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The Influence of Fat-Free Mass to Maximum Exercise Performance in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서 제지방량이 최대운동능력에 미치는 영향)

  • Mun, Yeung Chul;Park, Hye Jung;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.346-354
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    • 2002
  • Background : Dyspnea and a limitation in exercise performance are important cause of disability in patients with chronic obstructive pulmonary disease(COPD). A depleted nutritional state is a common problem in patients with a severe degree of chronic airflow limitation. This study was carried out to assess the factors determining the maximum exercise capacity in patients with COPD. Methods : The resting pulmonary function, nutritional status, and maximum exercise performance was assessed in 83 stable patients with moderate to severe COPD. The nutritional status was evaluated by bioelectrical impedance analysis. Maximum exercise performance was evaluated by maximum oxygen uptake($VO_2max$). Results : Among the 83 patients, 59% were characterized by nutritional depletion. In the depleted group, a significantly lower peak expiratory flow rate(p<0.05), Kco(p<0.01) and maximum inspiratory pressure(p<0.05), but a significantly higher airway resistance(p<0.05) was observed. The maximum oxygen uptake and the peak oxygen pulse were lower in the depleted group. The $VO_2max$ correlated with some of the measures of the body composition : fat-free mass(FFM), fat mass(FM), body mass index(BMI), intracellular water index(ICW index), and pulmonary function : forced vital capacity(FVC), forced inspiratory vital capacity(FIVC), diffusion capacity(DLCO) : or maximum respiratory pressure : maximum inspiratory pressure(PImax), maximum expiratory pressure(PEmax). Stepwise regression analysis demonstrated that the FFM, DLCO and FIVC accounted for 68.8% of the variation in the $VO_2max$. Conclusion : The depletion of the FFM is significant factor for predicting the maximum exercise performance in patients with moderate to severe COPD.

Immunohistochemical Study of Phosphatase and Tensin Homolog Deleted on Chromosome Ten in Gefitinib Treated Nonsmall Cell Lung Cancer Patients (폐암 조직에서의 PTEN 발현 정도와 Gefitinib의 반응율과의 관계)

  • Lee, Sung Yong;Lee, Ju Han;Jung, Jin Yong;Lee, Kyoung Ju;Lee, Seung Hyeun;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.473-479
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    • 2005
  • Background : Gefitinib targets the epidermal growth factor receptor r(EGFR), and Gefitinib has antitumor activity in patient with non-small cell lung cancer (NSCLC). However, only 10 to 20 percent of patients show a clinical response to this drug, and the molecular mechanisms underlying patient sensitivity to gefitinib are unknown. PTEN (Phosphatase and tensin homolog deleted on chromosome Ten) plays a role for the modulation of the phosphatidylinositol 3-kinase pathway (PI3K), which is involved in cell proliferation and survival, so that it can inhibit cell cycle progression and induce G1 arrest. Therefore, we analyzed the relationship between PTEN expression and gefitinib's responsiveness in patients having advanced non small cell lung cancer that had progressed after previous chemotherapy. Methods : The expression of PTEN was studied by immunohistochemistry in paraffin-embedded tumor blocks that were obtained from 22 patients who had been treated with gefitinib from JAN, 2001 to AUG. 2004. For the evaluation of the relationships between the PTEN expression, the clinical stage and the basal characteristics, those cases that showed the respective antigen expression in >50% of the tumor cells were considered positive. Results : The positive rate of PTEN staining was 55% of the total of 22 patients. There was a significant relationship between the increased expression of PTEN and the response group (p=0.039). However, there was no significant relationship between the expression of PTEN and other clinicopathologic characteristics. Conclusion: The expression of PTEN in patients with advanced non small cell lung cancer that has progressed after previous chemotherapy may play a role in gefitinib's responsiveness.

