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대한결핵 및 호흡기학회> Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases update

  • : 대한결핵 및 호흡기학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 계간
  • : 1738-3536
  • : 2005-6184
  • : 결핵 및 호흡기 질환(~2004) → tuberculosis and respiratory diseases(2004~)

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84권2호(2021) |수록논문 수 : 10
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KCI등재 SCOPUS

1Interstitial Lung Disease and Diffuse Alveolar Hemorrhage, the Two Key Pulmonary Manifestations in Microscopic Polyangiitis

저자 : Min Jung Kim , Kichul Shin

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 255-262 (8 pages)

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Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated necrotizing vasculitis, which mainly affects small vessels in various organs, especially the lungs. The two key pulmonary manifestations, interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), increase the morbidity and death rate of patients with MPA. ILD is more common in MPA than in other ANCA-associated vasculitis subsets and is primarily associated with myeloperoxidase-ANCA. Unlike alveolar hemorrhage due to pulmonary capillaritis, ILD can initially manifest as isolated pulmonary fibrosis. Of note, its most frequent radiographic pattern is the usual interstitial pneumonia pattern, similar to the characteristic pattern seen in idiopathic pulmonary fibrosis. In this review we present the pathogenesis, clinical manifestations, and radiographic and histopathologic features of ILD and DAH in MPA. We also briefly summarize the outcome and therapeutic options for the two conditions.

KCI등재 SCOPUS

2Revised Korean Cough Guidelines, 2020: Recommendations and Summary Statements

저자 : Hyonsoo Joo , Ji-yong Moon , Tai Joon An , Hayoung Choi , So Young Park , Hongseok Yoo , Chi Young Kim , Ina Jeong , Joo-hee Kim , Hyeon-kyoung Koo , Chin Kook Rhee , Sei Won Lee , Sung Kyoung Kim , Kyu

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 263-273 (11 pages)

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Cough is the most common respiratory symptom that can have various causes. It is a major clinical problem that can reduce a patient's quality of life. Thus, clinical guidelines for the treatment of cough were established in 2014 by the cough guideline committee under the Korean Academy of Tuberculosis and Respiratory Diseases. From October 2018 to July 2020, cough guidelines were revised by members of the committee based on the first guidelines. The purpose of these guidelines is to help clinicians efficiently diagnose and treat patients with cough. This article highlights the recommendations and summary of the revised Korean cough guidelines. It includes a revised algorithm for the evaluation of acute, subacute, and chronic cough. For a chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered in differential diagnoses. If UACS is suspected, first-generation antihistamines and nasal decongestants can be used empirically. In cases with CVA, inhaled corticosteroids are recommended to improve cough. In patients with suspected chronic cough due to symptomatic GERD, proton pump inhibitors are recommended. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, intake of angiotensin-converting enzyme inhibitor, intake of dipeptidyl peptidase-4 inhibitor, habitual cough, psychogenic cough, interstitial lung disease, environmental and occupational factors, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and unexplained cough can also be considered as causes of a chronic cough. Chronic cough due to laryngeal dysfunction syndrome has been newly added to the guidelines.

KCI등재 SCOPUS

3Reliability of Portable Spirometry Performed in the Korea National Health and Nutrition Examination Survey Compared to Conventional Spirometry

저자 : Hye Jung Park , Chin Kook Rhee , Kwang Ha Yoo , Yong Bum Park

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 274-281 (8 pages)

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Background: The Korea National Health and Nutrition Examination Survey (KNHANES) is a well-designed survey to collect national data, which many researchers have used for their studies. In KNHANES, although portable spirometry was used, its reliability has not been verified.
Methods: We prospectively enrolled 58 participants from four Korean institutions. The participants were classified into normal pattern, obstructive pattern, and restrictive pattern groups according to their previous spirometry results. Lung function was estimated by conventional spirometry and portable spirometry, and the results were compared.
Results: The intraclass correlation coefficients of forced vital capacity (FVC) (coefficient, 9.993; 95% confidence interval [CI], 0.988-0.996), forced expiratory volume in 1 second (FEV1) (coefficient, 0.997; 95% CI, 0.995-0.998), FEV1/FVC ratio (coefficient, 0.995; 95% CI, 0.992-0.997), and forced expiratory flow at 25-75% (FEF25-75%; coefficient, 0.991; 95% CI, 0.984-0.994) were excellent (all p<0.001). In the subgroup analysis, the results of the three parameters were similar in all groups. In the overall and subgroup analyses, Pearson's correlation of all the parameters was also excellent in the total (coefficient, 0.986-0.994; p<0.001) and subgroup analyses (coefficient, 0.915-0.995; p<0.001). In the paired t-test, FVC, FEV1/FVC, and FEF25-75% estimated by the two instruments were statistically different. However, FEV1 was not significantly different.
Conclusion: Lung function estimated by portable spirometry was well-correlated with that estimated by conventional spirometry. Although the values had minimal differences between them, we suggest that the spirometry results from the KNHANES are reliable.

