• Title/Summary/Keyword: Chronic obstructive pulmonary disease (COPD)

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Alteration of Coagulation and Fibrinolysis System According to Right Ventricular Dysfunction in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서 우심실 기능 부전에 따른 혈액응고 및 섬유소용해계 변화)

  • Kim, Young;Jang, Yoon Soo;Kim, Hyung Jung;Kim, Se Kyu;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Kwak, Jin Young;Choi, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.625-630
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    • 2006
  • Background: Pulmonary hypertension in COPD patients is the result of a direct effect of tobacco smoke on the intrapulmonary vessels with the abnormal production of the mediators that control vasoconstriction, vasodilatation, and vascular cell proliferation, which ultimately lead to aberrant vascular remodeling and physiology. COPD patients are prone to the developmint of an acute and chronic thromboembolism with an elevation of the plasma procoagulant and fibrinolytic markers However, the roles of the coagulation and fibrinolysis system on the right ventricular dysfunction in COPD patients are not well defined. We examined the alteration of the coagulation and fibrinolysis system in COPD patients according to the right ventricular function measured using cardiac multidetector computed tomography (MDCT). Methods: The right ventricular ejection fraction (RVEF) was measured using cardiac MDCT in 26 patients who were diagnosed with COPD according to the definition of the GOLD guideline. The plasma level of thrombin antithrombin (TAT) and plasminogen activator inhibitor (PAI)-1 were measured using an enzyme linked immunoassay. Results: The plasma TAT was markedly elevated in COPD patients ($10.5{\pm}19.8{\mu}g/L$) compared with those of the control ($3.4{\pm}2.5{\mu}g/L$) (p<0.01). However, the plasma PAI-1 in COPD patients ($29.6{\pm}20.7ng/mL$) was similar to that in the controls. The plasma TAT showed a significant inverse relationship with the RVEF measured by the cardiac MDCT in COPD patients (r=-0.645, p<0.01). However, the plasma PAI-1 did not show a relationship with the RVEF (r=0.022, p=0.92). Conclusion: These results suggest that the coagulation system in COPD patients is markedly activated, and that the plasma level of TAT might be a marker of a right ventricular dysfunction in COPD patients.

Lonicerae Flos Inhibits Cigarette-induced Lung Inflammatory Responses in Animal Model of Chronic Obstructive Pulmonary Disease

  • Jung, Kyung-Hwa;Lee, Kye Seok;Kim, Youngeun;Park, Soojin;Hong, Moochang;Shin, Minkyu;Bae, Hyunsu
    • The Journal of Korean Medicine
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    • v.34 no.2
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    • pp.10-19
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    • 2013
  • Objectives: In the present study, we evaluate the anti-inflammatory effect of Lonicerae Flos on cigarette-induced lung inflammatory responses in animal model of chronic obstructive pulmonary diseases (COPD). Methods: To inspect the effects of Lonicerae Flos, we evaluated Lonicerae Flos functions in vivo including immune cell profiles in bronchoalveolar lavage (BAL) fluid, cytokine production and tissue morphological changes. Results: Lonicerae Flos significantly inhibited immune cell infiltrations into the BAL fluid (neutrophils, macrophages, lymphocytes). TNF-${\alpha}$, and interleukin-6 (IL-6) were substantially decreased in the BAL fluid of Lonicerae Flos-treated mice compared with cigarette-exposed control mice. In addition, the hypertrophy of goblet cells in the epithelial cells was reduced in both Lonicerae Flos- and roflumilast-treated mice. Conclusions: The results of this study provide evidence that treatment with Lonicerae Flos exerts strong therapeutic effects against cigarette-induced lung inflammation in vivo. Therefore, this herbal medicine may represent a novel therapeutic agent for lung inflammation in general, as well as a specific agent for the treatment of COPD.

The Survival Rate of Korean Patients with COPD with or without Acute Exacerbations

  • Uh, Soo-Taek;Lee, Ji-Yeon;Koo, So-Mi;Kim, Yang-Ki;Kim, Ki-Up;Park, Jong-Sook;Park, Sung-Woo;Jang, An-Soo;Kim, Do-Jin;Choi, Jae-Sung;Na, Joo-Ok;Suh, Ki-Hyun;Kim, Yong-Hoon;Park, Choon-Sik
    • 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.

