• Tuberculosis and Respiratory Diseases
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• 제85권3호
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• pp.221-226
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• 2022

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation due to chronic airway inflammation and destruction of the alveolar structure from persistent exposure to oxidative stress. The body has various antioxidant mechanisms for efficiently coping with such oxidative stress. The nuclear factor erythroid 2-related factor 2 (Nrf2)-antioxidant response element (ARE) is a representative system. Dysregulation of the Nrf2-ARE pathway is responsible for the development and promotion of COPD. Furthermore, COPD severity is also closely related to this pathway. There has been a clinical impetus to use Nrf2 for diagnostic and therapeutic purposes. Therefore, in this work, we systematically reviewed the clinical significance of Nrf2 in COPD patients, and discuss the value of Nrf2 as a potential COPD biomarker.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.307-311
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• 2016

Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.317-324
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• 2017

Small airway disease (SAD) has been recognized for many years as a central feature of chronic obstructive pulmonary disease (COPD). Histopathology studies have shown that the narrowing and destruction of small airways in COPD combined with inflammatory cell infiltration in the submucosa increases the severity of the disease. SAD is present in the early stages of COPD and becomes more widespread over time as the disease progresses to more severe COPD. The development of inhalers containing extra-fine particles allows the small airways to be pharmacologically targeted. Recent clinical trials have shown the efficacy of extra-fine triple therapy that targets the small airways in patients with COPD. This article reviews the importance and treatment of SAD in COPD.

• 수면정신생리
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• 제27권1호
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• pp.8-15
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• 2020

Sleep disorder in chronic obstructive pulmonary disease (COPD) is common and typically is associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatch. Despite the importance of sleep in patients with COPD, this topic is under-assessed in clinical practice. Impaired sleep quality is associated with more severe COPD and may contribute to worse clinical outcomes. Recent data have indicated that specific respiratory management of patients with COPD and sleep disordered breathing improves clinical outcomes. Clinicians managing patients with COPD should pay attention to and actively manage symptoms of comorbid sleep disorders. Management of sleep-related problems in COPD should particularly focus on minimizing sleep disturbance.

• Tuberculosis and Respiratory Diseases
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• 제76권4호
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• pp.169-174
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• 2014

Background: The Korean Obstructive Lung Disease (KOLD) Cohort Study is a prospective longitudinal study of patients with chronic obstructive pulmonary disease (COPD), asthma, or other unclassified obstructive lung diseases. It was designed to develop new classification models and biomarkers that predict clinically relevant outcomes for patients with obstructive lung diseases. Methods: Patients over 18 years old who have chronic respiratory symptoms and airflow limitations or bronchial hyper-responsiveness were enrolled at 17 centers in South Korea. After a baseline visit, the subjects were followed up every 3 months for various assessments. Results: From June 2005 to October 2013, a total of 477 subjects (433 [91%] males; 381 [80%] diagnosed with COPD) were enrolled. Analyses of the KOLD Cohort Study identified distinct phenotypes in patients with COPD, and predictors of therapeutic responses and exacerbations as well as the factors related to pulmonary hypertension in COPD. In addition, several genotypes were associated with radiological phenotypes and therapeutic responses among Korean COPD patients. Conclusion: The KOLD Cohort Study is one of the leading long-term prospective longitudinal studies investigating heterogeneity of the COPD and is expected to provide new insights for pathogenesis and the long-term progression of COPD.

• Tuberculosis and Respiratory Diseases
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• 제60권5호
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• pp.510-515
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• 2006

