• Title/Summary/Keyword: Bronchodilator

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Study of Instruments for Assessment and Clinical Research Trends in Common Cold (감기 임상연구의 최신 동향 및 평가도구에 관한 연구)

  • Yang, Su-Young;Byun, Jun-Seop;Hwang, Ji-Ho;An, Joung-Jo;Hong, Kweon-Eey;Kang, Wee-Chang;Lee, Yong-Koo;Park, Yang-Chun
    • The Journal of Korean Medicine
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    • v.29 no.2
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    • pp.165-181
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    • 2008
  • Objectives: This study was conducted to help clinical studies for treating the common cold with Oriental medicine. We inspected tendencies of clinical studies of the common cold in western medicine and analyzed the assessing instruments for it by scrutinizing PubMed publications for the last five years. Materials and Methods: We inspected 32 theses and scrutinized their objectives, periods, participants, materials and methods, the instrument of assessment for the studies, and validity, reliability, criteria and symptom score for questionnaires, results and JADAD score. Results: 1. The median for total period of study was 7 months, the median for days of treatment was 7.5, and most studies were carried out during the winter/spring period, because of the enhanced risk of cold infections. 2. The studies focused on unorthodox medicines or new drug products, such as antipyretic analgesics (e.g. paracetamol), decongestant and bronchodilator (e.g. ephedrine), echinacea, antioxidants (e.g. zinc), probiotic bacteria and so on. 3. All theses except one had subjectscomposed of cold patients who were infected naturally. The median number of subjects for final analysis was 187. 4. 27 studies used survey as the instrument of assessment. Among these, only one thesis was verified for validity. 5. The mean of JADAD score was 4.41, suggesting most of theses of worth. 7 studies were assessed as ineffective. Conclusion: Recent studies of the common cold are focused on unorthodox medicines or new drug products, and it is necessary to provide an objective instrument for assessing common cold treatments.

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Relationship of Knowledge about Disease, Illness Attitude, and Quality of Life for Patients with Chronic Obstructive Pulmonary Disease(COPD) (만성 폐쇄성 폐질환자의 질병관련 지식, 질병태도, 삶의 질에 관한 연구)

  • Bang, Yun Yi;Park, Hyojung
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.410-422
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    • 2017
  • The purpose of this study was to investigate the correlation between knowledge related to disease(KRD), illness attitude, and quality of life(QOL) in relation to the Chronic Obstructive Pulmonary Disease(COPD). According to the study result, there were significant differences with regard to KRD in accordance with subjects' education, monthly income, mMRC(modified Medical Research Council) Dyspnea Scale, inhaled bronchodilator and antibiotic treatment. In addition, there were significant differences with respect to illness attitude according to monthly income and mMRC. In case of the QOL, there were significant differences in accordance with age, marital status, monthly income, inpatient status, history of hospital admission, oxygen use, comorbidity, mMRC, and inhaled steroid. It has shown that there was a significant correlation between KRD and QOL(r=-.438, p<.001), illness attitude and QOL(r=.279, p=.001). Thus, it is important to grasp monthly income and mMRC, which are correlated with the three elements in common. As per assessment about COPD patients in the clinical situation, it is necessary to develop a multi-disciplinary approach, health coaching program for improving KRD and having a positive attitude based on the low-income group with taking interest in the circumstances of mMRC as well as objective test results.

Radioaerosol Inhalation Imaging in Bronchial Asthma (기관지 천식의 연무흡입 폐환기스캔 소견)

  • Kim, Bum-Soo;Park, Young-Ha;Park, Jeong-Mi;Chung, Myung-Hee;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.46-52
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    • 1991
  • Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and simple application system. To evaluate its clinical utility in the study of impaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical college, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a BARC(Bhabha Atomic Reserch Center, India) nebulizer with 15 mCi of $^{99m}Tc-phytate$. The scanning was peformed in anterior, posterior and lateral projections following 5-minute inhalation of radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusion image with $^{99m}Tc-MAA$. Follow-up scans were obtained in 5 patients after bronchodilator therapy. The patients were divided into (1) attack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bronchial wall and accentuation of basal interstitial markings in 26 of the 31 patients. Chest radiographs were norma! in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Broomstick sign was present in 17 patients. The abnormality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abnormality and the effect of treatment with bronchodilators in patients with bronchial asthma.

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Radioaerosol Inhalation Lung Scan in Pulmonary Emphysema (폐기종의 연무흡입 폐환기스캔 소견)

  • Jeon, Jeong-Su;Park, Young-Ha;Chung, Soo-Kyo;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.229-236
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    • 1990
  • Perfusion and ventilaion imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonry emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebulizer with 15 mCi of Tc-99m-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to 10-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with $^{99m}Tc-MAA$ was performed in 12 patients. In five patients, we performed follow-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was diffuse (6/21), discrete(6/21), intermediate (3/21), or combined (6/21). In 12 patients studied also with perfusion scans, perfusion defects matched closely with ventilation defects in location and configuration. But the size of the ventilation defects was generally larger than the perfusion defects. In all four patients treated with bronchodilators, the follow-up study demonstrated decrease in abnormal of radioaerosol deposition in the central airway with improvement of ventilation defects. RII was useful technique for the evaluation of regional ventilatory abnormality and the effects of treatment with bronchodilators in pulmonary emphysema.

