• Title/Summary/Keyword: 만성호흡기질환

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Skeletal Muscle Dysfunction in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 골격근 기능 이상)

  • Kim, Ho-Cheol;Lee, Gi-Dong;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.3
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    • pp.125-139
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    • 2010
  • Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.

Outbreak of Bovine Viral Diarrhea Virus in Korean Indigenous Calf (한우송아지에서 소 바이러스성 설사병 바이러스 발생)

  • Song, Moo-Chan;Choi, Kyoung-Seong
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.578-581
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    • 2009
  • A 25-day-old, Korean indigenous calf was presented with a 10 days history of respiratory disorders and bloody diarrhea, and died. This calf was extremely unthrifty compared to others and had evidence of chronic diarrhea based on matting of feces in the hair of the tail and perineum. Ecchymotic hemorrhages were observed on multiple organs at necropsy. Bovine viral diarrhea virus (BVDV) infection was identified by RT-PCR. The phylogenetic analysis showed that this case belonged to BVDV-2a subgroup and was related to highly pathogenic USA isolate 890 (U18059). This case provided evidence for circulation of BVDV-2 in Republic of Korea. The occurrence of BVDV-2 was also reconfirmed.

Physiological Functional Status and the Levels of Unmet Care Needs after Discharge in Patients with Chronic Pulmonary Disease, Colorectal Cancer, and Strokes (퇴원환자의 신체적 기능상태 및 미충족 간호요구도: 만성호흡기질환, 장루보유 대장암, 뇌졸중 환자를 중심으로)

  • Oh, Eui Geum;Sung, Ji Hyun;Park, Young-Su;Lee, Hyun Joo;Kim, Yu Kyung
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.194-204
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    • 2016
  • Purpose: The purpose of this study was to identify physiological functional status and unmet care needs among patients with chronic pulmonary disease, colorectal cancer, and strokes after discharge. Methods: A crosssectional study was conducted with 224 patients diagnosed with aforementioned diseases from January to July in 2014 in two different tertiary hospitals in Seoul and its suburban area. Physiological functional status and unmet care needs were collected using Karnofsky Performance Status (KPS) Scale and Problems After Discharge Questionnaire-English version(PADQ-E) respectively. Data were analyzed using SPSS/WIN 21.0 program. Results: Patients with chronic pulmonary disease and colorectal cancer showed a low level of physiological functional status (mean: 77.20 and 77.60 out of 100 respectively) and a high level of unmet care needs (mean 2.23 and 2.63 out of 4 respectively). Stroke patients showed a high level of unmet care needs in the category of 'counseling', 'physical complaints', and 'instructions'. Physiological functional status was significantly associated with unmet care needs in all three patient groups and it showed a significant effect on unmet care needs in patients with stroke. Conclusion: The results showed that patients after discharge were still having insufficient functional status and various unmet care needs. The results of this study suggest a development of nursing care service for patients with chronic diseases after discharge.

The Effect of Respiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease - Preliminary Study - (만성 폐쇄성 폐질환 환자에 있어서 호흡근육 훈련의 효과에 관한 실험적 연구)

  • Kim Mae-Ja
    • Journal of Korean Academy of Nursing
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    • v.16 no.1
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    • pp.55-66
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    • 1986
  • The effect on strength and endurance training (SET) (2 patients) were compared with those of strength training(ST) (2 patients) in patients with-chronic obstructive pulmonary disease. The result of training was assessed by 4 tests: maximal inspiratory pressure(PImax), sustainable inspiratory pressure (SIP), maximal voluntary ventiiation(MVV) and bronchitis-emphysema symptom checklist(BESC). Measurements were repeated before and after training per week for 6 weeks. The SET group performed inspiratory muscle training, using a inspiratory muscle trainer 30 minutes per day, 6 days per week and performing endurance training-12-minute walking-2 days per week for 6 weeks, whereas the ST-only group trained for 30 minutes daily, 6 days per week using inspiratory muscle trainer. SET was no significant increase in exercise performance, whereas ST produced an increase in SIP and a decrease in BESC. There was significant change in BESC betweet the two groups. A simple at home training program using inspiartory muscle trainer was more effective than that of SET program in improving exercise performance of some patients with COPD.h COPD.

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A Case of Acute Eosinophilic Pneumonia (급성 호산구성 폐렴 1예)

  • Lee, Ki-Hoon;Cho, Chul-Ho;Koh, Kwang-Kon;Moon, Tai-Hoon;Jang, Dong-Seob;Park, Chan-Sup;Kim, Jin-Joo;Kim, Joon-Mee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.99-104
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    • 1995
  • Most cases of eosinophilic pneumonia reported previously have followed a chronic course. The case presented here was acute in onset, suggesting a acute eosinophilic pneumonia. A model of criteria for acute and chronic eosinophilic pneumonia was made by Umeki in 1992. A previously healthy young man presented with cough, sputum, fever, and multiple small nodules on the chest radiograph. We confirmed eosinophilic pneumonia with bronchoalveolar lavage analysis and transbronchial lung biopsy. This case examplifies the recently descrived acute eosinophilic pneumonia.

