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이상도,권오정,이춘택,조상헌,남귀현,한성구,심영수,김건열,한용철 대한내과학회 1990 대한내과학회지 Vol.38 No.3
It is well known that cigarette smoking induces chronic obstructive lung disease. Recently it has been noted that inflammatory changes of the small airways are the earliest lesions of chronic obstructive lung disease. Impairment of pulmonary function in teenage smokers, or in nonsmokers who are exposed chronically to cigarette smoke, is reported frequently, and after stopping cigarette smoking, restoration of pulmonary function is observed. Many studies are currently being carried out regarding pulmonary function tests for early detection of small airway disease. Different from chronic effect of cigarette smoking, increased resistance of central airways is reported as an acute effect of cigarette smoking, while others report increased resistance of small airways as an acute effect of cigarette smoking. There is many controversies about the major site of acute effect of cigarette smoking. Maximal expiratory flow volume curve, airway resistance, compliance(static and dynamic) and closing volume was measured in healthy medical students without present symptoms of pulmonary disease, with the object of comparison of the sensitivity of pulmonary function test items used for detection of small airway disease in young-age smokers, and to study about the acute effect of cigarette smoking. The results are as follows; 1) Mean age of smokers was 22.9±1.2(21~26) years and the mean of their smoking history was 4.2±1.2(3~7) pack-year. Mean age of nonsmokrs was 22.0±1. 0(21~23) years. 2) Compared to nonsmokers, CV/VC was significantly high(p<0.05) and C1.0/C0.0(Cdyn at repiration rate of 60/min/Cst) was significantly low(p<0.05) in smokers, while other pulmonary function test items showed no significant difference between smokers and and nosmokers. 3) Of 21 smokers, 12 persons(57%) showed significant decrease of Cdyn with an increase of respiration rate, while 2 persons(13%) showed abnormal MMF and other 2 showed abnormal CV/VC among 16 smokers who performed the tests and they all showed significant decrease of Cdyn with an increase of respiration rate. 4) Of 21 smokers, 13 persons(62%) had symptoms of cough or sputum, but there was no significant difference of pulmonary function tests between symptomatic and asymtomatic smokers. 5) After smoking, FEV1/FVC, MMF and PEFR were decreased significantly(p<0.05), and SRAW was increased significantly(p<0.005). 6) After smoking, the decrease of C1.0/C0.0 was significantly larger(p<0.05) in nonsmokers compared to smokers and increase of SRAW was somewhat larger in nonsmokers but without statistical significance.