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

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Management of Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환의 치료)

  • Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.587-596
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    • 1994
  • COPD의 치료에 대해 약술하였다. 예방을 위해서는 개인적으로는 금연, 국가사회적으로는 공해의 해결이 필요하며 진행된 질병에서는 진행을 막기 위한 감염의 예방 및 감염시 즉각적인 항균제 치료, 필요에 따라서 항염증제, 그리고 생활의 질을 높이기 위해서 각종 재활요법이 필요하다. 원활한 재활요법을 위해서는 필요한 기구 장비의 구입이 쉬워야 하고 치료진에서는 호흡기 전문의사, 호흡치료사, 의료기사, 병원 및 가정간호사, 사회사업가(social worker), 정신과의사, 영양사 등의 팀으로의 접근이 필요하고 제도적으로 보험적용이 되도록 해야 하겠다. 불구가 심한 예에서는 폐이식이 시도되며 기술적인 문제는 다소 해결된듯하나 장기공여자 등의 문제로 보편화되지는 않고 있다.

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The Polyneuropathy in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자들의 다발성 말초신경병변에 대한 연구)

  • Baek, Jong-Cheul;Myung, Jae-Il;Kang, Heon-Seok;Kim, Yeong-Rock;Youm, Houng-Roul;Ryeu, Hyung-Seun;Lee, Soong;Kim, Wan;Noh, Jean-Yee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.806-814
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    • 1997
  • The incidence, type and distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneuropathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy(13 patients, 30%) more commonly occurs than clinical polyneuropathy(9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.

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Protective Effects of Maekmundong-tang on Elastase-induced Lung Injury (Elastase 매개성 폐조직 손상에 대한 맥문동탕(麥門冬湯)의 보호효과)

  • Kim, Hyoung-Won;Yang, Su-Young;Kim, Min-Hee;NamGung, Uk;Park, Yang-Chun
    • The Journal of Korean Medicine
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    • v.32 no.2
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    • pp.63-78
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    • 2011
  • Objective: This study aimed to evaluate the protective effects of Maekmundong-tang (MMDT) on an elastase-induced COPD model. Materials and Methods: The extract of MMDT was treated to A549 cells and elastase-induced COPD mice model. Then, various parameters such as cell-based cytoprotective activity and histopathological findings were analyzed. Results: MMDT showed a protective effect on elastase-induced cytotoxicity in A549 cells. This effect was correlated with analysis for caspase 3 levels, collagen and elastin contents, protein level of Cdk1, and gene expression of TNF-${\alpha}$ and IL-$1{\beta}$ in A549 cells. MMDT treatment also revealed a protective effect on the elastase-induced COPD mice model. This effect was evidenced via histopathological finding including immunofluorescence stains against elastin, collagen, and caspase 3, and protein level of Cdc2 in lung tissue. Conclusion: These data suggest that MMDT has pharmaceutical properties on COPD. This study can provide scientific evidence for the efficacy of MMDT for clinical application to patients with COPD.

Hospice & Palliative Care Policy in Korea (한국의 호스피스완화의료정책)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.8-17
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    • 2017
  • Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

