• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.167-171
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• 2014

Background: In Korea, patients with destroyed lung due to tuberculosis (TB) account for a significant portion of those affected by chronic pulmonary function impairment. The objective of our research was to evaluate the efficacy of inhaled tiotropium bromide in TB destroyed lung. Methods: We compared the effectiveness of inhaled tiotropium bromide for 2 months between pre- and post-treatment pulmonary function tests performed on 29 patients with destroyed lung due to TB. Results: The mean age of the total number of patients was $63{\pm}9$ years, where 15 patients were male. The pre-treatment mean forced expiratory volume in 1 second ($FEV_1$) was $1.02{\pm}0.31L$ ($44.1{\pm}16.0%$ predicted). The pre-treatment mean forced vital capacity (FVC) was $1.70{\pm}0.54L$ ($52.2{\pm}15.8%$ predicted). Overall, the change in $FEV_1%$ predicted over baseline with tiotropium was $19.5{\pm}19.1%$ (p<0.001). Twenty patients (72%) got better than a 10% increase in $FEV_1$ over baseline with tiotropium, but one patient showed more than a 10% decrease in $FEV_1$. Overall, the change in FVC% predicted over baseline with tiotropium was $18.5{\pm}19.9%$ (p<0.001). Seventeen patients (59%) experienced greater than a 10% increase in FVC over baseline with tiotropium; 12 (41%) patients had stable lung function. Conclusion: The inhaled tiotropium bromide therapy may lead to improve lung functions in patients with TB destroyed lung. However, the long-term effectiveness of this treatment still needs to be further assessed.

• Tuberculosis and Respiratory Diseases
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• v.80 no.1
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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.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.489-496
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• 2013

PURPOSE: The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk test, 6minute walk test) between pre and post in the experimental group. In comparison of two group, experimental group was significant different pulmonary function(FVC, FEV1, MVV) and gait ability(6minute walk test) than control group. but, There was no significant difference of the gait ability(10m walk test). CONCLUSION: This study showed experimental group can be used to improve pulmonary function and gait ability than control group. These findings suggest that the respiratory muscle strengthening training effect on pulmonary function and gait ability for rehabilitation in patients with subacute stroke.

• Tuberculosis and Respiratory Diseases
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• v.69 no.4
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• pp.243-249
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality worldwide. The aim of this study was to evaluate the risk factors associated with recurrent hospital admissions for exacerbation of COPD in Korea. Methods: A retrospective study of 77 consecutive patients hospitalized for exacerbation of COPD at Pusan National University Hospital during the time period January 2005 to May 2008 was performed. The information was collected from the hospitalization period: clinical information, spirometric measures, and laboratory variables. In addition, socioeconomic characteristics, co-morbidity, anxiety, and depression were reviewed. Frequent readmission was defined as 2 or more hospitalizations in the year following discharge. Results: During the 1-year period after discharge, 42 patients (54.6%) reported one hospital admission and 35 patients (45.4%) reported 2 or more hospital readmissions. Among the 35 frequent readmission patients, 4 had more than 10 readmissions. Univariate analysis showed that a body mass index (BMI) <$18.5kg/m^2$, duration >36 months, forced expiratory volume in 1 second ($FEV_1$) <50% predicted, arterial $CO_2$ partial pressure ($PaCO_2$) >40 mm Hg, and arterial oxygen saturation ($SaO_2$) <95% at discharge were associated significantly with frequent readmissions. The multivariate analysis revealed that BMI <$18.5kg/m^2$, $PaCO_2$ >40 mm Hg at discharge were independently associated with frequent readmissions for exacerbation of COPD. Conclusion: Frequent readmissions for exacerbation of COPD were associated with low BMI and hypercapnia at discharge.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.914-919
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• 1997

We analyzed the changes of pulmonary function after decortication i 33 patients with chronic empyema thoracis. In 11 patients of them, scintigraphic lung perfusion scan were performed. The results are as follows; 1, Forced expiratory volume in one second(FEVI) increased from 2.30 L/sec to 2.65 L/sec after decorticati on (p = 0.008) . 2. In patients under 20 years-old, PEV 1 increased significantly(p=0.001). 3. In patients who had tuberculosis empyema thoracis, FEVI increased significantly(p=0.008). The post-operative FEVI increased significantly 24 months later(p=0.013). 4. Te post-operative FEV1 increased significantly 24 months later(p=0013). 5. Perfusion and FEV1 of diseased lung changed from 21.5% to 26.9%(p=0.046) and 0.56 L/sec to 0.78 L/sec(p=0.071) after decortication respectively and perfusion of non-diseased lung changed 78.4% to 72.9% after decortication(p=0.042).

