• Title/Summary/Keyword: Diseases progression

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Prognostic Value of Serum Growth Differentiation Factor-15 in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

  • Kim, Miyoung;Cha, Seung-Ick;Choi, Keum-Ju;Shin, Kyung-Min;Lim, Jae-Kwang;Yoo, Seung-Soo;Lee, Jaehee;Lee, Shin-Yup;Kim, Chang-Ho;Park, Jae-Yong;Yang, Dong Heon
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.6
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    • pp.243-250
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    • 2014
  • Background: Information regarding prognostic value of growth differentiation factor 15 (GDF-15) and heart-type fatty acid-binding protein (H-FABP) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is limited. The aim of this study was to investigate whether serum levels of GDF-15 and H-FABP predict an adverse outcome for COPD exacerbation. Methods: Clinical variables, including serum GDF-15 and H-FABP levels were compared in prospectively enrolled patients with COPD exacerbation that did or did not experience an adverse outcome. An adverse outcome included 30-day mortality and need for endotracheal intubation or inotropic support. Results: Ninety-seven patients were included and allocated into an adverse outcome (n=10) or a control (n=87) group. Frequencies of mental change and $PaCO_2$>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and $PaCO_2$>37 mm Hg: 80% vs. 22%, p<0.001, respectively). Serum GDF-15 elevation (>1,600 pg/mL) was more common in the adverse outcome group (80% vs. 43%, p=0.041). However, serum H-FABP level and frequency of serum H-FABP elevation (>755 pg/mL) did not differ between the two groups. Multivariate analysis showed that an elevated serum GDF-15 and $PaCO_2$>37 mm Hg were significant predictors of an adverse outcome (odds ratio [OR], 25.8; 95% confidence interval [CI], 2.7-243.8; p=0.005 and OR, 11.8; 95% CI, 1.2-115.3; p=0.034, respectively). Conclusion: Elevated serum GDF-15 level and $PaCO_2$>37 mm Hg were found to predict an adverse outcome independently in patients with COPD exacerbation, suggesting the possibility that serum GDF-15 could be used as a prognostic biomarker of COPD exacerbation.

Antiinflammatory Effect of Aqueous Extract from Red Pepper on Lipopolysaccharide Induced Inflammatory Responses in Murine Macrophages (홍고추가루 수용성 추출물의 항염증 효과)

  • Kwon, Hyuck-Se;Shin, Hyun-Kyung;Kwon, Sang-O;Yeo, Kyung-Mok;Kim, Sang-Moo;Kim, Bok-Nam;Kim, Jin-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.10
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    • pp.1289-1294
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    • 2009
  • Inflammation is a pivotal component of a variety of diseases, such as atherosclerosis and tumour progression. Various naturally occurring phytochemicals exhibit antiinflammatory activity and are considered to be potential drug candidates against inflammation-related pathological processes. Red pepper is the most consumed species in Korea. However, the antiinflammatory effects of red pepper have not been characterized. Thus, the present study was designed to evaluate the effects of the aqueous extract from red pepper (RPAE) on lipopolysaccharide (LPS)-induced inflammatory responses in murine macrophages. RPAE demonstrated strong antiinflammatory activity through its ability to reduce nitric oxide and prostaglandin $E_2$ production in the LPS-stimulated mouse macrophage cell, RAW264.7. It also inhibited the production of interleukin-6 (IL-6) on the LPS-stimulated RAW264.7 cells. Further study indicated that LPS-stimulated induction of inducible nitric oxide synthase and cyclooxygenase-2 was significantly inhibited by RPAE exposure (1,000 mg/mL) in RAW264.7 cells. Collectively, these data suggest that the use of RPAE may be a useful therapeutic approach to various inflammatory diseases.

Blood-neural Barrier: Intercellular Communication at Glio-Vascular Interface

  • Kim, Jeong-Hun;Kim, Jin-Hyoung;Park, Jeong-Ae;Lee, Sae-Won;Kim, Woo-Jean;Yu, Young-Suk;Kim, Kyu-Won
    • BMB Reports
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    • v.39 no.4
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    • pp.339-345
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    • 2006
  • The blood-neural barrier (BNB), including blood-brain barrier (BBB) and blood-retinal barrier (BRB), is an endothelial barrier constructed by an extensive network of endothelial cells, astrocytes and neurons to form functional 'neurovascular units', which has an important role in maintaining a precisely regulated microenvironment for reliable neuronal activity. Although failure of the BNB may be a precipitating event or a consequence, the breakdown of BNB is closely related with the development and progression of CNS diseases. Therefore, BNB is most essential in the regulation of microenvironment of the CNS. The BNB is a selective diffusion barrier characterized by tight junctions between endothelial cells, lack of fenestrations, and specific BNB transporters. The BNB have been shown to be astrocyte dependent, for it is formed by the CNS capillary endothelial cells, surrounded by astrocytic end-foot processes. Given the anatomical associations with endothelial cells, it could be supposed that astrocytes play a role in the development, maintenance, and breakdown of the BNB. Therefore, astrocytes-endothelial cells interaction influences the BNB in both physiological and pathological conditions. If we better understand mutual interactions between astrocytes and endothelial cells, in the near future, we could provide a critical solution to the BNB problems and create new opportunities for future success of treating CNS diseases. Here, we focused astrocyte-endothelial cell interaction in the formation and function of the BNB.

