• Genomics & Informatics
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• v.17 no.1
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• pp.2.1-2.12
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• 2019

Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease, featured by airflow obstruction. Recently, a comprehensive analysis of the transcriptome in lung tissue of COPD patients was performed, but the heterogeneity of the sample was not seriously considered in characterizing the mechanistic dysregulation of COPD. Here, we established a new transcriptome analysis pipeline using a deconvolution process to reduce the heterogeneity and clearly identified that these transcriptome data originated from the mild or moderate stage of COPD patients. Differentially expressed or co-expressed genes in the protein interaction subnetworks were linked with mitochondrial dysfunction and the immune response, as expected. Computational protein localization prediction revealed that 19 proteins showing changes in subcellular localization were mostly related to mitochondria, suggesting that mislocalization of mitochondria-targeting proteins plays an important role in COPD pathology. Our extensive evaluation of COPD transcriptome data could provide guidelines for analyzing heterogeneous gene expression profiles and classifying potential candidate genes that are responsible for the pathogenesis of COPD.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.304-310
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• 2017

Background: Chronic obstructive pulmonary disease (COPD), is a chronic inflammatory disorder. We evaluated whether white blood cell (WBC) count, is associated with the severity of COPD, independent of other inflammatory conditions, such as metabolic syndrome. Methods: The WBC counts were compared between 1227 COPD patients and 8679 non-COPD adults older than 40. The relationships between the WBC count, lung function, and symptoms score in COPD patients, were determined, using general linear regression analyses. Results: The WBC count was negatively associated with forced vital capacity (FVC, L), FVC (% predicted), forced expiry volume in one second ($FEV_1$, L), and $FEV_1$ (% predicted) in COPD patients. Additionally, the WBC count was independently associated with the quality of life measure, by EQ5D-index score. However, this relationship between WBC count, and disease severity, was not significant in current smokers, because of the confounding effect of smoking, on the WBC count. Conclusion: The WBC count is associated with current smoking status and COPD severity, and a risk factor for poor lung function, and quality of life, especially in non-currently smoking COPD patients. The WBC count can be used, as an easily measurable COPD biomarker.

• Journal of the Korean Applied Science and Technology
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• v.37 no.3
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• pp.604-612
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• 2020

The purpose of this study is to analyze the level of obesity and sarcopenia among chronic obstructive pulmonary disease(COPD) patients in Korea. The current study recruited 75 patients with COPD who visited the department of respiratory medicine at J University Hospital in J-do. Height, body weight, waist circumference, and hip circumference were measured, and body composition, muscle strength, and flexibility were assessed. The levels of obesity were classified with body mass index(BMI), waist-hip circumference ratio(WHR) and percent body fat, and sarcopenia was classified with the value of skeletal muscle mass and muscle strength by Asian Working Group for Sarcopenia. In results, it was found that the level of obesity was very high as 43% by BMI, 88% by WHR, and 64% by percent body fat. The lower level of muscle strength was 15.50% in males and 23.50% in females. The lower level of muscle mass was 24.10% in males and .00% in females. Males who had one sarcopenia factors were 22.40%, and females were 23.50%, respectively. Males with sarcopenia were 6.90%, and females were .00%. In conclusion, regular resistance exercise is essential not only for the development of motor skills, but also for the normalization of skeletal muscle function and prevention of muscle dystrophy among COPD patients.

• 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.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Tuberculosis and Respiratory Diseases
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• v.80 no.4
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• pp.377-384
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• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• 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.

• The Korean Journal of Rehabilitation Nursing
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• v.18 no.2
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• pp.75-87
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• 2015

Purpose: The purpose of this study was to develop a home-based self-management support intervention (SMSI) for enhancing pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) in Korea. Methods: This methodological study was conducted by following these 4 steps: constructing the preliminary draft of a home-based SMSI from existing recommendation and a literature review on PR and self-management interventions; testing content validity with 6 experts in COPD; exploring clinical applicability of the intervention by applying it to 4 COPD patients; determining the final intervention. Results: The final intervention included 4 components and contents identified from the literature review as essentials for self-management of COPD patients: education; exercise training and practice including breathing, muscle strengthening and aerobic exercises; cognitive behavioral strategies including informative self-decision making, collaborative goal setting and supportive advice; and action planning for exacerbation. The intervention was designed to be run by a trained nurse and had 8 weekly sessions consisting of three 60-minute face-to-face sessions and five 20-minute phone-call sessions. Conclusion: The intervention developed in this study incorporates essential components of self-management, i.e. action plan and cognitive behavioral strategies, and will contribute to enhancing and maintaining effects of PR by increasing self-management in COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.474-481
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.