• Tuberculosis and Respiratory Diseases
• /
• 제80권3호
• /
• pp.241-246
• /
• 2017

Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and effective treatment of outpatients can prevent worsening of the illness and hospitalization. Current COPD guidelines provide appropriate guidance for the diagnosis and treatment of patients with COPD. In fact, it has been shown that when appropriate guidance and treatment are performed, the morbidity and mortality rates of COPD patients are reduced. However, there is a gap between the clinical guidelines and the actual clinical treatment. Therefore, the Health Insurance Review and Assessment Service (HIRA) conducted an evaluation of the adequacy of COPD diagnosis and treatment using the Claims Database of HIRA. This review provides a summary of the COPD adequacy assessment results reported by the HIRA and some brief comments on the results.

• 한국간호교육학회지
• /
• 제9권1호
• /
• pp.17-29
• /
• 2003

This study investigated the degree of self-care practice to maintain the stable respiratory function and the required respiratory nursing needs upon the elderly with chronic obstructive pulmonary diseases. The research subjects were 115 elderly people over 60 years old, who were diagnosed to have chronic obstructive pulmonary diseases (the mixed type, chronic bronchitis, bronchial asthma, emphysema) and were hospitalized in 3 university hospitals in Busan or treated as outpatient, and the data was collected over the period between June 1, 2002 and September 30, 2002. In order to measure the respiratory self-care practice degree and nursing needs of the subjects, the instrument on the self-care practice and the instrument on nursing needs were developed by the researcher. The research results are as follows: 1. The mean of respiratory self-care practice degree by the subjects was 2.41 out of 4 for each clause, and the degree of practicing general management was the highest(2.70), and nutrition control(2.66), respiratory exercise(2.65), expectoration of sputum (2.63), oxygen therapy(2.60), environment control(2.50), and medication control(2.36) succeeded. 2. The degree of self-care practice had a significant difference depending on age(F=2.82, P=0.02), frequency of hospitalization(F=3.11, P=0.01), and diagnosed disease(F=15.66, P=0.00). 3. The subjects nursing needs of respiratory system were 3.07 on the average out of 4.00, and 'I want to know how to prevent the infection of respiratory system such as cold scored the highest 3.83, while the clauses like 'want to know how to face the respiratory disorder properly'(3.77) and 'want the specific explanation of the symptoms of my disease'(3.66) also had scored high points. 4. The nursing needs of the respiratory system had a significant difference depending on diagnosed disease such as mixed type of chronic obstructive pulmonary diseases, emphysema, bronchitis, and asthma (F=6.70, P=0.00). The research showed that the subjects degree of self-care practice of respiratory system was low on the whole, while the nursing needs for managing respiratory organ were relatively high. Therefore, specific education concerning the nursing of the disease and self-care upon the elderly having chronic obstructive pulmonary disease is necessary.

• 환경위생공학
• /
• 제8권1호
• /
• pp.93-105
• /
• 1993

The major purpose of this study was to determine the effects of air pollution on respiratory diseases. From the analysis of $SO_2$, $NO_2$ and TSP levels measured at two air pollution monitoring stations(K & E area) of Seoul during Jan. 1988-Dec. 1990, pollution level of K area was higher than E area. Insurance out-patient records for the medical fee reimbusement submitted to the National Federation of Medical Insurance from Jan. to Dec. 1990 were used in order to assess the occurrence of respiratory disease. The results were as follows ; 1. The annual mean levels of $SO_2$, $NO_2$ and TSP in K area were 0.08lppm, O.03lppm and 173.4${\mu}g/m^3$, whereas those of E area were 0.044ppm, 0.02lppm and 146.0 ${\mu}g/m^3$ respectively. The mean levels of above three air pollutants between two areas showed difference about 1.2 times-1.8 times by air pollutant. 2. The monthly out-patient incidence rates of chronic obstructive pulmonary diseases, chronic bronchitis and asthma in K area were higher when compared with those of E area. The monthly out-patient incidence rates of above three chronic respiratory disease of two areas studied showed statistically significant difference about 1.3 times, 2.7 times, 1.4 times respectively. No difference were, however, shown in acute respiratory infections. 3. Highest incidence rates of out-patients could be observed among the group of children less than 10 years old, while adult out-patient incidence rates increased as age increased. 4. The relation between air pollution and chronic respiratory disease was obvious especially, the strongly significant correlation was observed between $NO_2$ and chronic bronchitis.

• Tuberculosis and Respiratory Diseases
• /
• 제77권4호
• /
• pp.172-177
• /
• 2014

Background: Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence. Methods: Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture. Results: Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern. Conclusion: These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.

• Tuberculosis and Respiratory Diseases
• /
• 제85권4호
• /
• pp.289-301
• /
• 2022

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation characterized by fixed airflow limitation and chronic respiratory symptoms, such as cough, sputum, and dyspnea. COPD is a progressive disease characterized by a decline in lung function. During the natural course of the disease, acute deterioration of symptoms leading to hospital visits can occur and influence further disease progression and subsequent exacerbation. Moreover, COPD is not only restricted to pulmonary manifestations but can present with other systemic diseases as comorbidities or systemic manifestations, including lung cancer, cardiovascular disease, pulmonary hypertension, sarcopenia, and metabolic abnormalities. These pulmonary and extrapulmonary conditions lead to the aggravation of dyspnea, physical inactivity, decreased exercise capacity, functional decline, reduced quality of life, and increased mortality. In addition, pneumonia, which is attributed to both COPD itself and an adverse effect of treatment (especially the use of inhaled and/or systemic steroids), can occur and lead to further deterioration in the prognosis of COPD. This review summarizes the long-term outcomes of patients with COPD. In addition, recent studies on the prediction of adverse outcomes are summarized in the last part of the review.

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

• 대한약학회:학술대회논문집
• /
• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
• /
• pp.175-176
• /
• 2002

Airway inflammation is a characteristic of many lung disorders including asthma, chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis. All these diseases involve the recruitment of immune and inflammatory cells to the lungs leading to systemic and local chronic inflammation and oxidative stress. (omitted)

• Tuberculosis and Respiratory Diseases
• /
• 제81권3호
• /
• pp.167-174
• /
• 2018

Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.

• Tuberculosis and Respiratory Diseases
• /
• 제75권3호
• /
• pp.125-127
• /
• 2013

In this paper, we describe 72-year-old female patient without evidence of malignant disease presented with significantly elevated serum carbohydrate antigen (CA) 19-9 levels by respiratory infections. She was diagnosed with respiratory infections due to Mycobacterium avium complex and Pseudomonas aeruginosa. The serum CA 19-9 levels remarkably increased (1,453-5,300 U/mL; reference range, <37 U/mL) by respiratory infection and abruptly decreased (357-534 U/mL) whenever infection was controlled by specific treatments. This case suggests that serum CA 19-9 levels may be used as a diagnostic marker to indicate new or resistant infections to previous antibiotics in chronic lung diseases without significant changes in chest X-ray findings.

• Tuberculosis and Respiratory Diseases
• /
• 제85권3호
• /
• pp.279-282
• /
• 2022