• Tuberculosis and Respiratory Diseases
• /
• v.87 no.1
• /
• pp.52-64
• /
• 2024

Chronic respiratory diseases such as idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and respiratory infections injure the alveoli; the damage evoked is mostly irreversible and occasionally leads to death. Achieving a detailed understanding of the pathogenesis of these fatal respiratory diseases has been hampered by limited access to human alveolar tissue and the differences between mice and humans. Thus, the development of human alveolar organoid (AO) models that mimic in vivo physiology and pathophysiology has gained tremendous attention over the last decade. In recent years, human pluripotent stem cells (hPSCs) have been successfully employed to generate several types of organoids representing different respiratory compartments, including alveolar regions. However, despite continued advances in three-dimensional culture techniques and single-cell genomics, there is still a profound need to improve the cellular heterogeneity and maturity of AOs to recapitulate the key histological and functional features of in vivo alveolar tissue. In particular, the incorporation of immune cells such as macrophages into hPSC-AO systems is crucial for disease modeling and subsequent drug screening. In this review, we summarize current methods for differentiating alveolar epithelial cells from hPSCs followed by AO generation and their applications in disease modeling, drug testing, and toxicity evaluation. In addition, we review how current hPSC-AOs closely resemble in vivo alveoli in terms of phenotype, cellular heterogeneity, and maturity.

• The Journal of Internal Korean Medicine
• /
• v.38 no.4
• /
• pp.520-530
• /
• 2017

Objectives: Gastro-esophageal reflux-induced chronic cough is not easy to diagnose and treat. In this study, three patients diagnosed with this disease were treated with Ojeok-san plus Saengmaek-san. Methods: Three patients with chronic cough, suspected to be gastro-esophageal and reflux-based, were diagnosed according to symptoms and abdominal examinations. They were treated with the herbal medicine, Ojeok-san plus Saengmaek-san. To evaluate the effectiveness of the treatment, a visual analogue scale (VAS) for measuring the severity of a cough and the Korean version of the Leicester Cough Questionnaire (LCQ-K) were used to determine the patients' quality of life. Results: After administration of Ojeok-san plus Saengmaek-san, the severity of the patients' coughing decreased based on VAS scores and quality of life improved based on LCQ-K scores for all patients. Conclusions: Ojeok-san plus Saengmaek-san is a potent therapeutic agent for gastro-esophageal reflux-induced chronic cough.

• The Journal of Internal Korean Medicine
• /
• v.29 no.3
• /
• pp.716-729
• /
• 2008

Objectives : We designed this study to evaluate the effectiveness of Chungin-troche(CIT) preparation as an adjunctive medicine to a herbal extract of Chungsangboha-tanggagambang(CSBH). Methods : A paralled, comparative study of CSBH+CIT and CSBH was conducted on 42 patients of chronic cough who attended Division of Allergy, Immune & Respiratory System, Department of Internal Medicine, College of Oriental Medicine, Kyung Hee University between December, 2007 and June, 2008. The treatment in each group lasted for two weeks. Patients were asked to fill in the Leicester Cough Questionnaire (LCQ) before and after administration of each treatment legimen. Results : 42 patients completed the trial and no adverse effects were reported. Both CSBH +CIT group and CSBH group showed statistical significant improvement in total LCQ score after 2 weeks from baseline. Social domain score and total score in patients taking CSBH+CIT showed a statistical significant increase compared to those scores in CSBH patients. Conclusion : CSBH+CIT compositive preparation and CSBH separate preparation appeared to have some benefits in the treatment of chronic cough. However, additional CIT preparation to CSBH can improve social domain in LCQ of chronic cough patients.

