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The Association between Mortality and the Oxygen Saturation and Fraction of Inhaled Oxygen in Patients Requiring Oxygen Therapy due to COVID-19-Associated Pneumonia

  • Choi, Keum-Ju;Hong, Hyo-Lim;Kim, Eun Jin
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.125-133
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    • 2021
  • Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO2) and the fraction of inhaled oxygen (FiO2) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO2, FiO2, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality. Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

Anti-inflammatory and Anti-oxidant Activities of Aster Scaber Ethanol Extract

  • Saba, Evelyn;Je, Nayeong;Song, Ji Eun;Shi, Sangwoo;Lee, Juho;Jung, Oneyoung;Han, Beom Jun;Lee, Soo Young;Park, Jongwon;Lee, Yuan Yee;Rhee, Man Hee
    • Biomedical Science Letters
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    • v.28 no.3
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    • pp.170-177
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    • 2022
  • In mountainous regions, wild herbs which can also be edible in nature for humans and animals possess a wide array of biologically diversified properties. It is because of the fact that due to the cold weather of mountains; they are enriched in certain kinds of phytochemicals such as anti-oxidants, anti-inflammatory and many more. One such kind of an herb is Aster scaber (AS) in Korean. It is a widely cultivated culinary herb in Korean peninsula and used as a side dish in Korean culinary cuisine. In view of its extensive use in cuisine, we geared to unravel the anti-oxidant and anti-inflammatory effects of AS in murine alveolar macrophage cell line (MH-S). 2,2'-Azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assays revealed a dose dependent (7.8~1,000 ㎍/mL) inhibition of oxidation by AS 70% ethanol (ASE) extract as compared to Trolox and Ascorbic acid respectively. Nitric oxide assay (NO) showed a dose dependent decrease (5~40 ㎍/mL) in MH-S cells with ASE when stimulated with Coal Fly Ash (CFA). Moreover, this dose for NO reduction was also found to be least cytotoxic for cells as determined by cellular viability (MTT) assay. The gene expression of pro-inflammatory mediators (iNOS and COX-2) and cytokines (IL-6 and IL-1β) and were also dose dependently inhibited by ASE in MH-S cells through RT-PCR. Therefore, in light of these findings, AS exhibited a strong anti-oxidant and anti-inflammatory agent. These results also justify the extensive use of this mountainous herb in culinary practices for beneficial effects on human health.

Implications of Sarcopenia and Glucometabolism Parameters of Muscle Derived From Baseline and End-of-Treatment 18F-FDG PET/CT in Diffuse Large B-Cell Lymphoma

  • Xiaoyue Tan;Xiaolin Sun;Yang Chen;Fanghu Wang;Yuxiang Shang;Qing Zhang;Hui Yuan;Lei Jiang
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.277-288
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    • 2024
  • Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using 18F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values. Materials and Methods: The records of 103 patients with DLBCL (median 54 years [range, 21-76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm2/m2 and < 32.50 cm2/m2 for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified. Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022-5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453-17.562]). Conclusion: Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

Effects of Curcumae longae Rhizoma and Cinnamomi Ramulus Mixture on Anti-inflammatory Activities in Lipopolysaccharide-stimulated RAW 264.7 Cells (강황(薑黃) 계지(桂枝) 복합물이 RAW 264.7 세포에서 항염증 활성에 미치는 영향)

  • Ji, Choi;Hae-Jin, Park;Il-ha, Jeong;Min Ju, Kim;Mi-Rae, Shin;Seong-Soo, Roh;Soon-Ae, Park;Mi-Lim, Kim
    • The Korea Journal of Herbology
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    • v.38 no.2
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    • pp.17-26
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    • 2023
  • Objectives : A persistent inflammatory response can cause diseases such as fibrosis, cancer, and allergies. This study aimed to investigate the anti-inflammatory activity of Curcumae longae Rhizoma and Cinnamomi Ramulus Mixture (CCM) in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Methods : The total polyphenol and flavonoid contents of CCM were confirmed through an in vitro experiment. Also, radical scavenging activities of 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and Hydroxyl were confirmed. Moreover, ferric reducing antioxidant power (FRAP) activity were confirmed. After, CCM (50, 100, and 200 ㎍/mL) were applied to 0.1 ㎍/mL LPS-stimulated RAW264.7 cells. The levels of nitric oxide (NO) and pro-inflammatory cytokines in the supernatant fraction were determined. Also, the expressions of mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) pathways were detected using Western blot. Results : As a result of in vitro experiments, there was an excellent antioxidant activity in CCM-treated cells. In addition, in RAW264.7 cells stimulated with LPS, the increased NO level was inhibited in a concentration-dependent manner by the treatment of CCM. In addition, inflammatory cytokines production were significantly inhibited in a concentration-dependent manner in CCM-treated group. CCM treatment significantly decreased the protein expressions of MAPKs. Moreover, the expressions of NF-κBp65 and cyclooxygenase-2 (COX-2) were significantly decreased when 200 mg/kg of CCM was applied, and phospho-inhibitor of nuclear factor kappa B-α (p-IκBα) and inducible nitric oxide synthase (iNOS) were significantly decreased at all concentrations treated with CCM. Conclusion : Our findings show that CCM exhibited excellent antioxidant activity and exhibited superior anti-inflammatory effect through the MAPKs and NF-κB pathways in LPS-stimulated RAW 264.7 macrophages.

