Tuberculosis and Respiratory Diseases最新文献

{"title":"Clinical Characteristics of Individuals with COPD, Pre-COPD, Smokers with Normal Lung Function in Korea: Updated Analysis of the KOCOSS Cohort.","authors":"Jong Geol Jang, Youlim Kim, Jung-Kyu Lee, Hye Yun Park, Dong Il Park, Seung Won Ra, Hyun-Kuk Kim, Myung Goo Lee, Yong Bum Park, Kwang Ha Yoo","doi":"10.4046/trd.2025.0040","DOIUrl":"https://doi.org/10.4046/trd.2025.0040","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disease characterized by persistent airflow limitation and is a leading cause of mortality worldwide. Pre-COPD refers to a pre-disease state associated with an increased risk of COPD development. This study aims to evaluate the clinical characteristics of individuals with COPD, pre-COPD, and smokers with normal lung function in South Korea, and to provide an updated analysis of the KOCOSS cohort data.</p><p><strong>Methods: </strong>We analyzed data from 4,502 participants in the KOCOSS database collected between 2012 and 2025, including 4,197 with COPD, 126 with pre-COPD, and 179 smokers with normal lung function. Baseline characteristics were compared across these groups.</p><p><strong>Results: </strong>Patients with COPD were more likely to be male, older, and had a lower body mass index than those with pre-COPD and smokers with normal lung function. Symptom burden, as assessed by the COPD Assessment Test and modified Medical Research Council dyspnea scale, was highest in patients with COPD, followed by pre-COPD and smokers with normal lung function. Patients with COPD had the highest overall use of respiratory medications (89.3%), including inhalers and other treatments, followed by pre-COPD individuals (61.5%) and smokers with normal lung function (47.4%). Hypertension was the most common comorbidity across all groups, with no significant differences in the prevalence of comorbidities.</p><p><strong>Conclusion: </strong>This analysis of the KOCOSS cohort highlights the distinct clinical characteristics of individuals with COPD, pre-COPD, and smokers with normal lung function. Notably, individuals without spirometric COPD still showed substantial symptom burden and inhaler use.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for Progression to Frequent Exacerbators in Stable Patients with COPD.","authors":"Sang Hyuk Kim, Hye Yun Park, Hyun Lee, Hyewon Seo, Ji-Hyun Lee, Hyeon-Kyoung Koo, Na Young Kim, Kwang Ha Yoo, Ju Ock Na, Youlim Kim","doi":"10.4046/trd.2025.0058","DOIUrl":"https://doi.org/10.4046/trd.2025.0058","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the transition to frequent exacerbators in stabilized patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>This study utilized data obtained from the Korean COPD subgroup study cohort (KOCOSS), including 511 patients with infrequent exacerbations. The outcome for these groups was progression to frequent exacerbators. Multivariable logistic regression analysis was used to investigate the risk factors for progression.</p><p><strong>Results: </strong>Within one year, 40 patients (7.8%) progressed to frequent exacerbators. Among those patients with severe airflow limitation and those who used inhaled corticosteroids (ICS), incidence of progression was significantly higher. The risk factors for this progression were older age (adjusted odds ratio [aOR] = 1.99, 95% confidence interval [CI] = 1.19-3.34; per 10-year increase), decreased post-bronchodilator forced expiratory volume in 1 second (aOR = 1.32, 95% CI = 1.05-1.66; per 10% predicted decrease), increased blood eosinophil count (aOR = 1.21, 95% CI = 1.08-1.35; per 100 cells/μL increase), and use of ICS/long-acting beta-agonists (LABA) (aOR = 9.16, 95% CI = 1.38-60.82) and ICS/LABA/long-acting muscarinic antagonists (aOR = 8.00, 95% CI = 1.25-51.18).</p><p><strong>Conclusions: </strong>Among stable COPD patients, older age, decreased lung function, increased eosinophil counts, and use of ICS-containing inhalers were associated with progression to frequent exacerbators.