• Title/Summary/Keyword: Chronic pulmonary disease

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Effect of Platelet Activation on Pulmonary Hypertension in Chronic Obstructive Pulmonary Diseases (만성폐쇄성폐질환에서 혈소판 활성도가 폐동맥 고혈압에 미치는 영향)

  • Kim, Hyung-Jung;Nam, Moon-Suk;Kwon, Hyuck-Moon;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young;Song, Kyung-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.147-152
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    • 1993
  • Background: There is evidence that platelet is activated in chronic obstructive pulmonary disease and activated platelet with injured endothelium contribute to the pathogenesis of pulmonary hypertension, prognostic factor of chronic obstructive pulmonary disease. So, we have investigated platelet function further in chronic obstructive pulmonary disease and effect of platelet activation on pulmonary hypertension. Method: We studied platelet aggregation ratio and alpha-granule products such as platelet factor 4(PF4) and beta-thromboglobulin (${\beta}$-TG) in control subjects and COPD without and with pulmonary hypertension subjects. Result: 1) The platelet aggregation ratio (PAR) was $0.99{\pm}0.04$ in control subjects, $0.98{\pm}0.05$ in COPD without pulmonary hypertension subjects and $0.89{\pm}0.08$ in COPD with pulmonary hypertension subjects. The platelet aggregation ratio of COPD subjects was tend to decrease than that of control subjects and the ratio of COPD with pulmonary hypertension subjects was significantly lower than that of control subjects. 2) The platelet factor 4 (PF4, IU/ml) was $4.7{\pm}1.2$ in control subjects, $18.6{\pm}4.9$ in COPD without pulmonary hypertension subjects and $57.2{\pm}12.7$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of control subjects and the level of COPD with pulmonary hypertension subjects was significantly higher than that of COPD without pulmonary hypertension subjects. 3) The beta-thromboglobulin (${\beta}$-TG, IU/ml) was $34.4{\pm}5.8$ in control subjects, $80.4{\pm}18.1$ in COPD without pulmonary hypertension subjects and $93.0{\pm}14.0$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of conrtrol subjects and the level of COPD with pulmonary hypertension subjects was tend to increase than that of COPD without pulmonary hypertension subjects. 4) There was no correlation between the clinical parameters and PAR, PF4 and ${\beta}$-TG but there was significant correlation among PAR, PF4 and ${\beta}$-TG. Conclusion: The platelet is activated in chronic obstructive pulmonary disease and the platelet of COPD with pulmonary hypertension is tend to be activated more than that of COPD without pulmonary hypertension. So, activated platelet may involve in the pathogenesis and maintenance of pulmonary hypertension in COPD subjects and modulation of platelet activity that might reduce pulmonary hypertension needs to be determined.

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Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.313-319
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    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

Convergence analysis of Prevalence and Risk Factors of chronic obstructive pulmonary disease among Non-smokers (비흡연자 만성폐쇄성폐질환의 유병률과 위험인자의 융합적 분석)

  • Song, Hye-young;Bang, Yun Yi
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.85-93
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    • 2018
  • The purpose of the study was to investigate the prevalence and risk factors of chronic obstructive pulmonary disease(COPD) among nonsmokers from the 6th Korea National Health and Nutrition Examination Survey(2013-2015). We used complex sample cross analysis and logistic regression analysis on 4, 911 non-smokers among the patients with chronic obstructive pulmonary disease over 40 years of age. In general characteristics, the prevalence of COPD is higher in the old(p<.001), men(p<.001), rural(p=.044), without spouses(p<.001), less educated(p<.001), agriculture(p<.001). Also, the non-smoker's COPD risk factor is age(p<.001), gender(p<.001), education(p=.022), occupation(p=.022), pulmonary tuberculosis(p<.001), asthma(p<.001). It is necessary to develop a respiratory rehabilitation and intervention program that can be applied in clinical practice based on nursing assessment considering the COPD prevalence and risk factors.

The Long-term Efficacy of Domiciliary Noninvasive Positive-Pressure Ventilation in Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials

  • Park, So Young;Yoo, Kwang Ha;Park, Yong Bum;Rhee, Chin Kook;Park, Jinkyeong;Park, Hye Yun;Hwang, Yong Il;Park, Dong Ah;Sim, Yun Su
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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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.