Lateral Supramalleolar Fasciocutaneous Island Flap for Reconstruction of the Foot and Ankle Soft Tissue Defect (외측 복사뼈 상부 근막-피부 섬피판을 이용한 발 및 발목관절 연부조직 결손의 재건)

  • Choi, Jae Hoon;Kim, Nam Gyun;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Joon Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.784-788
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    • 2006
  • Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

The Relationship Between Obstructive Sleep Apnea and Cartotid Artery Atherosclerosis (폐쇄성수면무호흡과 목동맥동맥경화증의 상관관계)

  • Cho, Jae-Wook;Kim, Yong-Wan;Lee, Hyun-Soon;Jeon, Doo-Soo;Kim, Yun-Seong;Jung, Dae-Soo
    • Annals of Clinical Neurophysiology
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    • v.11 no.2
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    • pp.54-58
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    • 2009
  • Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. The measure of common carotid artery intima-media thickness (IMT) has been extensively used as an early marker of atherosclerosis. The aim of this study was to test the hypothesis that early signs of atherosclerosis are present in patients with OSA and correlate with OSA severity Methods: Eleven male patients with OSA were studied by using full standard overnight polysomnography and high-definition echo-tracking device to measure intima-media thickness and carotid artery diameter. Eight healthy volunteers matched for age and sex were studied by portable respiratory monitoring device. All participants were free of hypertension, diabetes, and were not on any medications. Patients with OSA were naive to treatment. Results: All patients and normal controls were male. There was no significant difference of age between patients and controls ($48.4{\pm}8.85$ and $48.0{\pm}9.77$). Significant differences existed between control subjects and patients with mild to moderate and severe OSA (apnea-hypopnea index, $1.51{\pm}1.15$ and $38.51{\pm}19.13$ respectively) in intima-media thickness ($0.59{\pm}0.064$ and $0.93{\pm}0.16$; P=0.0023), and carotid diameter ($5.79{\pm}0.44$ and $6.47{\pm}0.51$; P=0.0227). Multivariate analyses showed that the apnea-hypopnea index correlated independently with intima-media thickness and carotid diameter (r=0.79, P=0.0008, and r=0.47, P=0.0482). Conclusions: Middle-aged patients with OSA who are free of overt cardiovascular diseases have early signs of atherosclerosis, which further supports the hypothesis that OSA plays an independent role in atherosclerosis progression.

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Percutaneous Intranodular Injection Therapy of Radioactive Iodine-131 in Treatment of Benign Thyroid Nodules: A Preliminary Study (방사선 요오드-131의 국소주입에 의한 양성 갑상선 결절의 치료)

  • Ha Il-Joo;Lim Dong-Pyo;Yoon Jung-Han;JaeGal Young-Jong;Boom Hee-Seoung
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.174-178
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    • 2001
  • Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

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Identification of microbiome with 16S rRNA gene pyrosequencing and antimicrobial effect of egg white in bovine mastitis (젖소 유방염에서 16S rRNA 파이로시퀀싱을 이용한 우유 내 마이크로바이옴의 동정과 난백의 항균효과)

  • Kim, Danil;Kim, Eun-Kyung;Seong, Won-Jin;Ro, Younghye;Ko, Dae-Sung;Kim, Nam-Hyung;Kim, Jae-Hong;Kwon, Hyuk-Joon
    • Korean Journal of Veterinary Research
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    • v.57 no.2
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    • pp.117-126
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    • 2017
  • Bovine mastitis is an important microbial disease in the dairy industry. We investigated the frequencies of bacterial pathogens in 62 farms and pathogen antibiotic resistance from mastitis samples (n = 748). We tested the antimicrobial activity of chicken and duck egg white and lysozyme purified from chicken egg white. Moreover, we compared the microbiomes of normal and mastitic raw milk obtained by 16S rRNA gene pyrosequencing and culture methods. The results showed that the frequencies of Gram-positive pathogens (Enterococcus faecalis 37% and Staphylococcus aureus 36%) were higher than that of a Gram-negative pathogen (Escherichia coli 15%). Resistance frequencies to ampicillin and norfloxacin were lowest in Staphylococcus aureus (21%), Enterococcus faecalis (23%), and Escherichia coli (33%), and the antimicrobial activity of chicken egg white was higher than those of lysozyme and duck egg white. Pyrosequencing results revealed clear differences between the microbiomes of mastitic and normal raw milk samples and revealed a slightly similar, but clearly different, composition of pathogens compared to that from the culture method. Thus, pyrosequencing may be useful for elucidating changes in microbiomes during mastitis progression and treatment. A chicken egg white and antibiotic combination may help with mastitis treatment; however, further studies are needed.