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OM-85 and Respiratory Symptoms in Korean COPD: A Multicenter Observational Study.","authors":"Chang-Seok Yoon, Tae-Ok Kim, Hong-Joon Shin, Hak-Ryul Kim, Ki-Eun Hwang, Sung Ho Yoon, Seoung Ju Park, Yong-Soo Kwon","doi":"10.4046/trd.2025.0105","DOIUrl":"https://doi.org/10.4046/trd.2025.0105","url":null,"abstract":"<p><strong>Background: </strong>Although OM-85 may lessen respiratory symptoms and reduce acute exacerbations in chronic obstructive pulmonary disease (COPD), its overall effectiveness remains incompletely proven.</p><p><strong>Methods: </strong>This prospective, observational, single-arm study was conducted at four university hospitals in South Korea from June 2022 to December 2023. Adults with spirometry-confirmed COPD who were prescribed OM-85 were enrolled and followed for six months (3-months treatment, 3-months observation). Symptoms and health-related quality of life were assessed using the modified Medical Research Council (mMRC) scale, COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ). Acute exacerbations and adverse events were recorded.</p><p><strong>Results: </strong>Of 323 patients analyzed (mean age 73.3 ± 7.8 years; 83.9 % male), 39.0 % had baseline CAT ≥ 10. Patients in this group experienced markedly greater and sustained improvements in both CAT and SGRQ scores compared with those with CAT < 10 (p for interaction < 0.001 for both), and the magnitude of these changes exceeded the MCID (CAT: -3.21 ± 3.85; SGRQ: -10.42 ± 14.87 at 6 months), indicating clinically meaningful symptom relief. Among these patients, achieving SGRQ responder status at 6 months was negatively associated with an increased frequency of acute exacerbations (OR 0.246, 95% CI 0.050-1.207, p = 0.084), showing a non significant trend. OM 85 was well tolerated, with only mild, reversible drug related adverse events.</p><p><strong>Conclusion: </strong>OM 85 treatment meaningful improvements in symptoms and health related quality of life, particularly among patients with more severe baseline symptoms, and was generally well tolerated.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Guidelines for Diagnosis and Management of Interstitial Lung Disease: Cryptogenic Organizing Pneumonia.","authors":"Yong Suk Jo, Jong Sun Park, Sun Hyo Park, Joon Sung Joh, Hye Jin Jang, Hyun-Kyung Lee","doi":"10.4046/trd.2024.0167","DOIUrl":"10.4046/trd.2024.0167","url":null,"abstract":"<p><p>Cryptogenic organizing pneumonia (COP), one of the idiopathic interstitial pneumonias (IIP), exhibits an acute or subacute course. It can be diagnosed after excluding secondary causes or diseases. COP accounts for approximately 5% to 10% of IIPs, with the average age of diagnosis ranging from 50 to 60 years. Patients primarily present with dry cough and dyspnea. They often experience fever, fatigue, and weight loss. Common radiologic findings on high-resolution computed tomography include localized consolidations, which are typically subpleural or located in the lower zones, though they can occur in all regions of the lungs. While treatment can be initiated without histopathological diagnosis, tissue biopsy may be necessary when the diagnosis is unclear. Response to steroid therapy is generally good, with rapid clinical improvement and a favorable prognosis, although relapses are common.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"477-487"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quality Changes in Intensive Care Units in South Korea since the Initiation of Intensive Care Unit Quality Assessments.","authors":"Su Hwan Lee, Sunghoon Park","doi":"10.4046/trd.2025.0039","DOIUrl":"10.4046/trd.2025.0039","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"603-605"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Severe Acute Respiratory Infection in Korea: 2022 to 2024 Surveillance Data.","authors":"Young Seok Lee, Hye Sun Lee, Jae Young Moon","doi":"10.4046/trd.2025.0043","DOIUrl":"10.4046/trd.2025.0043","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"610-613"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacologic Prevention of Acute Exacerbation Chronic Obstructive Pulmonary Disease.","authors":"Joon Young