• Neonatal Medicine
• /
• v.28 no.1
• /
• pp.1-6
• /
• 2021

Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.1-10
• /
• 2022

Pulmonary hypertension (PH) is a condition of increased blood pressure in the pulmonary arteries and is diagnosed with an increased a mean pulmonary artery pressure ≥25 mm Hg. This condition may be associated with multiple clinical situations. Based on pathophysiological mechanisms, clinical presentation, hemodynamic profiles, and treatment strategies, the patients were classified into five clinical groups. Although there have been major advances in the management of PH, it is still associated with significant morbidity and mortality. The diagnosis and treatment of PH have been performed mainly by following European guidelines, even in Korea because the country lacks localized PH guidelines. European treatment guidelines do not reflect the actual status of Korea. Therefore, the European diagnosis and treatment of PH have not been tailored well to suit the needs of Korean patients with PH. To address this issue, we developed this guideline to facilitate the diagnosis and treatment of PH appropriately in Korea, a country where the consensus for the diagnosis and treatment of PH remains insufficient. This is the first edition of the guidelines for the diagnosis and treatment of PH in Korea, and it is primarily based on the '2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.' with the acceptance and adaptation of recent publications of PH.

• The Korean Journal of Physiology
• /
• v.7 no.1
• /
• pp.13-21
• /
• 1973

An attempt was made to study circulatory and respiratory responses to the passive tilt. Anesthetized dogs were tilted from horizontal to upright $(+90^{\circ})$ and head down $(-90^{\circ})$ position. The arterial blood pressure was decreased in the upright position and was decreased slightly in the head down position comparing to that in the horizontal position. Cardiac index also decreased in the both upright and head down positions. The total systemic vascular resistance was slightly increased in the upright position and was markedly increased in the head down position. The mean pulmonary arterial pressure was significantly decreased in the both upright and head down positions. The total pulmonary vascular resistance was decreased in the both upright and head down positions. Oxygen consumption was slightly decreased in the upright position, whereas it was slightly increased in the head down position. The A-V $O_2$ difference (vol. %) was slightly increased in the upright position and increased in the head down position. From the above results, process of the circulatory compensation to the gravity in the Passive tilting test was discussed. Neuronal cardiovascular regulation to the gravity and tile adaptation of capacitance vessles to hydrostatic stress and oxygen consumption concerning anoxic endurance of the brain were also discussed.

• Molecules and Cells
• /
• v.46 no.7
• /
• pp.399-413
• /
• 2023

cAMP responsive element-binding protein (CREB) is one of the most intensively studied phosphorylation-dependent transcription factors that provide evolutionarily conserved mechanisms of differential gene expression in vertebrates and invertebrates. Many cellular protein kinases that function downstream of distinct cell surface receptors are responsible for the activation of CREB. Upon functional dimerization of the activated CREB to cis-acting cAMP responsive elements within the promoters of target genes, it facilitates signal-dependent gene expression. From the discovery of CREB, which is ubiquitously expressed, it has been proven to be involved in a variety of cellular processes that include cell proliferation, adaptation, survival, differentiation, and physiology, through the control of target gene expression. In this review, we highlight the essential roles of CREB proteins in the nervous system, the immune system, cancer development, hepatic physiology, and cardiovascular function and further discuss a wide range of CREB-associated diseases and molecular mechanisms underlying the pathogenesis of these diseases.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.828-837
• /
• 2006

