Effects of Green Tea to Absolute Neutrophil Count, MMP-9, %VEP1, and COPD Assessment Test Scores Stable COPD Patients

Backgrounds: Chronic obstructive pulmonary disease is the leading cause morbidity and mortality worldwide. Cigarette smoke and noxious agent causing oxidative stress activated nuclear factor-κB then increase inflammatory genes releases. Epigallocatechin-3-gallate green tea have antiiinflammatory effect which can be use as addition therapy for stable COPD. Methods: This study aimed to analyze the effect of EGCG to absolute neutrophil count (ANC), serum MMP-9, %FEV1, and CAT score stable COPD patients. Clinical trials of experimental with pre-test and post-test design was conducted on 30 patients in Dr. Moewardi Hospital Surakarta from February-April 2017. Samples were taken by consecutive sampling divided into treatment group (n=15) received standard therapy and green tea capsule 2x500mg/day during 28 days and control group received only standard therapy (n=15). Decreased inflammation measured by ANC and serum MMP-9, improvement of obstruction measured by %FEV1, and clinic improvement measured by CAT score. Results: There were no significant differences (P=0.135) decrease ANC treatment group (-662.45±1446.80 µL) compared control (413.79±2292.90 µL), decrease serum MMP-9 (P=0.413) treatment group (-324.34±333.56 ng/ml) compared control (-181.21±577.52 ng/ml), %FEV1 (P=0.236) treatment group (2.56±10.77), compared control (-4.30±19.12), and significant difference (P=0.034) CAT score treatment group (-1.07±1.16) compared control (-0.20±1.08). Conclusions: The addition of green tea capsule 2x500 mg/day during 28 days was significantly lowered CAT score, decreasing ANC, serum MMP-9 and increasing %FEV1 but not significant. (J Respir Indo 2018; 38(1): 7-15)

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The Effects of Quercetinon Interleuikin (IL-8) Serum, %Forced Expiratory Volume in One Second (FEV1), and COPD Assessment Test (CAT) Scores in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients

Jurnal Respirologi Indonesia ◽

10.36497/jri.v39i2.51 ◽

2019 ◽

Vol 39 (2) ◽

pp. 103-112

Author(s):

Maratus Sholihah ◽

Suradi Suradi ◽

Jatu Aphridasari

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Treatment Group ◽

Serum Level ◽

Pulmonary Disease ◽

Standard Therapy ◽

Flavonoid Compound ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Introduction: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Cigarette smoke and noxious agent result in oxidative stress and activate release of inflammatory mediators such as Interleukin-8 (IL-8). Quercetin is a flavonoid compound containing anti-inflammatory effects which can be used as an adjuvant therapy in stable COPD. Objective: To analyze the effect of quercetin on serum IL-8 levels, % VEP1, and CAT score of stable COPD patients. Methods: Experimental clinical trial with pre-test and pasca-test design was performed in 30 patients with stable COPD in Dr. Moewardi Surakarta between December 2017 and January 2018. The samples taken by using purposive sampling were divided into two groups treatment groups received standard therapy and quercetin 500mg/day for 28 days and control groups only received standard therapy. The decrease in inflammation was measured by serum IL-8 examination, improvement of obstruction measured by %FEV1 and clinical improvement measured by CAT score. Results: IL-8 serum level was significantly lower in treatment group than of in control group (p=0,001). The percentage of FEV1 was insignificant different between the two group (p=0,236). However CAT score was significantly lower in treatment group compared to that of in control group (p=0,001) Conclusions: Quercetin can decrease IL-8 serum level and decrease CAT score when given in combination with standard therapy for COPD patients. (J Respir Indo 2019; 39(2))

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Effects of Mangosteen pericarp Extract to Clinical Improvements, The Plasma Level of IL-6 and Malondialdehyde in Acute Exacerbation of COPD Patients

Jurnal Respirologi Indonesia ◽

10.36497/jri.v38i3.6 ◽

2018 ◽

Vol 38 (3) ◽

pp. 164-172

Author(s):