The Effect of Respiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease - Preliminary Study - (만성 폐쇄성 폐질환 환자에 있어서 호흡근육 훈련의 효과에 관한 실험적 연구)

  • Kim Mae-Ja
    • Journal of Korean Academy of Nursing
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    • v.16 no.1
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    • pp.55-66
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    • 1986
  • The effect on strength and endurance training (SET) (2 patients) were compared with those of strength training(ST) (2 patients) in patients with-chronic obstructive pulmonary disease. The result of training was assessed by 4 tests: maximal inspiratory pressure(PImax), sustainable inspiratory pressure (SIP), maximal voluntary ventiiation(MVV) and bronchitis-emphysema symptom checklist(BESC). Measurements were repeated before and after training per week for 6 weeks. The SET group performed inspiratory muscle training, using a inspiratory muscle trainer 30 minutes per day, 6 days per week and performing endurance training-12-minute walking-2 days per week for 6 weeks, whereas the ST-only group trained for 30 minutes daily, 6 days per week using inspiratory muscle trainer. SET was no significant increase in exercise performance, whereas ST produced an increase in SIP and a decrease in BESC. There was significant change in BESC betweet the two groups. A simple at home training program using inspiartory muscle trainer was more effective than that of SET program in improving exercise performance of some patients with COPD.h COPD.

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A Study about Voice of Patients with Chronic Obstructive Pulmonary Disease/Asthma before & after ${\beta}_2$-agonist (${\beta}_2$-촉진제 사용전후에 따른 만성폐쇄성폐질환/천식 환자의 음성 연구)

  • Kang, Young-Ae;Kim, Se-Hun;Jong, Seong-Su;Lee, Tae-Yong;Seong, Cheol-Jae
    • Phonetics and Speech Sciences
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    • v.2 no.2
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    • pp.101-108
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    • 2010
  • An inhaled salbutamol and salmeterol for chronic obstructive pulmonary disease(COPD) and asthma have been used worldwidely. But there has been few study about the voice change evoked from the post-medicine effect. To evaluate the voice influenced of short-acting and long-acting ${\beta}_2$-agonists, two experiments were carried out: one was salbutamol experiment 1 with eight patients, the other was salmeterol experiment 2 with six patients. Experiment 1 was made of two stages: premedication & postmedication. Experiment 2 was four stages: stageI was premedication, stageII was postmedication & pregaggling, stageIII was postmedication & postgaggling(100 ml with water), and stageIV was postmedication & 30 minutes later. Measured parameters were F0, F0_SD, Jitter_rap, Shimmer_apq11, HNR, BW(1, 2, 3), Intensity, and H1-H2. The mean data collected from 3 repetitions each was statistically analyzed by Wilcoxon signed rank test for experiment 1 and repeated measures ANOVA for experiment 2. In experiment 1, significant differences were found in the Jitter_rap(Z= -2.10, p=0.036). The findings indicated that the postmedicated voice was worse than premedicated voice. In experiment 2, there wasn't significant difference, but values of parameters related to voice quality(Jitter_rap, Shimmer_apq11, HNR, and H1-H2) showed changes toward stageⅣ, that is, the voice quality was worse under medication.

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The Association between Pulmonary Function Test Result and Combustible Cigarette Smoking or Electrical Cigarette Smoking in Korean Adults : Using the 2014-2019 Korean national health and nutrition examination survey data (한국 성인에서 일반담배 또는 가열 전자담배를 이용한 흡연 형태와 폐 기능 검사 결과와의 관련성: 2014-2019년도 국민건강영양조사 자료를 이용하여)

