• Title/Summary/Keyword: Obstructive Factors

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COMPREHENSIVE TREATMENT OF OBSTRUCTIVE SLEEP APNEA - THE ROLE OF DEPARTMENT OF DENTISTRY IN SLEEP CLINIC (폐쇄성 수면 무호흡증에 대한 포괄적 치료 - 수면 클리닉에서 치과의 역할)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Hwang, Sang-Hee;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.150-156
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    • 2004
  • The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree & site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.

Human adipose-derived mesenchymal stem cell spheroids improve recovery in a mouse model of elastase-induced emphysema

  • Cho, Ryeon Jin;Kim, You-Sun;Kim, Ji-Young;Oh, Yeon-Mok
    • BMB Reports
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    • v.50 no.2
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    • pp.79-84
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    • 2017
  • Emphysema, a pathologic component of the chronic obstructive pulmonary disease, causes irreversible destruction of lung. Many researchers have reported that mesenchymal stem cells can regenerate lung tissue after emphysema. We evaluated if spheroid human adipose-derived mesenchymal stem cells (ASCs) showed greater regenerative effects than dissociated ASCs in mice with elastase-induced emphysema. ASCs were administered via an intrapleural route. Mice injected with spheroid ASCs showed improved regeneration of lung tissues, increased expression of growth factors such as fibroblast growth factor-2 (FGF2) and hepatocyte growth factor (HGF), and a reduction in proteases with an induction of protease inhibitors when compared with mice injected with dissociated ASCs. Our findings indicate that spheroid ASCs show better regeneration of lung tissues than dissociated ACSs in mice with elastase-induced emphysema.

Factors associated with surgical polysomnography and Videofluoroscopy in patients with obstructive sleep apnea (폐쇄성수면무호흡증 환자에 있어서 수면다원검사 및 Videofluoroscopy의 수술적 인자와의 연관성)

  • Kim, Ki-Jeong;Jung, Hong-Ryang
    • Proceedings of the Korea Contents Association Conference
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    • 2015.05a
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    • pp.145-146
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    • 2015
  • 폐쇄성수면무호흡증(Obstructive sleep apnea syndrome : OSAS)은 신경근육계, 호흡계, 심혈관계의 복합적인 질환으로서 사회적, 생리학적으로 심각한 문제를 발생시킬 수 있는 질병이다. 수술적치료를 결정하기에 앞서 환자의 증상 및 징후, 신체 상태와 습관 등을 정밀검사하고, 기도폐쇄가 일상생활 및 정신건강에 미치는 영향을 고려하여 수술여부를 결정하여야 한다. 폐쇄성수면무호흡증후군의 진단에 유용한 검사인 수면다원검사와 Videofluoroscopy의 검사결과를 바탕으로 수술소견을 비교분석하고자 하였다.

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A literature study on the nasal stuffiness (鼻塞의 病因.病機.治療에 對한 文獻的 考察)

  • Yun, Chan-ho;Roh, Sek-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.1
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    • pp.295-312
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    • 1999
  • A literature study on the nasal stuffiness, the results are as follows. 1. The pathogenic factors nasal stuffiness are wind-cold, cold, fire-heat, heart & lung disease, deficiency of lung-energy and spleen & stomach disease caused by internal damage. 2. The method on the external treatment of nasal stuffiness are obstructive method, blowing method and pouring method, obstructive method used many. 3. The method on the internal treatment of nasal stuffiness are diaphoretic therapy, clearing away heat & toxic materials and warming the lung & invigorating the spleen. 4. You-taek-tong-gue-tang is used in nasal stuffness. 5. Herba Asari, Radix Angelicae Dahuricae, Flos Magnaliae, Fructus Xanthii, Rhizama Acori Graminei, Herba Menthae, Zanthoxyli Fructus and Spina Gleditsiae are used in nasal stuffness.

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Factors Associated with Indacaterol Response in Tuberculosis-Destroyed Lung with Airflow Limitation

  • Kim, Tae Hoon;Rhee, Chin Kook;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.1
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    • pp.35-41
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    • 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.

Clinical Features of Chronic Obstructive Pulmonary Disease with High Fractional Exhaled Nitric Oxide