Relationship between Dyspnea and Disease Severity, Quality of Life, and Social Factor in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자에서 질병 중증도 및 삶의 질을 비롯한 사회적 요인과 호흡곤란과의 관계)

  • Kim, Eun-Jin;Park, Jae-Hyung;Yoon, Suk-Jin;Lee, Seung-Jun;Cha, Seung-Ick;Park, Jae-Yong;Jung, Tae-Hoon;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.4
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    • pp.397-403
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    • 2006
  • Background: Chronic obstructive pulmonary disease(COPD) is categorized by the percentage of the predicted $FEV_1$(Forced expiratory volume in 1 second) result which is highly correlated with disease severity(morbidity and mortality). In COPD patients, dyspnea seems to be different from disease severity. We investigated whether dyspnea is correlated with disease severity, as measured by $FEV_1$, quality of life(QoL), occupation, and supporting level of family members and neighbors. Method: Thirty-six clinically stable patients with chronically irreversible airflow limitation were enrolled. We used the Medical Research Council(MRC) dyspnea scale to assess the level of dyspnea and the Korean St. Goerge's respiratory questionnaire(SGRQ) as measure the QoL. Result: The mean percentage of the predicted $FEV_1$ was 32.0%. Dyspnea was not correlated with GOLD stage using $FEV_1$(p=0.114). With deteriorating level of dyspnea the scores of symptoms(p=0.041), activity(p=0.004), impact(p=0.001), and total SGRQ score(p<0.001) were significantly increased. Dyspnea was not correlated with the level of occupation(p=0.259). The supporting level of family members and neighbors was significantly negatively correlated with dyspnea scale(p=0.011). Conclusion: In the management of COPD patients, we have to remember that the level of subjective dyspnea is correlated with QoL(symptom, activity and impact on society) and social supporting level as well as GOLD stage($FEV_1$).

Detection of Pathogenic Viruses in the Atmosphere during Asian Dust Events in Incheon City (인천지역에서 황사 기간 동안 대기 중의 바이러스 검출에 관한 연구)

  • Park, Jeong Woong;Lim, Young Hee;Kyung, Sun Young;An, Chang Hyeok;Lee, Sang Pyo;Jeong, Seong Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.279-285
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    • 2005
  • Background : Ambient particles during Asian dust events are usually less than $10{\mu}m$ in size, and known to be associated with the adverse effects on the general population. There is little evidence linking Asian dust to adverse effects on the airways. In 2002, the authors found that particulate matter during Asian dust events had an effect on the symptoms and pulmonary function of patients with bronchial asthma. An aggravating factor might be that of a viral infection, but this remains unclear. Conversely, it has been speculated that African dust may carry the virus responsible for foot and mouth disease. Asian dust events are also likely to be responsible for transporting viruses, some of which are pathogenic, and common in many environments. Therefore, in this study, air samples were screened for the presence of viruses. Methods : Air samples were collected 20 times each during Asian dust events and under non-dust conditions, for at least 6 hours per sample, using a high volume air sampler (Sibata Model HV500F), with an airflow rate of 500L/min, between April and August 2003, and between April and August 2004. The samples were then screened for the presence of targeted viruses (Influenza A, B, Hog cholera virus, and Aphthovirus) using a polymerase chain reaction method. Results : One Asian dust event occurred between April and August 2003, and 3 between April and August 2004, with a 24 hour average PM10 level of $148.0{\mu}g/m^3$. The 24 hour average PM10 level was $57{\mu}g/m^3$. There was a significant difference in the PM10 concentration between dusty and clear days. No viruses (Influenza virus, Aphthovirus, and Hog cholera virus) were identified in the air samples obtained during the dusty days. Conclusions : Although no virus was detected in this study, further studies will be needed to identify suspected viruses carried during Asian dust events, employing more appropriate virus detection conditions.

