• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.158-170
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• 2001

Background : Although an oxidants and antioxidants imbalance has been considered in the pathogenesis of chronic obstructive pulmonary disease (COPD), there is a paucity of reports focussing on the smoking-induced changes of oxidants and antioxidants in COPD. Method : The concentration of antioxidants (ascorbic acid, uric acid, retinol, and $\alpha$- & $\gamma$-tocopherol) was measured in the serum and induced sputum of 30 healthy controls and 34 stable COPD patients using high performance liquid chromatography (HPLC). The inhibition of lipid peroxidation as an index of antioxidant capacity was measured in the serum by a TBA assay. Results : The serum concentration of ascorbic acid, $\alpha$-tocopherol, and retinol were significantly lower in the patients with COPD than in healthy controls ($484.8{\pm}473.3$ vs $1497.8{\pm}819.2\;pmol/L$, $48.38{\pm}17.34$ vs $73.96{\pm}26.29\;pmol/L$, p<0.001, and $9.51{\pm}8.33$ vs $15.01{\pm}5.88\;pmol/L$, p<0.05, respectively, mean$\pm$SD). However, there were little differences in the ascorbic acid and uric acid concentrations in the induced sputum between the COPD patients and the controls. The induced sputum to serum ratio of ascorbic acid was significantly higher in COPD patients compared with healthy control (0.375 vs 0.085, p<0.05). In the normal controls, the serum ascorbic acid concentration was lower in smokers than in nonsmokers ($1073{\pm}536$ vs $1757{\pm}845\;pmol/L$, p<0.05), but the level was still higher than that of the COPD patients (p<0.05). The serum retinol levels were correlated with $FEV_1$ in COPD patients (r=0.58, p<0.05). The products of lipid peroxidation were increased in normal smokers and COPD compared with norma1 nonsmokers ($115.56{\pm}19.93$ vs $120.02{\pm}24.56$ vs $91.87{\pm}20.71\;{\mu}mol/{\mu}mol$ Pi of liposome, p<0.05). Conclusion : Cigarette smoking may induce the dep1etion of serum antioxidants and this depletion of antioxidants is suggested to play a role in the pathogenesis of COPD.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.214-219
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• 2017

Coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary disease (COPD) are characterized as chronic inflammation of the lung in miners exposed to coal mine dust. The aim of the present study was to compare the levels of serum lactate dehydrogenase (LD) and C-reactive protein (CRP) as the inflammatory indices between subjects with CWP and those with CWP and COPD (CWP+COPD), among a total of 97 subjects (27 control, 40 CWP, and 30 CWP+COPD patients). The mean levels of serum LD (165.7 vs 184.6 U/L, p=0.016) and CRP (0.08 vs 0.15 mg/dL, p=0.002) in subjects with CWP were higher than those of in subjects without CWP. The mean level of serum CRP (0.10 vs 0.19 mg/dL, p=0.008) in subjects with COPD was higher than that in subjects without COPD. In an analysis of covariance adjusted by age, the mean level of serum CRP showed statistical significance among the study groups, control, CWP, and CWP+COPD (0.07 vs 0.13 vs 0.19 mg/dL, p=0.005); the mean level of serum CRP in the CWP+COPD group was significantly higher than that of the control group (p=0.001). The results suggest that a high level of CRP in the serum may be associated with CWP and COPD in retired coal miners.

• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.31-38
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• 2010

Background: Data comparing the clinical characteristics and outcomes in chronic obstructive pulmonary disease (COPD) patients hospitalized with community-acquired pneumonia (CAP-COPD) and acute exacerbation (AECOPD) are very limited. Methods: Eighty episodes of hospitalization in 65 CAP-COPD patients, and 111 episodes of hospitalization in 82 AE-COPD patients were included in this study. The baseline characteristics, clinical presentations, potential bacterial pathogens and clinical outcomes in these patients were retrospectively reviewed and compared. Results: No significant differences were found between the two groups in parameters related to COPD and co-morbidities, except a higher rate of male among CAP-COPD patients. Clinical presentations by symptoms and laboratory findings on admission were significantly more severe in CAP-COPD patients, who showed higher rates of fever and crepitation, but less wheezing than AE-COPD patients. S. pneumoniae and P. aeruginosae were the most common bacterial pathogens in both groups. With no difference in the overall hospital mortality between both groups, the mean length of hospital stay was significantly longer in the CAP-COPD patients than in AE-COPD patients (15.3 vs. 9.8 days, respectively, p<0.01). Additional analysis on CAP-COPD patients showed that systemic steroid use did not influence the length of hospital stay. Conclusion: Although there was no significant difference in bacterial pathogens and overall hospital mortality between the two groups, CAP-COPD patients had more severe clinical symptoms and laboratory findings at presentation, and longer hospital stay than AE-COPD patients.

