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Role of Plasma and Tissue Interleukin-33 in Chronic Obstructive Pulmonary Disease
( Hyonsoo Joo ),( Jin Woo Kim ),( Hyoung Kyu Yoon ),( Chin Kook Rhee ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Purpose The role of interleukin (IL)-33 in patients with chronic obstructive pulmonary disease (COPD) has not been well elucidated. The aim of this study is to analyze the association between plasma IL-33 level and acute exacerbation of COPD. Methods Plasma IL-33 was measured in 62 COPD patients during their stable state. Patients were prospectively followed up for 1 year. The expression of IL-33 was measured in lung tissue obtained from 38 patients who underwent surgery. Results The number of exacerbations was significantly higher in the high plasma IL-33 group compared with the low plasma IL-33 group. On Poisson regression analysis, high plasma IL-33 was associated with increased risk of exacerbation (incidence rate ratio = 2.166, P = 0.043). The expression of IL-33 in the lung was higher in COPD patients than in controls. The expression of IL- 33 was significantly correlated with smoking pack years (R = 0.45, P < 0.01) and Forced expiratory volume in 1 second (%) (R = -0.58, P < 0.01). Conclusion The plasma level of IL-33 in patients with COPD was significantly associated with the risk of exacerbation in prospective follow up. The expression of IL-33 in the lung was positively correlated with smoking and negatively correlated with lung function.
Prevalence of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts
( Hyonsoo Joo ),( So-young Park ),( So Young Park ),( Seo Young Park ),( Sang-heon Kim ),( You Sook Cho ),( Kwang Ha Yoo ),( Ki Suck Jung ),( Chin Kook Rhee ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Background Asthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype. Methods Patients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). In the COPD cohort, ACO was defined as bronchodilator response (BDR) ≥ 15% and ≥ 400 mL from baseline or blood eosinophil count ≥ 300 cells/μL. In the severe asthma cohort, ACO was defined as age ≥ 35 years, smoking ≥ 10 pack-years, and post-bronchodilator FEV1/FVC < 0.7. Patients with ACO were divided into four groups according to smoking history and blood eosinophil count. Results The prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1839] vs. 12.5% [104/832], respectively, P < 0.001). The numbers of patients in each group were as follows: Group A (smoking 10-20 pack-years and blood eosinophil count ≥ 300 cells/μL), 42 (9.1%); Group B (smoking 10-20 pack-years and eosinophil count < 300 cells/ μL), 17 (3.7%); Group C (smoking ≥ 20 pack-years and eosinophil count ≥ 300 cells/μL), 341 (73.8%); and Group D (smoking ≥ 20 pack-years and eosinophil count < 300 cells/μL), 62 (13.4%). Age, sex, BDR, comorbidities, and medications significantly differed among the four groups. Conclusion The prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.
Revised Korean Cough Guidelines, 2020: Recommendations and Summary Statements
( 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 L 대한결핵 및 호흡기학회 2021 Tuberculosis and Respiratory Diseases Vol.84 No.4
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.
Validity and reliability of the Korean version of the Wisconsin Smoking Withdrawal Scale
( Hyonsoo Joo ),( Hyeon Hui Kang ),( Hwa Sik Moon ),( Sang Haak Lee ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1
Background/Aims: This study evaluated the validity and reliability of the Korean version of the Wisconsin Smoking Withdrawal Scale (WSWS-K) for use in clinical practice and research on Korean smokers. Methods: The Wisconsin Smoking Withdrawal Scale was translated into Korean and then back-translated into English. The authors reviewed the translation and back-translation and approved the final questionnaire draft. The validity and reliability of the WSWS-K were evaluated based on data collected from 300 participants. Construct validity was evaluated with a confirmatory factor analysis. Criterion-related validity was assessed by examining the relationships between the subscales of the WSWS-K and the matched items of the Korean version of the Minnesota Nicotine Withdrawal Scale (MNWS-K). Results: The participants were predominantly male (93.6%) and the mean age was 59.23 ± 15.19 years. The confirmatory factor analysis revealed that fit indices (namely, the goodness-of-fit index, adjusted goodness-of-fit index, comparative fit index, and the normed fit index) exceeded or approached 0.9. Cronbach’s alpha for the entire scale was 0.87. The total score of the WSWS-K had a statistically significant positive correlation with that of the MNWS-K (Pearson’s correlation coefficient, 0.768; p < 0.01). Additionally, we performed linear regression between the WSWS-K and MNWS-K scores after adjusting for age, gender, comorbidity, and smoking history. After this adjustment, the p value of the WSWS-K was < 0.001. Conclusions: The WSWS-K had satisfactory validity and reliability. The WSWS-K can be used with acceptable validity and reliability in research and clinical evaluation of Korean smokers.
