• Title/Summary/Keyword: Patients with Chronic Pulmonary Disease

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Bronchial Hyperresponsiveness in Chronic Renal Failure Undergoing Hemodialysis (만성 신부전 환자에서 혈액투석 전후의 기관지 과민반응검사)

  • Hwang, Young-Sil;Shim, Dae-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.548-554
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    • 1995
  • Background: Cardiogenic pulmonary edema increases nonspecific airway responsiveness in humans and animals. Increased extravascular lung water from overt pulmonary edema to subclinical interstitial edema is a common finding in patients with chronic renal failure. Several studies carried out to assess pulmonary function disturbances in this condition have documented a reduction in forced expiratory volume that usually reverses after hemodialysis, suggesting airway edema as the underlying mechanism. This interstitial edema may also lead to nonspecific bronchial hyperresponsiveness. We hypothesized that patients with chronic renal failure may present nonspecific bronchial hyperresponsiveness due to subclinical interstitial pulmonary edema. Methods: We studied 18 chronic renal failure undergoing regular hemodialysis 3 times a week(New York Heart Association Class II) without concomittent disease. These patients were checked pulmonary function test and metacholine provocation test before hemodialysis and same procedure was repeated if responsive, after hemodialysis. Results: 1) 12 out of 18 patients before hemodialysis were reactive in metacholine provocation test(66.7%) before hemodialysis. This airway hyperresponsiveness were decreased after hemodialysis. 2) Pulmonary function was improved after hemodialysis and change in $FEV_1$ was correlated with change in weight(r=-0.62, p<0.01). 3) There was a close correlation between log $PD_{20}$ and $FEF_{25}$, which is one of the variables of the peripheral airways(r=0.58, p<0.05). Conclusion: We speculated interstitial pulmonary edema may play a significant role in bronchial hyperresponsiveness and lung function impaired in patients with chronic renal failure.

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Development of the Home-Based Pulmonary Rehabilitation Program for Patients with Chronic Lung Disease (만성 폐질환 환자에서 재택 호흡재활치료방법 개발 연구)

  • Yoon, Seong-Ho;Na, Joo-Ok;JeGal, Yang-Jin;Kim, Myung-Wha;Kim, Eung-Suk;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.597-607
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    • 2002
  • Background : Even though it is well known that pulmonary rehabilitation (PR) improves exercise capacity, and the quality of life, in patients with chronic lung diseases, not many patients can attend hospital based intensive PR in Korea. The purpose of this study was to develop a method for a home-based PR program, and study its effectiveness. Materials and Methods : Twenty patients with chronic lung diseases were randomly divided into two groups : a home PR group comprising of 10 male patients, with a mean age of 70 years, and a control group comprising of 10 male patients, with a mean age of 65 years. We developed exercise programs, depending on the exercise capacity of each patient, which were easy to do at home. The PR program consisted of a 12 week period of enforced aerobic (mostly walking) and muscle strengthening exercises, as prescribed by the exercise specialist, in accordance with the functional capacity of the patient. In addition to the education, nutritional and psychiatric consultation was undertaken, and respiratory muscle training arranged. Patients visited hospital every 2 weeks for evaluation and exercise prescription. Results : All patients finished the 12 week course of therapy. Following the home PR, the endurance times and work capacity of the upper and lower extremities were significantly increased in the treatment group in comparison to the controls. The six minute working (Eds note:should) 'working' read "walking"?) distance was increased from $465{\pm}60m$ to $508{\pm}37m$ and the maximal inspiratory pressure from $72.8{\pm}27.2cmH_2O$ to $91.4{\pm}30.9cmH_2O$. The quality of life, as assessed by St Georges Respiratory Questionnaire (SGRQ), was also improved following PR. (Eds note:do you have figures for before and after, and a reference for the SGRQ?i.e. for the main paper.) Conclusion : The home PR program we developed seemed to be applicable, and effective, to most of the patients with chronic lung diseases in this study.

