• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.65-79
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• 2024

Background: Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated. Methods: We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively. Results: Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George's Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV₁)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV₁ exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017). Conclusion: Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.497-503
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• 2005

Backgrounds : The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. Methods : 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. Results : The mean $FEV_1/FVC$ in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. Conclusions : This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.195-201
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• 2011

Background: Osteopontin (Opn) is recognized as an important adhesive bone matrix protein and a key cytokine involved in immune cell recruitment and tissue repair and remolding. However, serum levels of osteopontin have not been evaluated in patients with chronic obstructive pulmonary disease (COPD). Thus, the aim of this study was to evaluate and compare the serum levels of osteopontin in patients experiencing COPD exacerbations and in patients with stable COPD. Methods: Serum samples were obtained from 22 healthy control subjects, 18 stable COPD patients, and 15 COPD with exacerbation patients. Serum concentrations of osteopontin were measured by the ELISA method. Results: Serum levels of osteopontin were higher in patients with acute exacerbation than with stable COPD and in healthy control subjects ($62.4{\pm}51.9ng/mL$, $36.9{\pm}11.1ng/mL$, $30{\pm}11ng/mL$, test for trend p=0.003). In the patients with COPD exacerbation, the osteopontin levels when the patient was discharged from the hospital tended to decrease compared to those at admission ($45{\pm}52.1ng/mL$, $62.4{\pm}51.9ng/mL$, p=0.160). Osteopontin levels significantly increased according to patient factors, including never-smoker, ex-smoker and current smoker ($23{\pm}5.7ng/mL$, $35.5{\pm}17.6ng/mL$, $58.6{\pm}47.8ng/mL$, test for trend p=0.006). Also, osteopontin levels showed a significantly negative correlation with forced expiratory volume in one second ($FEV_1$%) predicted in healthy controls and stable COPD patients (r=-0.389; p=0.013). C-reactive protein (CRP) was positively correlated with osteopontin levels in patients with COPD exacerbation (r=0.775; p=0.002). Conclusion: The serum levels of osteopontin increased in patients with COPD exacerbation and tended to decrease after clinical improvement. These results suggest the possible role of osteopontin as a biomarker of acute exacerbation of COPD.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.273-279
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• 2010

Background: Pulmonary hypertension is considered as a poor prognosis factor in patients with chronic obstructive pulmonary disease (COPD). There has been reported brain natriuretic peptide (pro-BNP) is related with increased right ventricular (RV) workloads. However, there are few studies that evaluate the relationship between BNP and pulmonary arterial pressure (PAP), RV function and St. George Respiratory Questionnaire (SGRQ) score in patients with COPD, and the effects of angiotensin converting enzyme inhibitor (ACEI) on these parameters. Methods: Pulmonary function test, echocardiography, blood BNP, and SGRQ score were evaluated in stabilized moderate degree COPD patients ($FEV_1$/FVC< 70%, $50%{\leq}FEV_1$ < 80%) aged 45 years and over, without worsening of symptoms within recent 3 months. After treating with ramipril 10 mg for 3 months, the same evaluation was repeated. Results: Twenty-two patients were included in this study. BNP was significantly correlated with PAP (Pearson coefficient ${\rho}=0.51$, p=0.02), but not with RV ejection fraction (EF) and predicted $FEV_1%$. The values for predicted $FEV_1%$ showed significant correlation with SGRQ total score and activity score, but not with BNP or PAP. After ramipril treatment, PAP showed significant decrease ($42.8{\pm}8.1$ vs. $34.5{\pm}4.5mm$ Hg p=0.0003), tricuspid annular plane systolic excursion significant increase ($21.5{\pm}3.3$ vs. $22.7{\pm}3.1mm$ p=0.009). BNP showed a tendency to decrease without statistical significance ($40.8{\pm}59.6$ vs. $18.0{\pm}9.1pg/mL$ p=0.55). SGRQ scores showed no significant change. Conclusion: BNP showed significant correlation with resting PAP, which means BNP could be used as markers for pulmonary hypertension. Treatment with ACEI didn't show significant change in the level of BNP, while pulmonary hypertension and RV function were improved.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.304-310
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• 2003

