• Tuberculosis and Respiratory Diseases
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• v.56 no.5
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• pp.536-541
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• 2004

Streptococcus pyogenes 는 지역 사회 폐렴의 드문 원인균으로 독감, 홍역, 만성 폐쇄성 폐질환등의 합병증으로 대부분 발생하고 진행 경과가 빠르며, 고령 및 패혈증을 동반한 경우 특히 사망률이 높다고 알려져 있다. 저자들은 만성 폐쇄성 폐질환 환자에서 균혈증을 동반한 Streptococcus pyogenes 폐렴 1 예를 보고한다.

• The Monthly Diabetes
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• s.123
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• pp.42-43
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• 2000

• The Korean Chronic Disease News
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• no.33
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• pp.7.1-7.1
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• 1983

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.311-318
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• 1994

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.782-785
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• 2006

Chronic pulmonary obstructive disease is known to be a significant risk factor for mortality in patients who under-went operation for abdominal aortic aneurysm. To decrease perioperative respiratory complication in these patients, maintenance of self respiration as possible is one of the better method. A seventy-seven year old male patient complained of abdominal pain and he was diagnosed for 9 cm sized abdominal aortic aneurysm. But he had severe chronic obstructive pulmonary disease which was expected to increase surgical mortality. So we introduced epidural anesthesia with maintenance of self respiration and performed surgical resection and graft replacement of abdominal aorta, and he recovered without any complication.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.346-352
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• 2007

Background: Pulmonary hypertension is one of the cardiovascular complications of in COPD. However, a diagnosis of pulmonary hypertension requires an invasive test, such as right heart catheterization. NT-proBNP is a cardiac hormone that is elevated when a cardiac volume or pressure overload is present. It was hypothesized that NT-proBNP might play a role in detecting of pulmonary hypertension in COPD patients. Method: The 31 COPD patients, who underwent all of NT-proBNP, echocardiography, and spirometry in Seoul National University Bundang Hospital during the period from November 2003 to July 2005, were retrospectively analyzed. Result: Of the 31 COPD patients, 9 patients had pulmonary hypertension. A significant positive correlation was observed between the NT-proBNP and pulmonary arterial pressure (r=0.589, p=0.002). However, there was no significant correlation observed between the $FEV_1$ and NT-proBNP and $FEV_1$ and pulmonary arterial pressure. Conclusion: NT-proBNP might indicate the presence of pulmonary hypertension in COPD patients.

• Journal of Veterinary Clinics
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• v.27 no.2
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• pp.194-197
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• 2010

A 14-year-old gelded dressage horse weighing 500 kg was presented to the Equine Medical Center of the Seoul Racecourse of Korea Racing Authority (KRA) due to coughing and mucopurulent nasal discharge. The horse was initiated with empirical antibiotic in the first place. However, the clinical signs did not improve but were rather exacerbated even after 3 weeks of therapy. Extensive diagnostic procedures including transtracheal wash (TTW) fluid cytology were undertaken. The localized wheezes and crackles were auscultated and an increase in the amount of mucopurulent exudate in trachea was observed at endoscopy. Infiltration of neutrophils was observed in the TTW fluid cytology implying chronic obstructive pulmonary disease (COPD). Therefore, the systemic glucocorticoid therapy was to be given for 3 weeks with improved ventilation provided at the same time. The respiratory symptoms started to improve in 7 days of therapy and were fully resolved by when the therapy was terminated. The horse is clinically normal now and being monitored for development of any signs of chronic obstructive pulmonary disease.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.386-394
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• 2003

Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.213-219
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• 1988

In the geriatric patient with COPD, incidence of postoperative pulmonary complication is higher than young patient. Therefore, some anesthesiologists preferred spinal anesthesia to general anesthesia for surgery of the perineum, lower extrimities, and pelvic extra peritoneal organs. But, during spinal anesthesia, the same careful observation is requiered as during general anesthesia. We experienced a case of the convulsive seizure at about 1 hour after spinal anesthesia for open prostatectomy in a 76-year-old male patient wit COPD. It was suspected that his convulsive seizure be resulted from hypercapnea combined with hypoxia following upper airway obstruction. This patient was treated successfully by ultrashort acting barbiturate and controlled ventilation.

• 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.