• Title/Summary/Keyword: Lung disease obstructive

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Postinfectious bronchiolitis obliterans in children: lessons from bronchiolitis obliterans after lung transplantation and hematopoietic stem cell transplantation

  • Yu, Jinho
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.459-465
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    • 2015
  • Postinfectious bronchiolitis obliterans (PIBO) is an irreversible obstructive lung disease characterized by subepithelial inflammation and fibrotic narrowing of the bronchioles after lower respiratory tract infection during childhood, especially early childhood. Although diagnosis of PIBO should be confirmed by histopathology, it is generally based on history and clinical findings. Irreversible airway obstruction is demonstrated by decreased forced expiratory volume in 1 second with an absent bronchodilator response, and by mosaic perfusion, air trapping, and/or bronchiectasis on computed tomography images. However, lung function tests using spirometry are not feasible in young children, and most cases of PIBO develop during early childhood. Further studies focused on obtaining serial measurements of lung function in infants and toddlers with a risk of bronchiolitis obliterans (BO) after lower respiratory tract infection are therefore needed. Although an optimal treatment for PIBO has not been established, corticosteroids have been used to target the inflammatory component. Other treatment modalities for BO after lung transplantation or hematopoietic stem cell transplantation have been studied in clinical trials, and the results can be extrapolated for the treatment of PIBO. Lung transplantation remains the final option for children with PIBO who have progressed to end-stage lung disease.

Lack of Association between the Klotho Gene and COPD

  • Kim, Woo-Jin;Oh, Yeon-Mok;Kim, Tae-Hyung;Lee, Ji-Hyun;Kim, Eun-Kyung;Lee, Jin-Hwa;Lee, Sang-Min;Shin, Tae-Rim;Yoon, Ho-Il;Lim, Seong-Yong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.4
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    • pp.254-258
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    • 2011
  • Background: Although the aging process and features of chronic obstructive pulmonary disease (COPD) have several similarities, the relationship between aging and COPD pathogenesis remains incompletely understood. The klotho gene was found to be related to premature aging and emphysematous changes in an animal model. We investigated whether klotho gene polymorphisms are related to COPD susceptibility and emphysema severity. Methods: A total of 219 COPD subjects from the Korean Obstructive Lung Disease Cohort and 305 control subjects were genotyped for two single nucleotide polymorphisms (SNPs) of the klotho gene associated with coronary artery disease. Logistic regression was performed to determine the association of these SNPs with COPD susceptibility and linear regression was performed to investigate their association with emphysema severity in COPD subjects. Results: The mean age of the COPD subjects was 66 years and their mean FEV1 was 1.46 L. There were no associations between either SNP or COPD susceptibility (p=0.6 and 0.2, respectively) and there were no associations with emphysema severity. Conclusion: Genetic polymorphisms of the klotho gene were not associated with COPD in a Korean population.

Different Pattern of Chronic Obstructive Pulmonary Disease Assessment Test Score between Chronic Bronchitis and Non-chronic Bronchitis Patients

  • Yoo, Sang Hoon;Lee, Jae Ha;Yoo, Kwang Ha;Jung, Ki-Suck;Rhee, Chin Kook
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.228-232
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    • 2018
  • Background: Chronic bronchitis (CB) is an important phenotype in chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate different pattern of COPD assessment test (CAT) score between CB and non-CB patients. Methods: Patients were recruited from 45 centers in Korea, as part of the Korean COPD Subgroup Study cohort. CB was defined when sputum continued for at least 3 months. Results: Total 958 patients with COPD were eligible for analysis. Among enrolled patients, 328 (34.2%) were compatible with CB. The CAT score was significantly higher in patients with CB than non-CB, and each component of CAT score showed a similar result. CB was significantly associated with CAT score when adjusted with age, sex, modified Medical Research Council, and post-bronchodilator forced expiratory volume in 1 second. Each component of CAT score between patients with CB and non-CB showed different pattern according to Global Initiative for Chronic Obstructive Lung Disease grade. Conclusion: CAT score is significantly higher in patients with CB than non-CB. Each component of CAT score was significantly different between two groups.