Joo, Hyonsoo,Han, Deokjae,Lee, Jae Ha,Rhee, Chin Kook The Korean Academy of Tuberculosis and Respiratory 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4
Background: Roflumilast is the only approved oral phosphodiesterase-4 inhibitor for the treatment of severe chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis and a history of frequent exacerbations. The purpose of this study was to examine the incidence of adverse effects associated with roflumilast treatment in a real-world setting. Further, we compared the incidence of adverse effects and the discontinuation rate among patients receiving different doses. Methods: We identified all outpatients diagnosed with COPD at Seoul St. Mary's Hospital between May 2011 and September 2016 and retrospectively reviewed their medical records. Roflumilast was prescribed to patients in doses of $500{\mu}g$ and $250{\mu}g$. Results: A total of 269 COPD patients were prescribed roflumilast in our hospital during the study period. Among them, 178 patients were treated with $500{\mu}g$ and 91 patients were treated with $250{\mu}g$. The incidence of adverse effects was 38.2% in the $500{\mu}g$ group and 25.3% in the $250{\mu}g$ group (p=0.034). The discontinuation rate of roflumilast was 41.6% (n=74) in the $500{\mu}g$ group and 23.1% (n=21) in the $250{\mu}g$ group (p=0.003). When adjusted by age, sex, smoking status, and lung function, $500{\mu}g$ dose was significantly associated with the discontinuation of roflumilast (odds ratio, 2.87; p<0.001). Conclusion: There was a lower incidence of adverse effects and discontinuation among patients treated with $250{\mu}g$ compared with $500{\mu}g$ dose. Further studies regarding the optimal dose of roflumilast are required.
( Hyonsoo Joo ),( Deokjae Han ),( Jae Ha Lee ),( Chin Kook Rhee ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.4
Background: Roflumilast is the only approved oral phosphodiesterase-4 inhibitor for the treatment of severe chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis and a history of frequent exacerbations. The purpose of this study was to examine the incidence of adverse effects associated with roflumilast treatment in a real-world setting. Further, we compared the incidence of adverse effects and the discontinuation rate among patients receiving different doses. Methods: We identified all outpatients diagnosed with COPD at Seoul St. Mary’s Hospital between May 2011 and September 2016 and retrospectively reviewed their medical records. Roflumilast was prescribed to patients in doses of 500 µg and 250 µg. Results: A total of 269 COPD patients were prescribed roflumilast in our hospital during the study period. Among them, 178 patients were treated with 500 µg and 91 patients were treated with 250 µg. The incidence of adverse effects was 38.2% in the 500 µg group and 25.3% in the 250 µg group (p=0.034). The discontinuation rate of roflumilast was 41.6% (n=74) in the 500 µg group and 23.1% (n=21) in the 250 µg group (p=0.003). When adjusted by age, sex, smoking status, and lung function, 500 µg dose was significantly associated with the discontinuation of roflumilast (odds ratio, 2.87; p<0.001). Conclusion: There was a lower incidence of adverse effects and discontinuation among patients treated with 250 µg compared with 500 µg dose. Further studies regarding the optimal dose of roflumilast are required.
Joo, Hyonsoo,Choi, Yeon‐,Geun,Cho, Sung‐,Yeon,Choi, Jae‐,Ki,Lee, Dong‐,Gun,Kim, Hee‐,Je,Jo, Irene,Park, Yeon‐,Joon,Lee, Kyo‐,Young John Wiley and Sons Inc. 2016 Mycoses Vol.59 No.1
<P><B>Summary</B></P><P><I>Pseudozyma</I> species rarely cause invasive diseases in humans, which are usually isolated from plants. There have been anecdotal reports regarding <I>Pseudozyma</I> species infections in patients with underlying diseases or in neonates. However, clinical data and the pathogenicity in humans are still insufficient. We experienced a case of <I>Pseudozyma aphidis</I> fungaemia with invasive fungal pneumonia that developed during reinduction chemotherapy in a 51‐year‐old male with acute myeloid leukaemia (AML). <I>P. aphidis</I> was suspected based on the morphology of the yeast isolated from the blood and was confirmed via rDNA gene sequencing analysis. The patient successfully underwent stem cell transplantation with continuing antifungal treatment and finally completely recovered from both the AML and infectious complications. Here, we report a case of <I>P. aphidis</I> infection that developed during neutropenia in an AML patient and review the global literature.</P>