Nihon rinsho. Japanese journal of clinical medicine
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Although chronic obstructive pulmonary disease (COPD) has high prevalence and mortality, there are underestimated and many COPD patients still remain not diagnosed worldwide including Japan. In spite of high prevalence in Western countries, it had been reported that COPD patients were estimated about 200,000 in Japan. Here, the prevalence of COPD in Japan is discussed according to the NICE Study.
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Review
[CT imaging of COPD--importance of phenotyping (emphysema dominant and airway disorder dominant)].
We have been engaged in the analysis of the distribution of low attenuation area (LAA) representing emphysema, and the measurement of airway dimensions using CT images from the view point of phenotyping of COPD. (1) L AA% (area ratio of LAA to all lung area) did not correlate with reversibility to bronchodilators, whereas WA% (area ratio of bronchial wall to cross section of bronchus) positively correlated with reversibility. Thus, bronchodilators may be effective in proportional to the extent of airway disorders. (2) The incidence of Gc*1F(+) was significantly higher in patients with severe emphysema. ⋯ Furthermore, there were significant correlations between the body mass index and the CT measures of emphysema. These data demonstrate that emphysema-like changes are present in the lungs of patients who are chronically malnourished.
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Oxygen therapy is one of the principal non-pharmacologic treatments for severe chronic obstructive pulmonary disease (COPD) patients. Home oxygen therapy(HOT), or long-term oxygen therapy(LTOT) for 15 hours or more per day, can improve the survival rate of severe COPD patients with beneficial effects on hemodynamic state, hematological characteristic, exercise capacity, lung mechanics, and mental state. ⋯ The induction of oxygen therapy needs evaluations of oxygen desaturation during exercise and sleep as well as hypoxia at rest. It also required to consider CO2 narcosis.