• Title/Summary/Keyword: Chronic Obstructive

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Gut Microbiome as a Possible Cause of Occurrence and Therapeutic Target in Chronic Obstructive Pulmonary Disease

  • Eun Yeong Lim;Eun-Ji Song;Hee Soon Shin
    • Journal of Microbiology and Biotechnology
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    • v.33 no.9
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    • pp.1111-1118
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    • 2023
  • As a long-term condition that affects the airways and lungs, chronic obstructive pulmonary disease (COPD) is characterized by inflammation, emphysema, breathlessness, chronic cough, and sputum production. Currently, the bronchodilators and anti-inflammatory drugs prescribed for COPD are mostly off-target, warranting new disease management strategies. Accumulating research has revealed the gut-lung axis to be a bidirectional communication system. Cigarette smoke, a major exacerbating factor in COPD and lung inflammation, affects gut microbiota composition and diversity, causing gut microbiota dysbiosis, a condition that has recently been described in COPD patients and animal models. For this review, we focused on the gut-lung axis, which is influenced by gut microbial metabolites, bacterial translocation, and immune cell modulation. Further, we have summarized the findings of preclinical and clinical studies on the association between gut microbiota and COPD to provide a basis for using gut microbiota in therapeutic strategies against COPD. Our review also proposes that further research on probiotics, prebiotics, short-chain fatty acids, and fecal microbiota transplantation could assist therapeutic approaches targeting the gut microbiota to alleviate COPD.

Influence of Environmental Exposures on Patients with Chronic Obstructive Pulmonary Disease in Korea

  • Hong, Yoonki;Lim, Myoung Nam;Kim, Woo Jin;Rhee, Chin Kook;Yoo, Kwang Ha;Lee, Ji-Hyun;Yoon, Ho Il;Kim, Tae-Hyung;Lee, Jin Hwa;Lim, Seong Yong;Lee, Sang Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.226-232
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    • 2014
  • Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and results from environmental factors and genetic factors. Although cigarette smoking is a major risk factor, other environmental exposures can influence COPD. The purpose of this study is to investigate the clinical characteristics of COPD according to the history of environmental exposure. Methods: The study population comprised of 347 subjects with COPD who were recruited from the pulmonary clinics of 14 hospitals within the Korean Obstructive Lung Disease Study Group. We classified environmental exposures according to history of living near factory, and direct exposure history to firewood or briquette. According to living environmental exposures, we compared the frequency of respiratory symptoms, pulmonary function, quality of life, exercise capacity, and computed tomography phenotypes. Results: Thirty-one subjects (8.9%) had history of living near factory, 271 (78.3%) had exposure history to briquette, and 184 (53.3%) had exposure history to firewood. Patients with history of living near a factory had a significantly longer duration of sputum, while patients with exposure to firewood tended to have lower forced expiratory volume in one second, and patients with exposure to briquette tended to have lower six minute walk distance. Conclusion: COPD subjects with the history of living near factory had more frequent respiratory symptoms such as sputum. Our data suggest that environmental exposure may influence clinical phenotype of COPD.

Chronic Obstructive Pulmonary Disease in a Dressage Horse (마장마술마에서 발생한 만성폐쇄성폐질환 증례)

  • Jeong, Hyo-Hoon;Ahn, Kei-Myung;Kim, A-Ram;Roh, Ha-Jung;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.194-197
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    • 2010
  • A 14-year-old gelded dressage horse weighing 500 kg was presented to the Equine Medical Center of the Seoul Racecourse of Korea Racing Authority (KRA) due to coughing and mucopurulent nasal discharge. The horse was initiated with empirical antibiotic in the first place. However, the clinical signs did not improve but were rather exacerbated even after 3 weeks of therapy. Extensive diagnostic procedures including transtracheal wash (TTW) fluid cytology were undertaken. The localized wheezes and crackles were auscultated and an increase in the amount of mucopurulent exudate in trachea was observed at endoscopy. Infiltration of neutrophils was observed in the TTW fluid cytology implying chronic obstructive pulmonary disease (COPD). Therefore, the systemic glucocorticoid therapy was to be given for 3 weeks with improved ventilation provided at the same time. The respiratory symptoms started to improve in 7 days of therapy and were fully resolved by when the therapy was terminated. The horse is clinically normal now and being monitored for development of any signs of chronic obstructive pulmonary disease.

Convergence analysis of Prevalence and Risk Factors of chronic obstructive pulmonary disease among Non-smokers (비흡연자 만성폐쇄성폐질환의 유병률과 위험인자의 융합적 분석)

  • Song, Hye-young;Bang, Yun Yi
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.85-93
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    • 2018
  • The purpose of the study was to investigate the prevalence and risk factors of chronic obstructive pulmonary disease(COPD) among nonsmokers from the 6th Korea National Health and Nutrition Examination Survey(2013-2015). We used complex sample cross analysis and logistic regression analysis on 4, 911 non-smokers among the patients with chronic obstructive pulmonary disease over 40 years of age. In general characteristics, the prevalence of COPD is higher in the old(p<.001), men(p<.001), rural(p=.044), without spouses(p<.001), less educated(p<.001), agriculture(p<.001). Also, the non-smoker's COPD risk factor is age(p<.001), gender(p<.001), education(p=.022), occupation(p=.022), pulmonary tuberculosis(p<.001), asthma(p<.001). It is necessary to develop a respiratory rehabilitation and intervention program that can be applied in clinical practice based on nursing assessment considering the COPD prevalence and risk factors.

