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Regulatory Mechanism of Vascular Contractility by Extracellular $\textrm{K}^{+}$: Effect on Endothelium-Dependent Relaxation and Vascular Smooth Muscle Contractility (세포 외 $\textrm{K}^{+}$의한 혈관 수축신 조절 기전: 혈관평활근 수축성과 내피세포 의존성 이완에 미치는 영향)

  • 유지영;설근희;서석효;안재호
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.210-219
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    • 2004
  • Extracellular $K^{+}$ concentration ([ $K^{+}$]$_{0}$ ) can be increased within several mM by the efflux of intracellular $K^{+}$. To investigate the effect of an increase in [ $K^{+}$]$_{0}$ on vascular contractility, we attempted to examine whether extracellular $K^{+}$ might modulate vascular contractility, endothelium-dependent relaxation (EDR) and intracellular $Ca^2$$^{+}$ concentration ([C $a^2$$^{+}$]$_{i}$ ) in endothelial cells (EC). We observed isometric contractions in rabbit carotid, superior mesenteric, basilar arteries and movse aorta. [C $a^2$$^{+}$]$_{i}$ was recorded by microfluorimeter using Fura-2/AM in EC. No change in contractility was recorded by the increase in [ $K^{+}$]$_{0}$ from 6 to 12 mM in conduit artery such as rabbit carotid artery. whereas resistant vessels, such as basilar and branches of superior mesenteric arteries (SMA), were relaxed by the increase. In basilar artery, the relaxation by the increase in [ $K^{+}$]$_{0}$ to from 1 to 3 mM was bigger than that by the increase from 6 to 12 mM. In contrast, in branches of SMA, the relaxation by the increase in [ $K^{+}$]$_{0}$ to from 6 to 12 mM is bigger than that by the increase from 1 to 3 mM. $Ba^2$$^{+}$ (30 $\mu$M) did not inhibit the relaxation by the increase in [ $K^{+}$]$_{0}$ from 1 to 3 mM but did inhibit the relaxation by the increase from 6 to 12 mM. In the mouse aorta without the endothelium or treated with $N^{G}$_nitro-L-arginine (30 $\mu$M), nitric oxide synthesis blocker, the increase in [ $K^{+}$]$_{0}$ from 6 to 12 mM did not change the magnitude of contraction induced either norepinephrine or prostaglandin $F_2$$_{\alpha}$. The increase in [ $K^{+}$]$_{0}$ up to 12 mM did not induce contraction of mouse aorta but the increase more than 12 mM induced contraction. In the mouse aorta, EDR was completely inhibited on increasing [ $K^{+}$]$_{0}$ from 6 to 12 mM. In cultured mouse aorta EC, [C $a^2$$^{+}$]$_{i}$ , was increased by acetylcholine or ATP application and the increased [C $a^2$$^{+}$]$_{i}$ , was reduced by the increase in [ $K^{+}$]$_{0}$ reversibly and concentration-dependently. In human umbilical vein EC, similar effect of extracellular $K^{+}$ was observed. Ouabain, a N $a^{+}$ - $K^{+}$ pump blocker, and N $i^2$$^{+}$, a N $a^{+}$ - $Ca^2$$^{+}$ exchanger blocker, reversed the inhibitory effect of extracellular $K^{+}$. In resistant arteries, the increase in [ $K^{+}$]$_{0}$ relaxes vascular smooth muscle and the underlying mechanisms differ according to the kinds of the arteries; $Ba^2$$^{+}$-insensitive mechanism in basilar artery and $Ba^2$$^{+}$ -sensitive one in branches of SMA. It also inhibits [C $a^2$$^{+}$]$_{i}$ , increase in EC and thereby EDR. The initial mechanism of the inhibition may be due to the activation of N $a^{+}$ - $K^{+}$pump. activation of N $a^{+}$ - $K^{+}$pump.p.p.p.

Tc-99m ECD Brain SPECT in MELAS Syndrome and Mitochondrial Myopathy: Comparison with MR findings (MELAS 증후군과 미토콘드리아 근육병에서의 Tc-99m ECD 뇌단일 광전자방출 전산화단층촬영 소견: 자기공명영상과의 비교)

  • Park, Sang-Joon;Ryu, Young-Hoon;Jeon, Tae-Joo;Kim, Jai-Keun;Nam, Ji-Eun;Yoon, Pyeong-Ho;Yoon, Choon-Sik;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.490-496
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    • 1998
  • Purpose: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. Materials and Methods: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were Performed and imaging features were analyzed. Results: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. Conclusion: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.

