• Title/Summary/Keyword: Chronic disease

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Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Synergistic Inhibition of Aronia melanocarpa and Moringa oleifera Seed Extract on Experimental Atopic Dermatitis (아로니아 및 모링가 종자 복합물의 항아토피 상승효과)

  • Ki, Hyeon-Hui;Lee, Ji-Hyun;Moon, Kwang-Hyun;Lee, Jeong-Ho;Kim, Dae-Geun;Jeong, Kyung-Ok;Im, So-Yeon;Lee, Young-Mi;Kim, Dae-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.3
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    • pp.298-305
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    • 2017
  • Atopic dermatitis is a chronic, relapsing inflammatory skin disease. This study aimed to investigate the therapeutic benefits of Aronia melanocarpa (AM) and Moringa oleifera seed extract (MO) on experimental atopic dermatitis. We examined the effects of AM or MO and their combination on 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis in BALB/c mice as well as tumor necrosis factor $(TNF)-{\alpha}$ and interferon $(IFN)-{\gamma}-stimulated$ HaCaT keratinocytes. Mice were orally treated with extract during repeated application of DNCB to shaved dorsal skin. Our results show that treatment with AM and MO in combination reduced histological manifestations such as epidermal hyperplasia and inflammatory cell infiltration. Furthermore, it significantly decreased skin thickness and serum immunoglobulin E (IgE) level compared to the AM or MO alone treated group. Combined extract of AM and MO suppressed expression of $TNF-{\alpha}/IFN-{\gamma}-induced$ T helper 2 (Th2) chemokines such as thymus and activation-regulated chemokine and macrophage-derived chemokine. To sum up, combination of AM and MO suppressed the inflammatory response and serum IgE as an indicator of several allergic diseases in DNCB-induced experimental atopic dermatitis and Th2 chemokine expression in HaCaT cells. This result suggests that combination of AM and MO could be a valuable strategy to improve atopic dermatitis.

Expression of Peroxiredoxin and Thioredoxin in Human Lung Cancer and Paired Normal Lung (인체의 폐암과 정상 폐조직에서 Peroxiredoxin 및 Thioredoxin의 발현 양상)

  • Kim, Young Sun;Park, Joo Hun;Lee, Hye Lim;Shim, Jin Young;Choi, Young In;Oh, Yoon Jung;Shin, Seung Soo;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.142-150
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    • 2005
  • Background : Continuous growth stimulation by various factors, as well as chronic oxidative stress, may co-exist in many solid tumors, such as lung cancer. A new family of antioxidant proteins, the peroxiredoxins (Prxs), have been implicated in the regulation of many cellular processes, including cell proliferation, differentiation and apoptosis. However, a real pathophysiological significance of Prx proteins, especially in lung disease, has not been sufficiently defined. Therefore, this study was conducted to investigate the distribution and expression of various Prx isoforms in lung cancer and other pulmonary conditions. Method : Patients diagnosed with lung cancer, and who underwent surgery at the Ajou Medical Center, were enrolled. The expressions of Prxs, Thioredoxin (Trx) and Thioredoxin reductase (TR) were analyzed using proteomic techniques and the subcellular localization of Prx proteins was studied using immunohistochemistry on normal mouse lung tissue. Result : Immunohistochemical staining has shown the isoforms of Prx I, II, III and V are predominantly expressed in bronchial and alveolar lining epithelia, as well as in the alveolar macrophages of the normal mouse lung. The isoforms of Prx I and III, and thioredoxin were also found to be over-expressed in the lung cancer tissues compared to their paired normal lung controls. There was also an increased amount of the oxidized form of Prx I, as well as a putative truncated form of Prx III, in the lung cancer samples when analyzed using 2-dimensional electrophoresis. In addition, a 43 kDa intermediate molecular weight protein band, and other high molecular weight bands of over 20 kDa, recognized by the anti-Prx I antibody, were present in the tissue extracts of lung cancer patients on 1-Dimensional electrophoresis, which require further investigation. Conclusion : The over-expressions of Prx I and III, and Trx in human lung cancer tissue, as well as their possible chaperoning function, may represent an attempt by tumor cells to adjust to their microenvironment in a manner advantageous to their survival and proliferation, while maintaining their malignant potential.