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Acute and Chronic Eosinophilic Pneumonia; Clinical and Laboratory Findings (급성 및 만성 호산구성 폐렴의 임상적 고찰)

  • Hyun, D.S.;Yeo, D.S.;Kim, J.W.;Lee, S.H.;Lee, S.Y.;Kim, S.C.;Seo, J.Y.;Song, S.H.;Kim, C.H.;Moon, H.S.;Song, J.S.;Park, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.795-804
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

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Clinical Characteristics of Elderly Patients with Pulmonary Tuberculosis (고령자 폐결핵에 대한 임상적 관찰)

  • Kim, Chung-Tae;Um, Hye-Suck;Lee, Hyang-Ju;Rhu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.432-440
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    • 2000
  • Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

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Flexible Bronchoscopic Findings and Therapeutic Effects in Atelectasis of Children (소아 무기폐에서 굴곡성 기관지내시경 소견 및 치료적 유용성)

  • Shin, Mee Yong;Hwang, Jong Hee;Chung, Eun Hee;Moon, Jeong Hee;Lee, Ju Suk;Park, Yong Min;Ahn, Kang Mo;Lee, Sang Il
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1090-1096
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    • 2002
  • Purpose : We evaluated the clinical manifestations, bronchoscopic findings and therapeutic effects of flexible fiberoptic bronchoscopy in atelectasis of children. Methods : Sixty six children who received bronchoscopy due to persistent atelectasis, acute severe atelectasis and incidental atelectasis on plain chest radiography were studied retrospectively. Results : The most common causative underlying disease was pneumonia(60.4%). Other underlying conditions were pulmonary tuberculosis, chronic lung disease, postoperative state, bronchial asthma and chest trauma. The most common abnormal findings were inflammatory changes such as bronchial stenosis(n=15), mucosal edema and large amount of secretion(n=14), granulation tissue( n=3) and mucus plug(n=3) although 39.4% showed normal airways. Other findings were congenital airway anomalies, endobronchial tuberculosis, extrinsic compression and obstruction by blood clot. In 32 children with pneumonia-associated atelectasis, 43.7% revealed normal airways, and the most common abnormal findings were also inflammatory changes. Eighteen out of 39 patients who received therapeutic intervention such as suctioning of secretion, bronchial washing and intrabronchial administration of N-acetylcysteine($Mucomyst^{(R)}$) had complete or partial resolution of their atelectasis. In 32 patients with pneumonia-associated atelectasis, 56.5% showed improvement by therapeutic intervention. Conclusion : In this study, atelectasis was mainly associated with inflammatory airway diseases such as pneumonia. The most common abnormal bronchoscopic findings were inflammatory changes such as mucosal edema and large amounts of secretion and bronchial stenosis, although about 40% revealed normal airway. Flexible bronchoscopy is helpful for either diagnosis or treatment, especially in pneumonia-associated atelectasis.

Assessment of Abnormality in Skeletal Muscle Metabolism in Patients with Chronic Lung Desease by $^{31}P$ Magnetic Resonance Spectroscopy ($^{31}P$ 자기 공명분석법을 이용한 만성 폐질환 환자에서의 골격근대사 이상에 관한 연구)

  • Cho, Won-Kyoung;Kim, Dong-Soon;Lim, Tae-Hwan;Lim, Chae-Man;Lee, Sang-De;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.583-591
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    • 1997
  • The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolic changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation, early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. $^{31}P$ MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p < 0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.

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Verification of the effect of Potentillae Chinensis Chinensis Herba extract and bioconversion fraction on chronic respiratory diseases (위릉채 추출물 및 생물전환 분획물의 만성호흡기 질환 효과 검증)

  • Dong-Hee Kim;Bo Ae Kim;Yun-Hwan Kang
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.6
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    • pp.1454-1463
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    • 2023
  • Evaluating the antioxidant efficacy using Potentillae Chinensis Herba extract, the anti-inflammatory efficacy was tested in respiratory mucosal epithelium, RAW264.7 cells, and zebrafish. As a result, antioxidant activity increased in a concentration-dependent manner in DPPH free radical scavenging and ABTS+ cation radical activities. As a result of MTT assay for cell experiments, the survival rate of NCI-H292 cells was reduced to less than 70% when treated at each concentration of 100 ㎍/ml, subsequent experiments were conducted at 50 ㎍/ml. Anti-inflammatory efficacy evaluation, NO production, TNF-𝛼, IL-1𝛽, and PGE2 decreased, and COX-2 also decreased significantly at 50 ㎍/ml. The mucin protein expression of Potentillae Chinensis Herba extract and bioconverted extract, it was observed that MUC5AC expression was significantly reduced. In the zebrafish toxicity evaluation, concentrations below 50 ㎍/ml did not show embryotoxicity and showed anti-inflammatory efficacy by reducing NO production due to LPS. The above results are valid to be valuable for use as a functional material that suppresses inflammation by helping the expression of Potentillae Chinensis Herba's respiratory mucus proteins.