• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.976-986
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• 1996

BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.15-21
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• 2003

Background : There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. Methods : A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. Results : The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). Conclusion : The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.

• Tuberculosis and Respiratory Diseases
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• v.72 no.4
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• pp.367-373
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• 2012

Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010, were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients' medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [$FEV_1$], 45% vs. 65.3%, p=0.001; $FEV_1$/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p<0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.638-644
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• 2006

Backgrounds: This study investigated whether or not a polymorphism in the gene encoding the surfactant protein A(SP-A) has any bearing on the individual susceptibility to the development of chronic obstructive pulmonary disease(COPD) in a genetically homogenous Korean population. Methods: The genotypes of 19 COPD patients and 20 healthy neonates as controls were tested using a polymerase chain reaction followed by restriction fragment length polymorphism analysis for the SP-A gene. Results: The specific frequencies of the 6A2 and 6A18 alleles of SP-A1 and the 1A2 allele of SP-A2 were much higher in the COPD group than control group (p<0.05). However, the frequencies of the 6A3 and 6A4 alleles of SP-A1 and the 1A0 allele of SP-A2 in the COPD group were significantly lower than the control group. In the COPD group, the frequencies of the +50 locus genotypes GG of SP-A1 and the +9 locus genotypes CC of SP-A2 were 85.0% and 60.6%, respectively, and 19.7% and 24.8% in the control group, respectively. The frequencies of the polymorphic genotypes or alleles showed a statistically significant difference between the COPD group and the control group (P<0.05). Conclusion: A genetic polymorphism in SP-A is associated with the development of COPD in the Korean population.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.8
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• pp.2134-2140
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• 2009

The purpose of this study is to compare relationship among pulmonary function, dyspnea, and health-related quality of life in patients with COPD. The instruments were used FEV1(%), the Baseline Dyspnea Index(BDI), the Medical Research Council Scale(MRCS), and the St. George's respiratory questionnaire(SGRQ). Dyspnea of patients with moderate and severe stage were deeper than one of patients with mild stage(BDI F=5.452, p=.007; MRCS F=4.925, p=.011). And health-related quality of life of patients with severe stage were poorer than one of patients with mild stage(F=3.778, p=.030). There were significant, but weak, correlations between scores of the BDI(r=.471), the MRCS(r=-.403), the SGRQ(r=-.476) and FEV1. There were strong correlations between scores of the BDI(r=-.752), the MRCS(r=.645) and the SGRQ. And FEV1 didn't correlated with the BDI, the MRCS, and the SGRQ scores in patient of moderate stage and severe stage. But there were also strong correlations between the BDI(r=-.719), the MRCS(r=.607) and the SGRQ in patient of moderate stage and severe stage. Specially, correlation between the BDI and the SGRQ were higher than one between the MRCS and the SGRQ. In conclusion, Using the BDI for evaluation of the subjective dyspnea with objective pulmonary functional test in patients with COPD, it will able to grasp the health-related quality of life.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.384-389
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• 2011

The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled ${\beta}_2$ agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.4
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• pp.233-236
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• 2006

A 67-year-old man with a history of chronic obstructive pulmonary disease (COPD) underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging of gastric cancer. The projection images of F-18 FDG PET/CT showed intensely increased F-18 FDG uptake in the anterior neck, chest wall, and upper abdomen. We suspected distant metastases of cervical lymph nodes, ribs, and peritoneum in gastric canter. However, the transaxial images of F-18 FDG PET/CT showed abnormal F-18 FDG uptake in scalene muscles of anterior neck, intercostal muscles of chest wall, and diaphragm of upper abdomen. Patients with COPD use respiratory muscles extensively on the resting condition. These excessive physiologic use of respiratory muscles causes increased F-18 FDG uptake as a result of increased glucose metabolism. The F-18 FDG uptake in respiratory muscles of gastric cancer patient with COPD mimicked distant metastases in cervical lymph nodes, ribs, and peritoneum.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.257-267
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• 2001

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3$\pm$16.7% and 41.1$\pm$11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29$\pm$122.24 vs 363.03$\pm$120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.

• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.234-251
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• 2024

Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers' direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers' economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients' lives and reduce the disease's rising economic burden.

• Proceedings of the Korea Information Processing Society Conference
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• 2024.05a
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• pp.652-655
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• 2024

COPD(Chronic Obstructive Pulmonary Disease)는 장기간에 걸쳐 기도가 좁아지는 폐질환으로, 규칙적 운동은 호흡을 용이하게 하고 증상을 개선할 수 있는 주요 자가관리 중재법 중 하나이다. 건강정보 데이터와 인공지능을 사용하여 규직적 운동 이행군과 불이행군을 선별하여 자가관리 취약 집단을 파악하는 것은 질병관리 측면에서 비용효과적인 전략이다. 하지만 많은 양의 데이터를 확보하기 어렵고, 규칙적 운동군과 그렇지 않은 환자의 비율이 상이하기 때문에 인공지능 모델의 전체적인 선별 능력을 향상시키기 어렵다는 한계가 있다. 이러한 한계를 극복하기 위해 본 연구에서는 국민건강영양조사 데이터를 사용하여 머신러닝 모델인 XGBoost와 딥러닝 모델인 MLP에 오버샘플링, 언더샘플링, 가중치 부여 등 불균형 데이터 처리 기법을 적용 후 성능을 비교하여 가장 효과적인 불균형 데이터 처리 기법을 제시한다.