Clinical Characteristics of Tuberculous Empyema (결핵성 농흉의 임상적 특성)

  • Shin, Moo Cheol;Lee, Seung Jun;Yoon, Seok Jin;Kim, Eun Jin;Lee, Eung Bae;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.516-522
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    • 2006
  • Background : In contrast to tuberculous pleurisy, tuberculous empyema is a chronic active infectious disease of the pleural cavity that is frequently accompanied by cavitary or advanced pulmonary lesions. The condition requires long-term anti-tuberculous medication with external drainage. The clinical features and treatment outcome of tuberculous empyema are unclear despite the high prevalence of tuberculosis in Korea. Methods : From January 1991 through April 2004, 17 patients diagnosed with tuberculous empyema in Kyungpook National University Hospital were enrolled in this study. Their medical records and chest radiographs were reviewed. Results : Twelve patients(71%) had a history of tuberculosis and six of the 12 patients were under current anti-tuberculous medication. Productive cough, fever, and dyspnea were the main complaints. There was no predominance between the right and left lungs. Nine patients(53%) had far-advanced pulmonary tuberculosis, two(12%) had a cavitary lesion, and seven(41%) had a pyopneumothorax on the chest radiograph. All eight cases in whom the data of pleural fluid WBC differential count was available showed polymorphonuclear leukocyte predominance. Eight patients(47%) had other bacterial infections as well. The overall rates of a positive sputum AFB smear and culture for M. tuberculosis were 71% and 64%, respectively. The positive AFB smear and culture rates for M. tuberculosis from the pleural fluid were 33% and 36%, respectively. Twelve of the 16 patients(75%) were treated successfully. Three underwent additional surgical intervention. Two patients (12%) died during treatment. Conclusion : Tuberculous empyema is frequently accompanied by advanced pulmonary lesions, and polymorphonuclear leukocytes are predominant in the pleural fluid. Other accompanying bacterial infections in the pleural cavity are also common in tuberculous empyema patients. Therefore, tuberculous empyema should be considered in differential diagnosis of patients with polymorphonuclear leukocyte-predominant pleural effusion. In addition, more active effort will be needed to achieve a bacteriological diagnosis in the pleural fluid.

Effects of Butanol Fraction of Pine Needle (Pinus Densiflora) on Serum Lipid Metabolism and Oxidative Stress in Rats (솔잎의 부탄올획분이 SD계 Rats의 지질대사와 산화적 스트레스에 미치는 영향)

  • 김현숙;이지혜;최진호;박수현;김대익;김창목
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.296-302
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    • 2002
  • This study was designed to investigate the effects of a butanol extract of pine needles (Pinus densiflora Sieb et Zucc) on lipid metabolism and oxidative stress in rats. Twenty-eight male Sprague-Dawley (SD) rats were divided into four groups over a 45 days study period: the control group on a basic diet, and three experimental groups on three different dietary levels of the butanol fraction, specifically 25 mg (BuOH-25), 50 mg (BuOH-50), and 100 mg (BuOH-100) butanol fraction/kg body weight/day, thereby 0.025%, 0.05%, 0.1% of butanol extract of pine needles was added to basic diet respectively. At the end of the experimental period, body weights and food intakes were food intakes were not different among the four groups. Total and LDL-cholesterol levels were markedly decreased in the BuOH-25, BuOH-50, and BuOH-100 groups, respectively, as follows: 12.8%, 19.1% and 21.6% reductions in total cholesterol; and 10.2%, 15.6% and 23.7% reductions in LDL-cholesterol. However, HDL-cholesterol levels were significantly increased (by approximately 20%) in the serum of the BuOH-100 group only, compared with the control and other experimental groups. Atherogenic indices were also markedly decreased in the three experimental groups, by 24.8%, 30.4% and 36.2%, for each of the BuOH-25, BuOH-50, and BuOH-100 groups, respectively, compared with the control group. The levels of the hydroxyl radical (·OH) and of lipid peroxide (LPO) in the serum of the three experimental groups were significantly reduced, by 9.8%, 19.7% and 21.2%; and by 13.3%, 13.3% and 16.7%, for the BuOH-25, BuOH-50, and BuOH-100 groups, respectively Significant increases in serum superoxide dismutase (SOD) were observed in the BuOH-50 and BuOH-100 groups; specifically, 12.1% in the BuOH-50 group and 23.3% in the BuOH-100 group, compared with the control group. Significant increases in catalase (CAT) avtivities, of 24.7% in the BuOH-50 group and 29.2% in the BuOH-100 group, were also observed, compared to the control group. These results suggest that a butanol extract of pine needles could inhibit chronic degenerative disease through improving lipid metabolism, and could also effectively modulate the aging process attenuating oxidative stress.

A Clinical Review of Primary Tracheal Carcinoma (원발성 악성기관종양의 임상적 고찰)

  • Ryu, Jeong-Seon;Cho, Hyun-Myung;Yang, Dong-Gyoo;Lee, Hong-Lyeol;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Shin, Kye-Chul;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.766-775
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    • 1997
  • Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.