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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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Changes of Polyamine Metabolism and Delayed Neuronal Degeneration of Hippocampus after Transient Cerebral Ischemia in Mongolian Gerbils (뇌허혈 손상에 있어서 Polyamine 대사의 변동이 해마신경세포의 지연성괴사에 미치는 효과에 관한 연구)

  • Shin, Kyung-Ho;Shin, Hwa-Jung;Lee, Young-Jae;Kim, Hyung-Gun;Choi, Sang-Hyun;Chun, Yeon-Sook;Chun, Boe-Gwun
    • The Korean Journal of Pharmacology
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    • v.32 no.3
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    • pp.323-334
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    • 1996
  • Male Mongolian gerbils $(60{\sim}80g)$ were given DL-difluoromethylornithine (DFMO; 250mg/kg, ip) and methylglyoxal bis(guanylhydrazone) (MGBG; 50 mg/k, ip), respectively, 1 h prior to transient (7 min) occlusion of bilateral common carotid arteries (OBC7) and a daily dose of one of them for 6 days after recirculation, and the polyamine contents, activities of ornithine and S-adenosylmethionine decarboxylases (ODC and SAM-DC), and light microscopic findings of the hippocampus were evaluated. The hippocampal putrescine (PT) levels of the control gerbils treated with saline (STGr), markedly increased after OBC7, showing a peak level at 24 h after recirculation. The peak PT level was reduced in DFMO treated gerbils (DTCr) and in MGBG treated gerbils (MTGr). And 7 days after recirculation, the PT level of DTGr was decreased to about 75% of the PT level in the sham operated group (nonTGr) and to about 55% of the STGr level, respectively. The hippocampal spermidine (SD) level of STGr tended to decline, showing the lowest value at 8 h after recirculation. But the spermidine (SD) level of DTGr was somewhat higher at 8 h after OBC7 than those of STGr and MTGr The hippocampal spermine (SM) levels of all the experimental groups were little changed for 7 days after OBC. OBC7 markedly increased the hippocampal ODC activity. reaching a maximum (about 3 times higher than preischemic level) at 8 h and rapidly recovered to the control value by 24 h in STGr gerbils, and the OBC7-induced increase of ODC activity was significantly attenuated by DFMO or MGBG treatment. Whereas OBC7 induced a rapid decrease of the hippocampal SAMDC activity follwed by gradual recovery to the preischemic level, and the decrease of the SAMDC activity was slightly attenuated by DFMO or MGBG treatment. 7 Days after OBC7 the histological finding of the hippocampal complex stained with cresyl violet showed an extensive delayed neuronal damage in the CA1 region and to a lesser extent, in the dentate gyrus, sparing the CA3 region. And the neuronal death was aggevated by DFMO but significantly attenuated by MGBG. The immunochemical reactivity of hippocampus to anti-GFAP antibody was significantly increased in the CA1 region and to a lesser extent, in the dentate gyrus 7 days after OBC7, but was little changed in the CA3. And the increase of the anti-GFAP immunoreactivity was moderately enhanced by DFMO and significantly suppressed by MGBG. These results suggest that the polyamine metabolism may play a modulatory role in the ischemic brain damage.

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Feed Intake Evaluation of Korean Cattle (Hanwoo) Fed Diets Containing Different Levels of Compound Fattening Periods (한우의 육성 및 비육기간중 배합사료 급여 수준에 따른 사료섭취량 조사)