Choi","doi":"10.4046/trd.2024.0155","DOIUrl":"10.4046/trd.2024.0155","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major global health issue, as acute exacerbation COPD (AECOPD) significantly worsens outcomes and increases healthcare burden. This review explores non-pharmacologic strategies to prevent AECOPD. Pulmonary rehabilitation consistently demonstrates its effectiveness in reducing exacerbations and mortality, while improving exercise capacity and the quality of life. Lung volume reduction, through both surgical and bronchoscopic methods, has shown promise in select patient groups, leading to improved lung function and reduced exacerbation risk. Smoking cessation remains a critical intervention, while the role of electronic cigarettes remains debatable; some evidence suggests they may help patients unable to quit tobacco smoking. Vitamin D supplementation has shown potential in reducing exacerbations, particularly in patients with severe deficiency, though conflicting results warrant further research. Furthermore, shielding measures, like mask-wearing and social distancing, have gained attention during the coronavirus disease 2019 (COVID-19) pandemic for their role in reducing exacerbation risk. Lastly, vaccination, diet and nutrition, and non-invasive ventilation may be important to prevent AECOPD. These non-pharmacologic approaches should be integrated into comprehensive COPD management to improve outcomes and prevent AECOPD.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"419-430"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximal Forced Inspiratory Flow Dynamics and Acute Exacerbation in Chronic Obstructive Pulmonary Disease Patients with Exacerbation History.","authors":"Heemoon Park, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Hyun Woo Lee","doi":"10.4046/trd.2024.0156","DOIUrl":"10.4046/trd.2024.0156","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD), characterized by progressive airflow obstruction and frequent exacerbations, is a significant global health burden. COPD severity has traditionally been assessed using expiratory flow measurements, like forced expiratory volume in 1 second. However, the role of inspiratory flow, specifically maximal forced inspiratory flow (FIFmax), in predicting exacerbation risk is gaining attention.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated COPD patients with a history of exacerbations who were receiving inhaled therapy. The eligible patients were followed up for 3 years with spirometric assessments. Patients were categorized into quartiles based on the annual change in FIFmax, from the greatest decrease (Q1) to the greatest increase (Q4). Primary outcome was acute exacerbation, stratified by severity as moderate-to-severe and severe exacerbation.</p><p><strong>Results: </strong>In total, 180 patients were followed up for 3 years. A greater increase in FIFmax was linearly associated with lower rates of both moderate-to-severe and severe exacerbations (p-value for trend <0.001 for both), but time-to-event analysis revealed no significant association between FIFmax changes and moderate-to-severe exacerbations. In contrast, a significant association with severe exacerbations was observed (log-rank p=0.005). Even after adjusting for confounders, FIFmax remained an independent predictor of severe exacerbations (Q3: hazard ratio, 0.506 [95% confidence interval, 0.306 to 0.836], p=0.008; Q4: hazard ratio, 0.491 [95% confidence interval, 0.291 to 0.830], p=0.008).</p><p><strong>Conclusion: </strong>Changes in FIFmax were not significantly associated with moderate-to-severe exacerbations, but were related to a reduced risk of severe exacerbations in COPD patients receiving inhaled therapy. These findings indicate that FIFmax may serve as a valuable prognostic marker for severe exacerbations in high-risk COPD patients.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"535-544"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration.","authors":"Pipu Tavornshevin, Poonchavist Chantranuwatana, Vorawut Thanthitaweewat, Virissorn Wongsrichanalai, Thitiwat Sriprasart, Nophol Leelayuwatanakul","doi":"10.4046/trd.2024.0134","DOIUrl":"10.4046/trd.2024.0134","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in sampling LNs.