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

• 건강소식
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• v.32 no.2 s.351
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• pp.4-11
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• 2008

서울의대.울산의대.고려의대 예방의학교실 연구팀이 대한민국 인구의 약 2.5%인 120만명을 무작위로 추출해 2002년부터 5년간 추적조사를 토대로 발표한 <한국인의 질병부담보고서(2005)>에 의하면 질병부담 1순위가 당뇨병인 것으로 나타났다. 이어 뇌졸중, 천식, 위.십이지장 궤양, 심근경색증, 간경화.류머티스 관절염, 우울증, 간암, 위암, 폐암, 만성 폐쇄성 폐질환 순으로 질병부담이 높은 것으로 측정되었다. 질병부담이란 질병에 걸릴 뿐 아니라 해당 질병으로 인한 질병 후유증과 장애까지 포함하는 광범위한 개념이다. 이에 2008년에는 <건강 소식> 연간 특별기획으로‘한국인의 10대 질병부담, 그 예방과 극복’이라는 주제를 선정,한국인의 질병부담이 높은 10가지 질환에 대한 기초적인 지식과 실생활에 활용할 수 있는 예방과 관리, 극복방법등의 정보를 독자들에게 전하고자 한다

• Research in Community and Public Health Nursing
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• v.29 no.3
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• pp.290-299
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• 2018

Purpose: The purpose of the present study is to examine risk factors for unawareness of obstructive airflow limitation among adults with chronic obstructive pulmonary disease. Methods: Secondary data analysis was performed with the data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES; 2013-2014). The data were analyzed with the IBM SPSS 22.0 version using frequency, percentage, odds ratio, and logistic regression. Results: Ninety-eight percent of subject with a pulmonary function test score of $FEV_1/FVC$<0.7 (N=833) did not recognize that their lung function was impaired. The heavy drink, absence of tuberculosis or asthma diagnosis, and no symptom of expelling phlegm were identified as major risk factors for unawareness of airflow limitation. Conclusion: In order to increase awareness of airflow limitation and to prevent the worsening of the condition, the pulmonary function screening test should be provided to community residents including those who do not show symptoms of respiratory illness.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.836-842
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• 1999

Background: Mixed obstructive and restrictive pattern of spirometry can not be concluded in the presence of true restrictive disorders because pure obstructive disorders can also show reduced vital capacity. However, it is not known how many patients with mixed spirometric pattern really have restrictive disorders in Korea whose pattern of pulmonary diseases is somewhat different from foreign countries. To answer this question, I performed this study and tried to answer it according to diseases in addition. Method: Test results from 413 patients who undergone both spirometry and lung volume measurements on the same visit from August 1, 1998 to July 31, 1999 were included. Spirometry data were classified as mixed obstructive-restrictive pattern when spirometry showed '$FEV_1/FVC$<70% (<65% if age$\geq$60)' and FVC<80% of predicted value'. TLC by the method of nitrogen washout was considered as gold standard to diagnose restrictive disorders in which TLC is less than 80% of predicted value. Results: Out of 404 patients who could be evaluated, 58 had mixed pattern of spirometry. 58 patients were suffered from airway diseases(39 patients) such as COPD(22 patients, 38%), asthma(11, 19%), bronchiectasis (6,10%), and sequelae of pulmonary tuberculosis(15, 26%) or other diseases(4,7%). Only 18 out of 58(31%) were confirmed to have true restrictive disorders by TLC. The proportion of true restrictive disorders was different according to diseases, 20.5%(8/39patients) in patients with airway diseases and 53.3%(8/15) with sequelae of pulmonary tuberculosis(p<0.05). Conclusion: Many patients whose spirometry showed mixed pattern didn't have restrictive disorders but had pure obstructive disorders. This was true for more patients with airway diseases. Therefore it would be prudent that lung volume be tested to diagnose restrictive disorders in patients with mixed spirometric pattern.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1063-1071
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• 1997

Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1230-1234
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• 2003

Purpose : The aim of this study is to evaluate the value of lung biopsies for the management of children with lung disease. Methods : We retrospectively reviewed 19 lung biopsies done at Asan Medical Center, Seoul between 1993 and 2001. Data gathered included demographic information, underlying conditions, diagnosis before biopsy, final diagnosis, change in therapy, morbidity and mortality. Results : Nineteen patients underwent lung biopsy. Among them, 13 patients were male and six patients were female; the median age was 3.6 years(0.8 to 8.6 years). Twelve patients underwent open lung biopsies and seven patients had thoracoscopic biopsies. The overall diagnosis rate was 95 %. The most common diagnosis was interstitial lung disease(12 patients, 64%) and infection was detected in four patients(21%). The biopsy-proven bronchiolitis obliterance was confirmed in two of seven patients suspected by CT findings. Specific treatment was changed after biopsy in 16 patients (85%). The morbidity & overall mortality rates of the patients were 5%(one patient) and 21%(four patients) respectively. Only one complication was seen : empyema. The causes of death were acute respiratory distress syndrome(one patient), respiratory failure(two patients), and septicemia(one patient). Conclusion : The lung biopsy is a safe procedure and it contributes to more accurate diagnosis and proper management of pediatric lung diseases. We recommend lung biopsies should be considered more positively in the diagnosis of pediatric lung diseases.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.410-422
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• 2017

