The Fagerstrom Test for Nicotine Dependence (FTND) and Cigarette dependence scale-12 (CDS-12) were used to evaluate smoking status, and they were divided into smoking group (n=23), and non-smoking group (n=24). The thickness of respiratory muscles (diaphragm, intercostal muscle, external oblique, internal oblique, and transverse abdominis) were evaluated using the ultrasound at maximum exhalation and inhalations. And, to measure the pulmonary function, FEV1 and PEF were evaluated using digital peak flow instrument. Additionally, thoracic cage mobility was measured. As the results, there was no significant between smoking group and non-smoking group in respiratory muscle thickness at maximum inhalation. At maximum exhalation, only external oblique thickness was a significantly lower in smoking group than non-smoking group (p=.039). And, in the lung function (FEV1 and PEF) and thoracic cage mobility, there was no significant between smoking group and non-smoking group. The correlation between nicotine dependence level and respiratory muscle thickness and lung function was no significant. Therefore, in their 20s male, smoking mostly did not have a structural and functional differences in the respiratory system. However, smoking is a major factor in reducing lung function, future study should be conducted on subjects with long smoking period or high nicotine dependence.

본 연구는 심혈관질환의 위험인자인 맥압과 혈청지질 그리고 폐기능 사이의 연관성이 존재하는지를 융합적으로 연구하고자 서울에 위치한 일개 회사의 사무직 종사자 109명(남성 51명, 여성 58명)을 대상으로 진행하였다. 대상자의 평균 연령은 43.44±7.23세, 남성 43.44±7.27세, 여성 49.1±11.5세였고, 키와 체중, BMI, 수축기혈압과 이완기 혈압을 측정하였고, 남녀의 차이가 있었다. 대상자의 맥압 평균은 47.82±9.02 mmHg 로 남녀의 차이는 없었다. %FVC의 평균은 84.26±9.91%로 남녀의 차이는 없었다. 맥압과 수축기혈압에서 남성(p<0.01), 여성(p<0.01)과 양의 상관관계를 나타내었으며, 남성에게서 FVC와 HDL는 양의 상관관계로 나타났다(p<0.05). 맥압과 %FVC는 음의 상관관계로 나타났다(-0.267, P<0.01). 회귀분석 결과 R2 은 0.071 로 맥압이 %FVC에 영향을 미치는 것으로 나타났다. 따라서, 혈압 측정에서의 맥압과 폐기능 검사는 심혈관계질환의 예측인자로 유용성이 있을 것으로 사료되며, 향후 심혈관질환의 연구의 융복합 연계가 필요할 것이다.

The purpose of this study was to investigate whether there is a relationship between pulmonary function, serum lipid and pulse pressure, which is a risk factor of cardiovascular disease, in subjects with 109 office workers(51 males and 58 females) be at Seoul, Korea. The mean age of the subjects was 43.44±7.23 years old (male 43.44±7.27, fenale 49.1 ± 11.5). The subjects' height, weight, BMI, systolic and diastolic blood pressures were measured and there was statistical difference between men and women.The mean pulse pressure of the subjects was 47.82±9.02 mmHg, and the mean of FVC was 84.26±9.91%. There was no difference between men and women in both. There was a positive correlation between pulse pressure and systolic blood pressure in males (p<0.01) and females (p<0.01), and FVC and HDL in males were positively correlated (p<0.05). Pulse pressure and %FVC were negatively correlated (r =-0.267, P<0.01). Pulse pressure and %FVC were negatively correlated (r =-0.267, P<0.01). Regression analysis showed that PP was the independent affected %FVC. Therefore, pulse pressure and %FVC may be useful as a predictor of cardiovascular disease in middle-aged subjects with normal, suggest a long-term convergence follow-up is warranted to elucidate the incidence of cardiovascular disease.

The objective of this study was to investigate the effects of the combi-nation of elastic band resistance exercise (EBRE) with modified Thai yoga on the alleviation of blood glucose and oxidative stress in type 2 diabetes mellitus (T2DM). Forty-two patients with T2DM were enrolled and allocated to an exercise or control group (n=21/group). The exer-cise group participated in EBRE combination with modified Thai yoga for 40 min, 5 days/wk, for 12 consecutive weeks. Blood glucose, oxida-tive stress markers, antioxidants, pulmonary function, respiratory mus-cle strength, and airway inflammation were measured before and after the 12 weeks. The results showed that the exercise group had a signifi-cant reduction in fasting blood glucose and glycated hemoglobin. More-over, T2DM patients in the exercise group showed a significant reduc-tion in plasma malondialdehyde, while superoxide dismutase and cata-lase were significantly increased. The exercise group also observed a significant improvement in pulmonary function; forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, peak ex-piratory flow, and forced midexpiratory flow as well as respiratory mus-cle strength. Interestingly, the combination of EBRE with modified Thai yoga markedly improved airway inflammation through the reduction in fractional exhaled nitric oxide. In conclusion, these findings suggest that the combination of EBRE with modified Thai yoga improves blood glu-cose, oxidative stress, antioxidants, pulmonary function, respiratory mus-cle strength, and airway inflammation in T2DM patients. Hence, it could be considered as a possible exercise program for T2DM patients.

