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The Usefulness and Safety of Natural Stent in a Canine Model of Tracheal Stenosis (Nd-YAG laser를 이용한 기관협착 동물모델에서 Natural 스텐트의 안전성 및 유효성 -Dumon 스텐트와의 비교 실험-)

  • Kim, Ho-Joong;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Kim, Jhin-Gook;Suh, Soo-Won;Kwon, O-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.431-438
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    • 2002
  • Background : In order to investigate the usefulness and safety of Natural Stent, we performed this study in a canine model of tracheal stenosis induced using Nd-YAG laser. Materials and Methods : After tracheal stenosis was induced in 12 Mongrel dogs using Nd-YAG laser, either Dumon (n=6) or Natural (n=6) stent was inserted into the trachea. To assess the degree of stent migration and mucostasis, bronchoscopy was performed every week for 4 weeks, after which all stents were removed. One week after stent removal, tracheal stenosis was evaluated by bronchoscopy. Results : The degree of stent migration was not different between the dogs with Dumon stent ($3.0{\pm}0.8$) and those with Natural ($2.0{\pm}1.0$), nor was the degree of mucostasis, at Dumon ($1.7{\pm}0.5$) and Natural Stent ($1.5{\pm}0.6$), respectively. One week after stent removal, the degree of tracheal stenosis was not different between the Dumon ($1.5{\pm}0.5$) and the Natural group ($1.0{\pm}0.4$). In addition, there was no death and the degree of tracheal stenosis remained always within the safe limit (less than 2.0) in all animals. Conclusion : In a canine model of tracheal stenosis induced using Nd-YAG laser, the usefulness and safety of Natural Stent were similar to those of Dumon Stent. A clinical trial is necessary to document the usefulness and safety of Natural Stent in patients with tracheal stenosis.

The Changes of Arterial Oxygen Saturation During Sleep in Chronic Obstructive Pulmonary Disease Patients (만성 폐쇄성 폐질환 환자에서 수면중 동맥혈 산소 포화도의 변화)

  • Jeong, Ki-Ho;Choi, Hyung-Seok;Hyun, In-Gyu;Choi, Dong-Chull;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.255-261
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    • 1991
  • Frequently patients with chronic obstructive pulmonary disease have lowered arterial oxygen saturation in daytime. During sleep, they are apt to experience additional hypoxemia. These episode of nocturnal hypoxemia are usually associated with periods of relative hypoventilation. Noctunal hypoxemia may be associated with cardiac arrhythmia and with acute increase in pulmonary arterial pressure and may be implicated in the development of chronic pulmonary hypertension and cor pulmonale. We selected 14 patients with chronic obstructive pulmonary disease, 9 with emphysema dominant type and 5 with chronic bronchitis dominant type, to examine the frequency and severity of nocturnal hypoxemia and the effect of oxygen in prevention of nocturnal hypoxemia. The results were as follows; 1) On PFT, FVC, $FEV_1$, and $FEV_1$/FVC showed no significant difference between the emphysema dominant type (pink puffers, PP) and the chronic bronchitis dominant type (blue bloaters, BB). But DLCO/VA for the PP group was $45.7{\pm}15.1%$ which was significantly different from BB group, $82.4{\pm}5.6%$. 2) The daytime arterial oxygen saturation ($SaO_2$) and the lowest $SaO_2$, during sleep for the BB group were significantly lower than for the PP group. 3) The hypoxemic episodes during sleep were more frequent in BB group and the duration of hypoxemic episode was longer in BB group. 4) In both group studied, although there was a tendency for a lower L-$SaO_2$ (the lowest $SaO_2$, during sleep), an increase in hypoxemic episodes and duration as the daytime $SaO_2$, fell lower, the only parameter which showed significant correlation was daytime $SaO_2$, and the frequency of hypoxemic episodes in the PP group (r=-0.68, P<0.05). 5) In PP group, with oxygen supplementation, L-$SaO_2$, during sleep showed significant increase, and there was a tendency for the frequency of hypoxemic episodes and duration to fall but it was not significant. 6) In BB group, oxygen supplementation significantly increased the L-$SaO_2$ during sleep and also significantly decreased the frequency and duration of hypoxemic episode. From these results, we can see that oxygen supplementation during sleep can prevent the decrease in $SaO_2$ to some extent and that this effect of oxygen can be seen more prominently in the BB group.