The Effect of Types of Respiratory Exercise on Respiratory Muscle Activity and Health-Related Quality of Life of Patients with Severe Chronic Obstructive Pulmonary Disease

  • Kang, Jeong-Il;Jeong, Dae-Keun;Choi, Hyun
    • The Journal of Korean Physical Therapy
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    • v.28 no.1
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    • pp.46-51
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    • 2016
  • Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 subjects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was performed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quality of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.

Validity and Reliability of Korean Version of Self-Care Chronic Obstructive Pulmonary Disease Inventory (SC-COPD) and Self-Care Self-Efficacy Scale (SCES-COPD) (한국어판 만성폐쇄성폐질환 자가간호와 자가간호 자기효능감 측정도구의 타당도와 신뢰도)

  • Choi, Ja Yun;Yun, So Young
    • Journal of Korean Academy of Nursing
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    • v.52 no.5
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    • pp.522-534
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    • 2022
  • Purpose: This study examined the validity and reliability of the Korean version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) and the Chronic Obstructive Pulmonary Disease Self-Care Self-Efficacy Scale (SCES-COPD). The SC-COPDI consists of the Self-Care Maintenance Scale (SCMES), Self-Care Monitoring Scale (SCMOS), and Self-Care Management Scale (SCMAS). Methods: The original tool was translated using a back-translation process. Participants were 241 patients with COPD at the Chonnam National University Hospital in Korea. The construct validity was verified through confirmatory factor analysis, and reliability was verified using Cronbach's α. Results: The SCMES consisted of 10 items of three factors-one of four factors was deleted from the original tool. In the SCMOS, there were six items of two factors after two items were deleted from the original tool. The SCMAS consisted of the original 10 items of three factors. The SCES-COPD consisted of six items of two factors, with one item removed from the original tool. The model fit indices of all tools were good, and the construct validity was confirmed. Cronbach's α of SCMES was .72, SCMOS was .90, SCMAS was .81, and SCES-COPD was .85. Conclusion: The Korean version of SC-COPDI and SCES-COPD are valid and reliable instruments for measuring self-care in people with COPD. These instruments can be used in self-care studies of COPD patients in Korea.

Differences in physical function, self-efficacy, and health-related quality of life by disease severity in community-dwelling patients with chronic obstructive pulmonary disease

  • Hee-Young, Song;Kyoung A Nam
    • Journal of Korean Biological Nursing Science
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    • v.25 no.3
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    • pp.172-182
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    • 2023
  • Purpose: This study investigated the differences in physical function, self-efficacy (SE), and health-related quality of life (HRQoL) categorized by disease severity in community-dwelling patients with chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional study included 182 patients with COPD selected from the pulmonology outpatient department of a tertiary hospital. Disease severity was measured using forced expiratory volume in 1 second (FEV1). Physical function, SE, and HRQoL were measured with the six-minute walking distance, Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE), and St. George's Respiratory Questionnaire (SGRQ). Disease duration, FEV1, and 12-month history of exacerbations were obtained from medical records. Patients were categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Data were analyzed using the χ2 test, and one-way ANOVA. Results: Most of the participants were male and nonsmokers. The disease duration was 10.76 ± 10.03 years, the mean FEV1% was 62.13 ± 22.80, and 70.3% of the participants were in GOLD category 2 (moderate) or milder. Half of the participants reported modified Medical Research Council scores ≥ 2. Patients in GOLD categories 1 and 3 (mild and severe) exhibited significantly higher PRAISE scores than those in the other groups (F = 8.23, p < .001). The total SGRQ scores were highest in GOLD 4 (very severe), indicating the lowest HRQoL. Significant differences were identified among GOLD 1, GOLD 2 and 3, and GOLD 4 (F = 9.92, p < .001). Conclusion: We identified potentially useful variables to comprehensively assess disease severity and tailor management strategies, including airflow limitation, and to determine the consequences of COPD from patients' perspectives.

Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements

  • Hend M. Esmaeel;Kamal A. Atta;Safiya Khalaf;Doaa Gadallah
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.80-90
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    • 2024
  • Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

Inflammation, Injury and Transcription Factors in Chronic Lung Diseases: Therapeutic Targets

  • Rahman, Irfan
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.175-176
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    • 2002
  • Airway inflammation is a characteristic of many lung disorders including asthma, chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis. All these diseases involve the recruitment of immune and inflammatory cells to the lungs leading to systemic and local chronic inflammation and oxidative stress. (omitted)

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