Surgical Repair of Abdominal Aortic Aneurysm under Epidural Anesthesia in Patient with Chronic Obstructive Pulmonary Disease -A case report- (만성 폐쇄성 폐질환 환자에서 자발 호흡를 유지한 상태하의 복부 대동맥류 수술 -1예 보고-)

  • Park Sung-Yong;Hong You-Sun;Lee Gi-Jong;Yu Song-Hyeon
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.782-785
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    • 2006
  • Chronic pulmonary obstructive disease is known to be a significant risk factor for mortality in patients who under-went operation for abdominal aortic aneurysm. To decrease perioperative respiratory complication in these patients, maintenance of self respiration as possible is one of the better method. A seventy-seven year old male patient complained of abdominal pain and he was diagnosed for 9 cm sized abdominal aortic aneurysm. But he had severe chronic obstructive pulmonary disease which was expected to increase surgical mortality. So we introduced epidural anesthesia with maintenance of self respiration and performed surgical resection and graft replacement of abdominal aorta, and he recovered without any complication.

Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

  • Kim, Hyera;Cha, Seung-Ick;Shin, Kyung-Min;Lim, Jae-Kwang;Oh, Serim;Kim, Min Jung;Lee, Yong Dae;Kim, Miyoung;Lee, Jaehee;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.124-131
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    • 2014
  • Background: Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. Methods: A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. Results: Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. Conclusion: Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

Nutritional Status of Chronic Obstructive Pulmonary Disease Patients according to the Severity of Disease (만성 폐쇄성 폐질환 환자에서 병기에 따른 영양상태 평가)

  • Park, Young-Mi;Yoon, Ho-Il;Sohn, Cheong-Min;Choue, Ryo-Won
    • Journal of Nutrition and Health
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    • v.41 no.4
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    • pp.307-316
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    • 2008
  • The purpose of the study was to investigate nutritional status of chronic obstructive pulmonary disease (COPD) patients and to find out the differences according to the stages of disease. From March to October, 2006, 41 stable male patients of mild to severe COPD patients were recruited from Seoul National University hospital. The patients' of body weight and fat free mass were assessed by bioelectrical impedance analysis. The nutritional status of the patients was also assessed by 3-day recall, index of nutritional quality (INQ), dietary diversity score (DDS), dietary variety score (DVS), food group index pattern and dietary quality index (DQI). The total of 41 patients were classified into three groups, stage I, stage II and stage III groups according to the classification of Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard. The mean age of the patients in each stage were 67.2-66.9 years showing no significant difference. The ratio of $FEV_1$/FVC were $57.5{\pm}7.3$, $46.9{\pm}7.6$ and $38.2{\pm}6.8%$, respectively showing significant differences according to the stages of disease. The fat free mass of the stage II ($48.2{\pm}4.7kg$) and III ($47.3{\pm}4.5kg$) was significantly lower than that of stage I ($53.1{\pm}6.9kg$) patients. There were significant correlation of fat free mass with $FEV_{1}$, and BMI (body mass index) with $FEV_{1}$/FVC ratio (p < 0.05). COPD patients showed the diet-related clinical symptoms of anorexia, dyspnea, dyspepsia, and chewing difficulty. Daily intakes of calorie, K, vitamin $B_2$ and folate of the patients were very low ($83.8{\pm}20.7%$, $58.9{\pm}14.4%$, $70.7{\pm}19.6%$ and $74.4{\pm}10.2%$, respectively) however, they did not significantly different according to the stages of disease. Daily intake of calcium was significantly lower in the stage III patients (p < 0.05). The mean scores of dietary variety score was significantly lower in the stage III patients (p < 0.001). Dietary quality index of the patients were not different among the stages of disease and the scores indicated poor quality of diet. As a summary, we found that body fat free mass, regularity of exercise, frequency of having snacks and dietary variety score were significantly associated with the severity of chronic obstructive pulmonary disease.

