• Journal of the Korean Society of Physical Medicine
• /
• v.16 no.3
• /
• pp.99-106
• /
• 2021

PURPOSE: This study aimed to provide supporting data for the clinical use of breathing exercise with a WBV stimulation as a sustained and safe intervention program, by examining the effect of breathing exercise with WBV stimulation on the pulmonary function, gait ability, and life quality in patients with severe chronic obstructive pulmonary disease (COPD), who have difficulty performing exercise. METHODS: For this study, after collecting the samples from 20 patients with severe COPD, they were placed randomly in an experimental group to perform breathing exercises with a WBV stimulation (n = 10) and a control group to perform breathing exercises only (n=10). Before the intervention, pulmonary function, six-minute gait distance, and health-related life quality were measured as pre-tests. After applying the intervention program to the patients for 30 minutes once a day, for four days a week, for six weeks, the post-test items were remeasured in the same way as the pre-tests, and the results were analyzed. RESULTS: In the within-group comparison, both the experimental and control groups showed significant differences in the forced expiratory volume in one second, six-minute gait distance, and health-related life quality (p < .01) (p < .05). In the intergroup comparison, there were significant differences in the forced expiratory volume in one second and the six-minute gait distance (p < .05). CONCLUSION: WBV stimulation was more effective for the patients by improving the muscular strength and muscular endurance through the reflexive contraction of muscles, and increasing the exercise tolerance. This result could serve as an alternative means to clinically improve the physical function of patients with severe COPD, who have difficulty performing breathing exercises in the future.

• Tuberculosis and Respiratory Diseases
• /
• v.87 no.3
• /
• pp.234-251
• /
• 2024

Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers' direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers' economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients' lives and reduce the disease's rising economic burden.

• The Journal of Korean Physical Therapy
• /
• v.33 no.4
• /
• pp.179-186
• /
• 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.

• Journal of Korean Biological Nursing Science
• /
• v.19 no.1
• /
• pp.38-47
• /
• 2017

Purpose: This study was undertaken to examine the relationship between airflow obstruction and subjective health status reported by stable patients with chronic obstructive pulmonary disease (COPD) residing in the community. Methods: A cross-sectional descriptive study was conducted with 78 stable COPD patients aged 69.7 years old on average and selected by a convenient sampling from an outpatient department of pulmonology in tertiary hospitals. They completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI) and pulse oxymetry for $O_2$ saturation (Sat $O_2$). Medical records were reviewed to obtain disease-related characteristics including duration of the disease, cardiovascular comorbidity, and forced expiratory volume in 1 second ($FEV_1$). Data were analyzed using PASW statistics 20.0. Results: Mean $FEV_1%$ and CAT scores were 55.11% and 17.73, respectively. Those in the lower stage of mMRC showed significantly higher $FEV_1$ and lower CAT. $FEV_1$ and CAT showed significant negative correlations; age and BMI with $FEV_1$, and Sat $O_2$ with CAT. Conclusion: The findings suggest that the less airway obstruction was, the better health status was, and provide the support for using subjective measures in clinical practices for COPD patients.

• The Journal of the Korea Contents Association
• /
• v.22 no.9
• /
• pp.461-472
• /
• 2022

Purpose: This study aimed to acquire a better understanding of experiences about health information (HI) for self-management in patients with chronic obstructive pulmonary disease (COPD). Method: The thirty patients with COPD participated in in-depth interviews, until data saturation was reached. The data was analyzed using the content analysis method. Results: Four major themes emerged from the analysis of the self-management HI in patients with COPD such as "self-management practice based on HI", "difficulty in adhering to self-management based on HI", "various attempts to obtain self-management HI" and "satisfaction with provided HI". Conclusion: The majority of patients had no specific educational experience for self-management HI from other staff except for their doctors. Thus, it is necessary to prepare a hospital environment in which various medical staff can provide self-management HI of COPD while also ensuring that accurate and continuous HI could be easily obtained through various media types, family, and acquaintances.