A Clinical Review of Surgically Treated 115 Cases of Lung Abscess (외과적 치료를 가한 폐농양 115례에 대한 임상적 관찰)

  • 문한배;이호일
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.3-12
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    • 1969
  • Prior to availability of antibiotics, lung abscess has been recognized as one of the most serious pulmonary disease, and despite of diminished morbidity and mortality rate with the advent of antibiotics and development of better technique in the fields of surgery on pulmonary disease it continues to be a virulent form of pulmonary supuration. It is the purpose of this paper to present a clinical review of 115 lung abscess treated by surgically at "The National Medical Center" during past 9 years. 1. The most common age of occurrence is between the age of 30 and 50, and 105 cases were male and 31 cases occurred in female. 2. Numerous etiological factors may play a role in the formation of a pulmonary abscess; aspiration in 36 patients of which 2 patients had diabetes, 54 patients had preceding URI or pneumonia, and 5 patients followed liver abscess, one of which in hematogenous route. In 20 patients, no predisposing factor could be determined- 3. Clubbing digits were presented in 26 of 1315 patients suggesting chronicity of the disease, and gastric ulcer were combined in 3 of 136 patints. 4. Apparently the onset was insidious, and the progress was masked by indiscriminate administration of antibiotics for URI and TB remedies under impression of pul. tbc. Previous TB treatments were done in 56.%[76 cases] for one week to two years and administration of antibiotics in 51 cases. 5. 89 cases were on tbe right and 2t5 cascs were on the left side. 51 cases of pneumonectomy and 8 of open drainage, of which 4 of Monaldi procedure, were made and operative mortality rate was 5.2%. Numerous complications such as 8 of empyema, 4 of each bleeding and atelectasis, 2 of BPF, 1 of esophageal fistula and one of pneumothorax which were responded well to prolonged treatment with good results, were obtained. 6. The incidence of Klebsiella and Pseudomonas were increased recently. In these results, we submit the surgery should be performed if the conservative therapy had failed. The resection was most favorable operation for pulmonary abscess though drainage procedure may be of value in certain patients with grave systemic menifestations. In chronic long standing abscess, more complications and high mortality rate were assumable although the prognosis has been improved with the advent of antibiotics, the development of improved surgical technique and complete preoperative care.

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Sleep Disturbance, Physical Activity and Health Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자의 수면장애, 신체활동 및 건강관련 삶의 질)

  • Lee, Haejung;Lim, Yeonjung;Jung, Hee Young;Park, Hye-Kyung
    • 한국노년학
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    • v.31 no.3
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    • pp.607-621
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    • 2011
  • Purpose The purpose of this study was to examine the relationship between physical activities, sleep disturbance, and health related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). Methods A descriptive survey design used pretest dataset of COPD symptom management intervention study (N=245). Measures included the international physical activity questionnaire, the COPD and asthma sleep impact scale, and the St. George's respiratory questionnaire of HRQOL. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and simultaneous multiple regression by the SPSS WIN 18.0 program. Results The mean scores (SD) of HRQOL and sleep disturbance were 36.04 (19.43) and 14.33 (6.20), respectively. About 32% of participants were physically inactive. The multivariate approach showed the patients who have more sleep disturbance (β=.27), lower levels of FEV1 % predicted (β=-.23), lower physical activities (β=-.19), lower household income (β=-.16), and diagnosed longer than 5 years (β=.14) reported lower HRQOL (R2=.34). Conclusion The findings of this study suggest that improving the quality of sleep and physical activities can be efficient strategies for HRQOL in patients with COPD. Future research in enhancing HRQOL through improving sleep quality and physical activities is needed.

The Clinical report of Asthmatic Patients with CVA by treatment of Homins Placenta Aqua-Acupuncture (뇌졸중을 동반한 천식 환자 자하거 약침 투여 2례)

  • Kim, Sung-Kyun;Han, Jong-Hyun;Shim, Yun-Seub;Lee, Jung-Hee;Kim, Eun-Gon
    • Journal of Pharmacopuncture
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    • v.7 no.3
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    • pp.123-129
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    • 2004
  • Nowadays Asthma is considered to be an inflamatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Hominis Placenta is the dried placenta of a healthy women. It has correspondence to the meridians of lung and kindey. Hominis Placenta acupuncture therapy has effect on invigoration of vital energy nourishing blood and tonifying the essence. It can be applied to the disease as Asthma, pulmonary tuberculosis, chronic hepatitis, liver cirrhosis, degenerative change and cerebrovascular disease. We treated two patients of Asthma with CVA by Homins Placenta Aqua-Acupuncture. The effect of Homins Placenta Aqua-Acupuncture was assessed by analyzing the pulmonary function test(PFT) and Quality of Life Questionnaire for adult Korean Asthmatics(QLQAKA) in patients before and after treatment. Total score was increased. The patients are satisfied our treatment. But further research concerning this is still necessary.