Purpose: South Korea is rapidly aging, with older adult care costs soaring and lung diseases prevalent among the older adults. The correlation between hand grip strength (HGS) and lung function is contested, demanding further research to assess its viability as a predictor of lung health in this growing demographic. In this study, explored the relationship between HGS and lung function. Methods: In this cross-sectional study, of 32,379 participants, we selected 3,362 aged 65 years or older, after exclusions. We assessed lung function through forced vital capacity (FVC) and forced expiratory volume (FEV1) measurements, and gauged HGS using a digital dynamometer. The analysis accounted for various covariates including medical history, lifestyle factors, and socioeconomic status, using complex sample analysis in SPSS. Results: Analysis of 3,362 participants revealed that, after adjusting for relevant covariates, HGS retained a statistically significant correlation with FVC and FEV1, with regression coefficients of 0.03 and 0.02, respectively. These findings indicate that HGS may serve as a reliable indicator of respiratory health in an aging population. Conclusion: Findings showed HGS independently aligned with FVC and FEV1, requiring a significant post-adjustment for confounders. Consistent with prior studies, results suggest HGS could indicate respiratory health in older adults. Despite divergent outcomes from earlier research, a persistent link between HGS and lung function underscores its value in geriatric screenings for early lung-decline detection.

Purpose: Lung cancer has a profound impact on the whole family, particularly patients and familycaregivers. This research adopted a dyadic method to examine the dyadic effect of family function onquality of life (QoL) and the mediating role of financial toxicity in lung cancer patient?caregiver dyads. Methods: This was a cross-sectional research that included 218 pairs of participants. Family function,financial toxicity, and QoL were assessed by the General Function of Family Assessment Device (FADGF),Comprehensive Scores for Financial Toxicity based on Patient-Reported Outcome Measures (COSTPROM)and Global Health Status/Quality of Life (GHS/QoL) subscale of European Organization forResearch and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). SPSS 24.0and AMOS 23.0 statistical software were used for statistical analysis. Results: The actor?partner interdependence mediation model analysis demonstrated good model fit(χ 2 /df = 1.300, root mean square error of approximation (RMSEA) = 0.037, normed fit index (NFI) =0.997, Tucker-Lewis index (TLI) = 0.998, comparative fit index (CFI) = 0.992, and standard root meansquared residual (SRMR) = 0.004). Results revealed significant dyadic interdependence, showing thatboth patients’ and family caregivers’ QoL was associated with their own and their partner’s familyfunction and financial toxicity. Notably, family function exerted both actor effects (individual's familyfunction influencing their own QoL) and partner effects (individual’s family function influencing theirpartner’s QoL). Mediation analysis further indicated that these effects operated through both directpathways and indirect pathways mediated by financial toxicity―where one’s family function couldimpact either their own or their partner’s QoL via their own or their partner’s financial toxicity. Conclusion: The findings highlight the need for integrated interventions targeting both family dynamicsand financial distress to enhance well-being in cancer care dyads. Adopting this dyadic approach maysignificantly improve QoL for patients and caregivers, particularly in oncological settings where financialtoxicity intensifies disease-related challenges.

