• Tuberculosis and Respiratory Diseases
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• v.86 no.1
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• pp.61-62
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• 2023

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.8-14
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• 2012

Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with 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 Korean Society of Occupational and Environmental Hygiene
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• v.30 no.2
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• pp.196-204
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• 2020

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. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV₁/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV₁ predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV₁ predicted and current smoking in retired miners with COPD.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• Tuberculosis and Respiratory Diseases
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• v.71 no.4
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• pp.254-258
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• 2011

Background: Although the aging process and features of chronic obstructive pulmonary disease (COPD) have several similarities, the relationship between aging and COPD pathogenesis remains incompletely understood. The klotho gene was found to be related to premature aging and emphysematous changes in an animal model. We investigated whether klotho gene polymorphisms are related to COPD susceptibility and emphysema severity. Methods: A total of 219 COPD subjects from the Korean Obstructive Lung Disease Cohort and 305 control subjects were genotyped for two single nucleotide polymorphisms (SNPs) of the klotho gene associated with coronary artery disease. Logistic regression was performed to determine the association of these SNPs with COPD susceptibility and linear regression was performed to investigate their association with emphysema severity in COPD subjects. Results: The mean age of the COPD subjects was 66 years and their mean FEV1 was 1.46 L. There were no associations between either SNP or COPD susceptibility (p=0.6 and 0.2, respectively) and there were no associations with emphysema severity. Conclusion: Genetic polymorphisms of the klotho gene were not associated with COPD in a Korean population.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.433-444
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• 2017

This study was conducted to identify relationships between lung function disorders and Metabolic Syndrome(MetS) that have common comorbidities such as Cardio Vascular Diseases(CVD). According to the hypothesis that there may be a significant relationship between them, analyses were conducted to identify the proper management point for those diseases. Overall, 53,829 data were taken from KNHANES 2008-2013. Included data were PFT(Pulmonary Function Test) done and age over 40. All the 14 confounders applied, only 8,137 cases (M:3,951, F:4,186) were left. Low pulmonary function was divided into two categories, obstructive and restrictive patterns, based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD) criteria, while MetS was defined based on the revised NCEP-ATPIII criteria. The relationships between those diseases were analyzed using logistic regression analysis. In addition, for the prevalence rate, cross-tab analysis were conducted. There were no significant relationships observed between obstructive lung disease and MetS, but a restrictive pattern had a meaningful relationship with MetS. Specifically, MetS showed a higher prevalence rate for both obstructive and restrictive pattern patients than the control group. Restrictive pattern patients showed a higher prevalence rate to MetS than obstructive patients. Overall, restrictive lung patterns showed a meaningful association with MetS, but not with obstructive patterns. Additionally, the prevalence rate of MetS among restrictive patients was higher than among obstructive patients.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.68-71
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• 2005

We report a case of obstructive sleep apnea syndrome, which occurred primarily during the REM sleep stage. A 55-year-old female patient who complained of chronic insomnia on the initial visit turned out to have obstructive sleep apnea syndrome of a mild degree (respiratory disturbance index (RDI) of 13.8/hour, %time spent below 90% of SaO2=5.0%) on nocturnal polysomnography. Interestingly, apnea episodes and desaturations mainly occurred during REM sleep stage. And RDI and destaturations during REM sleep stage were found to be severe enough to classify as a severe degree of obstructive sleep apnea syndrome. These findings suggest that severe obstructive sleep apnea syndrome might be masked under the symptom of chronic insomnia and that apneas can be predominantly localized within REM sleep epochs. In terms of treatment, "REM sleep-dependent" apneas may call for different methods of treatment, especially REM sleep-specific pharmacological intervention.

• BMB Reports
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• v.50 no.2
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• pp.79-84
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• 2017

Emphysema, a pathologic component of the chronic obstructive pulmonary disease, causes irreversible destruction of lung. Many researchers have reported that mesenchymal stem cells can regenerate lung tissue after emphysema. We evaluated if spheroid human adipose-derived mesenchymal stem cells (ASCs) showed greater regenerative effects than dissociated ASCs in mice with elastase-induced emphysema. ASCs were administered via an intrapleural route. Mice injected with spheroid ASCs showed improved regeneration of lung tissues, increased expression of growth factors such as fibroblast growth factor-2 (FGF2) and hepatocyte growth factor (HGF), and a reduction in proteases with an induction of protease inhibitors when compared with mice injected with dissociated ASCs. Our findings indicate that spheroid ASCs show better regeneration of lung tissues than dissociated ACSs in mice with elastase-induced emphysema.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.323-330
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• 2010

A key mechanism in the pathogenesis of chronic obstructive pulmonary disease is thought to be an abnormal inflammatory response in the lungs to the inhalation of toxic particles and gases, derived from tobacco smoke, air pollution, and/or occupational exposures. This review highlights the potential participation of several alternative pathogenetic processes, particularly involving the potential participation of biological and pathobiological processes related to aging, including oxidative stress and enhanced expression of markers of senescence/aging in emphysematous lungs, and the potential for enhanced tissue destruction involving alveolar cell apoptosis.