• Tuberculosis and Respiratory Diseases
• /
• v.83 no.2
• /
• pp.116-121
• /
• 2020

Particulate matter (PM) is suspended dust that has a diameter of <10 ㎛ and can be inhaled by humans and deposited in the lungs, particularly the alveoli. Recent studies have shown that PM has an adverse effect on respiratory diseases. The aim of this article is to review respiratory diseases associated with PM. According to existing studies, PM is associated with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases and increases the mortality rates of these diseases. Moreover, increased exposure in the high concentration of atmospheric PM is associated with the development of lung cancer. The most simple and common way to protect an individual from airborne PM is to wear a face mask that filters out PM. In areas of high concentration PM, it is recommended to wear a face mask to minimize the exposure to PM. However, the use of N95 or KF94 masks can interfere with respiration in patients with chronic respiratory diseases who exhibit low pulmonary function, leading to an increased risk of respiratory failure. Conclusionally, reduction of the total amount of PM is considered to be important factor and strengthening the national warning notification system to vulnerable patients and proper early management of exacerbated patients will be needed in the future.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.1
• /
• pp.52-59
• /
• 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 Korean Academy of Nursing
• /
• v.37 no.3
• /
• pp.343-352
• /
• 2007

Purpose: The purpose of this study was to examine the effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life in inpatients with chronic lung disease. Method: This quasi experimental study was designed with a nonequivalent control group pre-post test time series. Twenty three patients were assigned to the experimental group and nineteen to the control group. The inpatient pulmonary rehabilitation program was composed of upper and lower extremity exercise, breathing retraining, inspiratory muscle training, education, relaxation and telephone contacts. This program consisted of 4 sessions with inpatients and 4 weeks at home after discharge. The control group was given a home based pulmonary rehabilitation program at the time of discharge. The outcomes were measured by the Borg score, 6MWD and the Chronic Respiratory Disease Questionnaire(CRQ). Results: There was a statistically significant difference in dyspnea between the experimental group and control group, but not among time sequence, or interaction between groups and time sequence. Also significant improvements in exercise capacity and health related quality of life were found only in the experimental group. Conclusions: An Inpatient pulmonary rehabilitation program may be a useful intervention to reduce dyspnea, and increase exercise capacity and health related quality of life for chronic lung disease patients.

• Tuberculosis and Respiratory Diseases
• /
• v.87 no.1
• /
• pp.80-90
• /
• 2024

Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.

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

• Tuberculosis and Respiratory Diseases
• /
• v.83 no.3
• /
• pp.195-200
• /
• 2020

The disease concept of interstitial lung disease with idiopathic pulmonary fibrosis at its core has been relied on for many years depending on morphological classification. The separation of non-specific interstitial pneumonia with a relatively good prognosis from usual interstitial pneumonia is also based on the perception that morphology enables predict the prognosis. Beginning with dust-exposed lungs, initially, interstitial pneumonia is classified by anatomical pathology. Diagnostic imaging has dramatically improved the diagnostic technology for surviving patients through the introduction of high-resolution computed tomography scan. And now, with the introduction of therapeutics, the direction of diagnosis is turning. It can be broadly classified into to make known the importance of early diagnosis, and to understand the importance of predicting the speed of progression/deterioration of pathological conditions. For this reason, the insight of "early lesions" has been discussed. There are reports that the presence or absence of interstitial lung abnormalities affects the prognosis. Searching for a biomarker is another prognostic indicator search. However, as is the case with many chronic diseases, pathological conditions that progress linearly are extremely rare. Rather, it progresses while changing in response to environmental factors. In interstitial lung disease, deterioration of respiratory functions most closely reflect prognosis. Treatment is determined by combining dynamic indicators as faithful indicators of restrictive impairments. Reconsidering the history being classified under the disease concept, the need to reorganize treatment targets based on common pathological phenotype is under discussed. What is the disease concept? That aspect changes with the discussion of improving prognosis.

• Tuberculosis and Respiratory Diseases
• /
• v.69 no.5
• /
• pp.323-330
• /
• 2010

A key mechanism in the pathogenesis of chronic obstructive pulmonary disease is thought to be an abnormal inflammatory response in the lungs to the inhalation of toxic particles and gases, derived from tobacco smoke, air pollution, and/or occupational exposures. This review highlights the potential participation of several alternative pathogenetic processes, particularly involving the potential participation of biological and pathobiological processes related to aging, including oxidative stress and enhanced expression of markers of senescence/aging in emphysematous lungs, and the potential for enhanced tissue destruction involving alveolar cell apoptosis.