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Polymorphisms of Angiotensin-converting Enzyme Gene Associated in Patients with COPD with or without Bronchial Hyperresponsiveness (만성폐쇄성폐질환에서 ACE 유전자 다형성과 기관지 과민성의 연관성)

  • Kim, Seung Soo;Choi, Eu Gene;Park, Seoung Ju;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.25-30
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    • 2005
  • Background : An insertion-deletion polymorphism of angiotensin converting enzyme (ACE) gene has been shown to be associated with enzyme activity levels of ACE. Reported results that have been mutually contradictory about asthmatic hypersensitiveness and occurrence according to ACE gene insertion (I)/deletion (D) polymorphism. Also, the involvement of the ACE genes as the genetic basis of bronchial asthma is currently controversy. We investigated whether there was any association between polymorphisms of the ACE genes and airway hyper-responsiveness in chronic obstructive pulmonary disease (COPD). Methods : A total of 100 patients with COPD were enrolled in this study. The ACE genotypes were determined in all subjects by polymerase chain reaction. Pulmonary function test including bronchodilator response (BDR), methacholine bronchial provocation test (MBPT) were done in those patients. Airway hyper-responsiveness include any findings of positive BDR or MBPT. Results : In COPD patients, the ACE genotype distribution did not differ significantly among groups of patients with severities of COPD, and with or without airway hyper-responsiveness. Conclusions : These results suggest that polymorphisms of the ACE gene may not be associated with airway hyper-responsiveness, development and severity of COPD.

Clinical Features of Chronic Obstructive Pulmonary Disease with High Fractional Exhaled Nitric Oxide

  • Ahn, Seong;Kim, Tae-Ok;Chang, Jinsun;Shin, Hong-Joon;Kwon, Yong-Soo;Lim, Sung-Chul;Kim, Yu-Il
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.234-241
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    • 2020
  • Background: The fractional exhaled nitric oxide (FENO) test is useful in asthma patients. However, a few studies on its usefulness in chronic obstructive pulmonary disease (COPD) patients have been reported. We analyzed the FENO level distribution and clinical characteristics according to the FENO level in COPD patients. Methods: From December 2014 to June 2019, COPD patients who underwent pulmonary function and FENO tests at Chonnam National University Hospital were retrospectively evaluated for FENO, comorbidities, asthma history, blood eosinophil, and pulmonary function test. The high FENO group was defined as those with FENO level>25 parts per billion (ppb). Results: A total of 849 COPD patients (mean age, 70.3±9.4 years) were included. The mean forced expiratory volume at 1 second was 66.5±21.7% and the mean FENO level was 24.3±20.5 ppb. Patients with FENO ≤25 ppb were 572 (67.4%) and those with FENO >25 ppb were 277 (32.6%). Blood eosinophil percentage was significantly higher (4.2±4.8 vs. 2.7±2.5, p<0.001) in patients with the high FENO group than the low FENO group. The high FENO group revealed a significantly higher frequency of patients with blood eosinophil percentage >3% (46.9% vs. 34.8%, p=0.001) and asthma history (25.6% vs. 8.6%, p<0.001) than the lower FENO group. Asthma history, blood eosinophil percentage >3%, and positive bronchodilator response (BDR) were independent risk factors for the high FENO level (adjusted odds ratio [aOR], 3.85; p<0.001; aOR, 1.46; p=0.017; and aOR, 1.57, p=0.034, respectively) in the multivariable analysis. Conclusion: The FENO level distribution varied in COPD patients and the mean FENO value was slightly elevated. Asthma history, eosinophil percent, and positive BDR were independent risk factors for the high FENO level.

Lung Function Trajectory Types in Never-Smoking Adults With Asthma: Clinical Features and Inflammatory Patterns

  • Kim, Joo-Hee;Chang, Hun Soo;Shin, Seung Woo;Baek, Dong Gyu;Son, Ji-Hye;Park, Choon-Sik;Park, Jong-Sook
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.614-627
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    • 2018
  • Purpose: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. Methods: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. Results: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. Conclusions: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels.

