BACKGROUND: Mixed obstructive and restrictive pattern of spirometry can not be concluded in the presence of true restrictive disorders because pure obstructive disorders can also shoy reduced vital ca pacity. However, it is not known how many patients with mixed spirometric pattern really have restrictive disorders in Korea whose pattern of pulmonary diseases is somewhat different from foreign countries. To answer this question, I performed this study and tried to answer it according to diseases in addtion. METHOD: Test results from 413 patients who undergone both spirometry and lung volume measurements on the same visit from August 1, 1998 to July 31, 1999 were included. Spirometry data were classified as mixed obstructive-restrictive pattern when spirometry showed 'FEV1/FNC <70% (<65% if age >or= 60)' and FVC <80% of predicted value. TLC by the method of nitrogen washout was considered as gold standard to diagnose restrictive disorders in which TLC is less than 80% of predicted value. RESULTS: Out of 404 patients who could be evaluated, 58 had mixed pattern of spirometry. 58 patients were suffered from airway diseases (39 patients) such as COPD (22 patients, 38%), asthma (11,19%), bronchiectasis (6,10%), and sequelae of pulmonary tuberculosis (15,26%) or other diseases (4,7%). Only 18 out of 58 (31%) were confirmed to have true restrictive disorders by TLC. The proportion of true restrictive disorders was different according to diseases, 20.5%(8/39 patients) in patients with airway diseases and 53.5%(8/15) with sequelae of pulmonary tuberculosis (p<0.05). CONCLUSION: Many patients whose spirometry showed mixed pattern didn't have restrictive disoders but had pure obstructive disorders. This was true for more patients with airway diseases. Therefore it would be prudent that lung volume be tested to diagnose restrictive disorders in patients with mixed spirometric pattern.
Asthma ; Bronchiectasis ; Humans ; Korea ; Lung ; Lung Diseases ; Lung Volume Measurements ; Nitrogen ; Pulmonary Disease, Chronic Obstructive ; Spirometry ; Tuberculosis, Pulmonary

BACKGROUND: It is well known that rifampin decreases the hypoprothrombinemic effect of warfarin by induction of cytochrome p-450 enzyme in healthy volunteer. However, in patients the dosage schedule o f warfarin during rifampin therapy is not established. Therefore, patients taking both rifampin and warfarin were reviewed to find out the adequate dosage schedule of warfafin in addition to side effects by interaction of two drugs. METHOD: Patients taking both rifampin and warfarin were retrieved from patients who were admitted due to heart disease and tuberculosis at Boochun Sejong Hospital from January of 1995 to August of 1999. To decide the adequate dosage of warfarin, the dosage of warfarin before, during, and after rifampin was evaluated in patients who kept adequate hypoprothrombinemic effect of warfarin during rifampin. To decide the adequate dosage schedule of warfarin, the time interval from the beginning of rifampin to normalization of prothrombin time(INR Appointments and Schedules ; Cerebral Hemorrhage ; Cytochrome P-450 Enzyme System ; Healthy Volunteers ; Heart Diseases ; Humans ; Intracranial Embolism ; Prothrombin ; Prothrombin Time ; Rifampin* ; Tuberculosis ; Warfarin*

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

No abstract available.
Pulmonary Disease, Chronic Obstructive*

Inhaled corticosteroids (ICSs) have been widely used as a key medication for asthma control. However, ICSs have been known to cause respiratory infections, such as pneumonia and pulmonary tuberculosis. Consequently, a dilemma exists regarding recommendation of persistent lifetime use of ICSs to mild asthma patients. Short-acting β-agonists (SABAs) have also been widely used for symptom relief. However, SABAs have been reported to increase the risk of asthma-related death, though incidences have been very rare. Consequently, a dilemma exists regarding recommendation of a SABA alone without an ICS or a controller to asthma patients even with very mild disease. In the real world, asthma patients tend to intermittently use ICS and more likely to be dependent on SABA since many patients want immediate relief of their symptoms. Consequently, a dilemma exists regarding the underuse of ICSs but the overuse of SABAs. One strategy for solving the presented dilemma would be identification of patients with asthma who require persistent use of asthma controllers. Such patients, who may be referred to as “persistent controller users,” should continuously receive ICSs, even under controlled states of asthma. Another strategy would be a patient-adjusted, symptom-driven, intermittent-to-regular treatment combining low-dose ICS/rapid-onset long-acting β-agonists instead of using a SABA alone or with low-dose ICS for the asthma patients with mild disease. Both of these two strategies could avoid the risky treatment of a SABA alone without an ICS and could reduce the dose of ICS with the maintenance of asthma control.
Adrenal Cortex Hormones ; Asthma ; Humans ; Incidence ; Pneumonia ; Respiratory Tract Infections ; Tuberculosis, Pulmonary

Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease, featured by airflow obstruction. Recently, a comprehensive analysis of the transcriptome in lung tissue of COPD patients was performed, but the heterogeneity of the sample was not seriously considered in characterizing the mechanistic dysregulation of COPD. Here, we established a new transcriptome analysis pipeline using a deconvolution process to reduce the heterogeneity and clearly identified that these transcriptome data originated from the mild or moderate stage of COPD patients. Differentially expressed or co-expressed genes in the protein interaction subnetworks were linked with mitochondrial dysfunction and the immune response, as expected. Computational protein localization prediction revealed that 19 proteins showing changes in subcellular localization were mostly related to mitochondria, suggesting that mislocalization of mitochondria-targeting proteins plays an important role in COPD pathology. Our extensive evaluation of COPD transcriptome data could provide guidelines for analyzing heterogeneous gene expression profiles and classifying potential candidate genes that are responsible for the pathogenesis of COPD.
Gene Expression Profiling ; Humans ; Lung ; Lung Diseases ; Mitochondria ; Pathology ; Population Characteristics ; Pulmonary Disease, Chronic Obstructive ; Transcriptome

Asthma in the elderly tends to be underdiagnosed and undertreated despite its high morbidity and mortality. The diagnosis and management of asthma in the elderly is essentially the same as in adult patients. For diagnosis, spirometry is crucial, in addition to an assessment of typical symptoms; for management, the use of an inhaled corticosteroid is essential to control asthma. In elderly asthmatics, medications controlling asthma appear to be less efficacious than in younger asthmatics, and show more adverse effects. Other diseases with symptoms similar to asthma in the elderly are chronic obstructive pulmonary disease, tuberculous destroyed lung, bronchiectasis, lung cancer, and heart disease, and care should therefore be taken to differentiate these conditions from asthma. Vaccinations for influenza and pneumococcus are recommended for elderly individuals with asthma.
Adult ; Aged ; Asthma ; Bronchiectasis ; Diagnosis ; Heart Diseases ; Humans ; Influenza, Human ; Lung ; Lung Neoplasms ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Spirometry ; Streptococcus pneumoniae ; Vaccination

Chronic obstructive pulmonary disease (COPD) should be considered in any patient who has dyspnea, chronic cough or sputum production, and/or a history of exposure to risk factors for the disease, such as cigarette smoking, biomass exposure, and occupational dust. Spirometry is required to make the diagnosis, and a post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio < 0.7 confirms the presence of persistent airflow limitation. The goal of COPD assessment is to determine the severity of the disease, including the severity of airflow limitation, the impact of the disease on the patient's health status, the risk of future events (such as exacerbations, hospital admission, or death), and comorbidities in order to guide therapy. Concomitant chronic diseases occur frequently in COPD patients, including cardiovascular disease, skeletal muscle dysfunction, metabolic syndrome, osteoporosis, depression, anxiety, and lung cancer. These comorbidities should be actively surveilled and treated appropriately when present, as they can independently influence mortality and hospitalization. Above all, further efforts are required to increase the diagnosis rate of COPD in Korea.
Anxiety ; Biomass ; Cardiovascular Diseases ; Chronic Disease ; Comorbidity ; Cough ; Depression ; Diagnosis ; Dust ; Dyspnea ; Forced Expiratory Volume ; Hospitalization ; Humans ; Korea ; Lung Neoplasms ; Mortality ; Muscle, Skeletal ; Osteoporosis ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Smoking ; Spirometry ; Sputum ; Vital Capacity

There is no therapy currently available that influences the natural history of disease progression in patients with chronic obstructive pulmonary disease (COPD). Although stem cell therapy is considered a potential therapeutic option in COPD, there are no clinical trials proving definitive therapeutic effects in patients with COPD. Recently, it was reported that pioglitazone might potentiate the therapeutic effects of stem cells in patients with heart or liver disease. To test the capacity of pioglitazone pretreatment of stem cells for emphysema repair, we evaluated the therapeutic effects of pioglitazone-pretreated human adipose-derived mesenchymal stem cells (ASCs) on elastase-induced or cigarette smoke-induced emphysema in mice. We also investigated the mechanisms of action of pioglitazone-pretreated ASCs. Pioglitazone-pretreated ASCs had a more potent therapeutic effect than non-pretreated ASCs in the repair of both elastase-induced and smoke-induced emphysema models (mean linear intercept, 78.1±2.5 μm vs 83.2±2.6 μm in elastase models and 75.6±1.4 μm vs 80.5±3.2 μm in smoke models, P<0.05). Furthermore, we showed that pioglitazone-pretreated ASCs increased vascular endothelial growth factor (VEGF) production both in vitro and in mouse lungs in the smoke-induced emphysema model. Pioglitazone-pretreated ASCs may have more potent therapeutic effects than non-pretreated ASCs in emphysema mouse models.
Animals ; Disease Progression ; Emphysema* ; Heart ; Humans ; In Vitro Techniques ; Liver Diseases ; Lung ; Mesenchymal Stromal Cells ; Mice* ; Natural History ; Pancreatic Elastase ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Stem Cells* ; Therapeutic Uses* ; Tobacco Products ; Vascular Endothelial Growth Factor A