  • Shin, K.J.;Oh, Y.G.;Lee, S.S.;Kim, K.H.;Kim, C.H.;Paik, B.H.
    • Journal of Animal Science and Technology
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    • v.44 no.1
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    • pp.95-104
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    • 2002
  • A study was conducted to evaluate feed intake of Hanwoo bulls and steers fed diets of compound feed and rice straw. Twenty bull calves and sixty steers at 5 to 7 months old were used. The experimental period was divided into three feeding stages which are growing period (〈300 kg body weight (BW)), early fattening period (300-450 kg BW) and late fattening period (〉450 kg BW). The animals were given the diets containing 14.1% crude protein (CP) and 70.0% total digestible nutrients (TDN) in the growing period, 12.1% CP and 70.6% TDN in the early fattening period, and 11.2% CP and 71.9% TDN in the late fattening period, respectively. Experiment 1 was designed to compare feed intake (as-fed basis) between Hanwoo bulls and steers fed the experimental diets ad libitum. In Experiment 2, Hanwoo steers were allocated in one of three compound feed feeding treatments to investigate feed intake (as-fed basis). The treatment groups were ① feeding level 1 group fed compound feed ad libitum through the whole periods; ② feeding level 2 group fed 1.0% compound feed per kg BW in the growing period, 1.5% compound feed per kg BW in the early fattening period and compound feed ad libitum in the late fattening period; and ③ feeding level 3 group fed 1.5% compound feed per kg BW in the growing period, 2.0% compound feed per kg BW in the early fattening period and compound feed ad libitum in the late fattening period. In Experiment 1, the average daily feed intake of bulls increased linearly through the whole experimental period while the feed intake of steers increased until their body weight was reached upto 521 kg, afterward reduced. Average daily feed intake was about 3.5% per kg BW of both bulls and steers at the beginning (150 kg BW) of Experiment 1 while bulls and steers at 600 kg BW consumed the diets of 2.0 and 1.5% per kg BW, respectively. In Experiment 2, the average daily feed intake of steers in the feeding level 1 group gradually increased through the growing and early fattening periods and then steadily reduced over the late fattening period. The average daily feed intake in the feeding level 2 group linearly increased through the whole period while the feed intake in the feeding level 3 group showed a relatively rapid increase and reached a peak at 455 kg BW, and then sharply dropped. The average daily feed intake of steers in the feeding level 1 at the beginning (150 kg BW) of Experiment 2 was about 3.5% per kg BW but there was a reduction (1.5% per kg BW) at 600 kg BW. Besides, The feed intake of steers in the feeding level 2 and 3 in which compound feed was given with limitation increased to 2.0-3.0% per kg BW in the growing period and then reduced to 1.5-2.0% per kg BW. The limited compound feed feeding of steers in Experiment 2 resulted in higher rice straw intakes up to two to three folds and two folds in the growing and early fattening periods, respectively, than the ad libitum feeding.

Processing of Intermediate Product(Krill Paste) Derived from Krill (크릴을 원료로 한 식품가공용 중간소재(크릴페이스트) 가공에 관한 연구)

  • LEE Eung-Ho;CHA Yong-Jun;OH Kwang-Soo;Koo Jae-Keun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.3
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    • pp.195-205
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    • 1985
  • As a part of investigation to use the Anatrctic krill, Euphausia superba, more effectively as a food source, processing conditions, utilizations and storage stability of krill paste (intermediate product of krill) were examined and also chemical compositions of krill paste were analyzed. Frozen raw krill was chopped, agitated with $25\%$ of water to the minced krill and then centrifuged to separate the liquid fraction from the residue. This liquid fraction was heated at $98^{\circ}C$ for 20 min. to coagulate the proteins of krill, and it was filtered to separate the protein fraction. Krill paste was prepared with grinding the protein fraction, adding $0.2\%$ of polyphosphate and $0.3\%$ of sodium erythorbate to the krill paste for enhancing of functional properties and quality stability. The krill paste was packed in a carton box, and then stored at $-30^{\circ}C$. Chemical compositions of krill paste were as follows : moisture $78\%$, crude protein $12.9\%$, crude lipid $5.9\%$, and the contents of hazardous elements of krill paste as Hg 0.001 ppm, Cd 1.15 ppm, Zn 9.1 ppm, Pb 0.63 ppm and Cu 11.38ppm were safe for food. The amino acid compositions of krill paste showed relatively high amount of taurine, glutamic acid, aspartic acid, leucine, lysine and arginine, which occupied $55\%$ of total amino acid and also taurine, lysine, glycine, arginine and proline were occupied $65\%$ of total free amino acid. Fatty acid compositions of krill paste consist of $32.4\%$ of saturated fatty acid, $29.6\%$ of monoenoic acid and $38.0\%$ of polyenoic acid, and major fatty acids of product were eicosapentaenoic acid ($17.8\%$), oleic acid ($16.9\%$), palmitic acid ($15.3\%$), myristic acid ($8.7\%$) and docosahexaenoic acid ($8.4\%$). In case of procssing of fish sausage as one of experiment for krill paste use, Alaska pollack fish meat paste could be substituted with the krill paste up to $30\%$ without any significant defect in taste and texture of fish sausage, and the color of fish sausage could be maintained by the color of krill paste. Judging from the results of chemical and microbial experiments during frozen storage, the quality of krill paste could be preserved in good condition for 100 days at $-39^{\circ}C$.