• Clinical and Experimental Pediatrics
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• v.53 no.11
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• pp.951-956
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• 2010

Purpose: To compare the profiles of the bronchodilator response (BDR) among children with asthma and/or allergic rhinitis (AR) and to determine whether BDR in these children is reduced by treatment with inhaled and/or nasal corticosteroid. Methods: Sixty-eight children with asthma (mean age, 10.9 years), 45 children with comorbid asthma and AR (mean age, 10.5 years), and 44 children with AR alone (mean age, 10.2 years) were investigated. After a 2-week baseline period, all children were treated with inhaled fluticasone propionate (either 100 or $250{\mu}g$ b.i.d., tailored to asthma severity) or nasal fluticasone propionate (one spray b.i.d. in each nostril) or both, according to the condition. Before and 2 weeks after starting treatment, all children were evaluated with spirometry and bronchodilator testing. BDR was calculated as a percent change from the forced expiratory volume in 1 second ($FEV_1$) at baseline. Results: The mean BDR was 10.3% [95% confidence interval (CI) 8.3-12.4%] in children with asthma, 9.0% (95% CI 7.3-10.9%) in subjects with asthma and AR, and 5.0% (95% CI 4.1-5.9%) in children with AR alone ($P$<0.001). After treatment, the mean BDR was reduced to 5.2% (95% CI 4.2-6.3%) ($P$<0.001) in children with asthma and to 4.5% (95% CI 3.5-5.5%) ($P$<0.001) in children with asthma and AR. However, children with rhinitis showed no significant change in BDR after treatment, with the mean value being 4.7% (95% CI 3.7-5.8%) ($P$=0.597). Conclusion: The findings of this study imply that an elevated BDR in children with AR cannot be attributed to nasal inflammation alone and highlights the close relationship between the upper and lower airways.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.456-460
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• 2016

Background: Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide ($CO_2$) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy. Methods: Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using $CO_2$ gas and group without using $CO_2$ gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence. Results: The improvement of forced expiratory volume at 1 second in the group using $CO_2$ gas and the group not using $CO_2$ gas was $22.46{\pm}11.27$ and $21.08{\pm}5.39$ (p=0.84). The improvement of forced vital capacity 3 months after surgery was $16.74{\pm}10.18$ (with $CO_2$) and $15.6{\pm}0.89$ (without $CO_2$) (p=0.03). During follow-up ($17{\pm}17$ months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred. Conclusion: Thoracoscopic plication under single lung ventilation using $CO_2$ insufflation could be an effective, safe option to flatten the diaphragm.

• Journal of Korean Society for Atmospheric Environment
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• v.32 no.5
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• pp.457-468
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• 2016

Traffic-related air pollutants and particulates from diesel exhaust cause for increasing respiratory health problem. Recent epidemiologic studies have reported adverse effects of urban air pollution on various aspects of respiratory health. Bus or truck terminal workers have high probability of exposure to diesel exhaust particle than general office worker. This study was designed to evaluate the relationship between pulmonary function of people who working at the high-density area of diesel vehicles and pulmonary function of people who working at general office in Seoul. So, this study explored the effects on people with exposure to diesel traffic or exposure to diesel traffic, through the pulmonary function test (PFT). There were significant difference in Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second ($FEV_1$) between high-exposure group and control. High-exposure to diesel particle were increased risk of reduction in pulmonary function in this study. These results provide the necessity additional research that manage people who working at the high-density area of diesel vehicles.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.529-534
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• 2002

Interstitial pneumonia is a heterogenous group of inflammatory and fibrosing lesions that manifest themselves as infiltrative lung disease. Of these, nonspecific interstitial pneumonia is characterized as a variable degree of interstitial inflammation with or without fibrosis and is distinguished from usual interstitial pneumonia and desquamative interstitial pneumonia, histologically. The influx of inflammatory cells and the responses of immune effector cells injury to the alveolar wall and these initial injuries results in alveolitis and fibrosis. Consequently, the gas exchange throughout the alveolar wall is impaired and the patients suffer from lung diseases of a restrictive pattern. The chief complaints represented are dyspnea and dry cough. We experienced a case of nonspecific interstitial pneumonia in a 10-year old girl. The patient had been healthy and had not been exposed to organic dusts or other toxic materials. The pathology of lung biopsy tissue showed that the alveoli were thickened by a mixture of chronic inflammatory cells and collagen type fibrosis. High resolution computed tomography(HRCT) found the patchy areas of ground-glass opacity with patchy consolidation and irregular reticular opacity, and diffuse distribution without zonal predominance. The forced vital capicity(FVC) was 31%, forced expiratory volume in one second ($FEV_1$) 29% and $FEV_1/FVC$ 90%, so a restrictive pulmonary insufficiency was found.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.585-594
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• 2017

Purpose: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. Methods: There were 2,160 adults aged 50 and over who participated in the $5{\sim}6^{th}$ Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. Results: Among individuals in their 50s, intake of vitamin $B_1$ in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin $B_1$ and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin $B_1$ than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin $B_1$, vitamin $B_2$, and iron than the NCOPD group. Conclusion: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.