Osteoporosis in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

  • Oh, Jee Youn;Lee, Young Seok;Min, Kyung Hoon;Lee, Sung Yong;Shim, Jae Jeong;Kang, Kyung Ho;Hur, Gyu Young
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.73-79
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    • 2018
  • Background: Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS. Methods: This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted. Results: A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p<0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD. Conclusion: Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.

Role of AMP-Activated Protein Kinase (AMPK) in Smoking-Induced Lung Inflammation and Emphysema

  • Lee, Jae Seung;Park, Sun Joo;Cho, You Sook;Huh, Jin Won;Oh, Yeon-Mok;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.8-17
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    • 2015
  • Background: AMP-activated protein kinase (AMPK) not only functions as an intracellular energy sensor and regulator, but is also a general sensor of oxidative stress. Furthermore, there is recent evidence that it participates in limiting acute inflammatory reactions, apoptosis and cellular senescence. Thus, it may oppose the development of chronic obstructive pulmonary disease. Methods: To investigate the role of AMPK in cigarette smoke-induced lung inflammation and emphysema we first compared cigarette smoking and polyinosinic-polycytidylic acid [poly(I:C)]-induced lung inflammation and emphysema in $AMPK{\alpha}1$-deficient ($AMPK{\alpha}1$-HT) mice and wild-type mice of the same genetic background. We then investigated the role of AMPK in the induction of interleukin-8 (IL-8) by cigarette smoke extract (CSE) in A549 cells. Results: Cigarette smoking and poly(I:C)-induced lung inflammation and emphysema were elevated in $AMPK{\alpha}1$-HT compared to wild-type mice. CSE increased AMPK activation in a CSE concentration- and time-dependent manner. 5-Aminoimidazole-4-carboxamide-1-${\beta}$-4-ribofuranoside (AICAR), an AMPK activator, decreased CSE-induced IL-8 production while Compound C, an AMPK inhibitor, increased it, as did pretreatment with an $AMPK{\alpha}1$-specific small interfering RNA. Conclusion: $AMPK{\alpha}1$-deficient mice have increased susceptibility to lung inflammation and emphysema when exposed to cigarette smoke, and AMPK appears to reduce lung inflammation and emphysema by lowering IL-8 production.

Overlap Syndrome:Obstructive Sleep Apnea-Hypopnea Syndrome in Patients with Chronic Obstructive Pulmonary Disease (중첩증후군:만성 폐쇄성 폐질환을 가 진 폐쇄성 수면무호흡-저호흡 증후군)

  • Choi, Young-Mi
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.67-70
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    • 2008
  • Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

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Related Factors of Quality of Life in Male Patients with Chronic Obstructive Pulmonary Disease (남성 만성폐쇄성폐질환자의 삶의 질 관련요인)

  • Lee, Hae-Jung;Jee, Young-Ju
    • Korean Journal of Adult Nursing
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    • v.23 no.4
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    • pp.309-320
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    • 2011
  • Purpose: The purpose of the study was to examine the related factors of quality of life (QOL) among patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Patients diagnosed with COPD (N=230) were recruited from four hospitals in Kyeong-Nam province, from March 2 to November 30, 2010. The data collection instruments were the Short Form 36, perceived dyspnea measure by Modified Medical Research Council, COPD and Asthma Sleep Impact Scale, COPD Self-efficacy Scale, and Center for Epidemiologic Studies Depression Scale were used. Following the completion of the data collection instruments Pulmonary function was tested. Data were analyzed with descriptive statistics, Pearson correlation and simultaneous multiple regression using SPSS/WIN. Results: The mean QOL of this study was 68.24. Using a multivariate approach, the significant correlates of QOL were depression (${\beta}$=-.37), dyspnea (${\beta}$=-.28), self-efficacy (${\beta}$=.20), and a sufficient degree of household income (${\beta}$=.16). These variables explained 49% of variance in QOL. Conclusion: The study suggests that psychological aspects are an important factor in explaining QOL of the patients. Screening and minimizing depression could be effective strategies in enhancing QOL of patients with COPD and further investigation to reduce depression could warrant the improvement of QOL in patients with COPD.