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Media Habits of Sensation Seekers (감지추구자적매체습관(感知追求者的媒体习惯))

  • Blakeney, Alisha;Findley, Casey;Self, Donald R.;Ingram, Rhea;Garrett, Tony
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.179-187
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    • 2010
  • Understanding consumers' preferences and use of media types is imperative for marketing and advertising managers, especially in today's fragmented market. A clear understanding assists managers in making more effective selections of appropriate media outlets, yet individuals' choices of type and use of media are based on a variety of characteristics. This paper examines one personality trait, sensation seeking, which has not appeared in the literature examining "new" media preferences and use. Sensation seeking is a personality trait defined as "the need for varied, novel, and complex sensations and experiences and the willingness to take physical and social risks for the sake of such experiences" (Zuckerman 1979). Six hypotheses were developed from a review of the literature. Particular attention was given to the Uses and Gratification theory (Katz 1959), which explains various reasons why people choose media types and their motivations for using the different types of media. Current theory suggests that High Sensation Seekers (HSS), due to their needs for novelty, arousal and unconventional content and imagery, would exhibit higher frequency of use of new media. Specifically, we hypothesize that HSS will use the internet more than broadcast (H1a) or print media (H1b) and more than low (LSS) (H2a) or medium sensation seekers (MSS) (H2b). In addition, HSS have been found to be more social and have higher numbers of friends therefore are expected to use social networking websites such as Facebook/MySpace (H3) and chat rooms (H4) more than LSS (a) and MSS (b). Sensation seekers can manifest into a range of behaviors including disinhibition,. It is expected that alternative social networks such as Facebook/MySpace (H5) and chat rooms (H6) will be used more often for those who have higher levels of disinhibition than low (a) or medium (b) levels. Data were collected using an online survey of participants in extreme sports. In order to reach this group, an improved version of a snowball sampling technique, chain-referral method, was used to select respondents for this study. This method was chosen as it is regarded as being effective to reach otherwise hidden population groups (Heckathorn, 1997). A final usable sample of 1108 respondents, which was mainly young (56.36% under 34), male (86.1%) and middle class (58.7% with household incomes over USD 50,000) was consistent with previous studies on sensation seeking. Sensation seeking was captured using an existing measure, the Brief Sensation Seeking Scale (Hoyle et al., 2002). Media usage was captured by measuring the self reported usage of various media types. Results did not support H1a and b. HSS did not show higher levels of usage of alternative media such as the internet showing in fact lower mean levels of usage than all the other types of media. The highest media type used by HSS was print media, suggesting that there is a revolt against the mainstream. Results support H2a and b that HSS are more frequent users of the internet than LSS or MSS. Further analysis revealed that there are significant differences in the use of print media between HSS and LSS, suggesting that HSS may seek out more specialized print publications in their respective extreme sport activity. Hypothesis 3a and b showed that HSS use Facebook/MySpace more frequently than either LSS or MSS. There were no significant differences in the use of chat rooms between LSS and HSS, so as a consequence no support for H4a, although significant for MSS H4b. Respondents with varying levels of disinhibition were expected to have different levels of use of Facebook/MySpace and chat-rooms. There was support for the higher levels of use of Facebook/MySpace for those with high levels of disinhibition than low or medium levels, supporting H5a and b. Similarly there was support for H6b, Those with high levels of disinhibition use chat-rooms significantly more than those with medium levels but not for low levels (H6a). The findings are counterintuitive and give some interesting insights for managers. First, although HSS use online media more frequently than LSS or MSS, this groups use of online media is less than either print or broadcast media. The advertising executive should not place too much emphasis on online media for this important market segment. Second, social media, such as facebook/Myspace and chatrooms should be examined by managers as potential ways to reach this group. Finally, there is some implication for public policy by the higher levels of use of social media by those who are disinhibited. These individuals are more inclined to engage in more socially risky behavior which may have some dire implications, e.g. by internet predators or future employers. There is a limitation in the study in that only those who engage in extreme sports are included. This is by nature a HSS activity. A broader population is therefore needed to test if these results hold.