The Role and Significance of Biomarker for Plasma G-CSF in Patients with Primary Lung Cancer (원발성 폐암에서 혈장 과립구 자극인자의 암표지자로서의 역할과 의의)

  • Song, Jung Sub;Kim, So Young;Jo, Hyang Jeong;Lee, Kang Kyoo;Shin, Jeong Hyun;Shin, Seong Nam;Kim, Dong;Park, Seong Hoon;Lee, Young Jin;Ko, Chang Bo;Lee, Mi Kung;Choi, Soon Ho;Jeong, Jong Hoon;Park, Jung Hyun;Kim, Hui Jung;Kim, Hak Ryul;Jeong, Eun Taik;Yang, Sei Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.444-450
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    • 2009
  • Background: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. Methods: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. Results: The mean plasma G-CSF levels were 12.2$\pm$0.3 pg/mL and 46.0$\pm$3.8 pg/mL (mean$\pm$SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II

Proinflammatory Effects of High Mobility Group B1 (HMGB1) Versus LPS and the Mechanism of IL-8 Promoter Stimulation by HMGB1 (High mobility group B1(HMGB1)과 LPS의 염증유발효과 차이의 비교 및 HMGB1에 의한 IL-8 promoter 자극 기전의 규명)

  • Jeon, Eun Ju;Kwak, Hee Won;Song, Ju Han;Lee, Young Woo;Chung, Jae Woo;Choi, Jae Chul;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.299-307
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    • 2007
  • Background: High mobility group box 1 (HMGB1) is a novel, late mediator of inflammation. This study compared the pro-inflammatory effects of LPS and HMGB1. The transcriptional factors that play an important role in mediating the HMGB1-induced stimulation of IL-8 were also evaluated. Methods: RAW264.7 cells were stimulated with either LPS (100 ng/ml) or HMGB1 (500 ng/ml). The $TNF-{\alpha}$, MIP-2 and $IL-1{\beta}$ levels in the supernatant were evaluated by ELISA at 0, 2, 4, 8, 12 and 24h after stimulation. An acute lung injury was induced by an injection of LPS (5 mg/kg) or HMGB1 (2.5 mg/kg) into the peritoneum of the Balb/c mice. The lung cytokines and MPO activity were measured at 4h (for LPS) or 24h (for HMGB1) after the injection. The transcriptional factor binding sites for NF-IL6, $NF-{\kappa}B$ and AP-1 in the IL-8 promoter region were artificially mutated. Each mutant was ligated with pIL-6luc and transfected into the RAW264.7 cells. One hour after stimulation with HMGB1 (500 ng/ml), the cell lysate was analyzed for the luciferase activity. Results: The expression of MIP-2, which peaked at 8h with LPS stimulation, increased sequentially until 24h after HMGB1 stimulation. An intraperitoneal injection of HMGB1, which induced a minimal increased in $IL-1{\beta}$ expression, provoked the accumulation of neutrophils the lung. A mutation of AP-1 as well as $NF-{\kappa}B$ in the IL-8 promoter region resulted in a lower luciferase activity after HMGB1 stimulation. Conclusion: The proinflammatory effects of HMGB1, particularly on IL-8, are mediated by both $NF-{\kappa}B$ and AP-1.

A Study on the Effect of Location-based Service Users' Perceived Value and Risk on their Intention for Security Enhancement and Continuous Use: With an Emphasis on Perceived Benefits and Risks (위치기반서비스 사용자의 지각된 가치와 위험이 보안강화의도와 지속이용의도에 미치는 영향에 관한 연구: 지각된 혜택과 위험을 중심으로)

