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( Jinkyeong Park ),( Sang Do Lee ),( Ki Suck Jung ),( Yeon Mok Oh ),( Hui Jung Kim ) 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-
The patients with chronic obstructive pulmonary disease (COPD) show various symptoms. In addition to breathlessness, cough and phlegm are the major symptoms. Although many clinical trials revealed that breathlessness is improved by inhaled therapy in COPD patients, the effect of these inhalers on cough or phlegm was not evaluated.The SUPER study demonstrated the improvement in lung function of the fluticasone/salmeterol (FSC) added to tiotropium statistically superior to that of tiotropium alone. We performed a post hoc analysis of the SUPER study with particular focus on cough and phlegm.At baseline, 89 (tiotropium +FSC vs tiotropium 22% vs 21%) patients complained that they suffered cough in most days a week. 106 (27% vs. 25%) patients did in a few days a week. 151 (38% vs 36%) patients did in only with chest infection. 134 (tiotropium +FSC vs tiotropium 33% vs 32%) patients complained that they suffered phlegm in most days a week. 126 (31% vs 30%) patients did in a few days a week. 101 (25% vs 25%) patients did in only with chest infection. At the end of study, 148(40% vs 32%) patients showed the improvement on cough, 190(43.1% vs 49.0%) patients had no change, and 74 (17% vs 19%) patients aggravated the cough. 42 (38% vs 31%) patients showed the improvement on phlegm, 76 (15% vs 22%) patients had no change, and 194 (47% vs 48%) patients aggravated the phlegm. In the patients suffered cough in most days a week at the baseline, tiotropium+FSC group had significantly more improvement in cough than tiotropium alone (76% vs 55%, p=0.047). There was no effect of phlegm between groups. In COPD patients presenting with cough, tiotropium combined FSC treatment was more helpful than tiotropium alone. However the effect of triple inhaled treatment about phlegm in COPD patients were similar to tiotropium alone.The patients with chronic obstructive pulmonary disease (COPD) show various symptoms. In addition to breathlessness, cough and phlegm are the major symptoms. Although many clinical trials revealed that breathlessness is improved by inhaled therapy in COPD patients, the effect of these inhalers on cough or phlegm was not evaluated.The SUPER study demonstrated the improvement in lung function of the fluticasone/salmeterol (FSC) added to tiotropium statistically superior to that of tiotropium alone. We performed a post hoc analysis of the SUPER study with particular focus on cough and phlegm.At baseline, 89 (tiotropium +FSC vs tiotropium 22% vs 21%) patients complained that they suffered cough in most days a week. 106 (27% vs. 25%) patients did in a few days a week. 151 (38% vs 36%) patients did in only with chest infection. 134 (tiotropium +FSC vs tiotropium 33% vs 32%) patients complained that they suffered phlegm in most days a week. 126 (31% vs 30%) patients did in a few days a week. 101 (25% vs 25%) patients did in only with chest infection. At the end of study, 148(40% vs 32%) patients showed the improvement on cough, 190(43.1% vs 49.0%) patients had no change, and 74 (17% vs 19%) patients aggravated the cough. 42 (38% vs 31%) patients showed the improvement on phlegm, 76 (15% vs 22%) patients had no change, and 194 (47% vs 48%) patients aggravated the phlegm. In the patients suffered cough in most days a week at the baseline, tiotropium+FSC group had significantly more improvement in cough than tiotropium alone (76% vs 55%, p=0.047). There was no effect of phlegm between groups. In COPD patients presenting with cough, tiotropium combined FSC treatment was more helpful than tiotropium alone. However the effect of triple inhaled treatment about phlegm in COPD patients were similar to tiotropium alone.
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Lee, Sang Hoon,Yeo, Yoomi,Kim, Tae-Hyung,Lee, Hong Lyeol,Lee, Jin Hwa,Park, Yong Bum,Park, Jong Sun,Kim, Yee Hyung,Song, Jin Woo,Jhun, Byung Woo,Kim, Hyun Jung,Park, Jinkyeong,Uh, Soo-Taek,Kim, Young The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.2
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.
