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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

Development and Analysis of Community Based Independent Home Care Nursing Service (지역사회중심의 독립형 가정간호 시범사업소 운영체계 개발 및 운영결과 분석)

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1455-1466
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    • 2000
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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Three Cases of Aseptic Meningitis Following the Use of Intravenous Immune Globulin (정맥용 면역글로불린 투여 후 발생한 무균성 수막염 3례)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.202-207
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    • 2005
  • Intravenous immune globulin(IVIG) is widely used for immune thrombocytopenic purpura (ITP), Kawasaki disease and other autoimmune neuromuscular disease. Aseptic meningitis was one of the most serious neurologic complications reported following the use of IVIG. We experienced 4 episodes of aseptic meningitis associated with IVIG usage in 3 patients from 2003 to 2004. Underlying disease of each patients was ITP, Kawasaki disease and myathenia gravis and all of them received high dose IVIG treatment for their underlying disease. Within a days, they started to complain severe headache and diagnosed meningitis by cerebrospinal fluid analysis. Cerebrospinal fluid leukocyte counts varied from 92 to over a thound per microliter with dominance of polymorphonuclear leukocytes. Microbiologic studies revealed no organisms. All of them were free from headache within 2 days and did not suffer any neurological sequelae.

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Antagonic Effects of Dexamethasone on FK506-induced Antitumor Effects in Hep3B Cells (간암세포주(Hep3B cell)에서 FK506의 항암효과에 대한 dexamethasone의 길항효과)

  • Park, Hye-Min;Lee, Sei-Jin;Kim, Sun-Young;Go, Hyeon-Kyu;Jeon, Seol-Hee;Kim, Shang-Jin;Kang, Hyung-Sub;Kim, Jin-Shang
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.549-554
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    • 2011
  • FK506 is a widespread immunosuppressive drug after liver transplantion in patients with advanced-stage hepatocellular carcinoma. Dexamethasone is frequently used as co-treatment in cytotoxic cancer therapy, e.g. to prevent nausea, to protect normal tissue or for other reasons. Our aim was to investigate antitumor effects of FK506 in Hep3B cells, one of differentiated human hepatocellular carcinoma cell lines and inhibitory effects of dexamethsone on FK506- induced antitumor effects. Cell injury was evaluated by biochemical assays as cell viability, lactate dehydrogenase (LDH) and reactive oxygen species (ROS) in Hep3B cells. Intracellular calcium concentration ([$Ca^{2+}$]i) and the level of activation of the c-Jun-N-terminal kinase (JNK) and the Bax protein in cultured Hep3B cells was measured. Exposure of 0.1 ${\mu}M$ FK506 to Hep3B cells led to cell death accompanied by a decrease in cell viability and an increase in LDH, ROS and [$Ca^{2+}$]i. FK506 induced an increase in activity of Bax and JNK protein but inhibited the activity of Bcl-2 protein. Treatment of dexamethsone, per se, had no effects on cell viability, LDH and ROS. However, co-treatment of FK506 and dexamethasone diminished the FK506-induced LDH release, ROS generation and JNK activation. These results demonstrate that FK506 has antitumor effect in Hep3B cells but the combination of FK506 and dexamethasone antagonizes the FK506-induced antitumor effects.

Synthesis Characterization and Biodistribution of $^{99m}Tc$-Ethyl-3-Isocyanobutyrate as a New Myocardial Perfusion Agent (새로운 심관관류 영상 화합물로서 $^{99m}Tc$-Ethyl-3-Isocyano-butyrate의 합성, 표지 및 체내동태에 대한 연구)

  • Lee, Myung-Chul;Cho, Jung-Hyuck;Lee, Dong-Soo;Lim, Sang-Moo;Oh, Seung-Joon;Chung, Soo-Wook;Lee, Kyung-Han;Jeong, Jae-Min;Chung, June-Key;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.223-232
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    • 1993
  • Technetium labeled isonitrile analogues are widely used as myocardial perfusion imaging agents. We synthesized and characterized a new isonitrile compound, ethyl 3-isocyanobutyrate(EIB). Proton and $^{13}C$ NMR spectroscopy and thin layer chromatography with a $C_{18}$ coat was performed. EIB was easily labeled with $^{99m}TcO_4^-$- with sodium dithionite. The labeling efficiency measured by RP-HPLC was over 95%. The labeled product was stable with dilution in normal saline and with prolonged incubation at room temperature. There was no formation of secondary products or free $^{99m}TcO_4^-$. In vivo kinetics study of $^{99m}Tc$ (I) labeled EIB in rabbits showed adequate myocardial uptake, good contrast against lung background, and relatively rapid liver clearance. The heart to lung ratio was over 2.5 and the heart to liver ratio was approximately from 0.4 to 5 at 60 minutes post injection. Hepatic clearance of $^{99m}Tc-MIBI$ was faster ($t_{1/2}$=6 minutes) than that of $^{99m}Tc-MIBI$. In vivo kinetics observed in dog was similar to that in rabbit but there was faster gallbladder filling, and thus lower liver background. SPECT imaging of the canine myocardium showed favorable imaging characteristics. However, biodistribution in mice demonstrated a myocardial % injected dose/organ of less than 0.1%. This was thought to be due to interspecies difference in plasma esterase activity. In human plasma, $^{99m}Tc$ ( I ) labeled EIB was stable for at least 2 hours, without production of secondary products by HPLC. We conclude that ethyl 3-isocyanobutyrate may be a potential new myocardial perfusion imaging agent and deserves further investigation as to its usefulness for clinical use.