Khilyatul Baroroh ◽

Suradi Suradi ◽

Ade Rima

Keyword(s):

Treatment Group ◽

Plasma Level ◽

Length Of Stay ◽

Acute Exacerbation ◽

Clinical Symptoms ◽

Control Group ◽

Chronic Obstructive ◽

Copd Patients ◽

Significant Difference ◽

And Control

Background: Amplification of inflammation in acute exacerbation of chronic obstructive pulmonary disease (COPD) increases inflammatory mediators and oxidative stress in the airways, pulmonary and systemic circulation that are characterized by increased plasma level of IL-6 and MDA, resulting in worsening of clinical symptoms. Xanthones in mangosteen pericarp have anti-inflammatory and antioxidant effects, potentially as an adjuntive therapy in acute exacerbations of COPD. Methods: The aim of this study was to determine the effect of mangosteen pericarp extract to clinical improvements, plasma level of IL-6 and MDA of acute exacerbation COPD patients. A clinical trial of experimental with pretest and posttest was conducted on 34 acute exacerbation of COPD patients in Dr. Moewardi Hospital Surakarta and Dr. Ario Wirawan Lung Hospital Salatiga from April until May 2016. The sample was taken by consecutive sampling. Subjects were divided by randomized double blind technique into the treatment group (n=17) received mangosteen pericarp extract 2x1100mg/day and control group (n = 17) received placebo. Clinical improvements were measured in CAT score and length of stay. CAT score, plasma level of IL-6 and MDA were measured on admission and at discharge. Length of stay based on the number of days of care in hospitals. Results: There was significant difference (p=0,011) towards decreased of IL-6 plasma level between treatment group (-2,17 ± 3,46 pg/ mL) and control group (+1,67 ± 6,81 pg/mL). There were no significant difference towards decreased of length of stay (p=0,34) between treatment group (4,12 ± 1,54 days) and control group (5,24 ± 2,49 days), towards decreased of CAT score (p=0,252) between treatment group (-19,18 ± 3,96) and control group (-18,24 ± 2,75), and towards decreased of MDA plasma level (p=0,986) between treatment group (+0,03 ± 0,36μmol/L) and control group (+0,35 ± 1,58). Conclusions: The addition of mangosteen pericarp extract 2x1100mg/day during hospitalization was significantly lowered plasma levels of IL-6, but were not significant in lowering the CAT score, shortening the length of stay, and reducing the increase in plasma level of MDA.

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Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084207 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4207

Author(s):

Jose L. Gonzalez-Montesinos ◽

Jorge R. Fernandez-Santos ◽

Carmen Vaz-Pardal ◽

Jesus G. Ponce-Gonzalez ◽

Alberto Marin-Galindo ◽

...

Keyword(s):

Pulmonary Rehabilitation ◽

Rehabilitation Programme ◽

Group Differences ◽

Control Group ◽

Chronic Obstructive ◽

Maximum Value ◽

Copd Patients ◽

Significant Difference ◽

Pulmonary Rehabilitation Programme ◽

Positive Increment

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = −435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, −8.5 L/min, BF10 = 25), respiratory rate (RR, −3.3 breaths/min, BF10 = 2), heart rate (HR, −13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, −183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, −3.8 L/min, BF10 = 1.1) and compared to CG in VE (−8.3 L/min, BF10 = 3.6), VCO2 (−215.9 L/min, BF10 = 3.0), EqCO2 (−3.7 L/min, BF10 = 1.1) and HR (−12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (−4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.

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RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202110214 ◽

2021 ◽

Vol 74 (10) ◽

pp. 2605-2609

Author(s):

Tetyana M. Ternushchak ◽

Marianna I. Tovt-Korshynska

Keyword(s):

P Wave ◽

Doppler Imaging ◽

Control Group ◽

Chronic Obstructive ◽

Conduction Time ◽

Electromechanical Delay ◽

P Wave Dispersion ◽

Atrial Electromechanical Delay ◽

Copd Patients ◽

Significant Difference

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.