Independent and Additive Interaction Between Tumor Necrosis Factor β +252 Polymorphisms and Chronic Hepatitis B and C Virus Infection on Risk and Prognosis of Hepatocellular Carcinoma: a Case-Control Study

  • Jeng, Jen-Eing;Wu, Hui-Fang;Tsai, Meng-Feng;Tsai, Huey-Ru;Chuang, Lea-Yea;Lin, Zu-Yau;Hsieh, Min-Yuh;Chen, Shinn-Chern;Chuang, Wan-Lung;Wang, Liang-Yen;Yu, Ming-Lung;Dai, Chia-Yen;Tsai, Jung-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10209-10215
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    • 2015
  • To assess the contribution of tumor necrosis factor $(TNF){\beta}$ +252 polymorphisms to risk and prognosis of hepatocellular carcinoma (HCC), we enrolled 150 pairs of sex- and age-matched patients with HCC, patients with cirrhosis alone, and unrelated healthy controls. $TNF{\beta}$ +252 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism. Multivariate analysis indicated that $TNF{\beta}$ G/G genotype [odds ratio (OR), 3.64; 95%CI, 1.49-8.91], hepatitis B surface antigen (OR, 16.38; 95%CI, 8.30-32.33), and antibodies to hepatitis C virus (HCV) (OR, 39.11; 95%CI, 14.83-103.14) were independent risk factors for HCC. There was an additive interaction between $TNF{\beta}$ G/G genotype and chronic hepatitis B virus (HBV)/HCV infection (synergy index=1.15). Multivariate analysis indicated that factors associated with $TNF{\beta}$ G/G genotype included cirrhosis with Child-Pugh C (OR, 4.06; 95%CI, 1.34-12.29), thrombocytopenia (OR, 6.55; 95%CI, 1.46-29.43), and higher serum ${\alpha}$-fetoprotein concentration (OR, 2.53; 95%CI, 1.14-5.62). Patients with $TNF{\beta}$ G/G genotype had poor cumulative survival (p=0.005). Cox proportional hazard model indicated that $TNF{\beta}$ G/G genotype was a biomarker for poor HCC survival (hazard ratio, 1.70; 95%CI, 1.07-2.69). In conclusion, there are independent and additive effects between $TNF{\beta}$ G/G genotype and chronic HBV/HCV infection on risk for HCC. It is a biomarker for poor HCC survival. Carriage of this genotype correlates with disease severity and advanced hepatic fibrosis, which may contribute to a higher risk and poor survival of HCC. Chronic HBV/HCV infected subjects with this genotype should receive more intensive surveillance for early detection of HCC.

Elevated Platelets Enhance Cancer Cell Migration, Promote Hematogenous Metastasis and Associate with a Poor Prognosis in Advanced Non-small Cell Lung Cancer Cases

  • Li, Yan;Miao, Li-Yun;Xiao, Yong-Long;Cai, Hou-Rong;Zhang, De-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.139-143
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    • 2014
  • Although correlations between platelets and lung cancer has been recognized, effects on non-small cell lung cancer (NSCLC) metastasis remain to be determined in detail. In the present study, wound healing assays revealed a role of platelets in NSCLC cell migration. Thus the mean migration rate of lung adenocarcinoma A549 cells was significantly elevated after co-culture with platelets ($81.7{\pm}0.45%$ vs $41.0{\pm}3.50%$, P<0.01). Expression of GAPDH was examined by reverse transcription-polymerase chain reaction to study the effect of platelets on NSCLC cell proliferation. The result showed that the proliferation of A549 and SPC-A1 cells was not affected. Mouse models were established by transfusing A549 cells and SPC-A1 cells into mice lateral tail veins. We found tumor metastasis nodules in lungs to be increased significantly after co-transfusion with platelets (in A549, $4.33{\pm}0.33$ vs $0.33{\pm}0.33$, P=0.01; in SPC-A1, $2.67{\pm}0.33$ vs $0.00{\pm}0.00$, P=0.01). In addition, consecutive inoperable patients with newly diagnosed NSCLC (TNM stage III or IV) between January 2009 and December 2011 were retrospectively reviewed. Using the Kaplan-Meier method, NSCLC patients with a high platelet counts demonstrated a significantly shorter progression free survival compared with those with a low platelet count (> $200{\times}10^9/L$, 3 months versus ${\leq}200{\times}10^9/L$, 5 months, P=0.001). An elevated platelet count was also identified as an independent prognostic factor by Cox regression analysis for prgression free survival (adjusted hazard ratio: 1.69; 95% CI: 1.16, 2.46; P=0.006). This study suggested that platelets might contribute to the hematogenous metastatic process by promoting cancer cell migration, which eventually affects the prognosis of NSCLC.

