• Journal of Korean Biological Nursing Science
• /
• v.25 no.3
• /
• pp.172-182
• /
• 2023

Purpose: This study investigated the differences in physical function, self-efficacy (SE), and health-related quality of life (HRQoL) categorized by disease severity in community-dwelling patients with chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional study included 182 patients with COPD selected from the pulmonology outpatient department of a tertiary hospital. Disease severity was measured using forced expiratory volume in 1 second (FEV1). Physical function, SE, and HRQoL were measured with the six-minute walking distance, Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE), and St. George's Respiratory Questionnaire (SGRQ). Disease duration, FEV1, and 12-month history of exacerbations were obtained from medical records. Patients were categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Data were analyzed using the χ² test, and one-way ANOVA. Results: Most of the participants were male and nonsmokers. The disease duration was 10.76 ± 10.03 years, the mean FEV1% was 62.13 ± 22.80, and 70.3% of the participants were in GOLD category 2 (moderate) or milder. Half of the participants reported modified Medical Research Council scores ≥ 2. Patients in GOLD categories 1 and 3 (mild and severe) exhibited significantly higher PRAISE scores than those in the other groups (F = 8.23, p < .001). The total SGRQ scores were highest in GOLD 4 (very severe), indicating the lowest HRQoL. Significant differences were identified among GOLD 1, GOLD 2 and 3, and GOLD 4 (F = 9.92, p < .001). Conclusion: We identified potentially useful variables to comprehensively assess disease severity and tailor management strategies, including airflow limitation, and to determine the consequences of COPD from patients' perspectives.

• BMB Reports
• /
• v.36 no.1
• /
• pp.95-109
• /
• 2003

Inflammatory lung diseases are characterized by chronic inflammation and oxidant/antioxidant imbalance. The sources of the increased oxidative stress in patients with chronic inflammatory lung diseases such as asthma and chronic obstructive pulmonary disease (COPD) derive from the increased burden of inhaled oxidants, and from the increased amounts of reactive oxygen species (ROS) generated by several inflammatory, immune and various structural cells of the airways. Increased levels of ROS produced in the airways is reflected by increased markers of oxidative stress in the airspaces, sputum, breath, lungs and blood in patients with lung diseases. ROS, either directly or via the formation of lipid peroxidation products such as 4-hydroxy-2-nonenal may play a role in enhancing the inflammation through the activation of stress kinases (JNK, MAPK, p38) and redox sensitive transcription factors such as NF-${\kappa}B$ and AP-1. Recent evidences have indicated that oxidative stress and pro-inflammatory mediators can alter nuclear histone acetylation/deacetylation allowing access for transcription factor DNA binding leading to enhanced pro-inflammatory gene expression in various lung cells. Understanding of the mechanisms of redox signaling, NF-${\kappa}B$/AP-1 regulation, the balance between histone acetylation and deacetylation and the release and expression of pro- and anti-inflammatory mediators may lead to the development of novel therapies based on the pharmacological manipulation of antioxidants in lung inflammation and injury. Antioxidants that have effective wide spectrum activity and good bioavailability, thiols or molecules which have dual antioxidant and anti-inflammatory activity, may be potential therapeutic agents which not only protect against the direct injurious effects of oxidants, but may fundamentally alter the underlying inflammatory processes which play an important role in the pathogenesis of chronic inflammatory lung diseases.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.3
• /
• pp.226-229
• /
• 2017

Chronic obstructive pulmonary disease (COPD) had been considered the only major disease that is continuing to increase in prevalence. There were a few studies about the change of the prevalence of COPD, which showed the prevalence of COPD did not increase. In this review, we report on the trends in the prevalence of COPD in Korea using the data from Korea National Health and Nutrition Examination Survey (KNHANES). The prevalence of COPD in 2015 was 13.4% (male, 21.6%; female, 5.8%). The prevalence of COPD did not change much, which ranged from 13.1% to 14.6% during the period from 2010 to 2015. Among the subjects found to have COPD by spirometry, only 2.8% had been diagnosed as COPD by physicians during the period from 2011 and 2015. In conclusion, the prevalence of COPD did not change significantly during the period from 2010 to 2015. And most COPD patients still had not been diagnosed by physicians and consequently had not been treated appropriately.