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A Study of Clinical Investigations of Pulmonary Tuberculoma (폐 결핵종의 치료에 따르는 임상경과에 관한 연구)

  • Song, Suk Ho;Hahn, Hye Sook;Kyung, Sun Young;Hwang, Jun Kyu;An, Chang Hyeok;Lim, Young Hee;Park, Gye Young;Park, Jeong Woong;Jeong, Seong Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.330-337
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    • 2002
  • Background : A pulmonary tuberculoma is one of the most common causes of a solitary pulmonary lesion. Treating a tuberculoma is still controversial and there are few reports on antituberculosis chemotherapy. In this study, the clinical findings and changes in the size of tuberculomas on a radiograph after completing antituberculosis chemotherapy was investigated. Methods : The medical records, an chest radiographs of 18 pulmonary tuberculoma patients who were admitted to the Gachon medical school, Ghil medical center between April 1998 and August 2001, were reviewed. The symptomatic changes were recorded and the size of the tuberculomas following treatment were compared. To compare the size, the long distance of each tuberculoma on the chest radiographs were measured and the additional radiological findings of calcification, satellite nodules and cavities were investigated. Results : Fifteen patients were men and 3 were women. The median age was 46 (24-74). Among these 18 patients, 14 patients had clinical symptoms. The other 4 patients were diagnosed incidentally as during a routine chest radiograph. The mean size of the tuberculomas on the initial plain chest film was $4.3{\pm}2.3cm$(range : 1.7-10 cm) and after 6 months treatment, it had decreased to $1.68{\pm}2.00cm$(range : 1.5-6.5 cm) (P<0.05). At least 6 months of antituberculosis chemotherapy resulted in the findings of a tuberculoma with a disappearance in 9, a decreased size in 4, and no change in 5 on the chest radiograph. Calcifications were found in 3 patients on the initial chest film and the chest CT and all calcified tuberculomas had disappeared after treatment. Conclusion : Although a pulmonary tuberculoma can remain as an inactive lesion for a long time, if it is confirmed by pathological or bacteriological methods, antituberculosis chemotherapy will be beneficial despite the presence of calcification.

Apolipoprotein A1 Inhibits TGF-β1-Induced Epithelial-to-Mesenchymal Transition of Alveolar Epithelial Cells

  • Baek, Ae Rin;Lee, Ji Min;Seo, Hyun Jung;Park, Jong Sook;Lee, June Hyuk;Park, Sung Woo;Jang, An Soo;Kim, Do Jin;Koh, Eun Suk;Uh, Soo Taek;Kim, Yong Hoon;Park, Choon Sik
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.143-152
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    • 2016
  • Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal lung disease characterized by the accumulation of excessive fibroblasts and myofibroblasts in the extracellular matrix. The transforming growth factor ${\beta}1$ (TGF-${\beta}1$)-induced epithelial-to-mesenchymal transition (EMT) is thought to be a possible source of fibroblasts/myofibroblasts in IPF lungs. We have previously reported that apolipoprotein A1 (ApoA1) has anti-fibrotic activity in experimental lung fibrosis. In this study, we determine whether ApoA1 modulates TGF-${\beta}1$-induced EMT in experimental lung fibrosis and clarify its mechanism of action. Methods: The A549 alveolar epithelial cell line was treated with TGF-${\beta}1$ with or without ApoA1. Morphological changes and expression of EMT-related markers, including E-cadherin, N-cadherin, and ${\alpha}$-smooth muscle actin were evaluated. Expressions of Smad and non-Smad mediators and TGF-${\beta}1$ receptor type 1 ($T{\beta}RI$) and type 2 ($T{\beta}RII$) were measured. The silica-induced lung fibrosis model was established using ApoA1 overexpressing transgenic mice. Results: TGF-${\beta}1$-treated A549 cells were changed to the mesenchymal morphology with less E-cadherin and more N-cadherin expression. The addition of ApoA1 inhibited the TGF-${\beta}1$-induced change of the EMT phenotype. ApoA1 inhibited the TGF-${\beta}1$-induced increase in the phosphorylation of Smad2 and 3 as well as that of ERK and p38 mitogen-activated protein kinase mediators. In addition, ApoA1 reduced the TGF-${\beta}1$-induced increase in $T{\beta}RI$ and $T{\beta}RII$ expression. In a mouse model of silica-induced lung fibrosis, ApoA1 overexpression reduced the silica-mediated effects, which were increased N-cadherin and decreased E-cadherin expression in the alveolar epithelium. Conclusion: Our data demonstrate that ApoA1 inhibits TGF-${\beta}1$-induced EMT in experimental lung fibrosis.

Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening (선별 검사를 위한 탁상용 폐활량기 (HI-801)의 임상적 유용성에 관한 고찰)

  • Choi, Hye Sook;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo;Yoo, Hong Ji
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.276-283
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    • 2007
  • Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.

