• Title/Summary/Keyword: COPD

Search Result 484, Processing Time 0.026 seconds

Clinical Evaluation of Spontaneous Pneumothorax - A Review of 830 Cases - (자연기흉의 임상적 고찰)

  • Gwon, U-Seok;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
    • /
    • v.21 no.2
    • /
    • pp.299-306
    • /
    • 1988
  • We have reviewed 330 cases of spontaneous pneumothorax from Jan. 1980 to Jul. 1987 at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. The ratio of male to female was 8.4:1, predominant in male. The incidence according to the age group was highest as 32% in the adolescence between 21 and 30 years old. The site of pneumothorax was right in 48%, left in 45% and bilateral in 7%. The initial symptoms were frequently dyspnea in 85%, chest pain in 63%. The etiologic factors were as follows; bleb origin in 31%, tuberculous origin in 30%, COPD in 3.3%, lung cancer in 1.5%, unknown in 29%. There was no significant difference in seasonal incidence irrespective of tuberculous or sex. The employed managements were as follows; bed rest with oxygen inhalation in 4 cases, closed thoracostomy in 326 cases, open thoracotomy in 122 cases, median sternotomy in 23 cases. The operative procedures at thoracotomy were as follows; simple pleurodesis in 5 cases, bleb excision or wedge resection in 113 cases, segmentectomy or lobectomy in 17 cases, decortication in 42 cases. Recurrence rate of each treatment was as follow; 50% in conservative treatment, 19% in closed thoracostomy, 2% in open thoracotomy, 4% in median sternotomy. Therefore overall recurrence rate was 12%. Open thoracotomy was the most effective procedure in recurrent pneumothorax, previous contralateral pneumothorax, bilateral simultaneous pneumothorax, visible bleb or bullae on the chest x-ray and persistent air leakage. 23 cases of unilateral spontaneous pneumothorax was examined whether or not underlying pathology of pneumothorax at opposite lung. 18 cases[78%] were positive findings. Therefore, bilateral thoracotomy by median sternotomy was a good operative method preventing contralateral pneumothorax.

How Does the Filter on the Mask Affect Your Breathing?

  • Kum, Dong-Min;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
    • /
    • v.10 no.4
    • /
    • pp.438-443
    • /
    • 2021
  • Objective: The purpose of this study was to determine the effect of the difference in mask filters on the respiration rate of healthy people. Design: A randomized cross-over design. Methods: A total of 15 subjects were selected for this study (n=15). After filling out the Physical Activity Readiness Questionnaire, the selected participants abstained from caffeinated beverages and meals 30 minutes before and sat in a chair 10 minutes before stabilizing their breathing. Afterwards, the lung function test was performed 3 times for each mask, and the maximum value was used. The provided masks were Mask Free, Dental Mask, KF80, and KF94. Exhalation was measured for 6 seconds for each mask, and breathing was stabilized by repeating inhalation and exhalation until the next time. Results: In this study, the difference in respiratory function according to the mask type was statistically significant except for FEV1 and FVC (p<0.05). As a result of post-hoc analysis, FVC, FEV1, PEF, and FEF values were significantly lower than those of the control group not wearing a mask (p<0.05). When wearing KF94, FVC, FEV1, PEF25-25%, and FEF were significantly lower than when wearing a dental mask (p<0.05). When wearing a KF80 mask, it was significantly lower in FVC and FEV1 than when wearing a dental mask (p<0.05). In FEV1/FVC, the difference by mask type was not statistically significant (p<0.05), but it was lower than the spirometry standard of COPD patients (FEV1/FVC<0.7). Conclusions: As Now that wearing a mask is essential, it has been confirmed that the mask affects the respiratory rate.Therefore, in the case of healthy adults, it is recommended to rest after wearing a mask if attention deficit or headache occurs. People with low breathing capacity are recommended to have low-intensity activities and frequent rest periods after wearing a mask.

