• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.329-337
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• 2024

Background: Fractional exhaled nitric oxide (FeNO) is known to useful biomarker for detecting eosinophilic airway inflammation. However, there is a lack of evidence regarding the role of FeNO in chronic obstructive pulmonary disease (COPD). We aimed to assess whether elevated FeNO and its impact on treatment change into an inhaled corticosteroid (ICS)-containing regimen and association with acute exacerbation (AE) in patients with COPD. Methods: We retrospectively analyzed 107 COPD patients without a history of asthma from March 2016 to December 2019. The patients whose FeNO value was more than 50 parts per billion (ppb) were defined into the high FeNO group. Multivariable analysis with logistic regression was used to identify factors associated with AE in COPD. Results: The median FeNO value was 32 ppb (interquartile range, 19 to 45) and 34 (20.0%) patients were classified as high FeNO group (median 74 ppb). In the high FeNO group, changes in inhaler treatment into an ICS-containing regimen occurred in 23 of 34 patients after the measurement of FeNO. In multivariate analysis, high FeNO was not a contributing factor for AE, but only the high blood eosinophil count (≥300 cells/µL) was associated with AE (adjusted odds ratio, 2.63; 95% confidence interval, 1.01 to 6.91; p=0.049). Conclusion: High FeNO value had a significant impact on the prescription of ICSs in COPD patients, but it did not show a significant association with AE either on its own or with changes in treatment.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1229-1238
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• 2022

Background: We present a case of asthma-chronic obstructive pulmonary disease syndrome (ACOS), which has features of both asthma and chronic obstructive pulmonary disease, in a 63-year-old man treated with Korean medicine. Methods: For four weeks of hospitalization, the patient received acupuncture, Guarujisil-tang decoction, and herbal steam therapy. The main symptoms of ACOS, which are dyspnea, chest discomfort, and throat discomfort, were treated with acupuncture. Guarujisil-tang decoction and herbal steam therapy were administered to relieve cough and smooth the expectoration of mucus. Results: By the end of hospitalization, no significant change was observed in lung function. However, the patient's subjective symptoms, including dyspnea, chest discomfort, sore throat, and sweating, were improved. The patient's objective sign of opaque yellow mucus changed to clear mucus after the treatment. His scores for the quality of life questionnaire for adult Korean asthmatics and the modified Borg scale also showed improvement from 42 to 62 and from 3 to 1, respectively. Conclusions: Although we reported only one ACOS case, this study is significant in that case reports of ACOS treated with Korean medicine are rare. Further study is needed to confirm the effectiveness of Korean medicine in patients with ACOS.

• IMMUNE NETWORK
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• v.10 no.4
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• pp.109-114
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• 2010

The molecular mechanisms involved in the pathogenesis of chronic obstructive pulmonary disease (COPD) are poorly defined. Accumulating evidences indicate that chronic inflammatory responses and adaptive immunity play important roles in the development and progression of the disease. Recently, it has been shown that IL-17 producing CD4 T cells, named Th17 cells, which have been implicated in the pathogenesis of several inflammatory and autoimmune diseases, are involved in airway inflammation and COPD. In addition, we and others suggest that autoimmunity may play a critical role in the pathogenesis of COPD. Here, we will review the current understanding of roles of Th17 cells and autoimmune responses in COPD.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.99-106
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• 2021

PURPOSE: This study aimed to provide supporting data for the clinical use of breathing exercise with a WBV stimulation as a sustained and safe intervention program, by examining the effect of breathing exercise with WBV stimulation on the pulmonary function, gait ability, and life quality in patients with severe chronic obstructive pulmonary disease (COPD), who have difficulty performing exercise. METHODS: For this study, after collecting the samples from 20 patients with severe COPD, they were placed randomly in an experimental group to perform breathing exercises with a WBV stimulation (n = 10) and a control group to perform breathing exercises only (n=10). Before the intervention, pulmonary function, six-minute gait distance, and health-related life quality were measured as pre-tests. After applying the intervention program to the patients for 30 minutes once a day, for four days a week, for six weeks, the post-test items were remeasured in the same way as the pre-tests, and the results were analyzed. RESULTS: In the within-group comparison, both the experimental and control groups showed significant differences in the forced expiratory volume in one second, six-minute gait distance, and health-related life quality (p < .01) (p < .05). In the intergroup comparison, there were significant differences in the forced expiratory volume in one second and the six-minute gait distance (p < .05). CONCLUSION: WBV stimulation was more effective for the patients by improving the muscular strength and muscular endurance through the reflexive contraction of muscles, and increasing the exercise tolerance. This result could serve as an alternative means to clinically improve the physical function of patients with severe COPD, who have difficulty performing breathing exercises in the future.

• 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.79 no.1
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• pp.22-30
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• 2016

Background: The purpose of this study was to document outcomes following withdrawal of a single inhaler (step-down) in chronic obstructive pulmonary disease (COPD) patients on triple therapy (long-acting muscarinic antagonist and a combination of long-acting ${\beta}2$-agonists and inhaled corticosteroid), which a common treatment strategy in clinical practice. Methods: Through a retrospective observational study, COPD patients receiving triple therapy over 2 years (triple group; n=109) were compared with those who had undergone triple therapy for at least 1 year and subsequently, over 9 months, initiated inhaler withdrawal (step-down group, n=39). The index time was defined as the time of withdrawal in the step-down group and as 1 year after the start of triple therapy in the triple group. Results: Lung function at the index time was superior and the previous exacerbation frequency was lower in the step-down group than in the triple group. Step-down resulted in aggravating disease symptoms, a reduced overall quality of life, decreasing exercise performance, and accelerated forced expiratory volume in 1 second ($FEV_1$) decline ($54.7{\pm}15.7mL/yr$ vs. $10.7{\pm}7.1mL/yr$, p=0.007), but there was no observed increase in the frequency of exacerbations. Conclusion: Withdrawal of a single inhaler during triple therapy in COPD patients should be conducted with caution as it may impair the exercise capacity and quality of life while accelerating $FEV_1$ decline.

• Tuberculosis and Respiratory Diseases
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• v.69 no.3
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• pp.171-176
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• 2010

Background: The object of this study was to assess the validity and reliability of the Korean versions of chronic obstructive pulmonary disease assessment test (CAT) and Dyspnea-12 Questionnaire for patients with chronic pulmonary obstructive disease (COPD). Methods: For the 127 COPD patients, we obtained the Korean versions of the 3 questionnaires being tested: St George's Respiratory Questionnaire (SGRQ), CAT, and Dyspnea-12 with spirometric measurements. To assess the validity of CAT and Dyspnea-12, their correlation with SGRQ was evaluated. To assess the reliability of CAT and Dyspnea-12, Cronbach's alpha coefficient was evaluated. Results: The mean age of patient participants was $68.6{\pm}7.5$ years; 97.6% were male. The SGRQ score was correlated with the scores of the Korean version of CAT (r=0.71, p<0.0001) and Dyspnea-12 (r=0.73, p<0.0001). The Cronbach's alpha coefficient for the CAT and Dyspnea-12 were 0.77 and 0.78, respectively. Conclusion: The Korean versions of CAT and Dyspnea-12 were shown to be valid and reliable for the Korean COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.85 no.4
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• pp.313-319
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• 2022

Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM_2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO₂) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.313-315
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• 2017

• Tuberculosis and Respiratory Diseases
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• v.59 no.3
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• pp.242-249
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• 2005