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Snail Switches 5-FU-induced Apoptosis to Necrosis through Akt/PKB Activation and p53 Down-regulation (Snail의 Akt/PKB의 활성화와 p53의 downregulation를 통한 5-FU-induced apoptosis의 necrosis로의 전환)

  • Lee, Su-Yeon;Jeon, Hyun-Min;Ju, Min-Kyung;Kim, Cho-Hee;Jeong, Eui-Kyong;Park, Hye-Gyeong;Kang, Ho-Sung
    • Journal of Life Science
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    • v.22 no.8
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    • pp.1018-1023
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    • 2012
  • Snail is a zinc finger transcription factor that induces epithelial-to-mesenchymal transition (EMT), which promotes tumor invasion and metastasis by repressing E-cadherin expression. In addition, Snail restricts the cellular apoptotic response to apoptotic stimuli or survival factor withdrawal; however, its molecular mechanism remains largely unknown. In this study, we have investigated the mechanism underlying Snail-mediated chemoresistance to 5-fluorouracil (5-FU), one of the most widely used anti-cancer drugs. When Snail was overexpressed by doxycycline (DOX) in MCF-7 #5 cells, it inhibited 5-FU-induced apoptotic cell death and switched the cell death mode to necrosis. Snail expression, either by DOX treatment in MCF-7 #5 cells or by the transfection of Snail expression vectors pCR3.1-Snail-Flg, phosphorylation-resistant pCR3.1-S104, and 107A Snail-Flg in MCF-7 cells specifically induced PTEN down-regulation/inactivation and Akt/PKB activation, without affecting ERK1/2 activity. In addition, Snail prominently suppressed 5-FU-induced increases in p53 levels. These findings demonstrate that Snail switches 5-FU-induced apoptosis to necrosis through the activation of Akt/PKB and the down-regulation of p53 levels.

Review for CAREX(CARcinogen EXposure) Exposure Surveillance System: Limitation and Application to Korea (발암인자 노출감시를 위한 CAREX(CARcinogen EXposure, CAREX) 프로그램 고찰; 한계점과 활용 방안)

  • Jung, Hyejung;Ryu, Seunghun;Jang, Jiyoung;Kim, Seungwon;Ha, Kwonchul;Koh, Donghee;Kim, Won;Bae, Hyunjoo;Yoon, Chungsik;Yi, Kyonghui;Yi, Gwangyong;Kwak, Hyunseok;Shin, Jungah;Park, Donguk
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.3
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    • pp.247-255
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    • 2014
  • Objectives: We reviewed the CAREX (CARcinogen EXposure) program designed to estimate the prevalence of occupational exposure to carcinogens and summarized the advantages and limitations of this program. Methods: All literature, including reports on CAREX and the use of CAREX, were reviewed. The keyword search term was CAREX. Additional articles were identified from references cited in articles and reviewed. Results: An exposure information system, CAREX was developed based on data from the Finnish Institute of Occupational Health of Finland and from the US. CAREX has been applied in several countries, including in the EU, in order to estimate national exposure patterns to carcinogens. The initial exposure assessment carried out through CAREX was aimed at estimating exposures over the period of 1990-1993. To estimate the number of workers exposed to carcinogens by using CAREX, reference exposure prevalence from Finland and the United States was computed, which was then reviewed and corrected by national experts. Finally the overall number of workers exposed to carcinogens can be estimated. We found that CAREX has been used in a total of 18 countries. No Asian country has used CAREX. Conclusions: CAREX can be applied not only to estimate the number of workers exposed to carcinogens in Korea, but also to identify high-risk industries with workers most exposed to carcinogens.