Middle East Respiratory Syndrome Coronavirus-Encoded Accessory Proteins Impair MDA5-and TBK1-Mediated Activation of NF-κB

  • Lee, Jeong Yoon;Bae, Sojung;Myoung, Jinjong
    • Journal of Microbiology and Biotechnology
    • /
    • v.29 no.8
    • /
    • pp.1316-1323
    • /
    • 2019
  • Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly emerging coronavirus which is zoonotic from bats and camels. Its infection in humans can be fatal especially in patients with preexisting conditions due to smoking and chronic obstructive pulmonary disease (COPD). Among the 25 proteins encoded by MERS-CoV, 5 accessory proteins seem to be involved in viral evasion of the host immune responses. Here we report that ORF4a, ORF4b, and ORF8b proteins, alone or in combination, effectively antagonize nuclear factor kappa B ($NF-{\kappa}B$) activation. Interestingly, the inhibition of $NF-{\kappa}B$ by MERS-CoV accessory proteins was mostly at the level of pattern recognition receptors: melanoma differentiation-associated gene 5 (MDA5). ORF4a and ORF4b additively inhibit MDA5-mediated activation of $NF-{\kappa}B$ while that of retinoic acid-inducible gene 1 (RIG-I) is largely not perturbed. Of note, ORF8b was found to be a novel antagonist of MDA5-mediated $NF-{\kappa}B$ activation. In addition, ORF8b also strongly inhibits Tank-binding kinase 1 (TBK1)-mediated induction of $NF-{\kappa}B$ signaling. Taken together, MERS-CoV accessory proteins are involved in viral escape of $NF-{\kappa}B$-mediated antiviral immune responses.

Health-Promoting Behaviors, Health Literacy, and Levels of Knowledge about Smoking-Related Diseases among Smokers and Non-smokers: A Cross-Sectional Study

  • Celebi, Cihat;Calik-Kutukcu, Ebru;Saglam, Melda;Bozdemir-Ozel, Cemile;Inal-Ince, Deniz;Vardar-Yagli, Naciye
    • Tuberculosis and Respiratory Diseases
    • /
    • v.84 no.2
    • /
    • pp.140-147
    • /
    • 2021
  • Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

Korean Red Ginseng water extract inhibits cadmium-induced lung injury via suppressing MAPK/ERK1/2/AP-1 pathway

  • Mitra, Ankita;Rahmawati, Laily;Lee, Hwa Pyoung;Kim, Seung A.;Han, Chang-Kyun;Hyun, Sun Hee;Cho, Jae Youl
    • Journal of Ginseng Research
    • /
    • v.46 no.5
    • /
    • pp.690-699
    • /
    • 2022
  • Background: Few studies reported the therapeutic effect of Korean Red Ginseng (KRG) in lung inflammatory diseases. However, the anti-inflammatory role and underlying molecular in cadmium-induced lung injury have been poorly understood, directly linked to chronic lung diseases (CLDs): chronic obstructive pulmonary disease (COPD), cancer etc. Therefore, in this study we aim to investigate the therapeutic activities of water extract of KRG (KRG-WE) in mouse cadmium-induced lung injury model. Method: The anti-inflammatory roles and underlying mechanisms of KRG-WE were evaluated in vitro under cadmium-stimulated lung epithelial cells (A549) and HEK293T cell line and in vivo in cadmium-induced lung injury mouse model using semi-quantitative polymerase chain reaction (RT-PCR), quantitative real-time PCR (qPCR), luciferase assay, immunoblotting, and FACS. Results: KRG-WE strongly ameliorated the symptoms of CdSO4-induced lung injury in mice according to total cell number in bronchoalveolar lavage fluid (BALF) and severity scores as well as cytokine levels. KRG-WE significantly suppressed the upregulation of inflammatory signaling comprising mitogen-activated protein kinases (MAPK) and their upstream enzymes. In in vitro study, KRG-WE suppressed expression of interleukin (IL)-6, matrix metalloproteinase (MMP)-2, and IL-8 while promoting recovery in CdSO4-treated A549 cells. Similarly, KRG-WE reduced phosphorylation of MAPK and c-Jun/c-Fos in cadmium-exposed A549 cells. Conclusion: KRG-WE was found to attenuate symptoms of cadmium-induced lung injury and reduce the expression of inflammatory genes by suppression of MAPK/AP-1-mediated pathway.

Determining the incidence and risk factors for short-term complications following distal biceps tendon repair

  • Goedderz, Cody;Plantz, Mark A.;Gerlach, Erik B.;Arpey, Nicholas C.;Swiatek, Peter R.;Cantrell, Colin K.;Terry, Michael A.;Tjong, Vehniah K.
    • Clinics in Shoulder and Elbow
    • /
    • v.25 no.1
    • /
    • pp.36-41
    • /
    • 2022
  • Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

Influencing factors for Sleep Disturbance in the Intensive Care Unit Patients: A Systematic Review (중환자실 환자의 수면에 영향을 미치는 요인: 체계적 고찰)