The study of mechanical human respiratory simulator via characteristic test of motor and proportional valve (모터와 비례제어 밸브의 특성실험을 통한 기계적 호흡 모사장치연구)

  • Lee, M.K.;Lee, T.S.;Chi, S.H.;Oh, S.K.
    • 한국전산유체공학회:학술대회논문집
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    • 2008.03b
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    • pp.492-495
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    • 2008
  • As the obesity patients increase recently, breath disease such an OSA(obstructive sleep apnea) is also increasing. When the breath disease occurs, the risk comes to be high. Dependence degree the PAP(positive airway pressure) is also coming to be high. The mechanical simulator is composed cylinder, valve, ball screw and the motor that they correspond to the lung and airway, the diaphragm of the human. In order to confirm the characteristic of the motor and the valve, it accomplished an test. The simulator traces breath pattern against the normal breath and the OSA.

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Accurate Evaluation and Treatment of Dyspnea in Patients with Gastrointestinal Cancer (소화기 암환자 호흡곤란의 정확한 평가와 치료)

  • Jong Yoon Lee
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.108-113
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    • 2023
  • Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.

Effects of Root of Liriope Spicata on LPS-induced Lung Injury (맥문동이 LPS로 유도된 폐손상에 미치는 영향)

  • Lee, Eung-Seok;Yang, Soo-Young;Kim, Min-Hee;NamGung, Uk;Park, Yang-Chun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.4
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    • pp.641-649
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    • 2011
  • This study was purposed to evaluate the effects of root of Liriope spicata (RLS) on LPS-induced COPD (chronic obstructive pulmonary disease) model. The extract of RLS was treated to A549 cells and LPS-induced COPD mice model. Then, various parameters such as cell-based cyto-protective activity and histopathological finding were analyzed. RLS showed a protective effect on LPS-induced cytotoxicity in A549 cells. This effect was correlated with analysis for caspase 3 levels, protein level of cyclin B1, Cdc2, and phospho-Erk1/2, and gene expression of TNF-${\alpha}$ and IL-$1{\beta}$ in A549 cells. RLS treatment also revealed the protective effect on LPS-induced lung injury in COPD mice model. This effect was evidenced via histopathological finding including immunofluence stains against caspase 3, and protein level of cyclin B1, Cdc2, and Erk1/2 in lung tissue. These data suggest that RLS has a pharmaceutical properties on lung injury. This study would provide an scientific evidence for the efficacy of RLS for clinical application to patients with COPD.

Potential Therapeutic Strategy in Chronic Obstructive Pulmonary Disease Using Pioglitazone-Augmented Wharton's Jelly-Derived Mesenchymal Stem Cells

  • Park, Jin-Soo;Kim, Hyun Kuk;Kang, Eun-Young;Cho, RyeonJin;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.2
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    • pp.158-165
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    • 2019
  • Background: A recent study reported that mesenchymal stem cells possess potential cellular therapeutic properties for treating patients with chronic obstructive pulmonary disease, which is characterized by emphysema. We examined the potential therapeutic effect of Wharton's Jelly-derived mesenchymal stem cells (WJMSCs), following pretreatment with pioglitazone, in lung regeneration mouse emphysema models. Methods: We used two mouse emphysema models, an elastase-induced model and a cigarette smoke-induced model. We intravenously injected WJMSCs ($1{\times}10^4/mouse$) to mice, pretreated or not, with pioglitazone for 7 days. We measured the emphysema severity by mean linear intercepts (MLI) analysis using lung histology. Results: Pioglitazone pretreated WJMSCs (pioWJMSCs) were associated with greater lung regeneration than non-augmented WJMSCs in the two mouse emphysema models. In the elastase-induced emphysema model, the MLIs were $59.02{\pm}2.42{\mu}m$ (n=6), $72.80{\pm}2.87{\mu}m$ (n=6), for pioWJMSCs injected mice, and non-augmented WJMSCs injected mice, respectively (p<0.01). Both pioWJMSCs and non-augmented WJMSCs showed regenerative effects in the cigarette smoke emphysema model (MLIs were $41.25{\pm}0.98$ [n=6] for WJMSCs and $38.97{\pm}0.61{\mu}m$ [n=6] for pioWJMSCs) compared to smoking control mice ($51.65{\pm}1.36{\mu}m$, n=6). The mean improvement of MLI appeared numerically better in pioWJMSCs than in non-augmented WJMSCs injected mice, but the difference did not reach the level of statistical significance (p=0.071). Conclusion: PioWJMSCs may produce greater lung regeneration, compared to non-augmented WJMSCs, in a mouse emphysema model.