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Effect of bronchial artery embolization in the management of massive hemoptysis : factors influencing rebleeding (대량객혈 환자에서 기관지 동맥색전술의 효과 : 색전술후 재발의 원인과 예측인자)

  • Kim, Byeong Cheol;Kim, Jeong Mee;Kim, Yeon Soo;Kim, Seong Min;Choi, Wan Young;Lee, Kyeong Sang;Yang, Suck Cheol;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Kim, Chang Soo;Seo, Heung Suk
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.590-599
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    • 1996
  • Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.

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The Clinical Characteristics and Prognosis of Elderly Patients with Lung Cancer Diagnosed in Daegu and Gyeongsangbukdo (대구 경북지역에서 진단된 노령자 폐암의 임상적 특징과 예후)

  • Kim, Hyun Sook;Hyun, Dae Sung;Kim, Kyung Chan;Lee, Sang Chae;Jung, Tae Hoon;Park, Jae Yong;Kim, Chang Ho;Cha, Seung Ick;Lee, Kwan Ho;Chung, Jin Hong;Shin, Kyeong Cheol;Jeon, Young June;Han, Seong Beom;Choi, Won Il;Kim, Yeun Jae;Chung, Chi Young;Lim, Geon Il
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.15-22
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    • 2008
  • Background: Lung cancer is the leading cause of cancer death in South Korea since the year 2000 and it is more common in elderly patients, with a peak incidence at around 70~80 years of age. However, these elderly patients receive treatment less often than do the younger patients because of organ dysfunction related to their age and their comorbidities, and they show poor tolerance to chemotherapy. The aims of this study were to analyze the clinical characteristics and treatment-related survival of elderly patients with lung cancer. Methods: In this retrospective study, we analyzed the clinical data of 706 lung cancer patients who were diagnosed at hospitals in Daegu and Gyeongsangbukdo from January 2005 to December 2005. We compared the clinical characteristics and outcomes of the patients who were aged 70 years and older (elderly patients) with those clinical characteristics and outcomes of the younger individuals. Results: The median age of the patients was 68 years (from 29 to 93) and the elderly patients were 38.7% (n=273) of all the study's patients. Squamous cell carcinoma was the most common type of lung cancer in both the elderly and younger patient groups. Elderly patients had more symptoms of dyspnea and chronic obstructive pulmonary disease (COPD) than the younger patients (p<0.001 and p<0.001, respectively). A good performance status (ECOG 0-1) was less common for the elderly patients (p<0.001). The median survival of the non-small cell lung cancer (NSCLC) patients was significantly higher in the younger patient group than in the elderly patient group (962 days vs 298 days, respectively, p=0.001). However, the median survival of the NSCLC patients who received any treatment showed no significant difference between the younger patient group and the elderly patient group (1,109 days vs 708 days, respectively, p=0.14). Conclusion: Our data showed that appropriate treatment for selected elderly patients improved the survival of patients with NSCLC. Therefore, elderly NSCLC patients with a good performance status should be encouraged to receive appropriate treatment.

The Effect of Eisenia bicyclis Extracts on Bone Tissues in Ovariectomized Rats (대황 추출물이 갱년기 유도 흰쥐의 골 조직에 미치는 영향)

  • Park, Yong Soo;Kang, Min Suk;Kim, Bo Kyung;Kim, Mihyang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.1
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    • pp.33-39
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    • 2013
  • Menopause is often associated with several chronic diseases, including osteoporosis, cardiovascular disease, and obesity. In this study, we investigated the ability of Eisenia bicyclis (EB) to prevent bone loss in ovariectomized rats, a model for postmenopausal osteoporosis. Extracts from EB obtained using ethanol or hot water were analyzed for total polyphenol content and osteoporosis effects in vivo. Total polyphenol content was higher with extraction by hot water compared to ethanol extraction. Fifty 8-week-old female Sprague-Dawley rats were randomly assigned to four groups: the group were sham-operated rats (SHAM), ovariectomized rats (OVX-CON), and ovariectomized rats that were treated with EB at 50 mg/kg body weight (OVX-EB50) and 200 mg/kg body weight (OVX-EB200), respectively. The diets were fed to rats for 6 weeks after their operation. We found that the alkaline phosphatase (ALP) activity was lower in the EB extract group compared to the OVX-CON group. Collagen and pyridinoline content, in bone and cartilage, were reduced by ovariectomy, but the supplemented EB extract groups exhibited higher concentrations in their bones. These results suggest that EB can be used for the industrial development of foods with therapeutic functions.

Usefulness Comparative Experimental Study of the CT and MR Imaging in the Dog Clonorchiasis (잡견 간흡충증의 전산화단층촬영과 자기공명영상의 유용성에 관한 실험적 연구)

  • Goo, Eun-Hoe;Kweon, Dae-Cheol;Kim, Dong-Sung;Choi, Chun-Kyu
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.33-39
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    • 2003
  • Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.

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