  • Cho, Young Shin;Joung, Sunae
    • Journal of Korean Critical Care Nursing
    • /
    • v.16 no.2
    • /
    • pp.1-14
    • /
    • 2023
  • Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

Production of Spirometer 'The Spirokit' and Performance Verification through ATS 24/26 Waveform (휴대형 폐기능 검사기 'The Spirokit'의 제작 및 ATS 24/26파형을 통한 성능검증)

  • Byeong-Soo Kim;Jun-Young Song;Myung-Mo Lee
    • Journal of Korean Physical Therapy Science
    • /
    • v.30 no.3
    • /
    • pp.49-58
    • /
    • 2023
  • Background: This study aims to examine the useful- ness of the portable spirometer "The Spirokit" as a clinical diagnostic device through technology introduction, precision test, and correction. Design: Technical note Methods: "The Spirokit" was developed using a propeller-type flow rate and flow rate measurement method using infrared and light detection sensors. The level of agreement between the Pulmonary Waveform Generator and the measured values was checked to determine the precision of "The Spirokit", and the correction equation was included using the Pulmonary Waveform Generator software to correct the error range. The analysis was requested using the ATS 24/26 waveform recognized by the Ministry of Food and Drug Safety and the American Thoracic Society for the values of Forced Voluntary Capacity (FVC), Forced Expiratory Volume in 1second (FEV1), and Peak Expiratory Flow (PEF), which are used as major indicators for pulmonary function tests. All tests were repeated five times to derive an average value, and FVC and FEV1 presented accuracy and PEF presented accuracy as the result values. Results: FVC and FEV1 of 'The Spirokit' developed in this study showed accuracy within ± 3% of the error level in the ATS 24 waveform. The PEF value of 'The Spirokit' showed accuracy within the error level ± 12% of the ATS 26 waveform. Conclusion: Through the results of this study, the precision of 'The Spirokit' as a clinical diagnosis device was identified, and it was confirmed that it can be used as a portable pulmonary function test that can replace a spirometer.

Immunomodulatory Effects of Ambroxol on Airway Hyperresponsiveness and Inflammation

  • Katsuyuki Takeda;Nobuaki Miyahara;Shigeki Matsubara;Christian Taube;Kenichi Kitamura;Astushi Hirano;Mitsune Tanimoto;Erwin W. Gelfand
    • IMMUNE NETWORK
    • /
    • v.16 no.3
    • /
    • pp.165-175
    • /
    • 2016
  • Ambroxol is used in COPD and asthma to increase mucociliary clearance and regulate surfactant levels, perhaps through anti-oxidant and anti-inflammatory activities. To determine the role and effect of ambroxol in an experimental model of asthma, BALB/c mice were sensitized to ovalbumin (OVA) followed by 3 days of challenge. Airway hyperresponsiveness (AHR), lung cell composition and histology, and cytokine and protein carbonyl levels in bronchoalveolar lavage (BAL) fluid were determined. Ambroxol was administered either before the first OVA challenge or was begun after the last allergen challenge. Cytokine production levels from lung mononuclear cells (Lung MNCs) or alveolar macrophages (AM) were also determined. Administration of ambroxol prior to challenge suppressed AHR, airway eosinophilia, goblet cell metaplasia, and reduced inflammation in subepithelial regions. When given after challenge, AHR was suppressed but without effects on eosinophil numbers. Levels of IL-5 and IL-13 in BAL fluid were decreased when the drug was given prior to challenge; when given after challenge, increased levels of IL-10 and IL-12 were detected. Decreased levels of protein carbonyls were detected in BAL fluid following ambroxol treatment after challenge. In vitro, ambroxol increased levels of IL-10, IFN-γ, and IL-12 from Lung MNCs and AM, whereas IL-4, IL-5, and IL-13 production was not altered. Taken together, ambroxol was effective in preventing AHR and airway inflammation through upregulation of Th1 cytokines and protection from oxidative stress in the airways.

Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease- (가정산소치료의 보험급여 실시 이후 처방 실태: 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구-)

  • Park, Myung Jae;Yoo, Jee-Hong;Choi, Cheon Woong;Kim, Young Kyoon;Yoon, Hyoung-Kyu;Kang, Kyung Ho;Lee, Sung Yong;Choi, Hye Sook;Lee, Kwan Ho;Lee, Jin Hwa;Lim, Sung-Chul;Kim, Yu-Il;Shin, Dong Ho;Kim, Tae Hyun;Jung, Ki-Suck;Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
    • /
    • v.67 no.2
    • /
    • pp.88-94
    • /
    • 2009
  • Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.