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Streptococcus Alpha growth in gingivitis patient’s dental plaque after rinsing with green tea extract (Camellia Sinensis)

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol19no1.14174 ◽

2007 ◽

Vol 19 (1) ◽

Author(s):

Isti Endah Kurniwati ◽

Juni Handajani ◽

Regina TC. Tandelilin

Keyword(s):

Treatment Group ◽

Green Tea ◽

Camellia Sinensis ◽

Dental Plaque ◽

Health Benefit ◽

Green Tea Extract ◽

Control Group ◽

Research Subjects ◽

Significant Difference ◽

Tea Extract

Green tea (Camellia sinensis) has been widely known as a healthy drink since long time ago. One of the substances in green tea which can give health benefit is catechin, an antibacterial substance. The purpose of this research is to know the efficacy of rinsing with green tea extract to Streptococcus alpha growth on gingivitis patient’s dental plaque. The research subjects include 30 mild gingivitis patients, and these subjects are divided into two groups: treatment group (20 patients) and control group (10 patients). Ten patients of treatment group rinse their mouth with 0.25% green tea extract and 10 other patients with 0.5% green tea extract. Meanwhile, control group use Bactidol (0.1% Hexetidine). Rinsing the mouth is performed every morning and night for five days. Sampling is conducted on the first and sixth day. Before rinsing data is analyzed using ANOVA and the result shows a significant difference. ANAVA testing then is done using proportion value. ANAVA Testing result shows that there is no significant difference among the patients in the treatment group. This result indicates that the effect of rinsing with 0.25% and 0.5% green tea extract is equivalent to the control (0.1% Hexetidine) to inhibit S. alpha growth on mild gingivitis patient’s dental plaque. From these two concentrations, it has not been known which one is the most effective concentration to inhibit S. alpha growth on mild gingivitis patient.

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PENGARUH PEMBERIAN INHALASI KOMBINASI SALMETEROL/FLUTIKASON PROPIONAT TERHADAP KUALITAS HIDUP PENDERITA PENYAKIT PARU OBSTRUKTIF KNONIK STABIL

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.155 ◽

2019 ◽

Vol 1 (2) ◽

pp. 28-33

Author(s):

Refi Sulistiasari

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Treatment Group ◽

Control Group ◽

Copd Assessment Test ◽

Copd Patients ◽

Significant Difference ◽

Inhaled Therapy ◽

St George's Respiratory Questionnaire

It is known that inflammation is the underlying cause of COPD, and this affects to quality of life of the patient. Provision of inhaled therapy combination of LABA and corticosteroids is one of therapy in pharmacology of stable PPOK patients. The aim of this study was to know the benefits of inhalation of 50 g / fluticasone propionate 500 g inhibition in stable COPD patients. The research design is clinical trial. The study was conducted for 3 months and was performed on 26 stable COPD patients divided into two groups: 15 patients for the treatment group and 15 patients for the control group. After the measurements were obtained, there was a significant difference in the quality of life as measured by St. George's Respiratory Questionnaire (SGRQ) (p = 0.001) and COPD Assessment Test (CAT) (0.001) measurements were made twice on the first and thirtieth days.

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THE EFFECT OF TRACHEAL DIVERTICULUM AND CHRONIC OSTRUCTIVE LUNG DISEASE ON CHEST ANTHROPOMETRY

10.22541/au.161248656.64273199/v1 ◽

2021 ◽

Author(s):

Mine ARGALI DENIZ ◽

Hilal ER ULUBABA ◽

M. Furkan ARPACI ◽

Fatih CAVUS ◽

Gokhan DEMIRTAS ◽

...

