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The Utility of Measurement of Plasma N-terminal Pro-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension (폐동맥고혈압 진단에 있어 N-terminal Pro-brain Natriuretic Peptide 측정의 유용성)

  • Hahn, Chang Hoon;Kang, Seok Min;Moon, Jin Wook;Cho, Jae Hee;Hwang, Sang Yon;Lee, Jung Min;Park, Moo Suk;Chung, Jae Ho;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Shim, Won Heum;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.67-76
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    • 2004
  • Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

Loss of FHIT Expression in Non-Small Cell Lung Cancer; The Clinical Significance and Effects on Apoptosis and Cell Proliferation Cycle (비소세포 폐암에서 FHIT 유전자의 발현소실의 임상적의의 및 세포고사 및 세포분열주기에 미치는 영향)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.610-620
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    • 2003
  • Background : 3p deletion has been shown to be the most frequently occurring change in lung cancers, suggesting the presence of a tumor suppressor gene in this region. Recent attention has focused on a candidate 3p14.2 tumor suppressor gene, FHIT. Therefore, the association of the expression of FHIT, with apoptosis, cell proliferation cycle and the clinicopathological features, including survival, were investigated Materials and Methods : 83 patients with non-small cell lung cancer, who underwent curative operation, between Jan. 1996 and Aug. 2000, at the Wonkwang university hospital, were analyzed. The expression of the FHIT was identified by immunohistochemical staining, and rate of apoptosis and cell proliferation cycle by flow cytometry. Results : 43% (36/83) of patients exhibited no FHIT expression. The rates of FHIT loss were 52% (28/54), 22% (5/23), 50% (3/6); 30% (11/37), 48% (16/33), 69% (9/13); 54% (30/56) and 22% (6/27), in squamous cell cancers, adenocarcinomas, large cell cancers, TNM stages I, II and III, smokers and non-smokers, respectively. All the differences in FHIT loss rates, according to the histopathology, TNM stages and smoking habits, were statistically significant. The median survival time and 2-year survival rate of the FHIT(-) group were 24 months and 44%, and those of the FHIT(+) group were 25 months and 51% (p>0.05), respectively. The apoptotic rate of the FHIT(-) and FHIT(+) groups were 50.72 (${\pm}13.93$) and 59.38 (${\pm}14.33$)%, respectively (p=0.01). The S- and G1-phase fractions of the FHIT(-) and FHIT(+) groups were 13.93 (${\pm}7.35$) and $51.50({\pm}23.15$)% and 15.65(${\pm}6.59$) and 54.16 (${\pm}20.25$)%, respectively (p>0.05). Conclusion : The loss of FHIT expression was increased to a greater extent with advancing TNM stage, smoking habits and squamous cell cancer compared to the adenocarcinomas. However, no survival differences were found according to the expression of FHIT. The apoptotic rate of the FHIT(+) group was greater than in the FHIT(-) group, but differences in the S- and G1-phase fractions, according to the expression of the FHIT, were not found.

Enhancement of Sensitivity of Human Lung Cancer Cell Line to TRAIL and Gefitinib by IGF-1R Blockade (폐암세포주에서 IGF-1R 억제를 이용한 TRAIL 및 gefitinib에 대한 감수성 증가를 위한 연구)

  • Lee, Yoon-Jin;Park, Mi-Young;Kang, Young-Ae;Kwon, Sung-Youn;Yoon, Ho-Il;Lee, Jae-Ho;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.42-51
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    • 2007
  • Background: TRAIL is a cytokine that selectively induces apoptosis in various cancer cell lines. Gefitinib is new targeted drug applied in lung cancer that selectively inhibits EGFR tyrosine kinase. However, lung cancers have shown an initial or acquired resistance to these drugs. This study examined the effect of IGF-1R and its blockade on enhancing the sensitivity of lung cancer cell lines to TRAIL and gefitinib. Methods: Two lung cancer cell lines were used in this study. NCI H460 is very sensitive to TRAIL and gefitinib. On the other hand, A549 shows moderate resistance to TRAIL and gefitinib. The IGF-1R blockade was performed using adenoviruses expressing the dominant negative IGF-1R and shRNA to IGF-1R and AG1024 (IGF-1R tyrosine kinase inhibitor). Results: The adenovirus expressing dominant negative IGF-1R(950st) induced the increased expression of defective IGF-1R on the lung cancer cell surface, and the adenovirus-shIGF-1R effectively decreased the level of IGF-1R expression on cell surface. The genetic blockade of IGF-1R by the adenovirus-dnIGF-1R and AG1024 increased the sensitivity of A549 cells to TRAIL. The reduction of IGF-1R by transduction with ad-shIGF-1R also increased the sensitivity of the A549 cells to gefitinib. Conclusion: The blockade of IGF-1R through various mechanisms increased the sensitivity of the lung cancer cell line that was resistant to TRAIL and gefitinib. However, further studies using other cell lines showing acquired resistance as well as in vivo animal experiments will be needed.

