• Tuberculosis and Respiratory Diseases
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• 제39권6호
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• pp.542-547
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• 1992

결절성경화증과 동반된 폐임파관평활근종증은 매우 드문 질환으로서 가임기의 여성에게 국한되어 발생한다. 저자들은 결절성경화증이 있던 39세의 여자 환자에게서 반복되는 자연기흉으로 폐조직 생검결과 폐임파관 평활근종증으로 확진된 예와 양측신 혈관근지반종을 동반한 결절성 경화증을 갖은 32세 여자 환자에서 호흡기 증상은 없었으나 흉부 X-선 및 고해상도 흉부 컴퓨터 단층 촬영상 폐임파관 평활근종증을 보였던 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.110-113
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• 2018

Tracheal cancer is rare and accounts for approximately 0.03% of all malignancies. Because of atypical symptoms, tracheal cancer can be misdiagnosed as obstructive lung disease, or tumors of thyroid or lung. Among patients of previous head and neck cancer, other primary cancer may accompany which called "econd primary cancer". We report a case of patient with tracheal cancer 3 years after definite radiation therapy of laryngeal cancer with a review of related literatures.

• Journal of Chest Surgery
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• 제50권2호
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• pp.86-93
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• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Tuberculosis and Respiratory Diseases
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• 제62권1호
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• pp.11-18
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• 2007

연구배경: 만성폐쇄성폐질환(chronic obstructive pulmonary disease, COPD) 환자군에서 우울증 및 불안장애의 유병률이 높고, 이는 치료경과 및 사망률에도 영향을 주는 것으로 알려져 있다. 저자들은 국내연구가 미비한 COPD환자들의 우울과 불안심리에 대한 평가를 하고자 하였다. 방 법: 2005년 9월부터 2006년 8월까지 이화의료원 호흡기내과에서 외래치료 중인 72명의 COPD환자와 정상 대조군 50명에서 Beck Depression Inventory (BDI)와 State-Trait Anxiety Inventory (STAI)로 설문조사를 시행하였고, 임상기록을 분석하였다. 결 과: 1) 연령과 체질량지수, 혈청 알부민 수치는 환자군과 대조군간의 유의한 차이를 보이지 않았다(p>0.05). 우울심리는 BDI점수가 환자군 16(0-37), 대조군 12(1-30)으로 환자군에서 유의하게 높았고(p=0.001), 21점 이상의 우울집단은 환자군이 36%로 대조군 6%에 비해 많았다(p<0.0001). 환자군에서는 경증군 18%(4/22), 중등증군 30%(6/20), 중증군 52%(13/25), 심한 중증군 60%(3/5)로 중증일수록 빈도가 높았다(p=0.008). 2) 불안심리는 환자군에서 SAI 점수 44(20-67), TAI점수 47(20-66)로 각각 대조군 39(26-65), 44(33-90)보다 유의하게 높았다(p=0.005, p=0.022). 환자군에서 BDI와 STAI점수는 상관관계를 보였고(p<0.001), 우울집단에서 불안점수가 유의하게 높았다. 3) COPD환자군에서 우울집단은 비우울집단보다 체질량지수, 기관지확장제후 $FEV_1$의 예측치가 유의하게 낮았고, 현재 흡연자의 비율과 중증도, STAI점수가 유의하게 높았다(p<0.05). 4) 연령과 성별을 통제한 다변량 로지스틱 회귀분석상 95% 신뢰구간으로 비차비는 체질량지수 0.9(p=0.311), 현재 흡연자 3.2(p=0.051), 중증군이상 3.9로(p=0.027), 중증이상의 중증도가 유일한 우울증 발생의 독립적 위험요인이었다. 결 론: COPD환자군에서 우울증과 불안심리가 흔하게 관찰되며, 체질량지수, 폐기능, 현재 흡연력이 우울관련 요인으로 특히 중증도가 높을수록 우울증과 불안장애의 관리가 필요함을 보여주었다.