Tobacco-Related Chronic Illnesses: A Public Health Concern for Jamaica

  • Crawford, Tazhmoye V.;McGrowder, Donovan A.;Barnett, Jasper D.;McGaw, Barbara A.;McKenzie, Irving F.;James, Leslie G.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4733-4738
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    • 2012
  • Background: Tobacco use is a leading cause of preventable morbidity and mortality from non-communicable diseases. The objectives of the study were to determine the percentage of annual income used to purchase tobacco-related products and treat tobacco-related illnesses, and assess the characteristics of smokers and their awareness of the health-related risks of smoking. Method: Stratified and snowball sampling methods were used to obtain information (via a 17-item, close-ended questionnaire) from 85 adult respondents (49 males and 36 females). The instrument comprised of demographic characteristics, smoking behavioural/lifestyle, health, and micro socio-economics. Results: There were no significant differences between individuals who were affected by chronic obstructive pulmonary disorder (COPD) (14.1%) and cardiovascular disease (18.8%). It was found that respondents spend 30-39% of their annual income on tobacco-related products. Forty percent (40.0%) and 41.7% of respondents with lung cancer and COPD respectively spend more than 50% of their annual income to treat these diseases. The majority (80%) of those who continues to consume tobacco-related products were uncertain as to why they were doing it. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. Conclusion: The majority of the respondents who had tobacco-related illnesses such as lung cancer and COPD spend a significant amount of their income on their health care. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. This suggests the need for increase public awareness where both smokers and non smokers are being fully or adequately informed about the dangers or health risks of tobacco consumption.

Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

Branched N-glycans and their implications for cell adhesion, signaling and clinical applications for cancer biomarkers and in therapeutics

  • Taniguchi, Naoyuki;Korekane, Hiroaki
    • BMB Reports
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    • v.44 no.12
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    • pp.772-781
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    • 2011
  • Branched N-glycans are produced by a series of glycosyltransferases including N-acetylglucosaminyltransferases and fucosyltransferases and their corresponding genes. Glycans on specific glycoproteins, which are attached via the action of glycosyltransferases, play key roles in cell adhesion and signaling. Examples of this are adhesion molecules or signaling molecules such as integrin and E-cadherin, as well as membrane receptors such as the EGF and TGF-${\beta}$ receptors. These molecules also play pivotal roles in the underlying mechanism of a variety of disease such as cancer metastasis, diabetes, and chronic obstructive pulmonary disease (COPD). Alterations in the structures of branched N-glycans are also hall marks and are useful for cancer biomarkers and therapeutics against cancer. This mini-review describes some of our recent studies on a functional glycomics approach to the study of branched N-glycans produced by N-acetylglucosaminyltransferases III, IV, V and IX (Vb) (GnT-III, GnT-IV, V and IX (Vb)) and fucosyltransferase 8 (Fut8) and their pathophysiological significance, with emphasis on the importance of a systems glycobiology approach as a future perspective for glycobiology.

Effects of Chest Resistance Exercise on Forced Expiratory Volume in One Second and Fatigue in Patients with COPD (흉곽저항운동이 만성폐쇄성폐질환 환자의 1초간 노력성 호기량과 피로도에 미치는 영향)

  • Kang, Jeong-Il;Jeong, Dae-Keun;Park, Seung-Kyu;Lee, Jun-Hee
    • The Journal of Korean Physical Therapy
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    • v.23 no.2
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    • pp.37-43
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    • 2011
  • Purpose: The purpose of this study was to determine the effects of chest resistance exercise on Forced Expiratory Volume per second and on fatigue in patients with chronic obstructive pulmonary disease (COPD). Methods: In all, 62 male patients with COPD were included in this study. The experimental group included 32 patients who were treated with chest resistance exercise using the PNF technique with medication. The control group included 30 patients who were treated only with medication. Subjects were stratified into the 2 groups by randomized clinical sampling. Before the start of the experiment, forced expiratory volume at the first second (FEV1) and lactic acid were tested in both experimental and control groups. The experimental group did chest resistance exercise for 6 weeks, 4 times per week, 30 min per day, and the effects of this exercise in patients with COPD was determined by comparing the results of FEV1 and lactic acid tests before and after the experiment between and within the experimental and control groups. Results: There was a statistically significant within group difference for FEV1 MEAS and FEV1 %PRED. There was statistically significant control group of FEV1 MEAS and FEV1 %PRED There was a statistically significant difference in the experimental group for fatigue, comparing scores before and after the test. There was a statistically significant control group of fatigue, in comparison of between the groups of FEV1 MEAS, FEV1 %PRED, fatigue(p<0.01)(p<0.05). Conclusion: More research on COPD will be necessary for improving pulmonary function and reducing fatigue. Further studies on COPD will be required for improving pulmonary function and reducing of fatigue.