• The Journal of Internal Korean Medicine
• /
• v.30 no.4
• /
• pp.732-745
• /
• 2009

Objectives : This study analyzed the contents of research papers of complementary and alternative medicine (CAM) concerning chronic obstructive pulmonary disease (COPD) published in PubMed during the last 5 years. This study was conducted to help clinical studies for treating COPD with Oriental medicine. Materials and Methods : We inspected 31 theses and scrutinized their objectives, periods, participants, materials and methods, methods of assessment, results and Jadad score. Results : The treatments in the studies were supplements, physical training, acupuncture, acu-TENS, Bojungikgi-tang (Buzhongyiqi-tang), counseling, breathing training, osteopathic manipulative treatment, reflexology, and distractive auditory stimuli. The aims of treatment were improvement of exercise capacity, lung function, quality of life, oxidative status, nutrient status, systemic inflammation, and cessation of smoking. The median for treatment period of study was 8 weeks, the median number of participants was 35 and the differences between mean $FEV_1$ from groups were less than 10% in 22 studies. The methods of assessment were lung function test, exercise capacity test, muscle strength test, questionnaire of QoL, laboratory studies, and measurement of nutrient state. The mean of Jadad score was $2.4\;{\pm}\;1.03$, and 24 treatment were assessed as effective. Conclusion : Recent CAM studies of COPD have focused on various topics in alternative and complementary medicine, and it is necessary to provide objective studies for treatment of this disease with Oriental medicines.

• Korean Journal of Clinical Laboratory Science
• /
• v.49 no.3
• /
• pp.214-219
• /
• 2017

Coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary disease (COPD) are characterized as chronic inflammation of the lung in miners exposed to coal mine dust. The aim of the present study was to compare the levels of serum lactate dehydrogenase (LD) and C-reactive protein (CRP) as the inflammatory indices between subjects with CWP and those with CWP and COPD (CWP+COPD), among a total of 97 subjects (27 control, 40 CWP, and 30 CWP+COPD patients). The mean levels of serum LD (165.7 vs 184.6 U/L, p=0.016) and CRP (0.08 vs 0.15 mg/dL, p=0.002) in subjects with CWP were higher than those of in subjects without CWP. The mean level of serum CRP (0.10 vs 0.19 mg/dL, p=0.008) in subjects with COPD was higher than that in subjects without COPD. In an analysis of covariance adjusted by age, the mean level of serum CRP showed statistical significance among the study groups, control, CWP, and CWP+COPD (0.07 vs 0.13 vs 0.19 mg/dL, p=0.005); the mean level of serum CRP in the CWP+COPD group was significantly higher than that of the control group (p=0.001). The results suggest that a high level of CRP in the serum may be associated with CWP and COPD in retired coal miners.

• Tuberculosis and Respiratory Diseases
• /
• v.81 no.4
• /
• pp.281-288
• /
• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• Journal of Yeungnam Medical Science
• /
• v.21 no.2
• /
• pp.133-142
• /
• 2004

Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

• Journal of Convergence for Information Technology
• /
• v.11 no.11
• /
• pp.248-255
• /
• 2021

This study confirmed the effects of improving lung damage of celecoxib using an animal model of chronic obstructive pulmonary disease(COPD). It was induced in models LPS + CSE and performed in vitro and in vivo. MTT assay and real-time PCR were performed in MRC5 cells as in vitro, and mRNA expression, BALF, collagen content, and protein expression were confirmed as in vivo. Celecoxib reduced the number of inflammatory cells, cytokine and soluble protein accumulation in BALF, decreased body weight and lung weight in animal models, and improved lung collagen deposition. In addition, the reduction of EMT markers was confirmed through Western blotting and real-time PCR. Consequently, celecoxib is thought to improve lung damage of COPD induced to LPS+CSE by regulating EMT.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.1
• /
• pp.35-41
• /
• 2019

Background: Pulmonary tuberculosis can result in anatomical sequelae, and cause airflow limitation. However, there are no treatment guidelines for patients with a tuberculosis-destroyed lung. Recently, indacaterol effectiveness in chronic obstructive pulmonary disease (COPD) patients with Tuberculosis history (INFINITY) study revealed indacaterol provided bronchodilation and symptom improvement in COPD patients with a tuberculosis-destroyed lung. Methods: We conducted a post-hoc subgroup analysis of the randomized controlled trial, the INFINITY study, to determine factors associated with indacaterol response in a tuberculosis-destroyed lung with airflow limitation. Data from 68 patients treated with inhaled indacaterol, were extracted and analyzed. Factors associated with the response of forced expiratory volume in one second ($FEV_1$) to indacaterol treatment, were determined using linear regression analysis. Results: Of 62 patients included, 68% were male, and 52% had history of cigarette smoking. Patients revealed mean $FEV_1$ of 50.5% of predicted value with mean improvement of 81.3 mL in $FEV_1$ after indacaterol treatment for 8 weeks. Linear regression analysis revealed factors associated with response of $FEV_1$ to indacaterol included a short duration of smoking history, and high short-acting bronchodilator response. When patients with history of smoking were excluded, factors associated with response of $FEV_1$ to indacaterol included high short-acting bronchodilator response, and poor health-related quality of life score as measured by St. George's Respiratory Questionnaire for COPD. Conclusion: In a tuberculosis-destroyed lung with airflow limitation, short-acting bronchodilator response and smoking history can play a critical role in predicting outcomes of indacaterol treatment.

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