Keyword(s):

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Group 4 ◽

Tracheal Diverticulum ◽

Copd Patients ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

Objective: In this study, the effect of tracheal diverticula (TD) on chest anthropometry and its relation with chronic obstructive pulmonary disease (COPD) was evaluated. Method: Between January 2019 and March 2020, 995 patients who underwent chest CT were retrospectively analyzed and TD was detected in 31 cases. Group 1 is only TD, Group 2 is TD + COPD, Group 3 is only COPD, Group 4 is defined as control group. We measured the localization, size, the distance to carina and vocal cord of TDs. In all groups chest diameters at T4 and T9 levels were measured as transverse and vertical plans. Results: TDs detected mostly at the T2 and T3 levels. In Group 1 and Group 2, there was a statistically significant difference the distance to TD of vocal chords. A statistically significant difference was found between Group 1 and Group 3 only in the vertical diameter at the T4 and T9 levels. Conclusion: We observed that COPD effect TD location and also TD had opposite effect on anteroposteriorly increasing chest parameters in COPD. Precence of TD is essential on COPD patients about thorax anthropometry. Keywords: Tracheal diverticulum; antropometry; radiology; COPD; chest diameter

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The effect of administration of lycopene on interleukin 8 levels and hospitalization time of patients with chronic obstructive pulmonary disease exacerbations

Jurnal Kedokteran Syiah Kuala ◽

10.24815/jks.v20i1.18291 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yusup Subagio Sutanto ◽

Diana Kurniasari Sagita ◽

Suradi Suradi ◽

Hendra Kurniawan

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Treatment Group ◽

Pulmonary Disease ◽

Standard Therapy ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Chronic Inflammatory Response ◽

Consecutive Sampling ◽

Hospitalization Time

Abstrak. Latar Belakang: Eksaserbasi pada penyakit paru obstruktif kronik merupakan kondisi akut yang ditandai dengan hambatan aliran udara yang persisten dari respon inflamasi kronik yang berlebihan pada saluran napas dan parenkim paru yang disebabkan oleh paparan gas atau partikel berbahaya. Peningkatan peradangan saluran napas selama eksaserbasi menyebabkan peningkatan kadar IL-8 dan risiko rawat inap. Likopen merupakan karotenoid yang memiliki efek positif pada sistem pernapasan. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian likopen terhadap kadar IL-8 dan lama rawat inap pasien PPOK eksaserbasi akut.Metode: Uji eksperimental dengan desain pretest dan posttest pada 30 pasien PPOK eksaserbasi di RSUD Dr. Moewardi, Surakarta dan RSUD Dr. Soehadi Prijonegoro, Sragen dilakukan pada bulan Februari-Maret 2018. Pengambilan sampel secara consecutive sampling dibagi menjadi dua kelompok yaitu kelompok perlakuan yang mendapat terapi standar dan likopen 1x10 mg/hari selama pengobatan dan kelompok kontrol hanya mendapat terapi standar. Dilakukan pengukuran kadar IL-8 dan waktu rawat inap pasien dengan PPOK eksaserbasi.Hasil: Terdapat perbedaan yang bermakna antara kelompok perlakuan dibandingkan dengan kelompok kontrol untuk penurunan IL-8 (p = 0,029) dan penurunan waktu rawat inap (p = 0,000).Kesimpulan: Pemberian likopen 1x10 mg / hari secara signifikan menurunkan kadar IL-8 dan lama rawat inap pasien eksaserbasi PPOK.Kata kunci: eksaserbasi akut, kadar IL-8, lama rawat inap, likopen, PPOK.Abstract. Background: Exacerbated chronic obstructive pulmonary disease is an acute condition, characterized by persistent air flow limitations, related to the excessive chronic inflammatory response in the airways and lung parenchyma caused by exposure to harmful gases or particles. Increased airway inflammation during exacerbations leads to increased levels of IL-8 and the risk of hospitalization. Lycopene is a carotenoid which has a positive effect on the respiratory system. The purpose of this study was to determine the effect of administration lycopene to IL-8 levels and hospitalization time of patients with COPD disease exacerbations.Methods: The experimental test with pretest and posttest design for 30 patients with COPD exacerbations in Dr. Moewardi Surakarta Hospital and Dr. Soehadi Prijonegoro Sragen Hospital was conducted from February to March 2018. Samples were taken by consecutive sampling divided into two groups including the treatment group receiving standard therapy and lycopene 1x10 mg / day during treatment and the control group only receiving standard therapy. IL-8 levels and hospitalization time of patients with COPD disease exacerbations were measured.Results: There were significant differences between the treatment group compared to the control group for a decrease in IL-8 (p = 0.029) and a decrease in hospitalization time (p = 0,000).Conclusion: The administration of lycopene 1x10 mg / day significantly reduce IL-8 levels and hospitalization time of patient with COPD exacerbations.Keywords: lycopene, COPD, acute exacerbation, IL-8 level, hospitalization time

