• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.52-59
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• 2017

Background: Inhaled indacaterol (Onbrez Breezhaler), a long-acting ${\beta}_2$-agonist, is approved in over 100 countries, including South Korea, as a once-daily bronchodilator for maintenance and treatment of chronic obstructive pulmonary disease (COPD). Here, we present an interim analysis of a post-marketing surveillance study conducted to evaluate the real-world safety and effectiveness of indacaterol in the Korean population. Methods: This was an open-label, observational, prospective study in which COPD patients, who were newly prescribed with indacaterol (150 or $300{\mu}g$), were evaluated for 12 or 24 weeks. Safety was assessed based on the incidence rates of adverse events (AEs) and serious adverse events (SAEs). Effectiveness was evaluated based on physician's assessment by considering changes in symptoms and lung function, if the values of forced expiratory volume in 1 second were available. Results: Safety data were analyzed in 1,016 patients of the 1,043 enrolled COPD patients receiving indacaterol, and 784 patients were included for the effectiveness analysis. AEs were reported in 228 (22.44%) patients, while 98 (9.65%) patients reported SAEs. The COPD condition improved in 348 patients (44.4%), while the condition was maintained in 396 patients (50.5%), and only 40 patients (5.1%) exhibited worsening of ailment as compared with baseline. During the treatment period, 90 patients were hospitalized while nine patients died. All deaths were assessed to be not related to the study drug by the investigator. Conclusion: In real-life clinical practice in South Korea, indacaterol was well tolerated in COPD patients, and can be regarded as an effective option for their maintenance treatment.

• 한국산업보건학회지
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• 제30권2호
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• pp.196-204
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• 2020

Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV₁/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV₁ predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV₁ predicted and current smoking in retired miners with COPD.

• 대한물리의학회지
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• 제16권3호
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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.

• The Journal of Korean Physical Therapy
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• 제33권4호
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• pp.179-186
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• 2021

Background: Patients with advanced asthma and chronic obstructive pulmonary disease (COPD) have postural deviations such as thoracic hyperkyphosis, forward shoulder posture (FSP) due to an increase in head and cervical protraction, reduced shoulder range of motion and a corresponding increase in scapula elevation and upward rotation. Unlike congenital vertebral kyphosis that are permanent and rigid deformities with bony and other structural deformations which cause respiratory impairment, these deformities in these patients may be more flexible. Since the thoracic hyperkyphosis has been implicated as having adverse health consequences it is necessary to evaluated the relationship between thoracic kyphosis and cardiopulmonary functions of patients with COPD and asthma. Methods: It was a cross-sectional analytical study. Eighty-four eligible patients with COPD and asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), and basic anthropometric parameters, pulmonary parameters, cardiovascular parameters, thoracic kyphosis (Cobb) angle and presence of respiratory symptoms of participants were assessed. Data was analyzed using SPSS version 20. Results: There was no significant correlation between the thoracic kyphosis and selected pulmonary parameters (Forced Expiratory Volume in one second (FEV1, p=0.36), Forced Vital Capacity (FVC, p=0.95), Peak Expiratory Flow Rate (PEFR, p=0.16), Thoracic expansion (TE, p=0.27)/cardiovascular parameters (Systolic Blood Pressure (SBP, p=0.108), Diastolic Blood Pressure (DBP, p=0.17) and Pulse Rate (PR, p=0.93) as well as the respiratory symptoms (SGRQ scores, p=0.11) in all subjects. Conclusion: There was no relationship between thoracic kyphosis and selected pulmonary/cardiovascular parameters as well as respiratory symptoms in patients with COPD and asthma.

• Journal of Korean Biological Nursing Science
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• 제19권1호
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• pp.38-47
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• 2017

Purpose: This study was undertaken to examine the relationship between airflow obstruction and subjective health status reported by stable patients with chronic obstructive pulmonary disease (COPD) residing in the community. Methods: A cross-sectional descriptive study was conducted with 78 stable COPD patients aged 69.7 years old on average and selected by a convenient sampling from an outpatient department of pulmonology in tertiary hospitals. They completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI) and pulse oxymetry for $O_2$ saturation (Sat $O_2$). Medical records were reviewed to obtain disease-related characteristics including duration of the disease, cardiovascular comorbidity, and forced expiratory volume in 1 second ($FEV_1$). Data were analyzed using PASW statistics 20.0. Results: Mean $FEV_1%$ and CAT scores were 55.11% and 17.73, respectively. Those in the lower stage of mMRC showed significantly higher $FEV_1$ and lower CAT. $FEV_1$ and CAT showed significant negative correlations; age and BMI with $FEV_1$, and Sat $O_2$ with CAT. Conclusion: The findings suggest that the less airway obstruction was, the better health status was, and provide the support for using subjective measures in clinical practices for COPD patients.

