Background: Roflumilast is the only approved oral phosphodiesterase-4 inhibitor for the treatment of severe chronic obstructive pulmonary disease (COPD) in patients with chronic bronchitis and a history of frequent exacerbations. The purpose of this study was to examine the incidence of adverse effects associated with roflumilast treatment in a real-world setting. Further, we compared the incidence of adverse effects and the discontinuation rate among patients receiving different doses. Methods: We identified all outpatients diagnosed with COPD at Seoul St. Mary's Hospital between May 2011 and September 2016 and retrospectively reviewed their medical records. Roflumilast was prescribed to patients in doses of $500{\mu}g$ and $250{\mu}g$. Results: A total of 269 COPD patients were prescribed roflumilast in our hospital during the study period. Among them, 178 patients were treated with $500{\mu}g$ and 91 patients were treated with $250{\mu}g$. The incidence of adverse effects was 38.2% in the $500{\mu}g$ group and 25.3% in the $250{\mu}g$ group (p=0.034). The discontinuation rate of roflumilast was 41.6% (n=74) in the $500{\mu}g$ group and 23.1% (n=21) in the $250{\mu}g$ group (p=0.003). When adjusted by age, sex, smoking status, and lung function, $500{\mu}g$ dose was significantly associated with the discontinuation of roflumilast (odds ratio, 2.87; p<0.001). Conclusion: There was a lower incidence of adverse effects and discontinuation among patients treated with $250{\mu}g$ compared with $500{\mu}g$ dose. Further studies regarding the optimal dose of roflumilast are required.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.17
no.2
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pp.98-102
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2006
Background and Objectives : Voice onset time(VOT) is defined as the time interval from oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristics of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. Stop consonants are characterized by creation of a pressure difference across a complete occlusion in the vocal tract, followed by a sudden release 'burst' due to opening that occlusion. The objects of this study is to evaluate a usefulness of voice onset time in the assessment of voice disorderd patients. Subjects : Subjects were 20 adults with normal voice and with benign laryngeal disorders. Subjects with voice disorders represented the following vocal pathologies : vocal polyp, vocal nodule, Reinke's edema and unilateral vocal fold paralysis(UVFP). Control subjects were matched for age (21-40 yews old) and sex(male) with the voice disorders subjects and had normal vocal qualities with no history of voice disorders. Methods : Each voice-disordered and matched control subject read the test passages containing three types of Korean bilabial consonants. VOT measures were made for the initial $/p/p^h/\;and\;/p'/$. VOT was measured using acoustic waveform or wide band spectrogram. Results : For each voiceless stop consonants, there was a significant difference in VOT between the voice disordered and normal subjects. The mean VOTs of the lax stops in UVFP was significantly shorter than those of control subjects in the UVFP. The mean VOTs of the aspirated stops in the vocal polyp and nodule were longer than those of control subjects, but not significant. The mean VOTs of the glottalized in voice disordered groups were longer than those of control subjects, and significant statistically in the UVFP. Conclusions : VOT may be a clinically useful acoustic parameter in the assessment of voice disordered patients, especially in the unilateral vocal fold paralysis.
Journal of Physiology & Pathology in Korean Medicine
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v.20
no.2
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pp.383-387
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2006
To investigate the effect of GyeongshinhaeGihwan 1(GGT1) frequently used as an anti-obesity herbal medicine in oriental medicine on the expression of obesity-related genes, we measured the changes in mRNA levels of these genes by GGT1 in human growth hormone transgenic (hGHTg) obese female rats, and these effects by GGT1 were compared with those of reductil (RD), an anti-obesity drug approved by FDA. Rats received once daily oral administrations of autoclaved water, RD, or GGT1 for 8 weeks. At the end of study, rats were sacrificed and tissues were harvested. Total RNA from adipose tissue, liver and kidney was prepared and the mRNA levels for LPL (lipoprotein lipase), $PPAR{\gamma}$ (peroxisome proliferator activated receptor-gamma), $PPAR{\delta}$ (peroxisome proliferator activated receptor-delta), leptin, $TNF{\alpha}$ (tumor necrosis factor-alpha), and internal standard G3PDH (glyceraldehyde-3-phosphate dehydrogenase) were analyzed by RT-PCR. Compared with control group, $PPAR{\gamma}$ mRNA levels of liver and kidney were decreased in both RD and GGT1 groups, and the effects were more prominent in GGT1 group than in RD group, suggesting that GGT1 is effective in the inhibition of lipid storage by decreasing the $PPAR{\gamma}$ expression. $PPAR{\delta}$ mRNA levels of adipose tissue were increased by RD and GGT1 compared with DW, and the magnitude of increase were higher in GGT1 group than in RD group, indicating that GGT1 stimulates fatty acid oxidation and energy metabolism by activating $PPAR{\delta}$ expression. GGT1 group had higher concentrations of serum leptin, a well-known inhibitor of appetite, than control and RD groups. However, The mRNA levels of leptin, LPL, and $TNF{\alpha}$ were not changed by GGT1. These results indicate that GGT1 can prevent obesity in hGHTg obese female rats by down-regulating and up-regulating the mRNA expression of $PPAR{\gamma}$ and $PPAR{\delta}$, respectively, and that this anti-obesity effects were more pronounced in GGT1 group compared with RD group. In addition, GGT1 seems to inhibit obesity by increasing the circulating leptin levels.
Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.
Journal of Korean Academy of Fundamentals of Nursing
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v.8
no.2
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pp.132-146
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2001
Purpose: This study was to analyze the trends and content of all the research (171 research papers) published in the Journal of Fundamentals of Nursing from 1994, when it began to 2000 using an objective tool developed by the researches, and to identify the direction for the future research in Fundamentals of Nursing. Method: Research published in the Journal of Fundamentals of Nursing from 1994 were reviewed. Result: Most of research (94.2%) was non-degree based and funded research was very limited. The average number of researchers per research study was 2.2 and collaborative research has been gradually increasing. The total number of key words was 331 and the average was 2.6 per research. The major key words were not different from other nursing departments and included home care nursing (10 times), health promotion (8 times), self-care (7 times). self-efficacy (7 times), and homo-dialysis (6 times). Eighty seven percent of the research was quantitative research. and there were very few qualitative studies. Considering theory level, it was found that 40% were factor related research For study design, non-experimental studies were most frequent (66%), and the rate, especially of surveys, has remarkably decreased. Selection of subjects by convenience sampling, was most frequent and there were very few studies that provided the rationale for the calculation of sample size. The major subjects of study were patients (44.8%) with various diagnoses. The subjects usually gave oral consent to take part in that study. Giving information (46.9%) and exercise (26.5%) were common nursing interventions, and physiological indices (16.5%). vital signs (10.3%), physical functioning (8.2%), level of knowledge/skill (7.2%) and level of activity (6.2%) were frequently measured as outcome. Variables questionnaires were the major approach used to collect data, and 57.8% of the research provided the Cronbach alpha to guarantee internal consistency of study instruments. Data were analyzed with computerized statistical packages using, ANOVA (42.0%), T test(39.5%), and chi-square test. For the last seven years, nursing research in Fundamentals of Nursing has gradually improved in both quantify and quality. Conclusion: It was difficult to find any uniqueness or difference compared to other departments of nursing. In fact, because the history of the Journal of Fundamentals of Nursing is rather short, we can expect that there will be further improvement in qualify and content in the future.
Background: Breast cancer is the most common malignancy of women in the world. The disease is caused by infectious and non-infectious, environmental and lifestyle factors. Tobacco smoke has been one of the most widely studied environmental factors wiith possible relevance to breast cancer. The purpose of this study was to assess the impact of tobacco smoking in breast cancer patients in a hospital based cohort and to establish prognostic implications if any. Materials and Methods: A retrospective audit of 100 women with pathological diagnosis of invasive breast cancer was included in this study. The verbal questionnaire elicited information on current and previous history of exposure to smoking in addition to active smoking. All analyses were adjusted for potential confounders, including stage at presentation, alcohol intake, hormonal replacement therapy, oral contraceptive intake, obesity and menopausal status. Results: The mean age at presentation of breast cancer was $51.4{\pm}10.86$ years. Mean age of presentation was $53.1{\pm}11.5$ and $45.7{\pm}11.9$ years in never smokers and passive smokers, respectively. Age at presentation varied widely in patients exposed to tobacco smoke for >10 years in childhood from $40.3{\pm}12.0$ years to $47.7{\pm}13.9$ in patients exposed for > 20years as adults. Among passive smokers, 60.9% were premenopausal and 39.1% of patients were postmenopausal. In never smokers, 71.4% were post menopausal. Expression of receptors in non-smokers vs passive smokers was comparable with no significant differences. Metastatic potential in lung parenchyma was slightlyelevated in passive smokers as compared to never smokers although statistically non-significant. Conclusions: An inverse relationship exists between the intensity and duration of smoking and the age at presentation and poor prognostic factors. The results strongly suggest efforts should be taken to prevent smoking, encourage quitting and restrict exposure to second hand smoke in India.