KCI등재 SCOPUS

4Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy

저자 : Kyung Soo Hong , Heeyun Ahn , Kwan Ho Lee , Jin Hong Chung , Kyeong-cheol Shin , Hyun Jung Jin , Jong Geol Jang , Seok Soo Lee , Min Hye Jang , June Hong Ahn

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 282-290 (9 pages)

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Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs.
Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields.
Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients.
Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

KCI등재 SCOPUS

5Effect of Chlorhexidine Mouthrinse on Prevention of Microbial Contamination during EBUS-TBNA: A Study Protocol for a Randomized Controlled Trial

저자 : Na Young Kim , Jae Hyeon Park , Jimyung Park , Nakwon Kwak , Sun Mi Choi , Young Sik Park , Chang-hoon Lee , Jaeyoung Cho

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 291-298 (8 pages)

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic method for mediastinal and hilar lymphadenopathy. Although rare, fatal infectious complications can occur following EBUS-TBNA. However, to date, there is a lack of effective preventive strategies to reduce these complications. We started a trial to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUSTBNA.
Methods: This study is a single-center, parallel-group, assessor-blinded randomized controlled trial (RCT). We will enroll 112 adult participants undergoing EBUS-TBNA using a convex probe, and randomly assign them to two groups at a 1:1 ratio. The intervention group will gargle for 1 minute with 100 mL of 0.12% chlorhexidine gluconate before EBUSTBNA, while the control group will have no mouthrinse before the procedure. Immediately after completion of EBUSTBNA on all targeted lesions with an aspiration needle, a needle wash sample will be taken by instilling 5 mL of sterile saline into the used needle. The primary outcome is colony forming unit (CFU) counts in aerobic cultures of the needle wash samples. Secondary outcomes are CFU counts in anaerobic cultures, fever within 24 hours after EBUS-TBNA, and infectious complications within 4 weeks after EBUS-TBNA.
Conclusion: This trial was designed as the first RCT to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Results from this trial can provide clinical evidence for a simple, safe, and cost-effective strategy to prevent infectious complications following EBUS-TBNA (ClinicalTrials.gov ID: NCT04718922, registered on 22 January 2021).

KCI등재 SCOPUS

6Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis

저자 : Ghea Mangkuliguna , Glenardi , Natalia , Laurentius A. Pramono

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 299-316 (18 pages)

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Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients.
Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967).
Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low.
Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was welltolerated and safe to use.

KCI등재 SCOPUS

7Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea

저자 : Ryoung-eun Ko , Kyung Hoon Min , Sang-bum Hong , Ae-rin Baek , Hyun-kyung Lee , Woo Hyun Cho , Changhwan Kim , Youjin Chang , Sung-soon Lee , Jee Youn Oh , Heung Bum Lee , Soohyun Bae , Jae Young Moon ,

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 317-325 (9 pages)

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Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea.
Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP.
Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii . During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities.
Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

KCI등재 SCOPUS

8Differences in Clinical Characteristics of Invasive Tracheobronchial Aspergillosis according to the Presence of Invasive Pulmonary Aspergillosis

저자 : Chuiyong Pak , Woori Jo , Jin Hyoung Kim , Jae Uk Im , Joseph Jeong , Hee Jeong Cha , Eun-young Choi , Seung Won Ra

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 326-332 (7 pages)