  • Il-hwan Kim;Il-Hyun Lee;Sae-Ron Shin
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.27-39
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    • 2024
  • Purpose : Smoking is a major factor in chronic obstructive pulmonary disease (COPD), but the effect of electrical cigarette smoking on COPD development is still uncertain. This study aimed to compare the functions of airways and lungs exposed to combustible cigarettes and electrical cigarettes based on the pulmonary function test (PFT) results from the Korean National Health and Nutrition Examination Survey (NHANES). Methods : This study used data from 8,942 participants with PFT results out of 47,309 total subjects from the 6th to 8th Korean NHANES (2014-2015, 2016-2018, and 2019, respectively). Individuals with diseases such as cancer, ex-smokers, and dual tobacco users were excluded. The PFT results were analyzed according to the COPD diagnostic criteria. After adjusting for confounding variables, a complex sample generalized linear model ANOVA test was performed to investigate the association between PFT results and combustible smoker or electrical cigarette user groups. Results : In an analysis based on the obstructive ventilatory disorders (forced expiratory volume in 1 second[FEV1]/forced vital capacity[FVC]<.7), combustible cigarette smokers showed a 3.46 times higher risk of COPD compared to non-smokers, while electrical cigarette smokers exhibited no significant difference in terms of COPD-related risks compared to non-smokers. FEV1 showed a negative relation with combustible cigarette smokers as reported elsewhere (B=-.07, p<.001). FEV1/FVC was negatively related to both combustible cigarette smokers (B=-.03, p<.001) and electrical cigarette smokers (B=-.02, p<.001). Conclusion : FEV1/FVC decreases were observed in the long-term exposure to both combustible and electrical cigarettes. The lower FEV1 in the combustible cigarette group implies the worsening of the severity of COPD, suggesting more damage to the airways and lungs in the short term. Therefore, the temporary electrical cigarettes use for the transition period in order to smoking cessation potentially aids to reduce the harmful effect of combustible cigarettes in COPD development.

Effect of Beraprost Sodium in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 Beraprost sodium의 효과에 대한 연구: 이중 맹검 무작위 임상시험)

  • Lee, Sang-Do;Seo, Kwang Won;Lee, Jung Yeon;Huh, Jin Won;Choi, Ik Su;Park, Jae Sun;Shim, Tae Sun;Oh, Yeon-Mok;Park, In Won;Ryu, Wang-Seong;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.320-328
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    • 2004
  • Background : Pulmonary vascular changes which occur early in the course of chronic obstructive pulmonary disease (COPD) are prevalent manifestation and later cause pulmonary hypertension, which is a bad prognostic factor in COPD. Beraprost sodium (BPS), an orally active prostacyclin analogue, has been shown to improve survival in patients with primary pulmonary hypertension. This study investigated the effect of BPS in the patients with COPD. Methods : This is a double-blind randomized placebo-controlled, two center clinical trial. Twenty one consecutive patients with COPD were enrolled from June 2003 to June 2004 (patients treated with BPS for 3 months, BPS group, n=11; those with placebo, placebo group, n=10). The baseline demographic, pulmonary function and hemodynamic data were not significantly different between two groups. Results : On echocardiographic examination, trans tricuspid valve pressure gradient has decreased significantly after 3 months with beraprost in the BPS group [17.7(${\pm}11.4$) to 8.2(${\pm}8.9$) mm Hg, p-value<0.05], while there was no significant change in the control group. Six-minute walking distance has decreased in the control group and increased in the BPS group, but there was no statistical significance. Conclusion : In patients with COPD oral administration of BPS reduced the pulmonary arterial pressure. The clinical significance of this finding, that is improving symptoms and natural course of the disease, needs further study.

Oxidative Stress, Chromatin Remodeling and Gene Transcription in Inflammation and Chronic Lung Diseases

  • Rahman, Irfan
    • BMB Reports
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    • v.36 no.1
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    • pp.95-109
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    • 2003
  • Inflammatory lung diseases are characterized by chronic inflammation and oxidant/antioxidant imbalance. The sources of the increased oxidative stress in patients with chronic inflammatory lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) derive from the increased burden of inhaled oxidants, and from the increased amounts of reactive oxygen species (ROS) generated by several inflammatory, immune and various structural cells of the airways. Increased levels of ROS produced in the airways is reflected by increased markers of oxidative stress in the airspaces, sputum, breath, lungs and blood in patients with lung diseases. ROS, either directly or via the formation of lipid peroxidation products such as 4-hydroxy-2-nonenal may play a role in enhancing the inflammation through the activation of stress kinases (JNK, MAPK, p38) and redox sensitive transcription factors such as NF-${\kappa}B$ and AP-1. Recent evidences have indicated that oxidative stress and pro-inflammatory mediators can alter nuclear histone acetylation/deacetylation allowing access for transcription factor DNA binding leading to enhanced pro-inflammatory gene expression in various lung cells. Understanding of the mechanisms of redox signaling, NF-${\kappa}B$/AP-1 regulation, the balance between histone acetylation and deacetylation and the release and expression of pro- and anti-inflammatory mediators may lead to the development of novel therapies based on the pharmacological manipulation of antioxidants in lung inflammation and injury. Antioxidants that have effective wide spectrum activity and good bioavailability, thiols or molecules which have dual antioxidant and anti-inflammatory activity, may be potential therapeutic agents which not only protect against the direct injurious effects of oxidants, but may fundamentally alter the underlying inflammatory processes which play an important role in the pathogenesis of chronic inflammatory lung diseases.