Thromboendarterectomy of Chronic Pulmonary Thromboembolism - A Case Report - (만성 폐색전증의 내막 절제술 1례보고)

  • Ban, Dong-Gyu;Kim, Hyuck;Kim, Young-Hak;Kang, Jung-Ho;Chung, Won-Sang;Jee, Heng-Ok;Lee, Chul-Bum;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.792-796
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    • 2001
  • Chronic pulmonary artery thromboembolism is a relatively rare phenomenon causing hypoxia and pulmonary hypertension that eventually leads to respiratory failure and right heart failure. Patients with acute pulmonary artery thromboembolism are generally treated with antithrombotics and thrombolytics. However, in cases with chronic pulmonary artery thromboembolism the fibrinized thrombus is so strongly adhered to the pulmonary artery wall that medical treatment becomes ineffective and surgical treatment must then be considered. We report a 47year old patient, with a history of repeated admission due to unresolved chronic obstructive pulmonary disease and chronic pulmonary artery thromboembolism at a local hospital, who underwent a successful endarterectomy of pulmonary artery thromboemboli using intermittent total circulatory arrest.

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Optimal Bronchodilation for COPD Patients: Are All Long-Acting β2-Agonist/Long-Acting Muscarinic Antagonists the Same?

  • Miravitlles, Marc;Baek, Seungjae;Vithlani, Vatsal;Lad, Rahul
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.198-215
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    • 2018
  • Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting ${\beta}_2-agonist$/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD.

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.

Effects of and barriers to hospital-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

  • Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
    • Physical Therapy Rehabilitation Science
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    • v.9 no.2
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    • pp.82-89
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    • 2020
  • Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

Perception of Long-Term Oxygen Therapy for Chronic Lung Diseases May Affect Poor Adherence in Korea

  • Hyo Jin Kim;Hongyeul Lee;Ji Young Yang;Jae Ha Lee;Seung Won Ra;SungMin Hong;Ho Young Lee;Sung Hyun Kim;Mi-Yeong Kim;Hyun-Kyung Lee
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.100-114
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    • 2024
  • Background: Long-term oxygen therapy (LTOT) improves the survival of patients with hypoxemia due to chronic respiratory diseases. The clinical outcomes of LTOT are strongly associated with patient adherence. To improve the adherence of patients, physicians have focused on the efficacy of LTOT. However, poor adherence may stem from patients' perceptions of LTOT. Herein we evaluated patients' perceptions of LTOT affecting adherence. Methods: We conducted a cross-sectional survey study using descriptive, open, and closed-ended questionnaire. Patients using oxygen therapy (OT) or requiring it but avoiding OT responded to the questionnaires at three university hospitals. Results: Seventy-nine patients responded to the questionnaires. The number of patients using home and portable OT was 69 (93%) and 37 (46.3%), respectively. Patients with good adherence were 22 (30.1%). Among patients with good adherence, 90.9% used oxygen according to physicians' prescriptions whereas only 37.3% of those with poor adherence followed physicians' prescriptions (p<0.01). The reasons for avoiding using home OT were fear of permanent use (50%), unwanted attention (40%), and lack of symptoms (40%). They avoided portable OT because of unwanted attention (39%), heaviness (31.7%), and lack of symptoms (21.6%). Conclusion: Patients on LTOT had the perception of the misunderstanding the effects of OT and of psychosocial barriers to initiate or use LTOT. Considering these findings, health professionals need to provide effective education on the purpose of LTOT to improve patient adherence to OT and provide sufficient support for the management of psychosocial barriers in patients using LTOT.