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Background: The association of invasive tracheobronchial aspergillosis (ITBA) with invasive pulmonary aspergillosis (IPA) is not well established. We aimed to compare clinical characteristics between patients who exhibited ITBA with IPA and those who exhibited isolated ITBA (iITBA). Additionally, the usefulness of serum or bronchial galactomannan (GM) tests in diagnosing ITBA was evaluated.
Methods: This retrospective single-center case-control study was conducted over a period of 4 years. Fifteen patients were enrolled after confirming the presence of ITBA using bronchoscopy-guided biopsy (iITBA, 7 vs. ITBA+IPA, 8). Clinical characteristics of patients and results obtained from serum or bronchial GM tests were compared between the two groups. Mortality was assessed using data collected from a 6-month follow-up period.
Results: The ITBA+IPA group showed a higher prevalence of hematologic malignancy (75% vs. 14%, p=0.029), a greater number of patients with multiple bronchial ulcers (75% vs. 14%, p=0.029), lower platelet counts (63,000/μL vs. 229,000/μL, p<0.001), and a mortality rate which was significantly higher (63% vs. 0%, p=0.026) than the iITBA group. In the ITBA+IPA group, 57% of patients tested positive according to the serum GM assay, whereas in the iITBA group, all patients tested negative (p=0.070). The bronchial GM level was high in both groups, but there was no significant difference between them.
Conclusion: Patients with ITBA+IPA had a greater number of hematologic malignancies with lower platelet counts and a poorer prognosis than patients diagnosed with iITBA. Findings obtained from bronchoscopy and bronchial GM tests were more useful in diagnosing ITBA than the serum GM test results.

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9Macklin Effect and Pneumomediastinum with Cardiac Compression in a Mechanically Ventilated Patient

저자 : Tsung-yeh Tsai , Jhong-ru Huang , Sheng-wei Pan , Hsin-kuo Ko , Li-ing Ho

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 333-334 (2 pages)

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10SARS-CoV-2 Sequel: Pulmonary Mucormycosis with a Mycotic Aneurysm in a Transplant Recipient

저자 : Klein Dantis , Vinay Rathore , Nitin Kumar Kashyap , Nilesh Gupta , Sajal De , Subrata Kumar Singha

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 4호 발행 연도 : 2021 페이지 : pp. 335-337 (3 pages)

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KCI등재SCOUPUS

1Recent Trends of Lung Cancer in Korea

저자 : Jae Guk Lee , Ho Cheol Kim , Chang-min Choi

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 89-95 (7 pages)

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Lung cancer is one of the leading causes of cancer-related deaths in Korea. Although the smoking rate has decreased over time, the prevalence of lung cancer still remains high. In this study, we reviewed recent trends on the incidence, epidemiology, screening, diagnosis, and treatment of lung cancer in Korea by analyzing data from the national lung cancer registry and recently-published studies. Although approximately 40% of patients with non-small cell lung cancer (NSCLC) were diagnosed as stage IV, the 5-year relative survival rate improved from 11.3% (1993-1995) to 30.2% (2013-2017), possibly due to advances in methods of diagnosis and therapy. In addition, the 2019 implementation of the national lung cancer screening program with low-dose computed tomography may have also contributed to these improvements in survival rates. Recently, molecular diagnosis has become more widely used in the identification of genetic mutations in tissue specimens. Target therapy and immune checkpoint inhibitors have also been successfully used, particularly in cases of advanced NSCLC. In the future, further research on the optimal management of lung cancer remains necessary.

KCI등재SCOUPUS

2Direct Switch from Tiotropium to Indacaterol/Glycopyrronium in Chronic Obstructive Pulmonary Disease Patients in Korea

저자 : Sang Haak Lee , Chin Kook Rhee , Kwangha Yoo , Jeong Woong Park , Suk Joong Yong , Jusang Kim , Taehoon Lee , Seong Yong Lim , Ji-hyun Lee , Hye Yun Park , Minyoung Moon , Ki-suck Jung

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 96-104 (9 pages)

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Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 μg to indacaterol/glycopyrronium (IND/GLY) 110/50 μg once daily in COPD patients in Korea.
Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 μg once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV1) ≥50%, post-bronchodilator FEV1/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV1 at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment.
Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV1 versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients.
Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

KCI등재SCOUPUS

3Awareness and Use of Complementary and Alternative Medicine in Korean Lung Cancer Patients

저자 : Joon Young Choi , Wonjun Ji , Chang-min Choi , Chaeuk Chung , Jae Myoung Noh , Cheol-kyu Park , In-jae Oh , Hong In Yoon , Hyeong Ryul Kim , Ho Young Kim , Chang Dong Yeo , Seung Hun Jang

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 105-114 (10 pages)