Soluble Triggering Receptor Expressed on Myeloid cells-1: Role in the Diagnosis of Pleural Effusions (흉수의 감별 진단 시 Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1)의 유용성)

  • Kim, Jung-Hyun;Park, Eun-Young;Kim, Won-Hee;Park, Woong;Jeong, Hye-Cheol;Lee, Ji-Hyun;Kim, Eun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.290-298
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    • 2007
  • Background: The currently available diagnostic markers for pleural effusion have a limited role. The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a molecule recently reported to play an important role in the myeloid cell mediated inflammatory response, and is up regulated in the body fluid by bacterial or fungal products. This study examined the expression of sTREM-1 in pleural effusion. Methods: Between April 2004 and December 2005, 48 patients with pleural effusions were enrolled in this study. The pleural fluids were taken and analyzed for the total protein, glucose, lactate dehydrogenase (LDH), adenosine deaminase (ADA), and sTREM-1. Bacterial cultures and cytology tests were also performed. Results: The clinical diagnoses were 17 parapneumonic, 14 tuberculous, and 13 malignant effusions. Four patients presented with transudates. The mean ages of the parapneumonic, tuberculous and malignant effusion groups were $57.1{\pm}19.7$, $49.5{\pm}18.6$, $66.9{\pm}15.5$, and $76.0{\pm}18.1$. respectively. The level of sTREM-1 expression was significantly higher in the parapneumonic effusions ($344.0{\pm}488.7$) than in the tuberculous effusions ($81.7{\pm}56.6$) and malignant effusions ($39.3{\pm}19.6$). With a cut-off value of 55.4pg/ml, the sensitivity and specificity for a parapneumonic effusion was 70.6% and 74.1%. Conclusion: sTREM-1 expression is significantly higher in parapneumonic effusions, suggesting its potential role as an additional diagnostic marker for pleural effusions.

A Study on the Knowledge Related to Children's Pain of pediatric Nurses According to their Career (아동병동 간호사의 경력에 따른 아동 통증지식에 대한 연구)

  • Choi, Seon-Il;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.7 no.1
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    • pp.69-87
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    • 2005
  • Purpose : The purpose of this study was to identify pediatric nurses's knowledge related to children's pain and pediatric nurses' career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October '2:7, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children's pain of pediatric nurses. Nurses' career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children's pain was measured by whether they had education related to children's pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children's pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children's pain. The difference of scores of the knowledge regarding children's pain according to nurses' career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children's pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children's pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children's pain while their undergraduate courses. The number of nurses who received education regarding children's pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children's pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children's pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children's pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children's pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children's pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children's pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children's pain.

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A Study on the Double-Wall Greenhouse Filled with Styrene Pellets (입자충전형 이중벽 온실에 관한 연구)

  • 이석건;이종원;이현우
    • Journal of Bio-Environment Control
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    • v.4 no.1
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    • pp.59-67
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    • 1995
  • This study was conducted to develope the automatic insulation system which control inside temperature of the greenhouse. For this purpose, the double- wall greenhouse and system which could automatically supply and discharge styrene pellets were constructed and abrasion of the pellets, blower ability, insulating property, transmittance and shading effect were analyzed by the experiments. The results obtained from this study can be summarized as follows : 1. It took an hour and fifteen minutes to supply and discharge about 2㎥ pellets in the experimental greenhouse. However, it is possible to reduce the operation time by proper selection of the blower and exhaust port, and by proper control of the supply and return pipe. 2. It was founded that the indirect delivery way was more profitable than the direct one in the supply and return of pellets. 3. When the transmittance was measured between 10 a.m. and 3 p.m., the average light transmissivity rate was 67%. 4. In winter nighttime, the inside temperature of the double- wall greenhouse with out the pellets was higher than the outside temperature by 3.4$^{\circ}C$ on an average. However, the inside temperature of the double - wall greenhouse with insulated area 73% was higher than the outside by one 6.6$^{\circ}C$ on an average, and the inside temperature of the greenhouse with insulated area 100% was higher than outside one by 13.5$^{\circ}C$ on an average. Therefore, it was proved that the insulating ability of the double - wall greenhouse in nighttime was excellent. 5. When the outside temperature was 36.9$^{\circ}C$ on an average, the inside temperature of the double- wail greenhouse with insulated area 100% was 3$0^{\circ}C$ on an average. As the inside temperature was lower than the outside one by 7$^{\circ}C$ on an average, we could know that the shading effects of the double- wall greenhouse were excellent in summer daytime.