Purpose: This study were investigated the effect of robot-assisted arm therapy on the arm function, gait and lung capacity in stroke patients. Methods: The study participants were selected 20 stroke patients who met the selection criteria. 10 people in the robot-assisted arm therapy group and 10 people in the task-oriented arm therapy group were randomly assigned. The experimental group performed robot-assisted arm therapy and the control group performed task-oriented arm therapy for 6 weeks, 5 days a week, 30 minutes a day. The measurement tools included Fugl-Meyer assessment of upper extremity(FMA-UE) and gait analysis system and spirometry. Data were analyzed using independent sample t-test and the paired sample t-test. Results: The results of comparing Fugl-Meyer assessment of upper extremity (FMA-UE) before and after the intervention within the group, both the experimental group and the control group were a significant difference in upper extremity item score and Fugl-Meyer assessment total score (p<.01), as a result of comparing Fugl-Meyer assessment of upper extremity (FMA-UE) after intervention between the groups, the experimental group were a significant difference only in the upper extremity item score compared to the control group (p<.05). When comparing the gait before and after intervention within the group, both the experimental group and the control group were a significant differences in temporo-spatial variables and 10 m walking (p<.001). When comparing the gait after intervention between the groups, the experimental group were a significant differences in temporo-spatial variables and 10 m walking compared to the control group (p<.05). When comparing the lung capacity before and after the intervention between the groups, the experimental group were a significant difference only in peak expiratory flow (PEF) (p<.05). Conclusion: Through this study it were confirmed that robot-assisted arm therapy applied to stroke patients for 6 weeks significantly improved function of the arm, gait and lung capacity. Based on these results, it is thought that robot-assisted arm therapy can be used as a useful treatment in clinical practice to improve the kinematic variables in chronic stroke patients.

본 연구는 건강한 성인을 대상으로 안정된 지면과 불안정한 지면에서 수행한 풍선 불기 운동이 허파의 기능 개선에 미치는 효과를 확인하고자 하였다. 건강한 성인 27명을 모집하여 안정 지면 그룹(n=14)과 불안정 지면 그룹(n=13)으로 나누었 다. 안정 지면 그룹은 일반적인 바닥에서 풍선불기 운동을 시행하였고, 불안정 지지면 그룹은 토구(Togu) 위에서 풍선 불기 운동을 수행하였다. 두 그룹은 5주 동안 총 12회의 세션에 참여하였으며, 운동 전후로 폐활량, 혈압, 그리고 복직근과 외복사근 의 기계적 근육 특성(긴장도, 강성, 탄성)을 측정하였다. 불안정 지면에서 운동을 수행한 그룹이 안정 지면에서 수행한 그룹에 비해 폐활량이 유의미하게 증가하였고(p<.05), 복직근의 긴장도와 강성이 증가하였으며, 근육 탄성 변화 역시 유의미하게 증가 하였다(p<.05). 외복사근의 긴장도, 강성 및 탄성은 두 그룹 모두에서 증가하였으나 통계적으로 유의미하지 않았다(p>.05). 따 라서 불안정 지면에서 시행한 호흡 운동이 허파와 복근의 기능 향상에 효율적으로 작용할 수 있는 환경으로 생각되며, 정상 성인들의 호흡 운동 방법에 다양하게 활용될 수 있을 것으로 판단된다.

This study aimed to investigate the effect of balloon inflation exercises on improving lung function in healthy adults when performed on stable and unstable surfaces. Twenty-seven healthy adults were recruited and divided into a stable surface group and an unstable surface group, with each group participating in 12 exercise sessions over a 5-week period. Lung capacity, blood pressure, and the mechanical muscle properties of the rectus abdominis and external oblique muscles were measured before and after the exercise sessions. The results showed that the unstable surface group had a significantly greater increase in lung capacity compared to the stable surface group (p<.05). Additionally, the tone and stiffness of the rectus abdominis increased, and muscle elasticity also significantly improved (p<.05). Therefore, performing breathing exercises on an unstable surface may be an effective method for improving both lung and abdominal muscle function.

본 연구의 목적은 호흡기 장애가 있는 제한성 폐질환 노인의 체간에 관절가동술과 스트레칭이 호흡기능, 자 세, 신체피로감의 개선효과를 확인하는데 있다. 연구대상자는 총 10명으로 2014년 1월부터 동년 11월까지 8주간 비 동시적으로 진행되었고, 주 3회, 1일 30분간 체간에 관절가동술과 스트레칭을 실시하였다. 연구 결과 FVC, FEV1, 체 간자세, 체간움직임, 신체피로감이 유의하게 개선되었다(p<.05). 본 연구를 통해 관절가동술과 스트레칭이 호흡기장애 노인의 호흡기능, 체간자세, 체간움직임, 신체피로감을 동시에 개선시킬 수 있는 호흡정형물리치료가 될 수 있음을 확인하였다. 이후 연구들에서는 제한성 폐질환 노인을 대상으로 본 연구에서 적용한 호흡정형물리치료와 운동 분야 들과의 치료적 융복합을 통한 지속적인 연구가 필요하겠다.