  • Park, Kyung Ah;Lee, Dae Yong;Koo, Chulmo
    • Asia pacific journal of information systems
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    • v.24 no.3
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    • pp.299-323
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    • 2014
  • The reason location based service is drawing attention recently is because smart phones are being supplied increasingly. Smart phone, basically equipped with GPS that can identify location information, has the advantage that it can provide contents and services suitable for the user by identifying user location accurately. Offering such diverse advantages, location based services are increasingly used. In addition, for use of location based services, release of user's personal information and location data is essentially required. Regarding personal information and location data, in addition to IT companies, general companies also are conducting various profitable businesses and sales activities based on personal information, and in particular, personal location data, comprehending high value of use among personal information, are drawing high attentions. Increase in demand of personal information is raising the risk of personal information infringement, and infringements of personal location data also are increasing in frequency and degree. Therefore, infringements of personal information should be minimized through user's action and efforts to reinforce security along with Act on the Protection of Personal Information and Act on the Protection of Location Information. This study aimed to improve the importance of personal information privacy by empirically analyzing the effect of perceived values on the intention to strengthen location information security and continuously use location information for users who received location-based services (LBS) in mobile environments with the privacy calculation model of benefits and risks as a theoretical background. This study regarded situation-based provision, the benefit which users perceived while using location-based services, and the risk related to personal location information, a risk which occurs while using services, as independent variables and investigated the perceived values of the two variables. It also examined whether there were efforts to reduce risks related to personal location information according to the values of location- based services, which consumers perceived through the intention to strengthen security. Furthermore, it presented a study model which intended to investigate the effect of perceived values and intention of strengthening security on the continuous use of location-based services. A survey was conducted for three hundred ten users who had received location-based services via their smartphones to verify study hypotheses. Three hundred four questionnaires except problematic ones were collected. The hypotheses were verified, using a statistical method and a logical basis was presented. An empirical analysis was made on the data collected through the survey with SPSS 12.0 and SmartPLS 2.0 to verify respondents' demographic characteristics, an exploratory factor analysis and the appropriateness of the study model. As a result, it was shown that the users who had received location-based services were significantly influenced by the perceived value of their benefits, but risk related to location information did not have an effect on consumers' perceived values. Even though users perceived the risk related to personal location information while using services, it was viewed that users' perceived value had nothing to do with the use of location-based services. However, it was shown that users significantly responded to the intention of strengthening security in relation to location information risks and tended to use services continuously, strengthening positive efforts for security when their perceived values were high.

The Effects of Nitric Oxide Inhibitor on Hyperdynamic Circulation in Portal Hypertensive Rats (산화 질소 억제제가 문맥 고혈압 쥐의 혈역학 변화에 미치는 영향)

  • Kim, Pill-Young;Jang, Byeong-Ik;Kim, Tae-Nyeun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.181-192
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    • 1999
  • Background: Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells, accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor, $N^{\omega}$-Nitro-L-Arginine(NNA) diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. Methods: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation, NNA ingestion group and water ingestion group received NNA 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope labeled microsphere methods. Vascular resistances were calculated by standard equation. Results: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control group (p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure with decreased cardiac output and cardiac index were developed in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group (p<0.05). But, there was no significant difference in portal pressure between the two groups. Conclusion: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat mode1 was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vasodilation in chronic portal hypertension.

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Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection

  • Zhou, Hang;Li, Xiong;Zhang, Yuan;Jia, Yao;Hu, Ting;Yang, Ru;Huang, Ke-Cheng;Chen, Zhi-Lan;Wang, Shao-Shuai;Tang, Fang-Xu;Zhou, Jin;Chen, Yi-Le;Wu, Li;Han, Xiao-Bing;Lin, Zhong-Qiu;Lu, Xiao-Mei;Xing, Hui;Qu, Peng-Peng;Cai, Hong-Bing;Song, Xiao-Jie;Tian, Xiao-Yu;Zhang, Qing-Hua;Shen, Jian;Liu, Dan;Wang, Ze-Hua;Xu, Hong-Bing;Wang, Chang-Yu;Xi, Ling;Deng, Dong-Rui;Wang, Hui;Lv, Wei-Guo;Shen, Keng;Wang, Shi-Xuan;Xie, Xing;Cheng, Xiao-Dong;Ma, Ding;Li, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3773-3777
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    • 2015
  • Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

Oxidative Stress Induced Damage to Paternal Genome and Impact of Meditation and Yoga - Can it Reduce Incidence of Childhood Cancer?

  • Dada, Rima;Kumar, Shiv Basant;Chawla, Bhavna;Bisht, Shilpa;Khan, Saima
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4517-4525
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    • 2016
  • Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.