An Evaluation of the Accuracy of Mini-Wright Peak Flowmeters in Patients with Asthma and Chronic Obstructive Pulmonary Disease (천식 및 만성폐쇄성폐질환 환자에서 Mini-Wright Peak Flowmeter로 측정한 최대호기유속의 정확도)

  • Choi, Won-Il;Han, Seung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.310-319
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    • 2001
  • Background : The peak flowmeter is very useful in monitoring of out-patients as well as those in emergency departments because of its convenience and simplicity with low cost. There have been many studies aimed at determining the accuracy and reproducibility of the peak flow meter in normal population. However, there is a paucity of reports regarding its accuracy in patients with chronic obstructive pulmonary disease(COPD) or asthma. The accuracy of the peak expiratory flow(PEF) measured with a mini-Wright peak flowmeter was assessed by a comparison with the results of a mass flow sensor. Methods : The PEF measurements were performed in 108 patients aged 19-82 years presenting with either a chronic obstructive lung disease or asthma before and after inhaling salbutamol. The PEF measurements from the mini-Wright flowmeter were compared with those obtained by the calibrated mass flow sensor. Results : The average of the readings taken by the mini-Wright meter were 37-39 l/min higher than those taken by the mass flow sensor. The average percentage error of the mini-Wright meter were higher, ranging less than 300 l/min. The mean of the differences between the values obtained using both instruments (the bias)$\pm$limits of agreement(${\pm}2$ SD) were $37.1{\pm}90\;l/min$ for the PEF(p<0.001). Conclusions : The mini-Wright peak flowmeter overestimated the flows in patients with COPD or asthma. It was also found that the accuracy of the mini-Wright peak flowmeter decreased in its mid to low range. The limits of agreement are wide and the difference between the two instruments is significant. Therefore, the measurements made between the two types of machines in patients with asthma or COPD cannot be used interchangeably.

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The Correlation of Dyspnea and Radiologic Quantity in Patients with COPD (만성폐쇄성폐질환 환자에서 호흡곤란과 영상학적 정량과의 상관관계)

  • Jung, Eun Jung;Kim, Yang Ki;Lee, Young Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong Hoon;Kim, Do Jin;Park, Choon Sik;Hwang, Jung Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.288-294
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    • 2009
  • Background: A lung hyperinflation, or air trapping, caused by expiratory flow-limitation contributes to dyspnea in patients with chronic obstructive pulmonary disease (COPD). Forced expiratory volume in 1 second ($FEV_1$) has served as an important diagnostic measurement of COPD, but does not correlate with patient-centered outcomes such as dyspnea. Therefore, this study was performed to investigate the role of radiologic quantity in evaluating the dyspnea in patients with COPD by measuring lung hyperinflation in chest x-ray and high resolution chest tomography (HRCT). Methods: Fifty patients with COPD were enrolled in this study. Their subjective dyspnea score (modified Borg scale dyspnea index), spirometry, and lung volume were measured. Simultaneous hyperinflations of chest x-ray score ("chest score") and degree of emphysema of HRCT ("HRCT score") were measured. The "chest score" were composed of lung length, retrosternal space width, and height of the arc of the diaphragm and "HRCT score" were composed of severity and extent of emphysema. Results: The mean age of patients was 69 years old and their mean $FEV_1$ was 51.7%. The Borg score significantly correlated with parameters of spirometry and lung volume, including FVC, $FEV_1$, $FEV_1$/FVC, RV, RV/TLC, and DLCO. The Borg score correlated well with "HRCT score", but did not correlate with "chest score". Also, the Borg scale correlates inversely with body mass index. Conclusion: The quantity of emphysema on chest HRCT may serve as an objective marker of dyspnea in patients with COPD.