The purpose of this study was to examine the effects of trunk mobilization and stretching activities on respiratory function, trunk posture, and physical fatigue for elderlies with restrictive lung diseases and related respiratory impairment. The present study was conducted with ten subjects, participating for eight weeks between January and November 2014. Subjects performed trunk mobilization and stretching routines for 30 minutes per day for three days each week. The study results showed that there were significant improvements in FVC and FEV1, trunk posture, trunk movement and physical fatigue(p<.05). The study results verified that trunk mobilization and stretching activities can be used as respiratory orthopedic manual therapy to improve respiratory function, trunk posture, trunk movement and physical fatigue simultaneously for elderly with respiratory impairment. Continuous studies through therapeutic convergence with the exercise field along with the respiratory orthopedic manual therapy that used in this study for elderly people with restrictive lung diseases will be necessary for the future.

Purpose: The purpose of this study was to identify the effects of the respiration strengthening exercise program for inpatients underwent lung surgery. Method: A quasi-experimental design was used. The subjects of this study were 31 inpatients (Exp. group; 15, Cont. group; 17) at the Korea Cancer Center Hospital. The subjects of experimental group participated in the respiration strengthening exercise program for 7 days. The program consisted of education on deep breathing (pursed-lip breathing, diaphragmatic breathing, deep breathing with Incentive spirometry), coughing, chest physiotherapy (vibration, percussion) and respiratory muscle enhancement exercise(chest mobilization exercise, leg exercise). The outcomes have been evaluated based on pulmonary function (Peak Expiratory Flow Rate, duration of chest tube insertion, pulmonary complication), anxiety and sleep. The obtained data were analyzed by using Repeated Measure ANOVA. Mann-Whitney U test, ANCOVA of SPSS. Results: The degree of pulmonary function, anxiety of experimental group were improved more than the control group, but it was not statistically significant. The sleep condition of experimental group were significantly improved more than the control group. Conclusion: The program has a potential on improving pulmonary function and sleep condition. This program showed the possibility of practical application as nursing intervention for the patients underwent lung surgery.

Purpose: This study was designed to evaluate the effect of TENS on pain and pulmonary function of post-lobectomy patients with lung cancer. Methods: The study data collection was done from February 4, 2008 to February 7, 2009. The subjects were assigned at random to the experimental group and control group with 20 subjects in each group. The experimental group was measured for pain and pulmonary function after surgery and then again after applying TENS 100 Hz frequency and 40 mA output for 20 minutes. The control group was measured the same as the experimental group except applying sham TENS. Results: The pain score of the experimental group which had TENS applied revealed that there were more significant reductions than the control group which had sham TENS applied. There was no significant difference with the number of times of receiving analgesics between the experimental and control group. The effect of TENS on pulmonary function was significantly different between the experimental group and the control group on VC 2 hours after surgery. There was no significant difference between FVC and FEV1. Conclusion: The findings of the study indicate that the TENS is effective in easing the pain of patients after a lobectomy.

In this study, we selected and trained 9 people in the diaphragm training group and 9 people in the power-breath training group among elderly people aged 65 or older living in the community, and investigated the effect of combined training using respiratory equipment on lung function, balance, and life satisfaction. We conducted the elderly to do combined exercises, twice a week for a total of 6 weeks, that include the breathing training by diaphragm, the breathing training using Power-breath equipment, and the training using a theraband. We evaluated the changes in the lung function, the balance, and the life satisfaction before and after the intervention for our study subjects.As a result of our measurement, lung function, balance, and life satisfaction showed significant changes in the experimental group that performed the combined training using Power-breath equipment. As a result of the study, we confirmed that the elderly in the community had a positive effect on the life satisfaction by improving lung function and balance ability after conducting a combined training using respiratory equipment.

Purpose: The purpose of the study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) training and respiratory muscle endurance training on pulmonary function and activity in chronic stroke patients. Methods: The participants were 25 chronic stroke patients. They were assigned to two groups: a PNF and respiratory muscle training group (experimental group; n = 12) and a conservative training group (control group; n = 13). The experimental group completed 50 minutes (30 minutes of conventional physical therapy, 10 minutes of PNF training, and 10 minutes of respiratory muscle endurance training). The control group also completed 50 minutes (30 minutes of conventional physical therapy and 20 minutes on a full-body workout machine). Pulmonary function and activity were measured before and after the intervention, using Cosmed to analyze pulmonary function and 6MWT as clinical evaluation indicators. Results: Both groups showed significant within-group differences on all tests before and after the intervention; the experimental group showed greater improvement on all tests. Conclusion: The findings confirm that PNF training and respiratory muscle endurance training have a positive effect on pulmonary function and activity index in chronic stroke patients.