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Comorbidities of Chronic Obstructive Pulmonary Disease in Koreans: A Population-Based Study
Joo, Hyejin,Park, Jinkyeong,Lee, Sang Do,Oh, Yeon-Mok The Korean Academy of Medical Sciences 2012 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.27 No.8
<P>Chronic obstructive pulmonary disease (COPD) includes pulmonary components with increased comorbidity rates, as well as being a systemic disease. Comorbidities may frequently occur in COPD patients over 40 yr old. We report the comorbidities of patients with COPD, diagnosed by spirometry, in a population-based epidemiologic survey in Korea. Data were derived from the fourth Korean Health and Nutrition Examination Survey in 2008, a stratified multistage clustered probability design survey of a sample representing the entire population of Korea. Results of spirometry and various health-related questionnaires were analyzed in 2,177 subjects aged ≥ 40 yr. The prevalence of COPD (FEV<SUB>1</SUB>/FVC < 0.7) in subjects ≥ 40 yr of age was 14.1%. Multivariate analysis showed that underweight (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.05-8.98), coronary heart disease (OR, 0.43; 95% CI, 0.20-0.93) and dyslipidemia (OR, 0.61; 95% CI, 0.45-0.82) were significantly associated with COPD, whereas allergic rhinitis, anemia, arthritis, chronic renal failure, depression, diabetes mellitus, hypertension, gastrointestinal ulcer, and osteoporosis were not. Underweight might be more prevalent but coronary heart disease and dyslipidemia are less prevalent in Koreans with than without COPD in population setting.</P>
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Resuscitation Fluid Use in a Single Surgical Intensive Care Unit
Yong Dae Lee,Jeong-Am Ryu,Dae-Sang Lee,Jinkyeong Park,Joongbum Cho,Chi Ryang Chung,Yang Hyun Cho,Jeong Hoon Yang,Gee Young Suh,Chi-Min Park 대한외상중환자외과학회 2020 Journal of Acute Care Surgery Vol.10 No.1
Purpose: The aim of this study was to analyze the temporal change of resuscitation fluid use based on all fluids administered in a surgical intensive care unit (ICU). Methods: The administration of resuscitation fluid to all patients admitted to a surgical ICU of a tertiary referral hospital was investigated from 2008 to 2015. The types and volumes of fluid, and laboratory data taken within 7 days after ICU admission were evaluated. Resuscitation fluids were defined as fluids infused according to stat orders, rather than routine orders. Results: There were a total of 8,885 admissions to the ICU for 7,886 patients. The volumetric proportion of crystalloid to total resuscitation fluids increased significantly over the study period (p < 0.001; 79.6% in 2008; 93.7% in 2015). Although the proportion of 0.9% saline to crystalloids decreased, that of balanced solutions increased (p < 0.001; 29.5% in 2008; 55.6% in 2015). The use of colloids decreased from 20.4% in 2008, to 6.3% in 2015 (p < 0.001). Proportions calculated using the number of individual fluids administered revealed trends similar to those calculated using volumetric data. The amount of infused 0.9% saline was weakly correlated with the lowest blood pH and the highest serum chloride levels (ρ = -0.26 and 0.19, respectively). Conclusion: Changes in the trends of fluid resuscitation practice were noted in a single surgical ICU over the 8-year study period. Crystalloid use increased owing to a rise in the utilization of balanced solutions with a downward trend in colloid use.
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Jong Bin Bae,Subin Lee,Hyunwoo Oh,Jinkyeong Sung,Dongsoo Lee,Ji Won Han,Jun Sung Kim,Jae Hyoung Kim,Sang Eun Kim,Ki Woong Kim 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.12
Objective A deep learning-based classification system (DLCS) which uses structural brain magnetic resonance imaging (MRI) to diagnose Alzheimer’s disease (AD) was developed in a previous recent study. Here, we evaluate its performance by conducting a single-center, case-control clinical trial.Methods We retrospectively collected T1-weighted brain MRI scans of subjects who had an accompanying measure of amyloid-beta (Aβ) positivity based on a 18F-florbetaben positron emission tomography scan. The dataset included 188 Aβ-positive patients with mild cognitive impairment or dementia due to AD, and 162 Aβ-negative controls with normal cognition. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the DLCS in the classification of Aβ-positive AD patients from Aβ-negative controls.Results The DLCS showed excellent performance, with sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 85.6% (95% confidence interval [CI], 79.8–90.0), 90.1% (95% CI, 84.5–94.2), 91.0% (95% CI, 86.3–94.1), 84.4% (95% CI, 79.2–88.5), and 0.937 (95% CI, 0.911–0.963), respectively.Conclusion The DLCS shows promise in clinical settings where it could be routinely applied to MRI scans regardless of original scan purpose to improve the early detection of AD.
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Direct and Indirect Costs of Chronic Obstructive Pulmonary Disease in Korea
( Changhwan Kim ),( Younhee Kim ),( Dong-Wook Yang ),( Chin Kook Rhee ),( Sung Kyoung Kim ),( Yong-Il Hwang ),( Yong Bum Park ),( Young Mok Lee ),( Seonglim Jin ),( Jinkyeong Park ),( Cho-Rom Hahm ),( 대한결핵 및 호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.1
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
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Direct and Indirect Costs of Chronic Obstructive Pulmonary Disease in Korea
Kim, Changhwan,Kim, Younhee,Yang, Dong-Wook,Rhee, Chin Kook,Kim, Sung Kyoung,Hwang, Yong-Il,Park, Yong Bum,Lee, Young Mok,Jin, Seonglim,Park, Jinkyeong,Hahm, Cho-Rom,Park, Chang-Han,Park, So Yeon,Jung The Korean Academy of Tuberculosis and Respiratory 2019 Tuberculosis and Respiratory Diseases Vol.82 No.1
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
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