Influencing Factors of Peripheral Blood Lymphocyte subsets in Workers with Chronic Obstructive Pulmonary Disease Exposed to Inorganic Dust (만성폐쇄성폐질환을 동반한 무기분진 노출 이직근로자의 혈중 림프구 아형분포에 미치는 영향요인)

  • Baek, Jin Ee;Shin, Jae Hoon;Hwang, Joo Hwan;Lee, Youlim;Lee, Jong Seong;Choi, Byung-Soon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.3
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    • pp.286-293
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    • 2021
  • Objectives: Inorganic dust is known to be a risk factor for chronic obstructive pulmonary disease (COPD) regardless of smoking and pneumoconiosis. Adaptive and innate immunity, including lymphocyte infiltrate, are involved in the pathogenesis of COPD. The purpose of this study was to analyze the lymphocyte subsets in the blood of workers exposed to inorganic dust and confirm the influencing factors. Methods: The general characteristics of the subjects (n=107) were analyzed through a personal questionnaire. Diagnosis of COPD was established according to pulmonary function tests with FEV1/FVC post bronchodilator lower than 70%, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. For lymphocyte analysis, blood was stained with a fluorescent CD marker and analyzed by flow cytometry. Results: The increase in CD4+ T lymphocytes was associated with a decrease in age (𝛽=-0.273, p=0.008) and an increase in the cumulative smoking amount (𝛽=0.205, p=0.034). The increase in NK cells was associated with an increase in age (𝛽=0.325, p=0.001) and a decrease in cumulative smoking (𝛽=-0.220, p=0.019). The period of exposure to dust, %FVC predicted and %FEV1/FVC, and the relative population of peripheral blood lymphocytes did not show a statistically significant relationship. Conclusions: CD4+ T lymphocytes and CD56+CD16+ NK cells in peripheral blood were more related to age and cumulative smoking than the duration of dust exposure. Age and smoking are major risk factors for the development of COPD, so it can be predicted that peripheral blood CD4+ T lymphocytes and CD56+CD16+ NK cells are related to the development of COPD in workers exposed to inorganic dust.

Inflammation and Oxidative Stress as related to Airflow Limitation Severity in Retired Miners with Chronic Obstructive Pulmonary Disease (광산 이직근로자의 만성폐쇄성폐질환 기류제한 중증도와 염증 및 산화스트레스)

  • Lee, Jong Seong;Shin, Jae Hoon;Baek, Jin Ee;Jeong, Ji Yeong;Choi, Byung-Soon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.2
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    • pp.251-258
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    • 2019
  • Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Inflammation and oxidative stress are associated with COPD. The aim of this study was to evaluate the relationship among inflammation, oxidative stress, and airflow limitation severity in retired miners with COPD. Methods: The levels of serum high-sensitivity C-reactive protein(hsCRP) as a biomarker for inflammation, degree of reactive oxygen metabolites(dROMs) and biological antioxidants potential(BAP) in plasma as biomarkers for oxidative stress were measured in 211 male subjects with COPD. Degree of airflow limitation severity as determined by spirometry was divided into three grades grouped according to the classification of the Global Initiatives for Obstructive Lung Disease(GOLD)(1, mild; 2, moderate; $3{\leq}$, severe or more) using a fixed ratio, post- bronchodilator $FEV_1/FVC$ < 0.7. Results: Mean levels of dROMs significantly increased in relation to airflow limitation severity(GOLD 1, 317.8 U.CARR vs. GOLD 2, 320.3 U.CARR vs. GOLD $3{\leq}$, 350.9 U.CARR, p=0.047) and dROMs levels were correlated with serum hsCRP levels(r=0.514, p<0.001). Mean levels of hsCRP were higher in current smokers(non-smoker, 1.47 mg/L vs. smoker, 2.34 mg/L, p=0.006), and tended to increase with degree of airflow limitation severity(p=0.071). Mean levels of BAP were lower in current smokers(non-smoker, $1873{\mu}mol/L$ vs. smoker, $1754{\mu}mol/L$, p=0.006). Conclusions: These results suggest that inflammation and oxidative stress are related to airflow limitation severity in retired miners with COPD, and there was a correlation between inflammation and oxidative stress.

Development and Validation of an Analytical Method for β-Agonists in Livestock and Fishery Products Using LC-MS/MS (LC-MS/MS를 이용한 축·수산물 중 β-agonist계 시험법 개발 및 검증)

  • Lee, Tae Ho;Kim, Yu Ra;Park, Su Jeong;Kim, Ji Young;Choi, Jang Duck;Moon, Gui Im
    • Korean Journal of Environmental Agriculture
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    • v.41 no.2
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    • pp.135-151
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    • 2022
  • BACKGROUND: The β-agonists known as phenyl ethanolamine derivatives have a conjugated aromatic ring with amino group. They are used as tocolytic agents and bronchodilator to human and animal generally, and some of them are used as growth promoters to livestock. METHODS AND RESULTS: β-agonists in samples were extracted by 0.4 N perchloric acid and ethyl acetate. The target compounds were analyzed by liquid chromatography-electrospray tandem mass spectrometry (LC-ESI-MS/MS). Validation of method was performed according to CODEX guidelines (CAC/GL-71). The matrix matched calibration gave correlation coefficients>0.98, and the obtained recoveries were in the range of 62.0-109.8%, with relative standard deviation ≤ 20.1%. In addition, a survey was performed to inspect any residual β-agonist from 100 samples of livestock and fishery products and ractopamine was detected in one of the 100 samples. CONCLUSION(S): In this study, we established the analytical method for β-agonists through using the expanded target compounds and samples. And we anticipate that the established method would be used for analysis to determine veterinary drug residues in livestock and fishery products.