Living as Severe COPD Patient - Life of Stepping on the Thin Ice (중증 만성폐쇄성 폐질환 환자로 살아가기 -살얼음판 위를 걸어가는 삶-)

  • Kim, Sung-Reul;Kim, Yun-Ok;Kwon, Kyoung-Min
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.663-675
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    • 2010
  • Purpose: The purpose of this study was to explore the life experiences of patients with a severe Chronic Obstructive Pulmonary Disease (COPD). Methods: The data were collected through in-depth interviews of six patients suffering from severe COPD. The interviewed data were audio-recorded and transcribed verbatim and checked for accuracy. The Giorgi method of phenomenology was used for analyzing data. Results: Eight themes forming the, units of meaning, were: Repeated and Unpredictable Suffering of Dyspnea, Confidence Loss/Exhaustion Life due to non-efficient breathing, Gradually Deprived Liberty, Absolute Being to Sustaining my life, Source of Burden but Significant Person I am in the Family, Endless Tug-of-War-Capability/Endeavor to Breath, Longing for my Life, and Dead-end of breathing. Conclusion: The study results provide an in-depth understanding of life experiences of patients suffering from severe COPD. The findings will be useful to nurses caring for this population.

Recombinant Human HAPLN1 Mitigates Pulmonary Emphysema by Increasing TGF-β Receptor I and Sirtuins Levels in Human Alveolar Epithelial Cells

  • Yongwei Piao;So Yoon Yun;Zhicheng Fu;Ji Min Jang;Moon Jung Back;Ha Hyung Kim;Dae Kyong Kim
    • Molecules and Cells
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    • v.46 no.9
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    • pp.558-572
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    • 2023
  • Chronic obstructive pulmonary disease (COPD) will be the third leading cause of death worldwide by 2030. One of its components, emphysema, has been defined as a lung disease that irreversibly damages the lungs' alveoli. Treatment is currently unavailable for emphysema symptoms and complete cure of the disease. Hyaluronan (HA) and proteoglycan link protein 1 (HAPLN1), an HA-binding protein linking HA in the extracellular matrix to stabilize the proteoglycan structure, forms a bulky hydrogel-like aggregate. Studies on the biological role of the full-length HAPLN1, a simple structure-stabilizing protein, are limited. Here, we demonstrated for the first time that treating human alveolar epithelial type 2 cells with recombinant human HAPLN1 (rhHAPLN1) increased TGF-β receptor 1 (TGF-β RI) protein levels, but not TGF-β RII, in a CD44-dependent manner with concurrent enhancement of the phosphorylated Smad3 (p-Smad3), but not p-Smad2, upon TGF-β1 stimulation. Furthermore, rhHAPLN1 significantly increased sirtuins levels (i.e., SIRT1/2/6) without TGF-β1 and inhibited acetylated p300 levels that were increased by TGF-β1. rhHAPLN1 is crucial in regulating cellular senescence, including p53, p21, and p16, and inflammation markers such as p-NF-κB and Nrf2. Both senile emphysema mouse model induced via intraperitoneal rhHAPLN1 injections and porcine pancreatic elastase (PPE)-induced COPD mouse model generated via rhHAPLN1-containing aerosols inhalations showed a significantly potent efficacy in reducing alveolar spaces enlargement. Preclinical trials are underway to investigate the effects of inhaled rhHAPLN1-containing aerosols on several COPD animal models.