• Journal of the Korean Data and Information Science Society
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• v.27 no.5
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• pp.1349-1360
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• 2016

The purpose of this study was to identify the degree of quality of life (QoL) and its related factors in patients with Korean Chronic Obstructive Pulmonary Disease (COPD). With data collected by Korea National Health and Nutrition Survey in 2013, general and disease-related variables, pulmonary function test, and EuroQol-5Dimension (EQ-5D) were analyzed. The mean of EQ-5D index was 0.916 in patients with COPD and 0.941 in non-COPD. The EQ-5D index and its sub dimensions (mobility, self-care, usual activity, pain/discomfort, anxiety/depression) of COPD patients were significantly lower than that of non-COPD. However, difference in COPD patients' airway limitation was significant only for self-care of EQ-5D (${\chi}^2=9.50$, p=.013). The related factors of QoL in COPD patients were age, gender, level of education, quartile of household income, smoking status, and number of comorbid diseases. Based on the results, it is important to pay close attention to COPD patients' QoL as well as comprehensive interventions which possibly improve their QoL.

• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.196-202
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• 2023

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) update 2023 proposed new definitions of chronic obstructive pulmonary disease (COPD) and COPD exacerbation. However, an agreement on the definitions has not been made, either internationally or domestically. This study aimed to reach an agreement between experts on the new definitions of COPD and COPD exacerbation in South Korea. Methods: A modified Delphi method was used to make an agreement on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023. We performed two rounds of the survey including 15 Korean experts on COPD, asthma, and tuberculosis. Results: More than two-thirds of the experts agreed on 12 of the 13 statements related to the definitions of COPD and COPD exacerbation in the two rounds of the survey. The experts agreed on the definitions of COPD and COPD exacerbation that should be revised in line with the definitions proposed by the GOLD update 2023. However, the experts showed an uncertain opinion on the statement that the definition of COPD includes patients with persistent airflow obstruction due to bronchiectasis. Conclusion: Based on this Delphi survey, experts' agreement was made on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.399-406
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• 2014

Objectives: Ryodoraku is a physiological function test using electric current. Since it can evaluate the patient's overall condition as well as a function of individual organs, Ryodoraku can be assumed as an effective way to diagnose chronic obstructive pulmonary disease (COPD). Therefore, this study aimed to investigate the values of Ryodoraku for diagnosing COPD. Methods: We designated a COPD group, who were over 40 and satisfying COPD criteria, $FEV_1$/FVC<0.7. The Control group also consisted of members over 40 years old but without COPD and any other lung disease. We conducted a comparative study by checking the Ryodoraku score (RS), the average of Rt.&Lt. H1 (mean H1), the mean difference value between both H1s (${\mid}H1^R-H1^L{\mid}$) and the ratio of patients whose RS was under 40. Then we investigated the correlation between the mean H1 and the results of pulmonary function test (PFT). Results & Conclusions: In the COPD group, RS, mean H1 and ${\mid}H1^R-H1^L{\mid}$ were significantly lower and the ratio of 'RS<40' patients was meaningfully higher than in the Control group. On the other hand, PFT seems not to be replaced by Ryodoraku since there was no correlation between mean H1 and the results of PFT. Though more experiments and researches are needed to be further confirmed, Ryodoraku is expected to be an adequate way for prediagnosing and following up the COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.132-137
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• 2018

Background: The pathophysiology of chronic obstructive pulmonary disease (COPD) includes inflammation, oxidative stress, an imbalance of proteases and antiproteases and apoptosis which has been focused on lately. Abnormal apoptotic events have been demonstrated in both epithelial and endothelial cells, as well as in inflammatory cells including neutrophils and lymphocytes in the lungs of COPD patients. An increased propensity of activated T lymphocytes to undergo apoptosis has been observed in the peripheral blood of COPD patients. Therefore, the apoptosis of T lymphocytes without activating them was investigated in this study. Methods: Twelve control subjects, 21 stable COPD patients and 15 exacerbated COPD patients were recruited in the study. The T lymphocytes were isolated from the peripheral blood using magnetically activated cell sorting. Apoptosis of the T lymphocytes was assessed with flow cytometry using Annexin V and 7-aminoactinomycin D. Apoptosis of T lymphocytes at 24 hours after the cell culture was measured so that the T lymphocyte apoptosis among the control and the COPD patients could be compared. Results: Stable COPD patients had increased rates of $CD4^+$ T lymphocyte apoptosis at 24 hours after the cell culture, more than the $CD4^+$ T lymphocyte apoptosis which appeared in the control group, while the COPD patients with acute exacerbation had an amplified response of $CD4^+$ T lymphocyte apoptosis as well as of $CD8^+$ T lymphocyte apoptosis at 24 hours after the cell culture. Conclusion: Stable COPD patients have more apoptosis of $CD4^+$ T lymphocytes, which can be associated with the pathophysiology of COPD in stable conditions.

• Tuberculosis and Respiratory Diseases
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• v.84 no.3
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• pp.188-199
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• 2021

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.507-514
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• 2005

Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

• 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.