Background: Tissue hypoxia is characteristic of many human malignant neoplasm, and hypoxia inducible factor-1(HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increasing $O_2$ delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-$1{\alpha}$ has been reported in many human malignancies, but in non-small cell lung carcinoma the influence of HIF-$1{\alpha}$ on tumor biology, including neovascularization, is not still defined. In present study the relationship of HIF-$1{\alpha}$ expression on angiogenetic factors, relationship between the tumor proliferation and HIF-$1{\alpha}$ expression, interaction of HIF-$1{\alpha}$ expression and p53, and relationship between HIF-$1{\alpha}$ expression and clinico-pathological prognostic parameters were investigated. Material and Method: Archival tissue blocks recruited in this study were retrieved from fifty-nine patients with primary non-small cell lung carcinoma, who underwent pneumonectomy or lobectomy from 1997 to 1999. HIF-$1{\alpha}$, VEGF(vascular endothelial growth factor), and p53 protein expression and Ki-67 labeling index in tumor tissues were evaluated, using a standard avidin-biotin-peroxidase complex(ABC) immunohistochemistry. Relationship between the HIF-$1{\alpha}$ expression and VEGF, p53 overexpression and correlation between the HIF-$1{\alpha}$ expresseion and Ki-67 index were analyzed. Clinico-pathologic prognostic parameters were also analyzed. Result: HIF-$1{\alpha}$ expression in cancer cells was found in 24 of 59 cases of non-small cell lung carcinoma(40.7%). High HIF-$1{\alpha}$ expression was significantly associated with several pathological parameters, such as pathological TMN stage(p=0.004), pT stage(p=0.020), pN stage (p=0.029), and lymphovascular invasion(p=0.019). High HIF-$1{\alpha}$ expression was also significantly associated with VEGF immunoreactivity(p<0.001), and aberrant p53 expression(p=0.040). but was marginally associated with Ki-67 labeling index(p=0.092). The overall 5-year survival rate was 42.3%. The survival curve of patients with a high HIF-$1{\alpha}$ expression was worse than that of patients with low-expression(p=0.002). High HIF-$1{\alpha}$ expression was independent unfavorable factors with a marginal significance in multivariate analysis performed by Cox regression. Conclusion: It is suggested that high HIF-$1{\alpha}$ expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway, and high HIF-$1{\alpha}$ expression could be associated with lymph node metastasis and post operative poor prognosis in patients with non-small cell lung carcinoma.

• The Journal of Internal Korean Medicine
• /
• v.41 no.1
• /
• pp.1-13
• /
• 2020

Objectives: Osteoarthritis (OA) is a chronic and degenerative joint disease characterized by progressive degeneration of articular cartilage. Inflammation is a recognized and important factor of OA progression. The present study was designed to investigate the protective effect of Corni Fructus water extract (CFW) on a monosodium iodoacetate (MIA)-induced rat model of OA. Methods: Osteoarthritis was induced by injection of MIA (50 µL; 80 mg/mL) into the knee joint cavity of rats. After an adaptation period for seven days, the rats were divided into 4 groups (n=8/group): normal, control, indomethacin-treated (5 mg/kg), and CFW-treated (200 mg/kg) groups. The rats were treated orally for 14 days. Pain was evaluated by determining hind paw weight distribution. For biochemical analyses, we measured the changes in reactive oxygen species (ROS) and peroxynitrite (ONOO^-) in the knee joint. The presence of anti-oxidant proteins and inflammatory proteins was determined by western blotting. Results: The administration of CFW significantly improved the hind paw weight distribution. The ROS and ONOO^- levels of knee joint were significantly decreased in the CFW group. CFW inhibited the production of inflammatory mediators, such as COX-2, and inflammatory cytokines, including IL-6 and IL-1β, via the NF-κB signaling pathway. The expression of anti-oxidant enzymes, such as catalase and GPx-1/2 also increased significantly. Conclusions: The findings indicate that CFW has a therapeutic and protective effect on OA by suppression of inflammation. Therefore, CFW could represent a potential and effective candidate for OA treatment.

