• Tuberculosis and Respiratory Diseases
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• 제65권5호
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• pp.385-389
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• 2008

연구배경: 이전의 연구에서 섭취의 제한은 폐기종과 유사한 변화를 유발할 수 있음이 알려져 왔다. 그러나 이러한 현상이 만성폐쇄성폐질환 환자에서 갖는 의미는 밝혀진 적이 없다. 저자들은 만성폐쇄성폐질환 환자에서 영양섭취량과 폐기능지표와의 상관관계를 알아보고자 본 연구를 수행하였다. 방 법: 분당서울대학교병원에서 2006년 3월부터 1년동안 진료받은 만성폐쇄성폐질환 환자들을 대상으로 하였으며 폐활량검사, 확산능검사, 폐용적검사와 함께 영양섭취상태평가를 시행한 후 분석하였다. 결 과: 총섭취열량과 1초간노력호기량이나 최대노력호기량(%예측치)과는 아무런 상관관계를 찾을 수 없었다. 반면 폐확산능의 지표인 DLCO (%예측치), DLCO/VA (%예측치)와는 양의 상관관계를, 총폐용량(%예측치)과는 음의 상관관계를 보임을 관찰할 수 있었다. 섭취한 열량 중 단백질섭취열량과 폐확산능 DLCO (%예측치), DLCO/VA (%예측치)은 통계적으로 의미 있는 상관관계를 보였다. 그러나 탄수화물 및 지방섭취에 의한 열량과 폐기능지표는 의미 있는 상관관계를 보이지 않았다. 결 론: 만성폐쇄성폐질환 환자의 하루 섭취 열량은 그 환자의 폐확산능과는 양의 상관관계, 총폐용량과는 음의상관관계에 있어 섭취열량과 폐기종의 관련성에 대한 추가 연구가 필요하다.

• Safety and Health at Work
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• 제5권2호
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• pp.91-96
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• 2014

Background: Chronic obstructive pulmonary disease (COPD) is an important cause of occupational mortality in miners exposed to coal mine dust. Although the inflammatory mediators involved in COPD have not been defined, many studies have shown that inflammatory mediators such as reactive oxygen and nitrogen species are involved in orchestrating the complex inflammatory process in COPD. Methods: To investigate the relevance of exhaled biomarkers of oxidative and nitrosative stress in participants with COPD, we determined the levels of hydrogen peroxide, malondialdehyde (MDA), and 3-nitrotyrosine (3-NT) in exhaled breath condensate (EBC) in 90 retired elderly coal miners (53 non-COPD and 37 COPD participants). Results: Mean levels of MDA (4.64 nMvs. 6.46 nM, p = 0.005) and 3-NT (3.51 nMvs. 5.50 nM, p = 0.039) in EBC were significantly higher in participants with COPD. The median level of MDA did show statistical difference among the COPD severities (p = 0.017), and the area under the receiver operating characteristic curve forMDA (0.67) for the diagnostic discrimination of COPD indicated the biomarker. The optimal cutoff values were 5.34 nM (64.9% sensitivity and 64.2% specificity) and 5.58 nM (62.2% sensitivity and 62.3% specificity) forMDA and 3-NT, respectively. The results suggest that high levels ofMDA and 3-NT in EBC are associated with COPD in retired elderly miners. Conclusion: These results showed that the elevated levels of EBC MDA and EBC 3-NT in individuals with COPD are biomarkers of oxidative or nitrosative stress.

• 대한한방내과학회지
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• 제31권1호
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• pp.84-101
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• 2010

Objectives : This study aimed to evaluate the protective effects of Seonpyejeongcheon-tang (SJT) on elastase-induced lung injury. Materials and Methods : The extract of SJT was treated to A549 cells and an elastase-induced lung injury mouse model. Then, various parameters such as cell-based cytoprotective activity and histopathological findings were analyzed. Results : SJT showed a protective effect on elastase-induced cytotoxicity in A549 cells. This effect was correlated with analysis for caspase 3 levels, collagen and elastin contents, protein level of cyclin B 1, Cdk1, and Erk1/2, and gene expression of TNF-$\alpha$ and IL-$1{\beta}$ in A549 cells. SJT treatment also revealed a protective effect on elastase-induced lung injury in mouse model. This effect was evidenced via histopathological findings, including immunofluoresence stains against elastin, collagen, and caspase 3, and protein levels of cyclin B1, Cdc2, and Erk1/2 in lung tissue. Conclusion : These data suggest that SJT has pharmaceutical properties on lung injury. This study thus provides scientific evidence for the efficacy of SJT for clinical application to patients with chronic obstructive pulmonary disease.

• Korean Journal of Radiology
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• 제21권7호
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• pp.880-890
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• 2020

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (D_Thorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. D_Thorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between D_Thorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV₁) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DL_CO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower D_Thorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.166-175
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• 2023

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The lower airways contain a rich and diverse microbiome, which may play a significant regulatory role in both health and disease. In COPD, the microbiome becomes perturbed, causing dysbiosis. Increased representation of members in the Proteobacteria phylum and certain members in the Firmicutes phylum has been associated with increased risk of exacerbations and mortality. Therapies such as inhaled corticosteroids and azithromycin may modulate the airway microbiome or its metabolites in patients with COPD. This paper provides an up-to-date overview of the airway microbiome and its importance in the pathophysiology of COPD and as potential therapeutic target in the future.

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.11-20
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• 2017

Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.

• 대한한의학회지
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• 제39권4호
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• pp.126-135
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• 2018

Objectives: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and irreversible airflow. This study aimed to evaluate the effects of GHX02 in a COPD-induced mouse model. Methods: The COPD mouse model was established by exposure to cigarette smoke extract and lipopolysaccharide which were administered by intratracheal injection three times with a 7 day interval. GHX02 (100, 200, 400 mg/kg) and all other drugs were orally administrated for 14 days from Day 7 to Day 21. Results: GHX02 significantly decreased the neutrophil counts in bronchoalveolar lavage fluid (BALF) and the number of $CD4^+$, $CD8^+$, $CD69^+$, and $CD11b^+/GR1^+$ cells in BALF and lung cells. GHX02 also suppressed the secretion of tumor necrosis factor-alpha ($TNF-{\alpha}$), interleukin-17A, macrophage inflammatory protein 2 (MIP2), and chemokine (C-X-C motif) ligand 1 (CXCL-1) in BALF and ameliorated the lung pathological changes. Conclusions: Thus, GHX02 effectively inhibited airway inflammation by inhibiting migration of inflammatory cells and expression of pro-inflammatory cytokines. Therefore, GHX02 may be a promising therapeutic agent for COPD.

• 셀메드
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• 제14권2호
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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.

• Journal of Chest Surgery
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• 제28권4호
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• pp.371-375
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• 1995

Surgical resection of lung cancer or other disease is recently required in patients with severely impaired lung function resulting from chronic obstructive pulmonary disease or disease extension. So prediction of pulmonary function after lung resection is very important in thoracic surgeon. We studied the accuracy of the prediction of postoperative pulmonary function using perfusion lung scan with 99m technetium macroaggregated albumin in 22 patients who received the pneumonectomy. The linear regression line derived from correlation between predicting[X and postoperative measured[Y values of FEV1 and FVC in patients are as follows: 1 Y[ml =0.713X + 381 in FEV1 [r=0.719 ,[P<0.01 2 Y[ml =0.645X + 556 in FVC [r=0.675 ,[P<0.01 In conclusion,the perfusion lung scan is noninvasive and very accurate for predicting postpneumonectomy pulmonary function.

• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.80-90
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• 2024

Background: There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods: In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results: Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion: The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.