Background : Recent discoveries on the physiology of an erection have demonstrated that the organic causes of impotence are more common, and psychogenic impotence is correspondingly less common than was formally believed. The incidence of sexual dysfunctions in chronic obstructive pulmonary disease (COPD) patients is largely unknown or may be perfunctorily attributed to the associated illness or to aging. This study investigated whether or not the impotence was related to the COPD itself as well as whether or not it nay stem from organic causes in a notable proportion of such patients. Methods : The sexual function was evaluated in 10 COPD patients and 10 normal control subjects. A nocturnal Rigi Scan was performed to evaluate the erectile function of each group. The level of hormones such as the free testosterone, prolactin and thyroid stimulating hormone (TSH) was measured, and a pulmonary function test and arterial blood gas analysis was performed. Results : The time duration and frequency of a penile erection were significantly lower in COPD patients than the controls (p<0.05). In addition, the $PaO_2$ levels correlated with the time duration of the penile erection. Conclusion : These results suggest that COPD is one of the causes of organic erectile dysfunction.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.24-32
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• 2010

Purpose: This study was conducted to evaluate the results after implementing a simulation based critical care nursing education with $MicroSim^{(R)}$. Method: Simulation based education was used for a clinical scenario on a patient with chronic obstructive pulmonary disease(COPD) and acute coronary syndrome(ACS). Self-learning program was used for an acute asthma attack and acute myocardial infarction(AMI) in the $MicroSim^{(R)}$. A total of 97 nursing students were chosen. A pretest and posttest was conducted to evaluate learning achievement, clinical performance ability and self-directed learning. Result: Learning achievement and clinical performance ability significantly increased but self-directed learning did not. Conclusion: Simulation based education used with $MicroSim^{(R)}$ was useful for improving learning achievement and clinical performance ability of nursing students. Further studies are needed to compare the effects of simulation based education.

• Korean Journal of Adult Nursing
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• v.24 no.2
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• pp.160-170
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• 2012

Purpose: The aim of this study was to assess knowledge, attitude, correct metered dose inhaler (MDI) use and compliance with self management among patients with chronic obstructive pulmonary disease (COPD). Methods: The participants of this study consisted of 109 COPD patients who were outpatients in C and K hospital located in G city from March 1 to September 30th, 2010. Data were measured using self-administered questionnaires and observational checklist. The data were analyzed using SPSS/WIN 18.0 program that included mean, standard deviation, ANOVA, Sheffe test, and Pearson's correlation. Results: There were significant relationships between knowledge and attitude (r=.33, $p$ <.001), between knowledge and correct MDI use (r=.37, $p$ <.001), and between knowledge and self-management compliance (r=.28, $p$=.003). There was significant relationship between attitude and self-management compliance (r=.33. $p$ <.001). In contrast, attitude was not significantly related to correct MDI use. Conclusion: The study showed that COPD knowledge and attitude of patients were related compliance in managing their disease. Therefore, strategies need to be utilized in education programs which would improve knowledge and subsequently improve attitude and compliance.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.299-304
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• 2018

Background: Roflumilast is the only approved oral phosphodiesterase-4 inhibitor for the treatment of severe chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis and a history of frequent exacerbations. The purpose of this study was to examine the incidence of adverse effects associated with roflumilast treatment in a real-world setting. Further, we compared the incidence of adverse effects and the discontinuation rate among patients receiving different doses. Methods: We identified all outpatients diagnosed with COPD at Seoul St. Mary's Hospital between May 2011 and September 2016 and retrospectively reviewed their medical records. Roflumilast was prescribed to patients in doses of $500{\mu}g$ and $250{\mu}g$. Results: A total of 269 COPD patients were prescribed roflumilast in our hospital during the study period. Among them, 178 patients were treated with $500{\mu}g$ and 91 patients were treated with $250{\mu}g$. The incidence of adverse effects was 38.2% in the $500{\mu}g$ group and 25.3% in the $250{\mu}g$ group (p=0.034). The discontinuation rate of roflumilast was 41.6% (n=74) in the $500{\mu}g$ group and 23.1% (n=21) in the $250{\mu}g$ group (p=0.003). When adjusted by age, sex, smoking status, and lung function, $500{\mu}g$ dose was significantly associated with the discontinuation of roflumilast (odds ratio, 2.87; p<0.001). Conclusion: There was a lower incidence of adverse effects and discontinuation among patients treated with $250{\mu}g$ compared with $500{\mu}g$ dose. Further studies regarding the optimal dose of roflumilast are required.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.570-578
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• 2001

Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.