The purpose of this study was to investigate the correlation between knowledge related to disease(KRD), illness attitude, and quality of life(QOL) in relation to the Chronic Obstructive Pulmonary Disease(COPD). According to the study result, there were significant differences with regard to KRD in accordance with subjects' education, monthly income, mMRC(modified Medical Research Council) Dyspnea Scale, inhaled bronchodilator and antibiotic treatment. In addition, there were significant differences with respect to illness attitude according to monthly income and mMRC. In case of the QOL, there were significant differences in accordance with age, marital status, monthly income, inpatient status, history of hospital admission, oxygen use, comorbidity, mMRC, and inhaled steroid. It has shown that there was a significant correlation between KRD and QOL(r=-.438, p<.001), illness attitude and QOL(r=.279, p=.001). Thus, it is important to grasp monthly income and mMRC, which are correlated with the three elements in common. As per assessment about COPD patients in the clinical situation, it is necessary to develop a multi-disciplinary approach, health coaching program for improving KRD and having a positive attitude based on the low-income group with taking interest in the circumstances of mMRC as well as objective test results.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.375-383
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• 2015

Purpose: The purpose of this study was to identify the relationship of resiliency and symptom experience and depression. Subjects (N=152) were patients with chronic obstructive pulmonary disease (COPD).admitted to D University Medical Center in B City. Methods: Data collection was conducted from July 20 to August 25, 2013. The levels of symptom, resilience, and depression were measured using a seven question symptom experience measuring instrument, a 25-question resilience instrument, and a 15-question Short Geriatric Depression Scale (SGDS). The collected data were analyzed by descriptive analysis, Pearson's correlation coefficients, and path analysis using SPSS/Win 19.0 and AMOS 5.0. Results: There was a significant negative correlation between symptom and resilience, a significant positive correlation between symptom and depression, and a significant negative correlation between resilience and depression. Symptom showed a direct effect on depression and an indirect effect on depression scores through resilience as a mediating variable. Conclusion: It is necessary to develop nursing intervention programs to relieve symptom in COPD patients, and to develop appropriate resilience enhancement programs to reduce their depression.

• Journal of Korean Academy of Nursing
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• v.33 no.6
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• pp.743-752
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• 2003

Purpose: This study was conducted to combine the effects of pulmonary rehabilitation program (PRP) on exercise capacity/tolerance and general health status of COPD patients based on the primary research results examined the effects of PRP, Method: Seventeen studies were selected by the sampling criteria established to include the studies that reported enough statistics necessary to conduct meta-analysis. Result: According to the study results, the most effective indicators for exercise capacity/tolerance were exercise time (such as cycling time or treadmill walking time) and ground walking distance within given time (6 minutes or 12 minutes), whereas effects on such indicators as VE and VO$_2$ were not statistically significant. PRP induced significant effect on patients' general health status, frequently measured by physical, psycho-emotional, and holistic indicators, the enhancement on psycho-emotional dimension resulted from PRP was more prominent than those of the other dimensions. From the results, it was noted that the place where PRP was given and the contents of PRP exercised their influence on the outcome variables. Which body part was trained was also one of the important factors that influence on the patients' perception of dyspnea during exercise as well as on exercise capacity/tolerance. Conclusion: PRP including exercise training significantly improved the exercise capacity and general health status of COPD patients.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.1-17
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• 1993

고빈도 환기법은 최근에 개발되어 임상에 응용되면서 호흡생리학, 마취학, 집중치료의 학등의 분야에서 호흡부전의 새로운 치료법으로 관심이 집중되고 있는 환기법이다. 현재까지 고빈도 환기법중 고빈도 양압 환기와 제트 환기는 비교적 많은 연구가 되고 있고 임상적으로 사용되고 있으나 고빈도 진동 환기법은 제한적으로 사용되고 있다. 앞으로 고빈도 진동 환기법에 대해서도 더 많은 연구가 되어야 할 것이다. 또한 최근 개발되고 있는 고빈도 흉벽 진동 환기와 체표면 진동 환기에도 관심을 기울이면 호흡부전 환자의 치료에 바람직한 새로운 환기법이 될 수 있을 것으로 기대된다. 현재 고빈도 환기법의 몇몇 적용형태는 기관지-늑막루등의 폐압손상으로 인한 병변의 치료외에도 기관수술, 흉부수술, 뇌수술에서 수술부위의 움직임을 최소화시키면서 충분한 가스교환율 이룩할 수 있어서 효과적으로 이용되고 있다. 그러나 응급심폐소생술, 폐쇄성 폐질환, 성인 또는 영아 호흡곤란증후군등과 같은 질환에서의 적용은 더 규명되어져야겠다. 고빈도 환기법의 여러가지 문제점중 적절한 환기빈도의 결정, 충분한 습도를 공급하는 장치, 고빈도 환기의 정확한 감시장치의 개발등은 앞으로 우선적으로 해결해야 할 문제점이다. 또한 임상에 더욱 효과적으로 응용될 수 있는 새로운 환기법이 되기 위해서는 고빈도 환기법의 호흡생리와 안정성등에 관한 연구도 병행되어야겠다.