Ahn, So Yoon;Shin, Son Moon;Kim, Kyung Ah;Lee, Yeon Kyung;Ko, Sun Young
Clinical and Experimental Pediatrics
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v.52
no.3
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pp.376-379
/
2009
We report a case of a premature newborn baby who presented with hyponatremia, hyperkalemia, and metabolic acidosis accompanied by severe polyhydramnios in utero. The baby was diagnosed with pseudohypoaldosteronism on the basis of normal 17-hydroxyprogesterone levels, elevated aldosterone, and clinical symptoms. His serum electrolyte levels were corrected with sodium chloride supplementation. Sodium supplementation was reduced gradually and discontinued at 5 months of age. At 5 months, the child was able to maintain normal serum electrolyte levels without oral sodium chloride supplementation, and showed normal physical and neurological development. This case illustrates that pseudohypoaldosteronism must be considered if a newborn infant with an antenatal history of severe polyhydramnios shows excessive salt loss with normal levels of 17-hydroxyprogesterone.
Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.
Yoon, Ji-Seon;Yabuzoe, Astushi;Sekiguchi, Maiko;Park, Jinho;Iwasaki, Toshiroh;Nishifuji, Koji
Journal of Veterinary Clinics
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v.30
no.3
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pp.210-213
/
2013
We herein describe a feline case of facial dermatitis whose histopathological features resembled to those of FHV-associated ulcerative dermatitis. A 3-year-old, intact male domestic short-haired cat was presented with 2-years history of pruritic dermatitis that initially appeared on periocular area and extended toward the entire face. The cat had ocular discharge and conjunctivitis from 2-month of age. Clinically, skin lesions were characterized as erythema, erosions and ulcers covered with crusts on the facial and perianal area. Histopathologically, the facial lesion was characterized as interface dermatitis with hydropic degeneration at the basal layer, and single cell necrosis of keratinocytes. In addition, the epidermal and dermal necrosis infiltrated with eosinophils, and intranuclear inclusion bodies in keratinocytes were also recognized. Moreover, feline herpesvirus-1 gene was detected by a PCR analysis using a swab obtained from the crusted lesions. Based upon these findings, the present case was considered as having FHV-associated ulcerative dermatitis. Therapy including oral acyclovir and topical recombinant feline interferon omega resulted in marked improvement of the skin and mucosal lesions.
Calcium sulfate has a long history of medical use as an implant material. The biocompatibiliry of the material has been clearly established. Bone ingrowth concomitant with resorption occurs rapidly with efficient conduction of bone from particle to particle. Calcium sulfate also has a potential for functioning as a good bamer membrane. The purpose of this study was to compare the biocompatibility of different types of calcium sulfate grafting materials including an expelimental calcium sulfate compound on periodontal ligament cells in vitro as a preliminary test towards the development of a more convenient and useful form of grafting material which could promote regeneration of periodontal tissue. Human periodontal ligament cells were collected from the premolar teeth extracted for orthodontic treatment. cells were cultured in a.MEM culture medium containing 20% FBS, at $37^{\circ}C$ and 100% humidity, in a 5% CO2 incubator. Cells were cultured into 96 well culture plate $1{\times}104$ cells per well with $\alpha$-MEM and incubated for 24 hours. After discarding the medium, those cells were cultured in $\alpha$-MEM contained with 10% FBS alone (control group), in medcal-grade calcium sulfate(MGCS group), in plaster(plaster group), experimental calcium sulfate paste(CS paste group) for 1, 2, 3 day respectively. And then each group was characterized by examining of the cell counting, MTI assay, collagen synthesis. The results \vere as follows. 1. In the analysis of cell proliferation by cell counting, both medical-grdde calcium sulfate group and plaster group showed no stastically significant difference at day 1, 2, 3 accept for plaster group at day 1 compared to control group, but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.05). 2. In the analysis of cytotoxicity by MIT assay, both medical-grade calcium sJlfate group and plaster group showed no stastically significant difference compared to control group at day 1, 2, 3 but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.OS). 3. In the analysis of collagen synthesis by immunoblotting assay, high level was detected for medical-grade calcium sulfate group and plaster group at day 1, 2, 3 compared to CS paste group. On the basis of these results, medical-grade calcium sulfate and plaster was shown to possess biocompatibility whereas the CS paste had unfavourable outcome. This observation shows a need for modification of the materials contained in calcium sulfate paste.
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