Background/Aims: Individuals with prior tuberculosis (TB) infection represent a high-risk group for lung cancer due to chronic pulmonary damage. Although associations between TB and lung cancer have been established, this study aimed to explore specific risk factors of lung cancer development in TB survivors. Methods: Data from 9,734 TB survivors within the Kangbuk Samsung Cohort Study (2011?2021) were analyzed. Pulmonary function was assessed by spirometry and classified as normal, restrictive, or obstructive. Multivariable Cox proportional hazard models were used to evaluate the relationships among lung function, smoking, alcohol consumption, comorbidities, and lung cancer incidence. Results: Participants were mostly male (65.4%), with an average age of 41.2 years. Over a median follow-up of 12.3 years, 22 lung cancer cases were identified. Univariate analysis revealed significant associations with restrictive (hazard ratio [HR] 2.58, 95% CI 1.00?6.65; p = 0.050) and obstructive (HR 6.48, 95% CI 2.05?20.43; p < 0.001) lung function, age (HR 2.35 per 5-year; p < 0.001), heavy smoking (HR 6.62; p < 0.001), alcohol (HR 3.05; p = 0.019), and diabetes (HR 6.40; p = 0.003). In multivariable models, restrictive lung function (HR 2.94, 95% CI 1.00?8.65; p = 0.050), age (HR 1.73; p < 0.001), and heavy smoking (HR 4.09; p = 0.010) persisted as independent risk factors. Obstructive lung function initially showed a strong association but was not significant after adjusting for covariates, indicating confounding. Conclusions: Restrictive lung function, likely indicative of post-TB fibrotic changes, heavy smoking, and older age significantly predict lung cancer development in TB survivors. These results highlight the need for surveillance using spirometry for TB survivors.

The importance of pulmonary rehabilitation has been growing due to the recent increase in chronic lung diseases and the emergence of coronavirus disease (COVID-19).Singing is a method of pulmonary rehabilitation that can improve respiratory symptoms in lung disease patients, but the effects of singing on lung function in these patients remain unclear. This study systematically analyzed the effects of singing on lung function inchronic lung disease patients. Systematic review and meta-analysis. We searched PubMed, Embase, and the Cochrane Libraryand selected randomized controlled trials. We searched forstudies that included singing, music therapy, respiratory, lung diseases, and outcomes. After screening 174 studies, the full texts of 44 studies were reviewed. Three studies were selected for the final analysis, including a total of 94 participants. Due to the nature of the partial physical intervention, the quality of the studies was low. All three studies reported no significant differences in forced expiratory volume in 1 second(P =0.97) and forced vital capacity(P =0.93), andtwo studies reported no significant differences in maximal inspiratory pressure(P =0.38) and maximal expiratory inspiratory pressure(P =0.56).One study reported a significant difference between groups in expiratory pressure (P =0.05).In contrast to positive experiences and reports of the health-improving effects of singing in patients with lung disease, numerical improvements in lung function were not observed. Conclusions: To deliver standardized rehabilitation therapy, further clinical trials for not only singing therapy for lung disease patients, but also for breathing exercises that utilize singing, are essential.

Purpose: Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this studywas to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation. Materials and Methods: We retrospectively reviewed the medical records of lung transplantation patients between October 2012and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lungtransplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range ofFEV1 (FEV1 ≥80% of predicted value vs. <80%). We compared the two groups and analyzed factors associated with lung functionrecovery. Results: Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ≥80% of the predicted value, whereas30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87?0.98; p=0.010], longerduration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03?1.26; p=0.015), and high-grade primary graft dysfunction(OR, 8.08; 95% CI, 1.67?39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery oflung function at 1 year after lung transplantation. Conclusion: Immediate postoperative status may be associated with recovery of lung function after lung transplantation.

Purpose: This study was performed to assist in the prediction of the clinical tolerance of patients with lung cancer to irradiation. Materials and Methods: The changes in lung function of 26 patients with lung carcinomas, who had received radiation with curative intent, or postoperative adjuvant radiotherapy, were prospectively studied. Their pulmonary function tests were conducted at presentation, and then at 2 weeks, 2 months, and 6 months, following radiotherapy. Results: When the parameters of postirradiation pulmonary functions (2 weeks, 2 months and 6 months) were compared with the preirradiation baseline data, there was a statistically significant decrease in FEF25~75% at 2 months, but the rest of the parameters showed no significant change following irradiation. However, when the baseline lung function was compared with the lung function at the lowest FVC, in patients with curative radiotherapy, there was a statistically significant decrease of about 10% in the FEV1 and DLCO. Conclusion: Preirradiation assessment of pulmonary functions, particularly the FEV1 and DLCO will be useful for the prediction of the clinical tolerance to irradiation. (Cancer Res Treat. 2002;34:264-267)

Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function ($FEV1{\leq}1L$).