Anti-oxidant and Anti-inflammatory Effects of Ethanol Extracts from Aerial Part of Coriandrum sativum L. (고수(Coriandrum sativum L.) 지상부 추출물의 항산화 및 항염증 활성 효과)

  • Nan, Li;Lee, Chang-Hyun;Choi, You-Na;Choo, Byung-Kil
    • Korean Journal of Organic Agriculture
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    • v.27 no.4
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    • pp.513-528
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    • 2019
  • Coriandrum sativum L., an annual herbaceous plant of Apiaceae family. The present study evaluated the anti-oxidant activities and anti-inflammatory effects of ethanol extracts of C. sativum. The anti-oxidant activities of C. sativum were measured by total contents of polyphenol, flavonoid, DPPH and ABTS radical scavenging and reducing power activity. And anti-inflammatory effects of C. sativum were measured by LPS-induced RAW 264.7 cells. The results showed that the contents of total polyphenol and flavonoid were 76.03 ± 1.36 mg of gallic acid equivalents/g and 182.23 ± 4.32 mg of rutin equivalents/g at concentration 1 mg/mL of C. sativum. The DPPH radical scavenging activity was found to be 52.8% at 500 ㎍/mL. The ABTS radical scavenging activity was shown in 58.3% after exposure to 1,000 ㎍/mL. Reducing power activity was found to be 66.8% at 2,000 ㎍/mL. The inhibitory effect of NO production was found to be 65% concentration 500 ㎍/mL. In the generation quantity of inflammatory cytokines such as TNF-α and IL-1β in cell culture medium, the expression levels of inflammatory proteins in cells were showed decrease with the increase of concentration. Therefore, we suggest that the C. sativum should be a potential source of alternative anti-inflammatory drug with good anti-inflammatory effects.

Anti-inflammatory activity of indigenous Tuber himalayense in Korea (자생 Tuber himalayense 자실체 추출물의 항염증 활성)

  • Kim, Minkyeong;Hong, Hyehyun;Kim, Jung-Hwan;Kim, Seung-Young;Kim, Changmu
    • Journal of Mushroom
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    • v.19 no.3
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    • pp.176-183
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    • 2021
  • In this study, the anti-inflammatory activity of an extract of the fruiting body of the Tuber himalayense (TH) truffle collected from oak growing areas in Korea was investigated. The extract was not cytotoxic at concentrations below 100 ㎍/mL in an experiment evaluating inflammation inhibitory effect in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. LPS-induced nitric oxide (NO) and prostaglandin E2 (PGE2) production was inhibited by the extract in a concentration-dependent manner. Western blot assay results indicated that the anti-inflammatory activity of TH extract was likely caused by the reduced production of NO and PGE2 via suppression of induced NO synthase and cyclooxygenase-2 gene expression. In addition, TH extract effectively inhibited the production of interleukin (IL)-1β and IL-6 by macrophages. Thus, TH extract effectively inhibits the overexpression of various inflammatory mediators and could be valuable in formulating anti-inflammatory foods and medicines that target these components.

Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience

  • Heera Yoen;Hye Eun Park;Se Hyung Kim;Jeong Hee Yoon;Bo Yun Hur;Jae Seok Bae;Jung Ho Kim;Hyeon Jeong Oh;Joon Koo Han
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1065-1076
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    • 2020
  • Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.

Association between Cigarette Smoking History and Mortality in 36,446 Health Examinees in Korea

  • Kim, Kyoungwoo;Yoo, Taiwoo;Kim, Yeonju;Choi, Ji-Ho;Myung, Seung-Kwon;Park, Sang-Min;Hong, Yun-Chul;Cho, Belong;Park, Sue K.;Yoo, Keun-Young
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5685-5689
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    • 2014
  • Background: It is well known that smoking is a preventable factor for all-cause mortality; however, it is still questionable how many years after smoking cessation that people will have reduced risk for mortality, in particular in those with a high interest in their own health. We aimed to examine the association between time since quitting smoking and total mortality among past-smokers relative to current smokers. Materials and Methods: We enrolled 36,446 health examinees that voluntarily taken with diverse health check-up packages of high cost burden in 1995-2003 and followed them till death by 2004. The history of cigarette smoking consumption was collected using a self-administrative questionnaire at the first visit time. Mortality risk by smoking cessation years was analyzed using Cox's proportional hazard model. Results: Compared to non-smokers, male smokers over 15 pack-years had higher risk for total mortality (HR=1.60, 95%CI 1.23-2.14). The mortality risk in female smokers with same pack-years was more pronounced than that in male smokers (HR=2.83, 95%CI 1.17-7.04) despite a small number of cases. Compared to current smokers, a decrease of total mortality was observed among those who ceased smoking, and inverse dose-response was found with years after cessation: RR 0.98 (95%CI, 0.64-1.41) (<2 yrs), 0.60 (95%CI, 0.43-0.83) (3-9 yrs), and 0.58 (95%CI, 0.43-0.79) (${\geq}10$ yrs). Conclusions: A reduced risk of total mortality was observed after 3 years of smoking cessation. Our findings suggest that at least 3 years of smoking cessation may contribute to reduce premature mortality among Asian men.