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Binding Mode Analysis of Bacillus subtilis Obg with Ribosomal Protein L13 through Computational Docking Study

  • Lee, Yu-No;Bang, Woo-Young;Kim, Song-Mi;Lazar, Prettina;Bahk, Jeong-Dong;Lee, Keun-Woo
    • Interdisciplinary Bio Central
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    • v.1 no.1
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    • pp.3.1-3.6
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    • 2009
  • Introduction: GTPases known as translation factor play a vital role as ribosomal subunit assembly chaperone. The bacterial Obg proteins ($Spo{\underline{0B}}$-associated ${\underline{G}}TP$-binding protein) belong to the subfamily of P-loop GTPase proteins and now it is considered as one of the new target for antibacterial drug. The majority of bacterial Obgs have been commonly found to be associated with ribosome, implying that these proteins may play a fundamental role in ribosome assembly or maturation. In addition, one of the experimental evidences suggested that Bacillus subtilis Obg (BsObg) protein binds to the L13 ribosomal protein (BsL13) which is known to be one of the early assembly proteins of the 50S ribosomal subunit in Escherichia coli. In order to investigate binding mode between the BsObg and the BsL13, protein-protein docking simulation was carried out after generating 3D structure of the BsL13 structure using homology modeling method. Materials and Methods: Homology model structure of BsL13 was generated using the EcL13 crystal structure as a template. Protein-protein docking of BsObg protein with ribosomal protein BsL13 was performed by DOT, a macro-molecular docking software, in order to predict a reasonable binding mode. The solvated energy minimization calculation of the docked conformation was carried out to refine the structure. Results and Discussion: The possible binding conformation of BsL13 along with activated Obg fold in BsObg was predicted by computational docking study. The final structure is obtained from the solvated energy minimization. From the analysis, three important H-bond interactions between the Obg fold and the L13 were detected: Obg:Tyr27-L13:Glu32, Obg:Asn76-L13:Glu139, and Obg:Ala136-L13:Glu142. The interaction between the BsObg and BsL13 structures were also analyzed by electrostatic potential calculations to examine the interface surfaces. From the results, the key residues for hydrogen bonding and hydrophobic interaction between the two proteins were predicted. Conclusion and Prospects: In this study, we have focused on the binding mode of the BsObg protein with the ribosomal BsL13 protein. The interaction between the activated Obg and target protein was investigated with protein-protein docking calculations. The binding pattern can be further used as a base for structure-based drug design to find a novel antibacterial drug.

The Cut-off Values and Related Factors for Serum Total Cholesterol in Normal Korean Adults (정상 성인에서 총콜레스테롤의 분별치와 관련 요인)

  • 홍인선;김지식;여영규
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.187-198
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    • 1996
  • The cut-off values and related factors for total cholesterol of serum in normal Korean adults were studied from March to October, 1995, based on the data of 1,818 healthy adults of human involved the male and female. The comparisons of the serum total cholesterol levels were analyzed by sex, age, systolic blood pressure, diastolic blood pressure, body weight, height, PIBW, BMI and other biochemical tests. 1. The serum total cholesterol level were 194.4 mg/dl in total group, 186.9 mg/dl for male, and 197.6 mg/dl for female. 2. There was no significant differences by sex among the 21 to 50 ages group, but significantly higher in women than in men over 51 years old. 3. In general, the levels of serum total cholesterol were increased with age, the highest level in men was 192.7 mg/ dl in 51 to 60 years old, and 210.5 mg/dl in more than 60 years old in women. 4. The cut-off values of serum total cholesterol for moderate risk were 191 mg/dl in 21 to 30 years group, 195 mg/dl in 31 to 40 years,214 mg/dl in 41 to 50 years, 227 mg/dl in 51 to 60 years, and 222 mg/dl in more than 61 years. The cut-off values of serum total cholesterol for high risk were 214 mg/dl dl in 21 to 30 years group, 214 mg/dll in 31 to 40 years, 239 mg/dl in 41 to 50 years, 213 mg/dl in 51 to 60 years, and 248 mg/dl in more than 61 years. 5. The mean values of serum total cholesterol were showed positive correlation with age, PIBW, BMI, systolic blood pressure and diastolic blood pressure. 6. Serum total cholesterol level of drinking group(188.9$\pm$34.85mg/dl) was showed love. than those of non-drinking group(196.0$\pm$36.0 mg/dl). 7. Serum total cholesterol levels of regular excercise group(192.1$\pm$33.3 mg/dl) was significantly lower than those of non regular excercise group(195.8$\pm$37.0 mg/dl).

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