Effect of $H_2O_2$ on Alveolar Epithelial Barrier Properties (폐상피세포 장벽에 대한 $H_2O_2$의 영향)

  • Suh, Duk-Joon;Cho, Se-Heon;Kang, Chang-Woon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.236-249
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    • 1993
  • Background: Among the injurious agents to which the lung airspaces are constantly exposed are reactive species of oxygen. It has been widely believed that reactive oxygen species may be implicated in the etiology of lung injuries. In order to elucidated how this oxidant causes lung cell injury, we investigated the effects of exogenous $H_2O_2$ on alveolar epithelial barrier characteristics. Methods: Rat type II alveolar epithelial cells were plated onto tissue culture-treated polycarbonate membrane filters. The resulting confluent monolayers on days 3 and 4 were mounted in a modified Ussing chamber and bathed on both sides with HEPES-buffered Ringer solution. The changes in short-circuit current (Isc) and monolayer resistance (R) in response to the exogenous hydroperoxide were measured. To determine the degree of cellular catalase participation in protection against $H_2O_2$ injury to the barrier, experiments were repeated in the presence of 20 mM aminotriazole (ATAZ, an inhibitor of catalase) in the same bathing fluid as the hydroperoxide. Results: These monolayers have a high transepithelial resistance (>2000 ohm-$cm^2$) and actively transport $Na^+$ from apical fluid. $H_2O_2$(0-100 mM) was then delivered to either apical or basolateral fluid. Resulting indicated that $H_2O_2$ decreased Isc and R gradually in dose-dependent manner. The effective concentration of apical $H_2O_2$ at which Isc (or R) was decreased by 50% at one hour ($ED_{50}$) was about 4 mM. However, basolateral $H_2O_2$ exposure led to $ED_{50}$ for Isc (and R) of about 0.04 mM. Inhibition of cellular catalase yielded $ED_{50}$ for Isc (and R) of about 0.4 mM when $H_2O_2$ was given apically, while $ED_{50}$ for basolateral exposure to $H_2O_2$ did not change in the presence of ATAZ. The rate of $H_2O_2$ consumption in apical and basolateral bathing fluids was the same, while cellualr catalase activity rose gradually with time in culture. Conclusion: Our data suggest that basolateral $H_2O_2$ may affect directly membrane component (e.g., $Na^+,\;K^+$-ATPase) located on the basolateral cell surface. Apical $H_2O_2$, on the other hand, may be largely degraded by catalase as it passes through the cells before reaching these membrane components. We conclude that alveolar epithelial barrier integrity as measured by Isc and R are compromised by $H_2O_2$ being relatively sensitive to basolateral (and insensitive to apical) $H_2O_2$.

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Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.192-197
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    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

The Role of Intraluminal Brachytherapy in Management of Esophageal Cancer (식도암 치료에 있어 관내근접치료의 역할)

  • Lee Chang Geol;Suh Chang Ok;Kim Gwi Eon;Chu Sung Sil;Chung Eun Ji;Kim Woo Cheol
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.331-338
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    • 1995
  • Purpose : To evaluate our clinical experience with the combination of teletherapy and intraluminal brachytherapy in patients with unresectable or inoperable esophageal cancers. Materials and Methods : From Nov 1989 to Mar 1993, twenty patients with esophageal cancer were treated with radical radiotherapy and intraluminal brachytherapy at Yonsei Cancer Center. All patients had squamous histolgy and stage distribution was as follows: stage II, 4($20{\%}$)patients; III, 15 ($75{\%}$)patients; IV, 1($5{\%}$)patients. A dose of S-12Gy/1-3weeks with intraluminal brachytherapy (3-5Gy/fraction) to 5mm from the outside of the esophageal tube using high dose rate Iridium-192 remotely afterloading brachytherapy machine was given 2 weeks after a total dose of 59-64Gy with external radiotherapy. Induction chemotherapy using cisplatin and 5-FU was performed in 13 patients with median 3 cycles(1-6 cycles), Response rate, local control rate, survival and complications were analysed retrospectively. Results : Two-year overall survival rate and median survival were $15.8{\%}$ and 13.5 months. Response rates were as follows complete remission(CR) 5($25{\%}$): partial remission a(PRa) 7($35{\%}$): partial remission b(PRb) 7($35{\%}$), no response(NR) 1($5{\%}$). Patterns of failure were as follows; local failure 13($65{\%}$), local and distant failure 3($15{\%}$), distant failure 0($0{\%}$). Ultimate local control rate was $20{\%}$. Treatment related complications included esophageal ulcer in two patients and esophageal stricture in one. Conclusion : Though poor local conrol rate, median survival was improved as compared with previous results of radiation therapy alone(8months) and chemoradiation combined treatment(11 months) in Yonsei Cancer Center High-dose-rate intraluminal brachytherapy following external irradiation is an effective treatment modality with acceptable toxicity in esophageal cancer.

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