• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.483-496
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• 1997

만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7.%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두 (100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명중 3명(23.1%)에만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되며 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성전환의 동반이 흔한 것으로 나타났다.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.329-336
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• 1997

만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두(100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명 중 3명(23.1%)에서만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되면 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성 전환의 동반이 흔한 것으로 나타났다.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.164-169
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• 2005

Background : The role of combination therapy of inhaled corticosteroid (ICS) plus long-acting ${\beta}_2-agonist$ (LABA) in asthma is well established, but nor much is known about this treatment in COPD. Recent studies have revealed that combining therapy is associated with fewer acute exacerbations in COPD, but in most of the studies, high-dose combination therapies have been employed. The current study assessed the effect of moderate or high-dose combination therapy of ICS plus LABA on the frequency of acute exacerbations in COPD. Methods : Between January 1, 2001 and August 31, 2004, 46 patients with COPD (moderate, severe, very severe) were enrolled who received either fluticasone/salmeterol (flu/sal) $250{\mu}g/50{\mu}g$ twice a day (group A) or flu/sal $500{\mu}g/50{\mu}g$ twice a day (group B) for more than a year. We divided them into two groups depending on the dosage of ICS plus LABA. Effect of drugs was compared based on the factors such as symptom aggravation, number of admission, and time to first exacerbation during a year after use. Results : Eleven of twenty-six patients in group A (42.3%) experienced acute exacerbation and eleven of twenty patients in group B (55%) experienced acute exacerbation during 1 year. Mean exacerbation rate of Group A was 0.96 and Group B was 1.05. Mean admission rate was 0.15 and 0.30, respectively. There was no statistically significant difference of aggravation rate, number of administration and time to first exacerbation between the two treatment groups. Conclusion : There was no significant difference between moderate and high dose combined inhaler therapy to reduce acute exacerbation in COPD patients (moderate, severe, very severe). Hence, the effective dose of combination therapy needs further study in patients with COPD.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.205-214
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• 2006

Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.

• The Journal of Bigdata
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• v.2 no.2
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• pp.115-128
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• 2017

Recently, Machine Learning Methods are widely used with high prediction performance. But if the limit of the data is solved by the statistical technique, It can, lead to higher prediction performance than the existing one. In this study, the SMOTE method is used to solve the imbalance problem in the longitudinal and imbalanced data. As a result, It, was confirmed that the prediction performance increases. Additionally, Although, studies on COPD have been actively conducted, only studies that are related to acute exacerbation have been conducted. So there are no studies on the prediction of acute exacerbation through multiple perspectives and predictive models for various factors. In this study, We examined the factors related to acute exacerbation of COPD and constructed a personalized specific disease prediction model.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.688-700
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• 2020

Purpose To compare the incidence, survival rate, and CT findings of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) between patients with and without lung cancer. Materials and Methods From June 2004 to July 2018, 89 consecutive patients diagnosed with IPF were included. Among them, 26 patients had IPF with lung cancer (IPF-LCA), and 63 patients had IPF alone. The clinical characteristics and CT findings associated with IPF, lung cancer, and AE were reviewed. Surgery and chemotherapy were performed for 6 and 23 cases of lung cancer, respectively, as the first- or second-line anticancer treatment. The overall survival, CT findings, disease-free period before AE, and duration from the onset of AE to death were compared. Results The incidence of AE was 61.5% in the IPF-LCA group and 58.7% in the IPF group (p = 0.806). The mean overall survival in the IPF-LCA and IPF groups were 16.8 and 83.0 months, respectively (p < 0.001). The mean durations from the start of the lung cancer treatment to the onset of AE were 16.0 and 4.6 months in cases of surgical treatment and chemotherapy, respectively. In comparison of death from AE, the survival rate was significantly lower in the IPF-LCA group than in the IPF group (p = 0.008). In the CT findings associated with AE, the IPF-LCA group tended to have a peribronchial (p < 0.001) or asymmetric distribution (p = 0.016). Conclusion In patients with IPF who develop lung cancer, the rate of death from AE is higher than that in patients with IPF alone. They tend to have unusual CT patterns associated with AE, such as a peribronchial or asymmetric distribution.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.152-159
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• 2005

Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the $NF-{\kappa}B$ is known to be an indicator of cellular activation and of inflammatory mediator production. This study was undertaken to investigate the change of cytokine characteristics and $NF-{\kappa}B$ activity in induced sputum of COPD patients during exacerbation and recovery of the disease. Methods : Sputum induction was performed in 37 patients with COPD during exacerbation and during recovery and in 15 healthy subjects. Cell counts, levels of IL-6, IL-8 and $TNF-{\alpha}$ in induced sputum and NF-kB activity in macrophage of induced sputum were measured. Results : Patients with COPD showed significantly increased levels of IL-6, IL-8 and $TNF-{\alpha}$(p<0.01) and increased $NF-{\kappa}B$ activity in induced sputum(p<0.05) as compared with control subjects. Level of IL-8 during exacerbation of COPD decreased significantly during recovery(p<0.05). $NF-{\kappa}B$ activity and levels of IL-6 and $TNF-{\alpha}$ tended to be decreased during recovery, but not siginificantly. Conclusion : Activation of $NF-{\kappa}B$ and increased levels of IL-6, IL-8 and $TNF-{\alpha}$ were thought to be associated with pathogenesis and exacerbations of COPD.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.420-430
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• 2002

Background : Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. Objectives ; The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods : We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results : There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusion : The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.

• 건강소식
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• v.36 no.11
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• pp.26-27
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• 2012

일교차가 큰 환절기나 추운 계절에 발생하는 급성편도염. 증상이 감기와 비슷해 많은 사람들이 방치하는 경우가 흔하다. 증상이 악화될 경우 심각한 합병증이 발생하기 때문에 현명한 자세로 대처하는 것이 중요하다.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.35-43
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• 2001

Background : The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during an asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. Method : A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age- and sex-matched subjects with stable asthma. Results : The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma($233{\pm}175\;pg/mL$) than in the 48 subjects with stable asthma($169{\pm}74\;pg/mL$). A trend toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids ($332{\pm}225\;pg/mL$) than in those who were not ($214{\pm}159\;pg/mL$) and higher levels were found in those admitted to the hospital ($275{\pm}212\;pg/mL$) than in those discharged after receiving only emergency treatment ($190{\pm}115\;pg/mL$). The eotaxin levels inversely correlated with the $FEV_$ (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent ($323{\pm}256\;pg/mL$) and severe persistent asthmatics ($276{\pm}170\;pg/mL$) than in mild intermittent asthmatics ($l60{\pm}60\;pg/mL$). Conclusion : Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.