연구 배경 : 만성폐쇄성폐질환(COPD)은 45세 이상의 성인에서 국내 유병률 17.2%로 주요 질환이다. 하지만, 국내 COPD 환자의 사망원인에 대한 연구는 불충분한 상황이다. 이에 국내 COPD 환자 사망원인에 대해서 알아보고자 서울아산병원 의무기록을 후향적으로 조사하였다. 방 법 : 2003년 1년간 서울아산병원에서 COPD로 진료한 1,078명의 사망여부를 통계청에 의뢰하여 총 사망자 88명을 얻었고 이중 폐결핵 후유증, 기관지확장증, 폐암 등 암 환자를 제외한 후 남은 28명의 COPD 환자 대상으로 사망원인을 분석하였다. 결 과 : COPD 환자의 사망원인은 폐렴 등 호흡기 원인이 16명 (57%), 심장 원인 5명 (18%), 급사 3명 (11%), 기타 4명 (14%) 등이었다. 서울아산병원 내에서 사망한 환자와 외에서 사망한 환자의 호흡기 관련 사망이 각각 83%(10명/12명)과 38%(6명/16명)이었다 (P=0.05) $FEV_1$이 50%예측치보다 큰 환자와 작은 환자의 호흡기 관련 사망은 각각 43%과 55%이었다 (P=0.89). 결 론 : 국내 3차 병원에서 진료하는 COPD 환자의 사망 원인은 폐렴 등 호흡기 원인 다수를 차지한다.

• Tuberculosis and Respiratory Diseases
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• 제71권1호
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• pp.1-7
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• 2011

Many findings suggest that chronic obstructive pulmonary disease (COPD) imposes an enormous burden on patients, health-care professionals and society. COPD contributes to morbidity and mortality and to a significant use of health-care resources. In spite of a higher prevalence of COPD in Korea, the result of COPD treatment is not effective. The purpose of this article was to review recent advances in the study of COPD in Korea with the aim of improving effective management. This review highlights articles pertaining to the following topics; prevalence, assessment of COPD, risk factors for hospitalization, co-morbid diseases, phenotypes, and treatment issues.

• 대한한방내과학회지
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• 제32권2호
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• pp.203-216
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• 2011

Objectives : This study was conducted to evaluate the protective effects of bee venom on lipopolysaccharide (LPS)-induced chronic obstructive pulmonary disease (COPD). Methods : In this study, LPS was administrated to Balb/c mice to induce a disease that resembles COPD. 2 hr prior to LPS administration, mice were treated with bee venom via an intraperitoneal injection. Total cell number and neutrophils number in bronchoalveolar lavage fluid were counted and pro-inflammatory cytokines were also measured. For histologic analysis, periodic acid Schiff (PAS) and hematoxylin and eosin (H&E) stains were evaluated. Proliferating cell nuclear antigens (PCNA) were also assessed by immunohistochemistry. Results : On 7 days after LPS stimulation, influx of neutrophils significantly decreased in the bee venom group, compared with the COPD group. In addition, TNF-a and IL-6 levels decreased in bee venom group. Histological results also demonstrated the attenuation effect of bee venom on LPS-induced lung inflammation. Conclusions : These data suggest that bee venom has protective effects on LPS-induced lung inflammation. Therefore, bee venom may represent a novel therapeutic agent for lung inflammation and in particular for COPD.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.196-202
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• 2023

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) update 2023 proposed new definitions of chronic obstructive pulmonary disease (COPD) and COPD exacerbation. However, an agreement on the definitions has not been made, either internationally or domestically. This study aimed to reach an agreement between experts on the new definitions of COPD and COPD exacerbation in South Korea. Methods: A modified Delphi method was used to make an agreement on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023. We performed two rounds of the survey including 15 Korean experts on COPD, asthma, and tuberculosis. Results: More than two-thirds of the experts agreed on 12 of the 13 statements related to the definitions of COPD and COPD exacerbation in the two rounds of the survey. The experts agreed on the definitions of COPD and COPD exacerbation that should be revised in line with the definitions proposed by the GOLD update 2023. However, the experts showed an uncertain opinion on the statement that the definition of COPD includes patients with persistent airflow obstruction due to bronchiectasis. Conclusion: Based on this Delphi survey, experts' agreement was made on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023.

• 보험의학회지
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• 제29권1호
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• pp.12-15
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• 2010

Global prevalence of chronic obstructive pulmonary disease(COPD) is known to 5.6 ~ 9.8%. Then life insurance applicants from persons with COPD are frequently encountered, and the underwriter and insurance medical doctors are called on with some regularity to render assessments of the mortality risk associated with COPD. According to previous article which contains long-term follow up of COPD, mortality ratio and excess death rate were 230% and 29 per 1000, respectively. Nowadays molecular genetic methodology such as GWAS has been developed. So it might be possible that molecular diagnostic methods may be one of useful underwriting tools in the life insurance risk selection of COPD applicants.