• 대한영상의학회지
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• 제84권4호
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• pp.900-910
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• 2023

목적 정상으로 보이는 chest CT를 정량화 분석하여 흡연 및 폐쇄성 폐질환(chronic obstructive pulmonary disease; 이하 COPD) 여부에 따른 차이가 있는지 확인하고자 하였다. 대상과 방법 2013년 1월부터 2014년 12월까지 chest CT가 정상이면서 정량화 분석이 있는 90명의 남자 환자[COPD 없는 비흡연자(n = 38)와 흡연자(n = 45), COPD 흡연자(n = 7)]를 대상으로 하였다. COPD 흡연자 7명을 대상으로 나이를 추출하여 환자-대조군 연구도 하위 분석하였다. Pi10, 왜도, 첨도, 평균감쇠계수, 저감쇠영역%와 같은 정령화 변수를 분석하였다. 결과 COPD가 없는 환자 중에서 흡연자의 Pi10 (4.176 ± 0.282, n = 45)이 비흡연자에 비해 약 0.1 mm 정도 두꺼웠고(4.070 ± 0.191, n = 38, p = 0.047), 흡연자의 왜도와 첨도(2.628 ± 0.484 and 6.448 ± 3.427)가 비흡연자보다 낮았다(2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.027). COPD가 있는 흡연자들의 Pi10 (4.427 ± 0.437, n = 7)이 COPD가 없는 비흡연자들보다 약 0.4 mm 두꺼웠다(4.001 ± 0.108, n = 14, p = 0.005). 그러나 평균감쇠계수와 저감쇠영역%에서는 유의한 차이가 없었다. 결론 정상 chest CT를 보이더라도 QCT로 COPD의 유무와 상관없이 흡연자들의 소기도가 두꺼운 것을 알 수 있으며 이는 폐실질 변화보다 더 선행한다.

• 대한한의학회지
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• 제34권3호
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• pp.54-68
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• 2013

Objectives: This study aimed to evaluate the effects of microparticles of Socheongryong-tang (SCRT) on chronic obstructive pulmonary disease (COPD) in a mouse model. Methods: The inhalable microparticles containing SCRT were produced by spray-drying with leucine as an excipient, and evaluated with respect to the aerodynamic properties of the powder by Andersen cascade impactor (ACI). Its equivalence to SCRT extract was evaluated using lipopolysaccharide (LPS) and a cigarette-smoking (CS)-induced murine COPD model. Results: SCRT microparticles provided desirable aerodynamic properties (fine particle fraction of $49.6{\pm}5.5%$ and mass median aerodynamic diameter of $4.8{\pm}0.3{\mu}m$). SCRT microparticles did not show mortality or clinical signs over 14 days. Also there were no significant differences in body weight, organ weights or serum chemical parameters between SCRT microparticle-treated and non-treated groups. After 14 days the platelet count significantly increased compared with the non-treated group, but the values were within the normal range. Inhalation of SCRT microparticles decreased the rate of neutrophils in blood, granulocytes in peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage fluid (BALF) and level of TNF-${\alpha}$ and IL-6 in BALF on COPD mouse model induced by LPS plus CS. This effect was verified by histological findings including immunofluorescence staining of elastin, collagen, and caspase 3 protein in lung tissue. Conclusions: These data demonstrate that SCRT microparticles are equivalent to SCRT extract in pharmaceutical properties for COPD. This study suggests that SCRT microparticles would be a potential agent of inhalation therapy for the treatment of COPD.

• Journal of Hospice and Palliative Care
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• 제20권2호
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• pp.81-92
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• 2017

