• Tuberculosis and Respiratory Diseases
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• 제87권3호
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• pp.309-318
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• 2024

Background: There is limited data regarding the clinical outcomes of clonal hematopoiesis of indeterminate potential (CHIP) in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the clinical significance of CHIP as a COPD biomarker. Methods: This retrospective study was conducted on patients with COPD who were enrolled prospectively in the Seoul National University Hospital Airway Registry from January 2013 to December 2019 and underwent pulmonary function and blood tests. We evaluated the CHIP score according to smoking status and severity of airflow obstruction. Results: We analyzed next-generation sequencing data to detect CHIP in 125 patients with COPD. Current smokers had a higher prevalence of CHIP in combination of DNMT3A, TET2, and PPM1D (DTP), DNA methyltransferase 3 alpha (DNMT3A), and protein phosphatase, Mg²⁺/Mn²⁺ dependent 1D (PPM1D) genes than in never- or ex-smokers. CHIP of DTP and DNMT3A genes was significantly associated with current smokers (adjusted odds ratio [aOR], 2.80; 95% confidence interval [CI], 1.01 to 7.79) (aOR, 4.03; 95% CI, 1.09 to 14.0). Patients with moderate-to-severe airflow obstruction had a higher prevalence of CHIP in most of the explored genes than those with mild obstruction, although the difference was not statistically significant. CHIP in ASXL transcriptional regulator 1 (ASXL1) genes was significantly associated with history of mild, severe, and total acute exacerbation. Conclusion: Given that CHIP in specific genes was significantly associated with current smoking status and acute exacerbation, CHIP can be considered as a candidate biomarker for COPD patients.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.47-55
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• 2022

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.105-110
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• 2000

저자들은 객담, 기침, 발열과 호흡곤란을 보이고 단순 흉부촬영상 다발성 공동과 경변을 보이며 흉부 전산화 촬영과 폐동맥 혈관조영술상 폐 동맥류가 확인된 환자에서 폐 절제술후 만성 괴사성 침입성 폐 국균증으로 진단된 1예를 경험하였기에 이에 보고하는 바이다.

• The Journal of Korean Physical Therapy
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• 제33권4호
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• pp.179-186
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• 2021

Background: Patients with advanced asthma and chronic obstructive pulmonary disease (COPD) have postural deviations such as thoracic hyperkyphosis, forward shoulder posture (FSP) due to an increase in head and cervical protraction, reduced shoulder range of motion and a corresponding increase in scapula elevation and upward rotation. Unlike congenital vertebral kyphosis that are permanent and rigid deformities with bony and other structural deformations which cause respiratory impairment, these deformities in these patients may be more flexible. Since the thoracic hyperkyphosis has been implicated as having adverse health consequences it is necessary to evaluated the relationship between thoracic kyphosis and cardiopulmonary functions of patients with COPD and asthma. Methods: It was a cross-sectional analytical study. Eighty-four eligible patients with COPD and asthma were recruited from the Respiratory Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), and basic anthropometric parameters, pulmonary parameters, cardiovascular parameters, thoracic kyphosis (Cobb) angle and presence of respiratory symptoms of participants were assessed. Data was analyzed using SPSS version 20. Results: There was no significant correlation between the thoracic kyphosis and selected pulmonary parameters (Forced Expiratory Volume in one second (FEV1, p=0.36), Forced Vital Capacity (FVC, p=0.95), Peak Expiratory Flow Rate (PEFR, p=0.16), Thoracic expansion (TE, p=0.27)/cardiovascular parameters (Systolic Blood Pressure (SBP, p=0.108), Diastolic Blood Pressure (DBP, p=0.17) and Pulse Rate (PR, p=0.93) as well as the respiratory symptoms (SGRQ scores, p=0.11) in all subjects. Conclusion: There was no relationship between thoracic kyphosis and selected pulmonary/cardiovascular parameters as well as respiratory symptoms in patients with COPD and asthma.

• Tuberculosis and Respiratory Diseases
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• 제44권1호
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• pp.104-113
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• 1997

연구배경 : 호기성 생물에서 산소의 대사과정 중에 산소의 불안전한 환원으로 산소유리기가 생성되는데 이들 산소유리기의 현저한 증가시 페손상 등 임상적으로 중요한 독성을 일으킬 수 있다고 5 알려져 있어 증가된 산화물이 여러 형태로 만성폐쇄성 폐질환의 발생에 관여 할 것으로 생각된다. 산소유리기의 폐손상과 이에 대한 항산화효소의 방어효과 및 활성도 변화를 관찰함으로 만성폐쇄성 폐질환의 병태생리의 일부분을 알 수 있겠다. 방법 : 만성폐쇄성 폐질환 환자군과 정상대조군 각 15명의 혈청과 적혈구에서 thiobarbituric acid reactant 변화와 항산화효소들(superoxide dismutase, glutathione peroxidase, catalase)의 활성도, 그리고 glutathione의 sulfhydry1기 를 측정하여 비교하였다. 결과 : Thiobarbituric acid reactant는 만성폐쇄성 폐질환 환자군에서 정상대조군보다 혈청과 적혈구에서 모두 유의한 증가를 보였고, superoxide dismutase활성도는 두 군사이에 유의한 차이가 없었으나, glutathione peroxidase와 catalase활성도는 만성폐쇄성 폐질환군에서 정상대조군보다 유의하게 감소되었다. 그리고 총 sulfhydryl기와 비단백 sulfhydryl기 모두 혈청과 적혈구에서 유의한 차이가 없었다. 결론 : 만성폐쇄성 폐 질환 환자에서 thiobarbituric acid reaclant의 증가를 보인 것은 산소유리기에 의한 세포손상을 나타내며, 항산화효소들중 superoxide dismutase는 큰 차이가 없었으나 glutathione peroxidase, catalase등은 대조군에 비해 유의하게 감소하여 만성폐쇄성 폐질환 환자에서 glutathione peroxidase 와 catalase 감소가 세포손상 기전의 한부분으로 작용한 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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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.

• 임상간호연구
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• 제23권2호
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• pp.170-178
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• 2017

Purpose: This study was done to investigate the correlation among symptom experience, self-efficacy, depression, and medication adherence in patients with chronic obstructive pulmonary disease (COPD). Methods: Participants were 100 patients with COPD recruited in one general hospital in Seoul. A structured questionnaire was used to measure the study variables. Data were analyzed using descriptive statistics, t-test, ANOVA, and Spearman correlation coefficient. Results: Symptom experience and depression were positively correlated (r=.41, p<.001), symptom experience and self-efficacy were negatively correlated (r=-.21, p=.035). Depression was negatively correlated with self-efficacy (r=-.60, p<.001) and medication adherence (r=-.48, p<.001). Self-efficacy and medication adherence were positively correlated(r=.76 p<.001). Conclusion: Findings from this study indicate that depression and self-efficacy are important variables related to medication adherence in patients with chronic obstructive pulmonary disease. Therefore, depression and self-efficacy should be assessed, and customized nursing interventions should be provided in order to increase medication adherence.

• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.234-241
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• 2019

Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.188-199
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• 2021

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

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