• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.426-431
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• 2007

A 5-month-old female Samoyed dog was presented with primary complaints including exercise tolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, anemia, elevated pre- and post-prandial serum bile acid, hypoproteinemia and bilirubinuria. Diagnostic imaging studies revealed an intrahepatic portosystemic shunt (IPSS). The shunted vessel was successfully occluded by transvenous coil embolization. Clinical signs were gradually improved after shunt occlusion. This case is a rare case of IPSS in a large breed dog fixed by transvenous coil embolization.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.35-45
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• 2021

Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.81-89
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• 2019

PURPOSE: To solve the problems of chronic obstructive pulmonary disease (COPD) patients complaining of muscle fatigue and having limited motor abilities, this study provided the clinical basic data for pulmonary rehabilitation by examining the effects of High Low-Frequency Neuromuscular Electrical Stimulation (NMES) on the respiratory muscle strength, quadriceps muscle activity, and life quality. METHODS: Samples were collected from 20 COPD patients and placed randomly in a low-frequency group (n=10) and high-frequency group (n=10). For a pretest, the respiratory muscle strength (MIP, MEP), quadriceps muscle activity (LF, VM, VL), and life quality (SGRQ) were measured. After applying NMES to each group for 30 minutes at a time, five times a week, for four weeks, a posttest was conducted in the same way as the pretest. RESULTS: Both groups showed significant differences in the respiratory muscle strength, quadriceps muscle activity, and quality of life within the groups and there were significant differences in the quadriceps muscle activity between the groups. CONCLUSION: The four-weeks NMES positively influenced the respiratory muscle strength and life quality by enhancing the function of the quadriceps and exercise tolerance. In particular, high-frequency(75 Hz) NMES was more effective than low-frequency (15 Hz) NMES. This result can be an alternative means to improve the physical functions of COPD patients clinically in the future.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.204-214
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• 1999

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.81-92
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• 2017

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

• Biomolecules & Therapeutics
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• v.11 no.4
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• pp.257-264
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• 2003

Carnitine, hydroxycitric acid, and soy peptide have been known to be anti-obesity agents. The purpose of this study was to evaluate the combined effects of carnitine, hydroxycitric acid, and soy peptide mixture as a potential anti-obesity supplement in overweight women. Overweight premenopausal women (n=33; PIBW>110; 20 to 39 years) were randomized into two groups: the placebo group and the functional beverage group (the test group). Functional beverage was composed of 2000 mg soy peptide, 20 mg L-carnitine and 300 mg garcinia(40% hydroxycitric acid). Body weight and 3 day food dimes, biochemical measurements and computerized tomography were measured at baseline and 8-week. After 8-week consumption of functional beverage with usual diet and exercise, body weight fell an average of 1.4 kg (2.1%). Visceral fat area reduced an average of 7.8% at L1($69.6{\pm}8.7\;vs\;64.2{\pm}7.5\;\textrm{cm}^2$) and 5.1% ($60.7{\pm}4.9\;vs\;57.6{\pm}4.8\;\textrm{cm}^2$, p<0.05) at L4level after weight loss in the test group. Calf fat area in the test group showed about 10% reduction ($31.0{\pm}2.7\;vs=\;27.7{\pm}1.7\;\textrm{cm}^2$, p<0.05) after weight loss. These reductions in fat areas were not shown in the placebo group. There were tendencies of increase in serum levels of $\beta-hydroxybutyrate$, acetoacetate, and total ketones in the test group. There were 7% and 17% insignificant increase in fasting free fatty acid (FFA) and response area of FFA during oral glucose tolerance test(OGTT), respectively, in this group. ill addition, little weight loss in the test group showed 8% but not significant reduction in insulin response area during OGTT. In conclusion, this study shows that taking a mixture of carnitine, hydroxycitric acid, and soy peptide as a potential anti-obesity supplement for 8-week produced advantageous changes in the weight and visceral fat accumulation of overweight women.

• Journal of Ethics
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• no.75
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• pp.63-98
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• 2009

The Social Conflict Index in Korea is considerably high. In the situation where both parties' interests conflict each other, Korean society has shown immature democracy, which couldn't peacefully resolve the conflict because of the lack of tolerance against the counterparty's position. In terms of upbringing educated citizens, who could democratically communicate with others and approach problems, communication skill training is very important, reducing social costs by extreme conflict. Thus, this paper studied the necessity of communication skills training and its sociopolitical implication through case studies about "Communication and Negotiation" class, which is proceeded under university liberal education. Under current university curriculums, increased liberal education programs, related with speaking, focus on cultivating logical and critical thinking in the main. Based on these thinking skills, "Communication and Negotiation" has important implication in terms of cultivating mindset which resolves conflicts and considers other's position by collaborative and emotional perspectives. In terms of cultivating practical communication skills, this "Communication and Negotiation" class requires the change of teaching skills with various training programs, under students' active participation and feedback in the class exercise for resolving problems. Ultimately, through "Communication and Negotiation" class, and as members of society, students could learn matured citizenship and sense of responsibility by respecting others' position and reasonably resolving conflicts.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.183-190
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• 2008

Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean $VO_2max%$ predicted ($39.0%{\pm}10.9%$) and $O_2$ pulse% predicted ($61.3%{\pm}13.6%$) were markedly decreased. In the SGRQ, the impact score (mean $27.8{\pm}18.5$) was significantly lower than the symptom score (mean $53.9{\pm}20.9$) or activity score (mean $50.8{\pm}27.3$) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with $FEV_1%$ predicted (r=-0.46, p<0.05) and $SaO_2$ (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.