• Journal of agricultural medicine and community health
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• v.46 no.1
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• pp.1-11
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• 2021

Objectives: This research aimed to identify the level of perception, knowledge, preventive behavior, and factors affecting preventive behavior of patients with asthma and chronic obstructive pulmonary disease against particulate matter. Methods: This research was a descriptive survey research, and the subjects were chronic pulmonary disease patients over the age of 19 and under 80 who visited a university hospital in Daegu City. Data was collected by convenience sampling through structured self-administered questionnaire survey from December 2019 to January 2020, and a total of 212 copies were used for analysis. Results: Out of 212 total subjects, 112 were asthma patients (52.8%) and 100 were chronic obstructive pulmonary disease patients (47.2%). The average score (out of 10) of perception, knowledge and preventive behavior of patients with asthma for particulate matter was 7.92, 6.99, and 7.10, respectively, while those with chronic obstructive pulmonary disease scored 7.72, 6.24, and 6.80, respectively. The knowledge score was significantly higher in patients with asthma than those with chronic obstructive pulmonary disease (p=0.007). Factors affecting particulate matter preventive behavior were perception score, knowledge score, and age for asthma patients, and perception score for chronic obstructive pulmonary disease patients. Conclusions: As a result of the above, the factors relate to the preventive behavior of patients with asthma and chronic obstructive pulmonary disease were perception score, knowledge score, and age for asthma, and perception score for chronic obstructive pulmonary disease. Raising the level of particulate matter preventive behavior can prevent the deterioration of chronic pulmonary diseases caused by particulate matter, so the development of arbitration programs considering the characteristics of the patients according to the disease and continuous and repetitive education are required.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1719-1729
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• 2021

Objective: Emphysema and small-airway disease are the two major components of chronic obstructive pulmonary disease (COPD). We propose a novel method of quantitative computed tomography (CT) emphysema air-trapping composite (EAtC) mapping to assess each COPD component. We analyzed the potential use of this method for assessing lung function in patients with COPD. Materials and Methods: A total of 584 patients with COPD underwent inspiration and expiration CTs. Using pairwise analysis of inspiration and expiration CTs with non-rigid registration, EAtC mapping classified lung parenchyma into three areas: Normal, functional air trapping (fAT), and emphysema (Emph). We defined fAT as the area with a density change of less than 60 Hounsfield units (HU) between inspiration and expiration CTs among areas with a density less than -856 HU on inspiration CT. The volume fraction of each area was compared with clinical parameters and pulmonary function tests (PFTs). The results were compared with those of parametric response mapping (PRM) analysis. Results: The relative volumes of the EAtC classes differed according to the Global Initiative for Chronic Obstructive Lung Disease stages (p < 0.001). Each class showed moderate correlations with forced expiratory volume in 1 second (FEV₁) and FEV₁/forced vital capacity (FVC) (r = -0.659-0.674, p < 0.001). Both fAT and Emph were significant predictors of FEV₁ and FEV₁/FVC (R² = 0.352 and 0.488, respectively; p < 0.001). fAT was a significant predictor of mean forced expiratory flow between 25% and 75% and residual volume/total vital capacity (R² = 0.264 and 0.233, respectively; p < 0.001), while Emph and age were significant predictors of carbon monoxide diffusing capacity (R² = 0.303; p < 0.001). fAT showed better correlations with PFTs than with small-airway disease on PRM. Conclusion: The proposed quantitative CT EAtC mapping provides comprehensive lung functional information on each disease component of COPD, which may serve as an imaging biomarker of lung function.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.129-136
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• 2006

Background: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the $FEV_1$/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. Methods: We obtained the age, gender, height, weight, $FEV_1$, FVC, and $FEV_1$/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the $FEV_1$/FVC' was evaluated in reference to the $5^{th}$ percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. Results: 1) The sensitivity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. Conclusion: The sensitivity and specificity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.

• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.207-213
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• 2016

Chronic obstructive pulmonary disease (COPD) encompasses several clinical syndromes, most notably emphysema and chronic bronchitis. Most of the current treatments fail to attenuate severity and progression of the disease, thereby requiring better mechanistic understandings of pathogenesis to develop disease-modifying therapeutics. A number of theories on COPD pathogenesis have been promulgated wherein an increase in protease burden from chronic inflammation, exaggerated production of reactive oxygen species and the resulting oxidant injury, or superfluous cell death responses caused by enhanced cellular injury/damage were proposed as the culprit. These hypotheses are not mutually exclusive and together likely represent the multifaceted biological processes involved in COPD pathogenesis. Recent studies demonstrate that mitochondria are involved in innate immune signaling that plays important roles in cigarette smoke-induced inflammasome activation, pulmonary inflammation and tissue remodeling responses. These responses are reviewed herein and synthesized into a view of COPD pathogenesis whereby mitochondria play a central role.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.5-13
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• 2005

Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease, characterized by irreversible airflow limitation, with a partially reversible component. The pathological abnormalities of COPD are associated with lung inflammation, imbalances of proteinase and antiproteinase, and oxidative stress, which are induced by noxious particles and gases in susceptible individuals. The physiological changes of COPD are mucus hypersecretion, ciliary dysfunction, airflow limitation, pulmonary hyperinflation, gas exchange abnormalities, pulmonary hypertension, cor pulmonale and systemic effects. The airflow limitation principally results from an increase in the resistance of the small conducting airways and a decrease in pulmonary elastic recoil due to emphysematous lung destruction. This article provides a general overview of the pathophysiology of COPD.

• CELLMED
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• v.14 no.2
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• pp.6.1-6.6
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• 2024

The prevalence of respiratory diseases is increasing due to social and environmental factors such as increased environmental pollution and air pollution, and among them, chronic obstructive pulmonary disease (COPD) in particular has a high mortality and morbidity rate worldwide. As a result, medical expenses are rapidly increasing, creating a social and economic burden. In response to this, there is a need to discuss ways to reduce the risk from diseases and manage them appropriately, and the most basic starting point in this process is how these chronic lung disease patients are treated in actual clinical settings and how to improve the quality of treatment. There is a need to look into whether there are effective drugs. Western treatment for chronic obstructive pulmonary disease is basically a disease in which the airway narrows, so bronchodilators are used to widen the bronchi, and corticosteroids and antibiotics are mainly used to relieve the inflammatory response in the lungs. However, since the mainly used Western medicine does not serve as a fundamental therapeutic drug and contains many side effects, there is a need for drugs that improve the quality of life of patients and are more effective in managing symptoms as symptomatic prescriptions. Therefore, Western and Oriental medicine treatments are needed. The purpose is to suggest better treatments through comparative analysis.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.22-34
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• 2021

The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.510-515
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• 2006

Background : Although 17% of Korean adults over the age of 45 years have chronic obstructive pulmonary disease (COPD), there is only limited data on the cause of death in COPD patients in Korea. Therefore, this retrospective study was performed to examine the cause of death in COPD patients at a referral hospital in Korea. Methods : The medical records of 28 deceased patients diagnosed as COPD in Asan Medical Center from January to December 2003 were reviewed patients had died in Asan Medical Center and 16 patients had died outside the hospital. The Korean National Statistical Office confirmed 88 deceased patients out of 1,078 patients diagnosed as COPD in Asan Medical Center in 2003. After excluding those with tuberculous destroyed lung, bronchiectasis, and lung cancer, 28 COPD patients were evaluated. Results : The causes of death were pulmonary disease including pneumonia in 16 patients (57%), cardiac disease in 5 patients (18%), sudden death in 3 patients (11%), and other causes in 4 patients (14%). The cause of death was pulmonary disease in 83% (10 out of 12 patients) and 38% (6 out of 16 patients) of patients who died in Asan Medical Center and outside the center, respectively (P=0.05). The cause of death was pulmonary disease in 43% of patients with $FEV_1$ more than 50 % of the predicted value and in 55% of patients with $FEV_1$ less than 50 % of the predicted value (P=0.89). Conclusion : Pulmonary disease is the leading cause of death in COPD patients in Korea.

• Tuberculosis and Respiratory Diseases
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• v.84 no.3
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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.