• The Korean Journal of Physiology and Pharmacology
• /
• v.26 no.2
• /
• pp.95-111
• /
• 2022

Chronic obstructive pulmonary disease (COPD) is an important healthcare problem worldwide. Often, glucocorticoid (GC) resistance develops during COPD treatment. As a classic hypoglycemic drug, metformin (MET) can be used as a treatment strategy for COPD due to its anti-inflammatory and antioxidant effects, but its specific mechanism of action is not known. We aimed to clarify the role of MET on COPD and cigarette smoke extract (CSE)-induced GC resistance. Through establishment of a COPD model in rats, we found that MET could improve lung function, reduce pathological injury, as well as reduce the level of inflammation and oxidative stress in COPD, and upregulate expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), multidrug resistance protein 1 (MRP1), and histone deacetylase 2 (HDAC2). By establishing a model of GC resistance in human bronchial epithelial cells stimulated by CSE, we found that MET reduced secretion of interleukin-8, and could upregulate expression of Nrf2, HO-1, MRP1, and HDAC2. MET could also increase the inhibition of MRP1 efflux by MK571 significantly, and increase expression of HDAC2 mRNA and protein. In conclusion, MET may upregulate MRP1 expression by activating the Nrf2/HO-1 signaling pathway, and then regulate expression of HDAC2 protein to reduce GC resistance.

• CELLMED
• /
• v.14 no.2
• /
• pp.6.1-6.6
• /
• 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
• /
• v.81 no.4
• /
• pp.289-298
• /
• 2018

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.74-79
• /
• 2022

Background: The effect of underlying chronic obstructive pulmonary disease (COPD) on coronavirus disease 2019 (COVID-19) during a pandemic is controversial. The purpose of this study was to examine the prognosis of COVID-19 according to the underlying COPD. Methods: COVID-19 patients were assessed using nationwide health insurance data. Comorbidities were evaluated using the modified Charlson Comorbidity Index (mCCI) which excluded COPD from conventional CCI scores. Baseline characteristics were assessed. Univariable and multiple logistic and linear regression analyses were performed to determine effects of variables on clinical outcomes. Ages, sex, mCCI, socioeconomic status, and underlying COPD were selected as variables. Results: COPD patients showed older age (71.3±11.6 years vs. 47.7±19.1 years, p<0.001), higher mCCI (2.6±1.9 vs. 0.8±1.3, p<0.001), and higher mortality (22.9% vs. 3.2%, p<0.001) than non-COPD patients. The intensive care unit admission rate and hospital length of stay were not significantly different between the two groups. All variables were associated with mortality in univariate analysis. However, underlying COPD was not associated with mortality unlike other variables in the adjusted analysis. Older age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.11-1.14; p<0.001), male sex (OR, 2.29; 95% CI, 1.67-3.12; p<0.001), higher mCCI (OR, 1.30; 95% CI, 1.20-1.41; p<0.001), and medical aid insurance (OR, 1.55; 95% CI, 1.03-2.32; p=0.035) were associated with mortality. Conclusion: Underlying COPD is not associated with a poor prognosis of COVID-19.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.4
• /
• pp.323-329
• /
• 2011

Background: Although patients with tuberculous-destroyed lung (TDL) account for a significant proportion of those with chronic airflow obstruction, it is difficult to distinguish patients with airway obstruction due to TDL from patients with pure chronic obstructive pulmonary disease (COPD) on initial presentation with dyspnea. We investigated clinical features differing between (i) patients with TDL and airway obstruction and (ii) those with COPD admitted to the intensive care unit (ICU) due to dyspnea. Methods: We reviewed the medical records of patients with TDL who had a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% on a pulmonary function test (PFT; best value closest to admission) and patients with COPD without a history of pulmonary tuberculosis (TB) who were admitted to the ICU. Ultimately, 16 patients with TDL and 16 with COPD were compared, excluding patients with co-morbidities. Results: The mean ages of the patients with TDL and COPD were 63.7 and 71.2 years, respectively. Mean FVC% (50.4% vs. 71.9%; p<0.01) and mean FEV1% (39.1% vs. 58.4%; p<0.01) were significantly lower in the TDL group than in the COPD group. More frequent consolidation with TB (68.8% vs. 31.3%; p=0.03) and more tracheostomies (50.0% vs. 0.0%; p=0.02) were observed in the TDL than in the COPD group. Conclusion: Upon ICU admission, patients with TDL had TB pneumonia more frequently, more diminished PFT results, and more tracheostomies than patients with COPD.