• Tuberculosis and Respiratory Diseases
• /
• v.48 no.4
• /
• pp.428-437
• /
• 2000

Background : Five year survival rate of postoperative stage I non-small cell lung cancer(NSCLC) reaches to 66%. In the remaining one third of patients, however, cancer recurs and the overall survival of NSCLC remains dismal. To evaluate clinical and pathologic characteristics of recurred NSCLC, the patterns and factors for postoperative recurrence in patients with staged I and II NSCLC were studied. Method : A retrospective analysis was performed in 234 patients who underwent radical resection for pathologic stage I and II NSCLC. All patients who were followed up for at least one year were included in this study. Results : 1) There were 177 men and 57 women The median age was 63. The median duration of the follow up period was 732 days (range 365~1,695 days). The overall recurrence rate was 26.5%, and the recurrence occurred $358.8{\pm}239.8$ days after operation. 2) The ages of recurred NSCLC patients were higher ($63.2{\pm}8.8$ years) than those of non-recurred patients ($60.3{\pm}9.8$ years)(p=0.043). The recurrence rate was higher in stage II (46.9%) than in stage I (18.8%) NSCLC p<0.001. The size of primary lung mass was larger in recurred ($5.45{\pm}3.22\;cm$) than that of non-recurred NSCLC ($3.74{\pm}1.75\;cm$, p<0.001). Interestingly, there were no recurrent cases when the resected primary tumor was less than 2cm. 3) Distant recurrence was more frequent than locoregional recurrence (66.1% vs. 33.9%). Distant recurrence rate was higher in females and in cases of adenocarcinoma. Brain metastasis was more frequent in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.024). Conclusion: The tumor size and stage were two important factors for determining the possibility of a recurrence. Because distant brain metastasis was more frequent in patients with adenocarinoma, a prospective study should be conducted to evaluate the effectiveness of preoperative brain imaging.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.6
• /
• pp.922-931
• /
• 2000

Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.5
• /
• pp.1012-1021
• /
• 1998

Background : It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough, and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time course of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. Method: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide ($400{\mu}g{\times}2/day$), twenty-two entered nedocromil ($4mg{\times}2/day$) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4- and/or 6 month after treatment. Results: The improvement of BHR and symptom was significant in 2 month (p<0.05), but there was no change of them during follow-up period of 4- and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration, age, gender, and the initial degree of PC20, there was a significant difference in each other(p<0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group(p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. Conclusion: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4- and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.4
• /
• pp.303-314
• /
• 2001

Background : Matrix metalioproteinase(MMP)-2 and MMP-9 have been known to play an important role in cell migration and the tissue remodeling process by type IV collagen lysis, a major component of the basement membrane. Intra-alveolar fibrosis, secondary to an injury to the basement membrane of the alveolar epithelial lining, is a major process in the pathogenesis of idiopathic pulmonary fibrosis(IPF). Therefore, MMP-2 and MMP-9 was hypothesized to play an important role in IPF pathogenesis. As a result, their level may reflect the activity or prognosis. Method : Forty one progressive IPF patients(age $59.82{\pm}1.73$ years, M:F=23:18), 16 patients with stable IPF for more than one year without therapy(age : $63.6{\pm}2.8$ years, M:F=13:3), and 7 normal controls were enrolled in this study. The MMP-2 and MMP-9 levels in the BAL fluid and alveolar macrophage conditioned media(AM-CM) were measured by zymography and the TIMP-1 level was measured by ELISA. Results : 1) The MMP-2 level in BALF was highest in the progressive IPF group ($1.36{\pm}0.28$) followed by the stable group ($0.46{\pm}0.13$) and the controls ($0.08{\pm}0.09$), which was statistically significant. The MMP-9 level of the IPF ($0.31{\pm}0.058$) and the stable group ($0.22{\pm}0.078$) were higher than that of the control group ($0.002{\pm}0.004$). In the AM-CM, only MMP-9 was detected, which was significantly higher in IPF group ($0.80{\pm}0.1O$) than in the control group($0.23{\pm}0.081$). The TIMP-1 level was also higher in both the IPF ($36.34{\pm}8.62\;{\mu}g/ml$) and stable group ($20.83{\pm}8.53\;{\mu}g/ml$) compared to the control group ($2.80{\pm}1.05\;{\mu}g/ml$) (p<0.05). 3) There was a correlation between the MMP-2 level in the BALF with the total cell number(r=0.298) and neutrophils(r=0.357) (p<0.05), and the MMP-9 level with the number of neutrophils (r=0.407) and lymphocytes (r=0.574)(p<0.05). The TIMP-1 level correlated with the total number of cell (r=0.338, p<0.05) and neutrophils(r=0.449, p=0.059). Conclusion : Both MMP and TIMP appear to play an important role in IPF pathogenesis, and their level may reflect the disease activity.