• Preventive Nutrition and Food Science
• /
• v.14 no.1
• /
• pp.1-7
• /
• 2009

Control of hyperglycemia and dyslipidemia is strongly correlated with decreased risk for cardiovascular disease, the most common and fatal diabetic complication. The purpose of this study is to determine the effects of garlic and aged black garlic on glycemic control and blood lipid profile in animal model of type 2 diabetes. Three week-old db/db mice (C57BL/Ks, n=21) were fed AIN-93G semipurified diet or diet containing 5% freeze-dried garlic or aged black garlic for 7 weeks after 1 week of adaptation. Fasting serum glucose, insulin, triglyceride, total cholesterol, and HDL-cholesterol and blood glycated hemoglobin were measured. Body weight and food intake of garlic and aged black garlic group were not significantly different from those of the control group. Fasting serum glucose and blood glycated hemoglobin levels were significantly decreased and insulin level was significantly increased in garlic group compared with control group (p<0.05). Consumption of aged black garlic significantly decreased homeostasis model assessment for insulin resistance (HOMA-IR) and tended to decrease serum glucose. Garlic consumption significantly decreased total cholesterol, while aged black garlic significantly reduced serum total cholesterol and triglyceride and increased HDL-cholesterol levels. These results suggest that garlic exerts hypoglycemic and hypocholesterolemic effect and aged black garlic improved insulin sensitivity and dyslipidemia in db/db mice.

• Journal of Chest Surgery
• /
• v.50 no.4
• /
• pp.275-280
• /
• 2017

Background: Video-assisted thoracoscopic surgery (VATS) anatomic lung resections are gradually becoming the standard surgical approach in early-stage non-small cell lung cancer (NSCLC). The technique is being applied in cases of larger tumors depending on the experience of the surgical team. The objective of this study was to compare early surgical and survival outcomes in patients undergoing anatomic pulmonary resections using VATS and thoracotomy techniques for clinical T2 NSCLC during the adaptation period of the surgical team to the VATS approach. Methods: The data of all patients who underwent anatomic pulmonary resection for NSCLC using VATS and open techniques since April 2012 were recorded to create a prospective lung cancer database. Clinical T2 NSCLC patients who underwent VATS anatomic lung resection were identified and compared with cT2 patients who underwent open resection. Results: Between April 2012 and August 2014, 269 anatomical resections for NSCLC were performed (80 VATS and 189 thoracotomy). Thirty-four VATS patients who had clinical T2 disease were identified and stage-matched to thoracotomy patients. The average tumor diameter was comparable ($34.2{\pm}11.1{\times}29.8{\pm}10.1mm$ vs. $32.3{\pm}9.8{\times}32.5{\pm}12.2mm$, p=0.4). Major complications were higher in the thoracotomy group (n=0 vs. n=5, p=0.053). There was no 30-day mortality, and the 2-year survival rate was 91% for VATS and 82% for thoracotomy patients (p=0.4). Conclusion: VATS anatomic resections in clinical T2 NSCLC tumors are safe and have perioperative and pathologic outcomes similar to those of thoracotomy, while remaining within the learning curve.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.2 no.1
• /
• pp.56-61
• /
• 2003

This is a review article about range of motion, stretching, and aerobic exercise in accelerated rehabilitation of knee and shoulder. If the joint was immobilized for a long time after injury, it would cause stiffness and atrophy. Therefore, this program includes various exercise techniques; range of motion for joint stiffness, and stretching for muscle relaxation, and cardiovascular training (e.g., swimming, upper body extremity, stationary bicycle) for prevention of cardiopulmonary function decrease. In accelerated rehabilitation, It is very important factor to make interaction between clinical exercise specialist and patients. Also, we recommend that they should discuss with sports medicine doctor as a team members the following; pain, adaptation of exercise, fitness level, and progression of program.

• Journal of Digital Convergence
• /
• v.13 no.9
• /
• pp.515-521
• /
• 2015

In this study, we tried to analyze arterial stiffness of Jeju female divers who diver into cold water without the assistance of oxygen. For this purpose we measured pulse wave velocity and ankle-brachial index of Jeju female divers and same aged females who didn't have any cardiovascular risk for comparing the vascular stiffness. The results were the following : First, the light-femoral pulse wave velocity of Jeju female divers was significantly lower than normal women of the same ages. Second, Jeju female divers's ABI showed higher tendency than normal same aged women. These result showed that Jeju female divers' body had been completed for adaptation to low temperature and high pressure water environment through a long-term immersion activities in old age, as well as due to higher physical activity levels of Jeju female divers peripheral vascular resistance was not reduced.