Somatic embryogenesis and plant regeneration of Hovenia dulcis Thunb (헛개나무의 체세포배발생 및 식물체 재분화)

  • Eom, Seung-Hee;Shin, Dong-Yong;Lee, Hyeon-Yong;Kim, Myong-Jo;Kim, Jong-Dai;Choi, Won-Cheol;Heo, Kwon;Yu, Chang-Yeon
    • Korean Journal of Medicinal Crop Science
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    • v.10 no.1
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    • pp.41-45
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    • 2002
  • An efficient and reproducible procedure for the large scale propagation of Hovenia dulcis Thunb. is described. Shoot primodia emerging from the leaf surface was induced from MS medium supplemented with NAA. Stem cuttings were suitable explants for multiple shoot proliferation. They produced axillary shoots which branched repeatedly, yielding an average of 7 shoots per explants after 4 weeks in culture, when cultured on a woody plant medium (WPM) containing 0.1mg/l BA and 0.1mg/l NAA. Stem, leaf and root segments from axenic seedlings were used as explant source to induce somatic embryogenesis. A high frequency of somatic embryos were induced directly from leaf in MS medium with NAA, 2,4-D and in medium containing NAA, 2,4-D with BA. Somatic embryos were germinated in MS medium supplemented with 1mg/ l $GA_3$. Somatic embryos proliferated secondary somatic embryos rapidly after transfer to MS medium supplemented with 1mg/ l kinetin, 1mg/ l $GA_3$ and 2% dextrose.

Induction of micronuclei in human, rabbit and dog lymphocytes irradiated in vitro with gamma radiation (사람, 토끼 및 개 유래 말초혈액 림프구의 미소핵을 이용한 방사선 피폭의 생물학적 선량측정)

  • Ryu, Si-yun;Kang, Bit-na;Kim, Ho-jun;Kim, Tae-hwan;Jeong, Kyu-sik;Kim, Se-ra;Lee, Hae-june;Kim, Sung-ho;An, Mi-Young
    • Korean Journal of Veterinary Research
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    • v.42 no.1
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    • pp.1-6
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    • 2002
  • The frequencies of gamma-ray-induced micronuclei (MN) in cytokinesis-blocked (CB) lymphocytes at several doses were measured in three donors of three species (human, rabbit, dog). Measurements performed after irradiation showed a dose-related increases in MN frequency in each of the donors studied. When analysed by linear-quadratic model the line of best fit was : human : $y=0.1184D+0.01867D^2+0.01$, rabbit : $y=0.0387D+0.00528D^2+0.01$ (y = number of MN/CB cells and D = irradiation dose in Gy). The relative sensitivity of rabbit lymphocytes compared with human lymphocytes was estimated by best fitting linear-quadratic model based on the radiation-induced MN data over the range from 0 Gy to 4 Gy. In the case of MN frequency with 0.2, the relative sensitivities of rabbit lymphocytes was 0.39. These data indicate that the induction of MN in rabbit CB cells following irradiation was much less sensitive to the MN induction effects of gamma-irradiation than those from human. The MN assay with dog lymphocytes was very difficult and time-consumed because the dog PHA-stimulated lymphocytes yielded cultures with very low level of CB cells formation in the condition of this experiment. Our in vitro radiobiological study confirmed that the cytogenetic response obtained in blood from rabbit can be utilized for application in environmental studies.

Monte Carlo Simulation of the Carbon Beam Nozzle for the Biomedical Research Facility in RAON (한국형 중이온 가속기 RAON의 의생물 연구시설 탄소 빔 노즐에 대한 Monte Carlo 시뮬레이션)

  • Bae, Jae-Beom;Cho, Byung-Cheol;Kwak, Jung-Won;Park, Woo-Yoon;Lim, Young-Kyung;Chung, Hyun-Tai
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.12-17
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    • 2015
  • The purpose of the Monte Carlo simulation study was to provide the optimized nozzle design to satisfy the beam conditions for biomedical researches in the Korean heavy-ion accelerator, RAON. The nozzle design was required to produce $C^{12}$ beam satisfying the three conditions; the maximum field size, the dose uniformity and the beam contamination. We employed the GEANT4 toolkit in Monte Carlo simulation to optimize the nozzle design. The beams for biomedical researches were required that the maximum field size should be more than $15{\times}15cm^2$, the dose uniformity was to be less than 3% and the level of beam contamination due to the scattered radiation from collimation systems was less than 5% of total dose. For the field size, we optimized the tilting angle of the circularly rotating beam controlled by a pair of dipole magnets at the most upstream of the user beam line unit and the thickness of the scatter plate located downstream of the dipole magnets. The values of beam scanning angle and the thickness of the scatter plate could be successfully optimized to be $0.5^{\circ}$ and 0.05 cm via this Monte Carlo simulation analysis. For the dose uniformity and the beam contamination, we introduced the new beam configuration technique by the combination of scanning and static beams. With the combination of a central static beam and a circularly rotating beam with the tilting angle of $0.5^{\circ}$ to beam axis, the dose uniformity could be established to be 1.1% in $15{\times}15cm^2$ sized maximum field. For the beam contamination, it was determined by the ratio of the absorbed doses delivered by $C^{12}$ ion and other particles. The level of the beam contamination could be achieved to be less than 2.5% of total dose in the region from 5 cm to 17 cm water equivalent depth in the combined beam configuration. Based on the results, we could establish the optimized nozzle design satisfying the beam conditions which were required for biomedical researches.