• Korean Journal of Soil Science and Fertilizer
• /
• v.10 no.3
• /
• pp.171-188
• /
• 1977

The response and effect on main upland crops to potassium were discussed and summarized as follows. 1. Adequate average amounts of potash per 10a were 32kg for forage crop; 22.5kg for vegetable crops; 17.3kg for fruit trees; 13.3kg for potatoes; and 6.5kg for cereal crops. Demand of potassium fertilizer in the future will be increased by expanding the acreage of forage crops, vegetable crops and fruit trees. 2. On the average, optimum potash rates on barley, wheat, soybean, corn, white potato and sweet potato were 6.5, 6.9, 4.5, 8.1, 8.9, and 17.7kg per 10a respectively. Yield increaments per 1kg of potash per 10a were 4-5kgs on the average for cereal crops, 68kg for white potato, and 24kg for sweet potato. 3. According to the soil testing data, the exchangeable potassium in the coastal area was higher than that in the inland area and medium in the mountainous area. The exchangeable potassium per province in decreasing order is Jeju>Jeonnam>Kangweon>Kyongnam. Barley : 4. The response of barley to an adequate rate of potassium seemed to be affected more by differences in climatic conditions than to the nature of the soil. 5. The response and the adequate rate of potassium in the southern area, where the temperature is higher, were low because of more release of potassium from the soil. However, the adequate rate of phosphorus was increased due to the fixation of applied phosphorus into the soil in high temperature regions. The more nitrogen application would be required in the southern area due to its high precipitation. 6. The average response of barley to potassium was lower in the southern provinces than northern provinces. Kyongsangpukdo, a southern province, showed a relatively higher response because of the low exchangeable potassium content in the soil and the low-temperature environment in most of cultivation area. 7. Large annual variations in the response to and adequate rates of potassium on barley were noticed. In a cold year, the response of barley to potassium was 2 to 3 times higher than in a normal year. And in the year affected by moisture and drought damage, the responses to potassium was low but adequate rates was higher than cold year. 8. The content of exchangeable potassium in the soil parent materials, in increasing order was Crystalline Schist, Granite, Sedimentary and Basalt. The response of barley to potash occurred in the opposite order with the smallest response being in Crystalline Schist soil. There was a negative correlation between the response and exchangeable potassium contents but there was nearly no difference in the adequate rates of potassium. 9. Exchangeable potassium according to the mode of soil deposition was Alluvium>Residium>Old alluvium>Valley alluvium. The highest response to potash was obtained in Valley alluvium while the other s showed only small differences in responses. 10. Response and adequate rates of potassium seemed to be affected greatly by differences in soil texture. The response to potassium was higher in Sandy loam and Loam soils but the optimum rate of potassium was higher in Clay and Clay loam. Especially when excess amount of potassium was applied in Sandy loam and Loam soils the yield was decreased. 11. The application of potassium retarded the heading date by 1.7 days and increased the length of culm. the number of spikelet per plant, the 1,000 grain weight and the ratio of grain weight to straw. Soybean : 12. Average response of soybean to potassium was the lowest among other cereal crops but 28kg of grain yield was incrased by applying potash at 8kg/10a in newly reclaimed soils. 13. The response in the parent materials soil was in the order of Basalt (Jeju)>Sedimentay>Granite>Lime stone but this response has very wide variations year to year. Corn : 14. The response of corn to potassium decreased in soils where the exchangeable potassium content was high. However, the optimum rate of applied potassium was increased as the soil potassium content was increased because corn production is proportional to the content of soil potassium. 15. An interaction between the response to potassium and the level of phosphorus was noted. A higher response to potassium and higher rates of applied potassium was observed in soils contained optimum level of phosphorus. Potatoes : 16. White potato had a higher requirement for nitrogen than for potassium, which may imply that potato seems to have a higher capability of soil potassium uptake. 17. The yield of white potato was higher in Sandy loam than in Clay loam soil. Potato yields were also higher in soils where the exchangeable potassium content was high even in the same soil texture. However, the response to applied potassium was higher in Clay loam soils than in Sandy loam soils and in paddy soil than in upland soil. 18. The requirement for nitrogen and phosphorus by sweet potato was relatively low. The sweet potato yield is relatively high even under unfavorable soil conditions. A characteristics of sweet potatoes is to require higher level of potassium and to show significant responses to potassium. 19. The response of sweet potato to potassium varied according to soil texture. Higher yields were obtained in Sandy soil, which has a low exchangeable potassium content, by applying sufficient potassium. 20. When the optimum rate of potassium was applied, the yields of sweet potato in newly reclaimed soil were comparable to that in older upland soils.