Safety and Significance of Surgical Lung Biopsy for Interstitial Lung Disease (간질성 폐질환에 대한 수술적 폐생검의 의의 및 안전성)

  • Lee, Yu Jin;Joung, Mi Kyong;Chung, Chae Uk;Park, Ji Won;Shin, Ji Young;Jung, Sun Young;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.59-66
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    • 2007
  • Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

Effects of a Yoga Program on School Stress of the Elementary School Children (요가 프로그램이 초등학생의 학교 스트레스에 미치는 효과)

  • Yang, Mi-Ae;Ahn, Ie-Hwan
    • The Korean Journal of Elementary Counseling
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    • v.9 no.2
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    • pp.175-193
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    • 2010
  • The aim of this study is to examine effects of a yoga program for children on school stress of the elementary school children. To achieve this goal, total 10 students out of 231 in 6 classes among the third graders in M elementary school in B city were selected as subjects for this study. After regular school hours, they participated in a children's yoga program for 16 times for 45 minutes per session in the course of 8 weeks. An ethnographic interview was conducted to identify the effects of the program. During the initial stage of the children's yoga program, the participants were interviewed preliminarily. An analysis of areas and an analysis of classifications were made based on the initial interview results, and an area classification table was drawn on the school stress perceived by the elementary school children. After the yoga program ended, a follow up interview was made to apply an analysis of components by comparing changes in the school stress level due to a yoga effect. A research report was written through a cycle of addition and supplement in which the previous data analysis was complemented and corrected by new findings of the study. As a result of the ethnographic interview to analyze the school stress perceived by the elementary school children, and an examination of the changes in the school stress level, the children's yoga program proved to be significantly effective in reducing the school stress. However there were limitations to a certain degree in stress reduction. Details of such findings in each sub-category are as follow. First, as a result of the initial interview analysis, the school stress was classified broadly into 4 categories of study stress, friendship stress, teacher stress, and school environment stress. Second, the study stress as the first category of the school stress was classified into 3 sub-categories of homework, class, and exam stresses. In spite of minor differences among 3 sub-categories, the stress was reduced in general. Third, the friendship stress as the second category of the school stress was also classified into 3 sub-categories of bullying, alienation, and performing one's duty. There were minor differences among sub-categories, however stress reduction also appeared with the exception of the performing one's duty category which had relatively little effect from the yoga program. Fourth, regarding the teacher stress as the third school stress, a classification was made into 3 sub-categories of preference, penalty, and teaching method. Minor differences among the 3 sub-categories notwithstanding, stress reduction appeared with the exception of the teaching method stress which had relatively little effect from the yoga program. Fifth, the school environment stress as the fourth category of the school stress was classified into 2 sub-categories of school meals and facilities. Minor differences between the 2 categories notwithstanding, stress reduction appeared with the facilities stress having relatively little effect.

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Allium tuberosum Reverses PCSK9-Mediated LDLR Degradation by Inhibition of HNF1α (부추 추출물의 PCSK9 억제를 통한 LDL 콜레스테롤 저감 효능)

  • Choi, Hyo-Kyoung;Kim, Hyo Jin;Hwang, Jin-Taek;Chung, Min-Yu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.11
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    • pp.1278-1285
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    • 2017
  • Accumulation of excess low density lipoprotein (LDL) cholesterol in the blood can initiate and accelerate atherosclerosis. Statins mediate the transactivation of proprotein convertase subtilisin/kexin type 9 (PCSK9), which in turn limits their cholesterol-lowering effects via LDL receptor (LDLR) degradation. The objective of this study was to investigate whether or not Allium tuberosum (AT) regulates LDLR and PCSK9. Mice were fed a low fat control diet (LD) or Western diet (WD) supplemented with AT (1%, w/w). AT significantly attenuated total and LDL cholesterol levels in mice fed WD (P<0.05). AT also significantly inhibited hepatic PCSK9 gene expression (P<0.05) while AT maintained hepatic LDLR gene expression. To further investigate AT-mediated PCSK9 regulation, HepG2 cells were treated with 10% delipidated serum (DLPS) in the presence or absence of AT. Non-toxic level of AT dose-dependently increased the LDLR protein level, and AT at $400{\mu}g/mL$ markedly inhibited PCSK9 protein expression. Similarly, AT significantly increased LDLR gene expression, whereas it significantly down-regulated PCSK9 gene expression. AT-mediated reduction of PCSK9 gene expression is likely due to decreased hepatic nuclear factor $1{\alpha}$ ($HNF1{\alpha}$) expression, but not SREBP2 in HepG2 cells under lipid-depleted conditions. AT-mediated PCSK9 inhibition contributed to LDLR protein stabilization via protection against LDLR lysosomal degradation in HepG2 cells under lipid-depleted conditions. Further investigation is warranted to determine the active components of AT and whether or not these components are effective in reducing hypercholesterolemia.