만성 폐쇄성 폐질환은 비가역적, 점진적 기도 폐쇄가 특징인 주요 사망 원인중의 하나이다. 말기 폐쇄성 폐질환 환자는 다양한 신체적, 정서적, 사회적, 기능적 문제로 인해 호스피스 완화의료가 필요하다. 따라서, 완화의료의 목적은 증상 조절, 운동 능력 및 삶의 질 향상이며, 아울러 급성 악화 빈도를 줄이고 질병의 진행을 늦추는 효과를 기대할 수 있다. 다양한 진행 과정 때문에 말기 시점을 예측하기 어렵다. 호흡곤란 정도, 폐기능, 혈액학적 임상 지표를 이용하여 대상자를 선정하는 기준을 마련하고 적용시점을 논의해야 한다. 질환의 특성상 진단 후 초기에는 완치 목적의 치료가 중심이 되어 완화의료가 이를 보완하는 방식으로 적용되다가, 완치 목적의 치료를 위해 입 퇴원을 반복하거나 치료의 반응이 낮고 나쁜 예후가 예상될 때 완화의료 비중이 확대되는 것이 바람직하겠다. 폐쇄성 폐질환 환자에게 적극적으로 호흡재활을 적용하고, 환자의 의사결정을 존중하여 증상 악화 이전에 미리 대책을 마련하고 앞으로의 치료 목표를 논의하기 위한 완화의료 팀을 구성하고, 국내 현실에 맞는 진료 연계 체계를 마련하는 것이 필요하다. 제도가 잘 정착하기 위해서는 일차 의료 및 암환자 대상의 완화의료 전문 팀과의 협업이 중요하며, 우선 고려되어야 할 것이다.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.123-131
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. Methods: We enrolled 85 patients with COPD (76 males, 9 females; mean age, $70.6{\pm}7.1years$) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. Results: The average AP diameter was significantly greater in patients with COPD compared with normal controls ($13.1{\pm}2.8cm$ vs. $12.2{\pm}1.13cm$, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls ($0.66{\pm}0.061$ vs. $0.61{\pm}0.86$; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=-0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). Conclusion: Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.

• 한국산업보건학회지
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• 제31권3호
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• pp.286-293
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• 2021

Objectives: Inorganic dust is known to be a risk factor for chronic obstructive pulmonary disease (COPD) regardless of smoking and pneumoconiosis. Adaptive and innate immunity, including lymphocyte infiltrate, are involved in the pathogenesis of COPD. The purpose of this study was to analyze the lymphocyte subsets in the blood of workers exposed to inorganic dust and confirm the influencing factors. Methods: The general characteristics of the subjects (n=107) were analyzed through a personal questionnaire. Diagnosis of COPD was established according to pulmonary function tests with FEV₁/FVC post bronchodilator lower than 70%, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. For lymphocyte analysis, blood was stained with a fluorescent CD marker and analyzed by flow cytometry. Results: The increase in CD4⁺ T lymphocytes was associated with a decrease in age (𝛽=-0.273, p=0.008) and an increase in the cumulative smoking amount (𝛽=0.205, p=0.034). The increase in NK cells was associated with an increase in age (𝛽=0.325, p=0.001) and a decrease in cumulative smoking (𝛽=-0.220, p=0.019). The period of exposure to dust, %FVC predicted and %FEV₁/FVC, and the relative population of peripheral blood lymphocytes did not show a statistically significant relationship. Conclusions: CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells in peripheral blood were more related to age and cumulative smoking than the duration of dust exposure. Age and smoking are major risk factors for the development of COPD, so it can be predicted that peripheral blood CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells are related to the development of COPD in workers exposed to inorganic dust.

• 한국산업보건학회지
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• 제29권1호
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• pp.42-49
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• 2019

Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Iron deficiency is associated with chronic inflammation, such as COPD. The aim of this study was to evaluate the relationship among iron deficiency, iron homeostasis, and inflammation in retired miners with COPD. Methods: The serum levels of ferritin, soluble transferrin receptor(sTfR), and transferrin saturation(TSat) as biomarkers for iron deficiency and high-sensitivity C-reactive protein(hsCRP) as a biomarker for inflammation and hepcidin as a biomarker for iron homeostasis were measured in 93 male subjects. Iron deficiency was defined as any one or more of (1) sTfR>28.1 nmol/L, (2) TSat<16%, and (3) ferritin< $12{\mu}g/L$. Results: Iron deficiency was found 28% of the study subjects. Median levels of serum hsCRP was significantly increased related to airflow limitation of COPD(GOLD 1, $0.09{\mu}g/dL$ vs. GOLD 2, $0.17{\mu}g/dL$ vs. GOLD $3{\leq}$, $0.30{\mu}g/dL$, p=0.010), and was positively correlated with hepcidin(p=0.009). Mean level of serum hepcidin was lower in COPD subjects with iron deficiency(p=0.004) and serum levels of hepcidin was negatively correlated with %$FEV_1$ predicted(p=0.030). Conclusions: These results suggest that high serum levels of hepcidin are related to severe airflow limitation or inflammation and can decrease iron availability, regardless of iron status.