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Background: Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients.
Methods: This prospective survey-based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users.
Results: Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users.
Conclusion: Specific clinical parameters were associated with patients' awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

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4Factors Associated with Worsening Oxygenation in Patients with Non-severe COVID-19 Pneumonia

저자 : Cho Rom Hahm , Young Kyung Lee , Dong Hyun Oh , Mi Young Ahn , Jae-phil Choi , Na Ree Kang , Jungkyun Oh , Hanzo Choi , Suhyun Kim

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 115-124 (10 pages)

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Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia.
Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO2 ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist.
Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 μg/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52).
Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

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5The Association between Mortality and the Oxygen Saturation and Fraction of Inhaled Oxygen in Patients Requiring Oxygen Therapy due to COVID-19-Associated Pneumonia

저자 : Keum-ju Choi , Hyo-lim Hong , Eun Jin Kim

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 125-133 (9 pages)

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Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO2) and the fraction of inhaled oxygen (FiO2) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality.
Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality.
Results: At the time of admission, the ratios of SpO2, FiO2, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality.
Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

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6Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion

저자 : Seul Lee , Heock Lee , Dong Hyun Lee , Bo Hyoung Kang , Mee Sook Roh , Choohee Son , Sung Hyun Kim , Hyun-kyung Lee , Soo-jung

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 134-139 (6 pages)

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Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase.
Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month.
Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success.
Conclusion: Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

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7Health-Promoting Behaviors, Health Literacy, and Levels of Knowledge about Smoking-Related Diseases among Smokers and Non-smokers: A Cross-Sectional Study

저자 : Cihat Celebi , Ebru Calik-kutukcu , Melda Saglam , Cemile Bozdemir-ozel , Deniz Inal-ince , Naciye Vardar-yagli

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 140-147 (8 pages)

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Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers.
Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ).
Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p< 0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p >0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%).
Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

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8The Effects of Simultaneous Pulmonary Rehabilitation during Thoracic Radiotherapy in the Treatment of Malignant Diseases

저자 : Myeong Geun Choi , Hyang Yi Lee , Si Yeol Song , Su Ssan Kim , Seung Hak Lee , Won Kim , Chang-min Choi , Sei Won Lee

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 148-158 (11 pages)

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Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR).
Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment.
Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. -10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017).
Conclusion: Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR's effects during thoracic radiotherapy.

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9Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013-2017

저자 : Jae Yeol Kim , Hye Seon Kang , Jae-woo Jung , Sun Young Jung , Hye Jung Park , Jong Sook Park , Joo Hun Park , Sang Haak Lee , Eun Mi Chun , Dong Il Park , Jisook Park , Hye Sook Choi

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 159-166 (8 pages)

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Background: E-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially nicotine dependence and stress susceptibility, have not been evaluated in comparison to those of nonsmokers or combustible cigarette smokers in Korea.
Methods: In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013-2017) were classified into the following three groups: non-smokers, smokers (current smokers and ex-smokers of combustible cigarettes only), and e-smokers (current smokers and ex-smokers of e-cigarettes regardless of combustible cigarette use).
Results: Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) subjects were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than nonsmokers or smokers. The number of e-smokers who smoked within 5 minutes of waking up (31.5% vs. 19.8%, p<0.001) and who planned to quit smoking within 6 months (39.1% vs. 35.7%, p<0.05) was greater than that of smokers. E-smokers perceived stress as “very much” (7.0% vs. 4.4%, p<0.001) and “a lot” (29.1% vs. 20.5%, p<0.001) compared to non-smokers. Suicidal ideation (6.5% vs. 4.7%, p<0.001), plans (2.4% vs. 1.3%, p<0.001), and attempts (1.1% vs. 0.5%, p<0.001) were higher in e-smokers than in non-smokers. Depressive episodes in 1 year (14.2% vs. 11.4%, p<0.05) and suicidal plans (2.4% vs. 1.8%, p<0.05) were more frequent among e-smokers than among smokers.
Conclusion: E-smokers were younger, more educated, and had a higher income, but they were more dependent on nicotine and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored according to the characteristics of e-smokers.

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10The Burden of Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases: A Non-Western Perspective

저자 : Kartik Deshmukh , Arjun Khanna

발행기관 : 대한결핵 및 호흡기학회 간행물 : Tuberculosis and Respiratory Diseases 84권 2호 발행 연도 : 2021 페이지 : pp. 167-170 (4 pages)

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