• 한국콘텐츠학회논문지
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• 제22권9호
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• pp.461-472
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• 2022

본 연구는 COPD 환자를 대상으로 자가관리를 증진시키기 위한 건강정보 경험을 탐색하였다. 자료가 포화상태에 이를 때까지 COPD를 진단받은 성인 환자 30명을 면담하였으며 수집된 자료는 전통적인 내용분석을 시행하였다. 환자의 자가관리 건강정보에 관한 경험은 '건강정보에 따른 자가관리 실천', '건강정보에 따른 자가관리 실천에 어려움', '자가관리 건강정보를 얻기 위한 다양한 노력', '건강정보 제공에 대한 만족감' 의 네가지 주제가 도출되었다. 대부분의 대상자는 주치의가 설명한 건강정보 외에는 자가관리 증진을 위한 구체적인 건강정보 제공을 받지 못하였음을 확인할 수 있었다. 다양한 의료진으로부터 건강정보를 제공받을 수 있는 병원환경 마련이 필요하며 다양한 매체, 가족, 지인 등 경로를 통해 얻는 건강정보가 정확하고 지속적일 수 있도록 건강정보 제공체계 마련이 필요하다.

• The Korean Journal of Physiology and Pharmacology
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• 제26권2호
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• pp.95-111
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• 2022

Chronic obstructive pulmonary disease (COPD) is an important healthcare problem worldwide. Often, glucocorticoid (GC) resistance develops during COPD treatment. As a classic hypoglycemic drug, metformin (MET) can be used as a treatment strategy for COPD due to its anti-inflammatory and antioxidant effects, but its specific mechanism of action is not known. We aimed to clarify the role of MET on COPD and cigarette smoke extract (CSE)-induced GC resistance. Through establishment of a COPD model in rats, we found that MET could improve lung function, reduce pathological injury, as well as reduce the level of inflammation and oxidative stress in COPD, and upregulate expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), multidrug resistance protein 1 (MRP1), and histone deacetylase 2 (HDAC2). By establishing a model of GC resistance in human bronchial epithelial cells stimulated by CSE, we found that MET reduced secretion of interleukin-8, and could upregulate expression of Nrf2, HO-1, MRP1, and HDAC2. MET could also increase the inhibition of MRP1 efflux by MK571 significantly, and increase expression of HDAC2 mRNA and protein. In conclusion, MET may upregulate MRP1 expression by activating the Nrf2/HO-1 signaling pathway, and then regulate expression of HDAC2 protein to reduce GC resistance.

• 셀메드
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• 제14권2호
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• pp.6.1-6.6
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• 2024

The prevalence of respiratory diseases is increasing due to social and environmental factors such as increased environmental pollution and air pollution, and among them, chronic obstructive pulmonary disease (COPD) in particular has a high mortality and morbidity rate worldwide. As a result, medical expenses are rapidly increasing, creating a social and economic burden. In response to this, there is a need to discuss ways to reduce the risk from diseases and manage them appropriately, and the most basic starting point in this process is how these chronic lung disease patients are treated in actual clinical settings and how to improve the quality of treatment. There is a need to look into whether there are effective drugs. Western treatment for chronic obstructive pulmonary disease is basically a disease in which the airway narrows, so bronchodilators are used to widen the bronchi, and corticosteroids and antibiotics are mainly used to relieve the inflammatory response in the lungs. However, since the mainly used Western medicine does not serve as a fundamental therapeutic drug and contains many side effects, there is a need for drugs that improve the quality of life of patients and are more effective in managing symptoms as symptomatic prescriptions. Therefore, Western and Oriental medicine treatments are needed. The purpose is to suggest better treatments through comparative analysis.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.289-298
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• 2018

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.74-79
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• 2022

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.