The Effects of Green Tea on the Serum Lipid and Liver Tissue of Cholesterol Fed Rats (녹차의 음용이 지방과 콜레스테롤을 투여한 흰쥐의 혈청지질 및 간의 조직에 미치는 영향)

  • Sin, Mee-Kung;Han, Sung-Hee;Han, Gun-Jo
    • Korean Journal of Food Science and Technology
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    • v.29 no.6
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    • pp.1255-1263
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    • 1997
  • This study was performed to investigate the effects of green tea on fat metabolism of rats and prevention to cardiovascular disease in drinking green tea. Male Spague-Dawley rats were divided into seven groups consisting of the control, lard and cholestrol, aqueous green tea at the level of 1% and 3%. After 4 weeks of feeding serum lipid levels were measured for experimental rats, and analyzed the total cholesterol (TC), HDL-cholesterol (HDL-C), triglyceride (TG), phospholipid (PL). And total lipid (TL) to Folch method, lipid deposition to oil red O staining on liver tissue. The results are as follows: Total cholesterol (TC) decreased by administration of 1% aqueous green tea group and increased addition to lard and cholesterol (LC) group as compared to each groups (p<0.05). HDL-cholestrol in serum increased by administration of la aqueous green tea group (1G) and decreased to the control group, 1% aqueous green tea (L-1G) added lard group (p<0.05). Triglyceride (TG) decreased by administration of 3% aqueous green tea groups (L-3G, LC-3G) and increased by lard and cholesterol group (LC) (p<0.01). Phospholipid(PL) decreased by administration of 3% aqueous green tea added lard and cholesterol group (LC-3G) and increased by control group, lard and cholestrol group (LC) (p<0.05). Total lipid of liver decreased by administration of aqueous green tea at the level of 1% group and increased by LC group (p<0.01). The fat deposition of liver was increased in fat diet groups and decrease in the drink green tea of some but did not showed significant differences from concentration of the green tea.

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Clinical Significance of Methacholine Bronchial Challenge Test in Differentiating Asthma From COPD (만성폐쇄성폐질환과 천식의 감별진단에서 메타콜린 기관지유발검사의 의의)

  • Hong, Yun Kyung;Chung, Chi Ryang;Paeck, Kyung Hyun;Kim, So Ri;Min, Kyung Hoon;Park, Seoung Ju;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.433-439
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    • 2006
  • Background: Although airway hyper-responsiveness is one of the characteristics of asthma. bronchial hyper-responsiveness has also been observed to some degree in patients with chronic obstructive pulmonary disease (COPD). Moreover, several reports have demonstrated that a number of patients have both COPD and asthma. The methacholine bronchial challenge test (MCT) is a widely used method for the detecting and quantifying the airway hyper- responsiveness, and is one of the diagnostic tools in asthma. However, the significance of MCT in differentiating asthma or COPD combined with asthma from pure COPD has not been defined. The aim of this study was to determine the role of MCT in differentiating asthma from pure COPD. Method: This study was performed prospectively and was composed of one hundred eleven patients who had undergone MCT at Chonbuk National University Hospital. Sixty-five asthma patients and 23 COPD patients were enrolled and their MCT data were analyzed and compared with the results of a control group. Result: The positive rates of MCT were 65%, 30%, and 9% in the asthma, COPD, and control groups, respectively. The mean $PC_{20}$ values of the asthma, COPD, and control groups were $8.1{\pm}1.16mg/mL$, $16.9{\pm}2.21mg/mL$, and $22.0{\pm}1.47mg/mL$, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT for diagnosing asthma were 65%, 84%, 81%, and 69%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT (ed note: please check this as I believe that these values correspond to the one $PC_{20}$ value. Please check my changes.) at the new cut-off points of$PC_{20}{\leq}16mg/ml$, were 80%, 75%, 78%, and 78%, respectively. Conclusion: MCT using the new cut-off point can be used as a more precise and useful diagnostic tool for distinguishing asthma from pure COPD.

Primary Synchronous Lung Cancer Detected using Autofluorescence Bronchoscopy (자가 형광 기관지 내시경을 이용한 동시성 원발성 폐암의 진단)

  • Kwon, Sun Jung;Lee, Yun Seun;Joung, Mi Kyong;Lee, Yu Jin;Jang, Pil Soon;Lee, Jeung Eyun;Chung, Chae Uk;Park, Hee Sun;Jung, Sung Soo;Kim, Sun Young;Kim, Ju Ock
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.645-652
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    • 2006
  • Objective: Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions. Methods: Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied. Results: Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy. Conclusions: Additional AFB is effective in detecting early secondary cancerous lesions and is a more precise tool in the staging workup of patients with primary lung cancer than with WLB alone.

Etiologic Distribution, Diagnostic Tests and Treatment in Prospectively Registered Patients with DILD for Two Years in a Tertiary Medical Center (한 3차 병원에서 2년간 전향적으로 등록된 DILD 환자의 원인, 진단 수기 및 치료 현황)

  • Kwon, Yong Soo;Chung, Man Pyo;Jeon, Gyeong Man;Lyu, Yeon Ju;Yu, Chang Min;Choi, Jae Chul;Kang, Eun Hae;Koh, Won-Jung;Suh, Gee Young;Kim, Hojoong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.570-575
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    • 2005
  • Introduction : Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. Method : From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. Results : 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. Conclusion : A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.