The Usefulness of the Chronic Obstructive Pulmonary Disease Assessment Test (만성 폐쇄성 폐질환 평가 테스트의 유용성)

  • Kim, Yu-Eun;Lee, Sang-Su;Kim, Cha-Young;Lee, Seung-Hun;Lim, Su-Jin;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Hwang, Young-Sil;Lee, Jong-Deog
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.4
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    • pp.271-277
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    • 2011
  • Background: A chronic obstructive pulmonary disease (COPD) assessment test (CAT) has recently been developed as a short and simple method for assessing the quality of life in COPD patients. The object of this study was to assess the usefulness of the Korean version of the CAT for assessing COPD patients in an outpatient clinic. Methods: The study included 60 COPD patients in a stable state from an outpatient clinic. The authors investigated the frequency of acute exacerbation during aprevious year through reviewing medical records. We evaluated the spirometry test, a 6-min walk distance test, and obtained the MMRC dyspnea scale, the Korean version of the CAT, and the BODE index at the time of visit. To assess the usefulness of the CAT, correlations between the CAT and other methods were evaluated. Results: The mean age of patients was $68.3{\pm}8.6$ years and 95% of patients were male. There was a significant correlation between the CAT score and $FEV_1%$ (r=-0.323, p=0.012), the frequency of acute exacerbation (r=0.292, p=0.024), the MMRC dyspnea scale (r=0.554, p<0.001), the BODE index (r=0.380, p=0.003), and 6 MWD (r=-0.372, p=0.004). The mean CAT score increased according to the GOLD stage (stage 1, $10.7{\pm}4.5$; stage 2, $13.1{\pm}7.9$; stage 3, $16.3{\pm}6.2$; stage 4, $16.5{\pm}14.8$; p=0.746). Conclusion: The CAT was shown to be useful for the assessment of COPD severity. Therefore, the CAT is an easily applied and simple method for assessing COPD severity in an outpatient clinic.

The Clinical Outcomes of Photodynamic Therapy in Early Lung Cancer Patients (조기 폐암환자에서 광역동치료의 효과)

  • Lee, Young-Seok;Oh, Yeon-Mok;Shim, Tae-Sun;Kim, Woo-Sung;An, Jung-Sun;Choi, Chang-Min;Jang, Seung-Hun
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.4
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    • pp.266-270
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    • 2011
  • Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.

Gefitinib in Selected Patients with Pre-Treated Non-Small-Cell Lung Cancer: Results from a Phase IV, Multicenter, Non-Randomized Study (SELINE)

  • Lee, Kwan-Ho;Lee, Kye-Young;Jeon, Young-June;Jung, Maan-Hong;Son, Choonhee;Lee, Min-Ki;Ryu, Jeong-Seon;Yang, Sei-Hoon;Lee, Jae-Cheol;Kim, Young-Chul;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.6
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    • pp.303-311
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    • 2012
  • Background: This study was designed to analyze the efficacy of gefitinib as a second-line therapy, according to the clinical characteristics in Korean patients with non-small-cell lung cancer (NSCLC). Methods: In this Phase IV observational study, we recruited patients, previously failed first-line chemotherapy, who had locally advanced or metastatic NSCLC, and who were found to be either epidermal growth factor receptor (EGFR) mutation-positive or satisfied 2 or more of the 3 characteristics: adenocarcinoma, female, and non-smoker. These patients were administered with gefitinib 250 mg/day, orally. The primary endpoints were to evaluate the objective response rate (ORR) and to determine the relationship of ORRs, depending on each patient's characteristics of modified intent-to-treat population. Results: A total of 138 patients participated in this study. One subject achieved complete response, and 42 subjects achieved partial response (ORR, 31.2%). The subgroup analysis demonstrated that the ORR was significantly higher in patients with EGFR mutation-positive, compared to that of EGFR mutation-negative (45.8% vs. 14.0%, p=0.0004). In a secondary efficacy variable, the median progression-free survival (PFS) was 5.7 months (95% confidence interval, 3.9~8.4 months) and the 6-month PFS and overall survival were 49.6% and 87.9%, respectively. The most common reported adverse events were rash (34.4%), diarrhea (26.6%), pruritus (17.5%), and cough (15.6%). Conclusion: Gefitinib was observed in anti-tumor activity with favorable tolerability profile as a second-line therapy in these selected patients. When looking at EGFR mutation status, EGFR mutation-positive showed strong association with gefitinib by greater response and prolonged PFS, compared with that of EGFR mutation-negative.