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PENGARUH PEMBERIAN INHALASI KOMBINASI SALMETEROL/FLUTIKASON PROPIONAT TERHADAP KUALITAS HIDUP PENDERITA PENYAKIT PARU OBSTRUKTIF KNONIK STABIL

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.88 ◽

2019 ◽

Vol 1 (2) ◽

pp. 28-33

Author(s):

Refi Sulistiasari

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Treatment Group ◽

Control Group ◽

Copd Assessment Test ◽

Copd Patients ◽

Significant Difference ◽

Inhaled Therapy ◽

St George's Respiratory Questionnaire

It is known that inflammation is the underlying cause of COPD, and this affects to quality of life of the patient. Provision of inhaled therapy combination of LABA and corticosteroids is one of therapy in pharmacology of stable PPOK patients. The aim of this study was to know the benefits of inhalation of 50 mg / fluticasone propionate 500 mg inhibition in stable COPD patients. The research design is clinical trial. The study was conducted for 3 months and was performed on 26 stable COPD patients divided into two groups: 15 patients for the treatment group and 15 patients for the control group. After the measurements were obtained, there was a significant difference in the quality of life as measured by St. George's Respiratory Questionnaire (SGRQ) (p = 0.001) and COPD Assessment Test (CAT) (0.001) measurements were made twice on the first and thirtieth days.

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Effect on Ubiquinone MDA Level of Plasma, FEV1% and CAT Score Stable COPD Patients

Jurnal Respirologi Indonesia ◽

10.36497/jri.v38i3.3 ◽

2018 ◽

Vol 38 (3) ◽

pp. 143-149

Author(s):

Ardorisye Fornia ◽

Suradi Suradi ◽

Aphridasari Aphridasari

Keyword(s):

Treatment Group ◽

Outpatient Clinic ◽

The Body ◽

Control Group ◽

Oxidation Stress ◽

Copd Patients ◽

Significant Difference ◽

Post Test ◽

Additional Therapy ◽

Expiratory Air

Background: Oxidation stress showed clinical evidence of increased in patients with COPD and contribute functionally to expiratory air flow resistance, so the body requires exogenous antioxidants to inhibit oxidative stress. This study was conducted to assess whether there is influence on levels of MDA plasma ubiquinone, FEV1% and patients with stable COPD CAT score. Methods: This study is a clinical trial experimental with pretest and post-test design which aims to determine the effect of plasma MDA, FEV1% and patients with stable COPD CAT score. Subjects consist of 30 patients with stable COPD who came to Pulmonary outpatient clinic of Moewardi hospital Surakarta during June to August 2016. The sample was taken by consecutive sampling. Subjects were divided into two group, the treatment group (n=15) received additional therapy ubiquinone 1x150mg/day and the control group (n=15) received standard therapy. MDA plasma levels, FEV1% and CAT scores were measured at the time of control pulmonary outpatient clinic. Results: Giving ubiquinone can significantly lower CAT score better in the treatment group compared to the control group. There were no statistically significant difference (p=0.744) in plasma MDA treatment group (1.37 ± 0.11) compared to controls (1,39 ± 0.16). There were no statistically significant difference between (p=0.276) the decline in FEV1% treatment group (43.28 ± 20.59) and the control group (36.01 ± 14.73). Conclusion : The use of Ubiquinone in decreasing CAT score for stable COPD patients. There was lowering effect in MDA plasma but there was no excalation value in FEV1%.

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