</p><p><strong>Methods: </strong>We assessed tissue adequacy in patients with mediastinal and hilar lymphadenopathy, comparing the combination of EBUS-MFB and EBUS-TBNA with EBUS-TBNA alone. EBUS-MFB was performed with the guide sheath (GS) dilatation technique. Tissue adequacy was a tumor cell count (TCC) of >100 and neoplastic cell neoplastic cell estimate of >25%. Further, we reported the diagnostic yield, tumor cell characteristics, and safety outcomes.</p><p><strong>Results: </strong>Among 69 patients (74 nodes), malignant diseases were diagnosed in 41 nodes using both techniques. Tissue adequacy with EBUS-TBNA (93.8% in 30/32 nodes) was comparable with the combined group (96.9% in 31/32 nodes, p=0.317). EBUS-TBNA yielded higher TCC (84.4% with >1,000 cells) than EBUS-MFB (53.1%, p=0.004). The combined approach significantly improved the diagnostic yield in non-malignant diseases compared with EBUS-TBNA alone (97% vs. 78.8%, p=0.014). Of the 32 nodes, 20 demonstrated discordant results between EBUS-TBNA and EBUS-MFB, with EBUS-MFB correctly diagnosing six nodes that EBUS-TBNA misdiagnosed. The complication rate was low (2.9%) with only minor bleeding reported.</p><p><strong>Conclusion: </strong>EBUS-TBNA alone and the combination of EBUS-MFB and EBUS-TBNA demonstrated comparable tissue adequacy, with EBUS-TBNA exhibiting better specimen characteristics, potentially sufficient for various molecular analyses. The addition of EBUS-MFB, performed using the GS-dilatation technique, to EBUS-TBNA improved the diagnostic yield and proved to be a safe and efficient approach, particularly in non-malignant diseases.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"545-556"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Limiting Life-Sustaining Treatment in Critically Ill COVID-19 Patients: A Multicenter Study in Korean Intensive Care Units.","authors":"I Re Heo, Tae Hoon Kim, Won Jai Jung, Gil Myeong Seong, Sun Jung Kwon, Jae Young Moon, Song-I Lee, Do Sik Moon, Tae-Ok Kim, Chul Park, Eun Young Choi, Jung-Wan Yoo, Sunghoon Park, Ae Rin Baek, Sung Yoon Lim, Jung Soo Kim, Jongmin Lee, Chi Ryang Chung, Sang-Min Lee, Su Hwan Lee, Moon Seong Baek, Jin Won Huh, Woo Hyun Cho, Ho Cheol Kim","doi":"10.4046/trd.2024.0137","DOIUrl":"10.4046/trd.2024.0137","url":null,"abstract":"<p><strong>Background: </strong>Understanding of the life-sustaining treatment (LST) decisions in critically ill coronavirus disease 2019 (COVID-19) patients remains limited. This study aimed to identify factors influencing LST decisions, and compare clinical outcomes between patients with, and without, LST.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study analyzed data from 1,081 COVID-19 patients admitted to intensive care units (ICUs) across Korea from January 1, 2020, to August 31, 2021. Patients were divided into LST and non-LST groups. Demographic, clinical, and outcome data were collected and compared.</p><p><strong>Results: </strong>Of 1,081 patients, 207 (19.2 %) received LST. LST patients were older (median age: 76 years vs. 67 years, p<0.001), and had more comorbidities (85.5% vs. 70.4%, p<0.001), especially cardiovascular and chronic lung disease. They showed higher blood urea nitrogen, lower albumin, and elevated D-dimer levels (all p<0.05). ICU interventions, including mechanical ventilation (82.6% vs. 50.9%, p<0.001) and extracorporeal membrane oxygenation (ECMO) (18.8% vs. 9.8%, p<0.001), were more common. ICU and hospital mortality rates were significantly higher in LST patients (82.6% and 94.2%, respectively, p<0.001). Logistic regression identified age (odds ratio [OR], 1.054 per year; p<0.001), mechanical ventilation (OR, 2.789; p=0.002), and ECMO use (OR, 3.580; p=0.002) as independent predictors of LST.</p><p><strong>Conclusion: </strong>Age, comorbidities, and ICU interventions significantly influence LST decisions, highlighting the need for ethical and evidence-based critical care guidelines.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"557-565"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}