  • Ahn, Seong;Kim, Tae-Ok;Chang, Jinsun;Shin, Hong-Joon;Kwon, Yong-Soo;Lim, Sung-Chul;Kim, Yu-Il
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.234-241
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    • 2020
  • Background: The fractional exhaled nitric oxide (FENO) test is useful in asthma patients. However, a few studies on its usefulness in chronic obstructive pulmonary disease (COPD) patients have been reported. We analyzed the FENO level distribution and clinical characteristics according to the FENO level in COPD patients. Methods: From December 2014 to June 2019, COPD patients who underwent pulmonary function and FENO tests at Chonnam National University Hospital were retrospectively evaluated for FENO, comorbidities, asthma history, blood eosinophil, and pulmonary function test. The high FENO group was defined as those with FENO level>25 parts per billion (ppb). Results: A total of 849 COPD patients (mean age, 70.3±9.4 years) were included. The mean forced expiratory volume at 1 second was 66.5±21.7% and the mean FENO level was 24.3±20.5 ppb. Patients with FENO ≤25 ppb were 572 (67.4%) and those with FENO >25 ppb were 277 (32.6%). Blood eosinophil percentage was significantly higher (4.2±4.8 vs. 2.7±2.5, p<0.001) in patients with the high FENO group than the low FENO group. The high FENO group revealed a significantly higher frequency of patients with blood eosinophil percentage >3% (46.9% vs. 34.8%, p=0.001) and asthma history (25.6% vs. 8.6%, p<0.001) than the lower FENO group. Asthma history, blood eosinophil percentage >3%, and positive bronchodilator response (BDR) were independent risk factors for the high FENO level (adjusted odds ratio [aOR], 3.85; p<0.001; aOR, 1.46; p=0.017; and aOR, 1.57, p=0.034, respectively) in the multivariable analysis. Conclusion: The FENO level distribution varied in COPD patients and the mean FENO value was slightly elevated. Asthma history, eosinophil percent, and positive BDR were independent risk factors for the high FENO level.

Contributors of the Severity of Airflow Limitation in COPD Patients

  • Hong, Yoon-Ki;Chae, Eun-Jin;Seo, Joon-Beom;Lee, Ji-Hyun;Kim, Eun-Kyung;Lee, Young-Kyung;Kim, Tae-Hyung;Kim, Woo-Jin;Lee, Jin-Hwa;Lee, Sang-Min;Lee, Sang-Yeub;Lim, Seong-Yong;Shin, Tae-Rim;Yoon, Ho-Il;Sheen, Seung-Soo;Ra, Seung-Won;Lee, Jae-Seung;Huh, Jin-Won;Lee, Sang-Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.8-14
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    • 2012
  • Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Risk Factors of Primary Lung Cancer and Spirometry (원발성 폐암의 위험인자와 폐활량 측정)

  • Rhee, Yang-Keun;Hwang, Keum-Man;Lee, Yong-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.646-652
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    • 1993
  • Background: Lung cancer and chronic obstructive lung disease often coexist in the same person who are elderly and cigarette smoking. There are several reports that the presence of chronic obstructive pulmonary disease constitutes an independent risk factor for the development of lung cancer. Moreover, the association between mucus hypersecrtion and lung cacer has been reported. Method: In 72 cases with primary lung cancer which were confirmed histopathologically at Chonbuk University Hospital from August 1986 to July 1991, We evaluated the relationship between spirometry and lung cancer characteristics. Results: Six cases(8.3%) showed normal lung function, 16(22.2%) cases showed pure restrictive lung disease, 46(63.9%) cases showed moderated obstructive lung disease and 4(5.6%) cases showed severe obstructive lung disease. $FEV_1$(%) was lower in central type than in peripheral type, lower in advanced non-small cell cancer and lower in subjects with phlegm. $FEV_1$/FVC(%) was higher in small cell cancer than in squamous cell cancer and higher in patients without previous pulmonary disease than with previous pulmonary disease. But there was no statistically significant difference in lung function according to histologic types and smoking history. Lung cancers with $FEV_1$/FVC less than 75% consisted of 35 cases of squamous cell cancer, 7 of small cell cancer(14%), 5 of adenocarcinoma(10%), 2 of large-cell carcinoma and 1 of unclassified carcinoma. Squamous cell carcinoma occured more in patients with $FEV_1$/FVC<75% than with $FEV_1$/FVC$\geq$75%(p<0.05). Conclusion: It was suggest that low $FEV_1$/FVC, as reflection of obstructive lung disease, may be at greater risk for squamous cell carcinoma in cigarette smoker.

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A Suggestion on the Traffic Flagger System in Japan (일본 교통유도 경비제도의 시사점)

  • Kim, Il-Gon
    • Proceedings of the Korea Contents Association Conference
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    • 2010.05a
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    • pp.200-203
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    • 2010
  • The obstructive factors of the smoothly running traffic are street improvement, major commercial buildings like department stores, the large markets, the stadiums, the concert buildings, a lot of steady cars for using parking lot. The accident of cost many lives and traffic congestion from these factors cause the result that it enables to pay the enormous expenditure socially and financially. For solving these problems, Japan adopts the Traffic Flagger System in 1972. This task has the effects of improving traffic flow in the traffic jam and mitigating risk of car accidents as leading pedestrians and vehicles thereby the task carries into effect in the area where the accident took place. Moreover, this security task is rapid growth after adopting and 59.6%(5,317) of the whole security company 8,924 in Japan based on December 2009 registered as the traffic leading security business. While South Korea is demanded of the measures about obstructive factors of the smoothly running traffic, it represents the limitation of the system and the safety management. Thus the current study suggests the we will analyze South Korea's actual condition and then discuss the law and education system for a realizable plan reached the public-Private cooperation for adopting Japan's Traffic Leading Security System.

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