• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.13-18
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• 2018

Bronchodilator therapy is central to the management of chronic obstructive pulmonary disease and are recommended as the preferred treatment by the Global Obstructive Lung Disease Initiative (GOLD). Long acting anti-muscarinics (LAMA) and long acting ${\beta}_2$ agonists (LABA) are both more effective than regular short-acting drugs but many patients remain symptomatic despite monotherapy with these drugs. Combination therapy with LAMA and LABA increases the therapeutic benefit while minimizing dose-dependent side effects of long-acting bronchodilator therapy. The TOviTO programme has investigated the benefits of treatment with a combination of tiotropium and olodaterol administered via a single inhaler. Tiotropium+olodaterol $5/5{\mu}g$ significantly improved forced expiratory volume in 1 second ($FEV_1$) area under the curve from 0 to 3 hours, trough $FEV_1$ health status and breathlessness versus the mono-components and placebo. Tiotropium+olodaterol $5/5{\mu}g$ also increased endurance time and reduced dynamic hyperinflation during constant work rate cycle ergometry. On the basis of these and other studies the 2017 GOLD report recommends escalating to dual bronchodilator therapy in patients in groups B and C if they remain symptomatic or continue to have exacerbations and as initial therapy for patients in group D.

• Journal of muscle and joint health
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• v.25 no.2
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• pp.112-121
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• 2018

Purpose: This study was conducted to explore the mediating effect of nutritional status on the relationship between symptom experience and functional status of patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 141 COPD patients visiting D hospital and I hospital in B city were enrolled in this study. Data were collected from January 2017 to July 2017. Outcome variables were measured by Mini Nutritional Assessment Short-Form (MNA-SF) for nutritional status, The Memorial Symptom Assessment Scale (MSAS) for symptom experience, and The Functional Performance Inventory Short Form (FPI-SF) for functional status. The data were analyzed with descriptive statistics, Pearson's correlation, and path analysis using SPSS/WIN 21.0 and AMOS 25. Results: There was a significant negative correlation between symptom experience and nutritional status (r=-.61, p<.001), a significant negative correlation between symptom experience and functional status (r=-.40, p<.001), and significant positive correlation between nutritional status and functional status (r=.47, p<.001). Symptom experience had indirect effects on functional status through nutritional status. Conclusion: For enhancing functional status in COPD patients, it is necessary to develop nursing intervention programs to enhance symptom management as well as nutritional status.

• 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 ㎛ (PM_2.5) 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.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.323-329
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• 2011

Background: Although patients with tuberculous-destroyed lung (TDL) account for a significant proportion of those with chronic airflow obstruction, it is difficult to distinguish patients with airway obstruction due to TDL from patients with pure chronic obstructive pulmonary disease (COPD) on initial presentation with dyspnea. We investigated clinical features differing between (i) patients with TDL and airway obstruction and (ii) those with COPD admitted to the intensive care unit (ICU) due to dyspnea. Methods: We reviewed the medical records of patients with TDL who had a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% on a pulmonary function test (PFT; best value closest to admission) and patients with COPD without a history of pulmonary tuberculosis (TB) who were admitted to the ICU. Ultimately, 16 patients with TDL and 16 with COPD were compared, excluding patients with co-morbidities. Results: The mean ages of the patients with TDL and COPD were 63.7 and 71.2 years, respectively. Mean FVC% (50.4% vs. 71.9%; p<0.01) and mean FEV1% (39.1% vs. 58.4%; p<0.01) were significantly lower in the TDL group than in the COPD group. More frequent consolidation with TB (68.8% vs. 31.3%; p=0.03) and more tracheostomies (50.0% vs. 0.0%; p=0.02) were observed in the TDL than in the COPD group. Conclusion: Upon ICU admission, patients with TDL had TB pneumonia more frequently, more diminished PFT results, and more tracheostomies than patients with COPD.

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

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.137-146
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• 2022

Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO₂max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO₂max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

• The Journal of the Convergence on Culture Technology
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• v.8 no.2
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• pp.299-307
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• 2022

This study is to understand the status of influenza vaccination in patients with chronic obstructive pulmonary disease and to analyze factors affecting vaccination behavior. The aim of this study was to investigate the factors influencing influenza vaccination among Chronic Obstructive Pulmonary Disease (COPD) patients over 40 years, sociodemographic characteristics and health behaviors. Data of 2,370 adults of over 40 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2014 to 2018 was used and analyzed. Overall influenza vaccination rate was 59.2%. Logistic regression analysis revealed that factors influencing on influenza vaccination were over 65 age, a low income, Never/past smoker, experience of health screening. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination among COPD patient over 40 years.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.46-51
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• 2016

Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 subjects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was performed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quality of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.

• Tuberculosis and Respiratory Diseases
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• v.80 no.4
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• pp.377-384
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• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.