Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.
Background : With the increase of cigarette consumption by women and the young, the incidence of lung cancer is expected to increase during the next three or four decades in Korea. The purpose of this study was to analyze the smoking habits in patients with lung cancer and to identify the gender differences in terms of their susceptibility to cigarette related carcinogens. Method : This investigation was a hospital-based case control study, which included the data of 178 case subjects (72 females, 106 males) with lung cancer and 218 control subjects (97 females, 121 males) with diseases unrelated to smoking. The information was obtained through a direct personal interview and a questionnaire related to personal smoking history. Results : The relative frequency of the squamous cell carcinoma was substantially higher in males than in females (61.3% in males, and 29.2% in females), while adenocarcinoma including bronchoalveolar cell carcinoma was higher in females(31.9% in females, 18.9% in males). Kreyberg I lung cancer was of relatively higher frequencies in males and smokers, while Kreyberg II lung cancer was higher in females and never smokers. The odds ratios (ORs) at each exposure level were consistently higher in females than males. For all cell types, the risk of lung cancer was increased with the quantity of smoked cigarettes, duration of smoking, and depth of inhalation. Odds ratio was distinctly higher in Kreyberg I lung cancer than in total lung cancer and a steeper gradient of risk with increased smoking was observed in females. Conclusion : The relative risk for lung cancer was consistently higher in females than in males at every level of exposure to cigarette smoke. This is believed to be due to the higher susceptibility of females to tobacco carcinogens, such as gender associated differences of carcinogen activation and/or the elimination of smoking related metabolites.
Background: The problem of cancer, especially lung cancer, is very acute in Bangladesh. The present study was conducted to evaluate the risk of lung cancer among Bangladeshi people based on hereditary, socio-economic and demographic factors. Materials and Methods: This study was carried out in 208 people (patients-104, controls-104) from January 2012 to September 2013 using a structured questionnaire containing details of lung cancer risk factors including smoking, secondhand smoke, tobacco leaf intake, age, gender, family history, chronic lung diseases, radiotherapy in the chest area, diet, obesity, physical activity, alcohol consumption, occupation, education, and income. Descriptive statistics and testing of hypotheses were used for the analysis using SPSS software (version 20). Results: According to this study, lung cancer was more prevalent in males than females. Smoking was the highest risk factor (OR=9.707; RR=3.924; sensitivity=0.8872 and P<0.0001) followed by previous lung disease (asthma, tuberculosis etc.) (OR=7.095; RR=1.508; sensitivity=0.316 and P<0.0001)) for male patients. Highly cooked food (OR=2.485; RR=1.126; sensitivity=0.418 and P=0.004)) and also genetic inheritance (OR=1.93; RR=1.335; sensitivity=0.163 and P=0.138) demonstrated significant correlation with lung cancer as risk factors after these two and alcohol consumption was not prevalent. On the other hand, for female patients, tobacco leaf intake represented the highest risk (OR=2.00; RR=1.429; sensitivity= 0.667 and P=0.5603) while genetic inheritance and highly cooked food also correlate with lung cancer but not so significantly. Socioeconomic status and education level also play important roles in causing lung cancer. Some 78.5% male and 83.3% of female cancer patients were rural residents, while 58.2% lived at the margin or below the poverty line. Most male (39.8%) and female (50.0%) patients had completed only primary level education, and 27.6% male and 33.3% female patients were illiterate. Smoking was found to be more prevalent among the less educated persons. Conclusions: The results obtained in this study indicate the importance of creating awareness about lung cancer risk factors among Bangladeshi people and making appropriate access to health services for the illiterate, poor, rural people.
It is known that obesity is associated with chronic adult disease including stroke. However the relationship between stroke and obesity has not been discussed sufficiently, The purpose of this study was to confirm whether the serum Leptin levels related to BMI and these were associated with serum lipid levels and other risk factors in stroke patients. The subjects were 68 stroke patients(male 36. female 32) hospitalized in the Department of Circulatory Internal Medicine, College of Oriental Medicine, Kyung Hee University, Seoul. Obesity was shown in 16 patients(24%) whose BMI were above 25. and in 15 patients(22%) who represented higher values than normal in serum Leptin levels. BMI correlated with serum Leptin level(p=0.04), with Triglyceride(p=0.019) and with Total lipid(p=0.001) significantly. Meanwhile serum Leptin levels significantly correlated with Total cholesterol(p=0.013) only. BMI in the group with a history of smoking was significantly lower than that of the non-smoking group(p=0.01). Serum Leptin levels were higher in the group with Hypertension than the non-Hypertension group(p=0.026), lower in the non-Drinking group(p=0.006) and the smoking group(p=0.001) than the drinking group and the non-smoking group. respectively. So we concluded that BMI significantly correlates with serum Leptin levels and serum lipid levels in stroke patients.
This study was done to investigate the effect of adolescent smoking on dietary intakes and nutritional status of serum lipids and antioxidant vitamins. Subjects were 82 somkers whose average pack-year was 0.73, and 85 nonsmokers of male technical high school students in Seoul. Anthropometric measurement was performed and % body fat was also analyzed by Bioelectrical Impedance Fatness Analyzer(GIF-891). Dietary intakes and habits were examined through questionnaires and nutrient intakes were analyzed by Computer Aided Nutritional (CAN) analysis programs. Serum TG and total cholesterol levels were measured by Spotchem sp-4410 and serum HDL-cholesterol levels were measured by test kit. serum vitamin C level was measured by 2,4-dinitrophenylhydrazine method and serum levels of vitamin A and vitamin E were measured by HPLC. All data were statistically analyzed by SAS PC package program. There was a significant difference in body fat percentage and systolic blood pressure while other anthropometric measurements were not different between smokers and monsmokers. Caloric intakes(2335㎉) in adolescent smokers tended to be higher than that of nonsmokers (2,175㎉) but the difference was not statistically significant. Intakes of protein(76.67g) and niacin(16.49㎎) in adolescent male smokers were significantly higher(P<0.05) than those of nonsmokers although other nutrient intakes were not significantly different. Analysis of serum lipids showed that serum HDL-cholesterol level of smokers was significantly different. Analysis of serum lipids showed that serum HDL-cholesterol level of smokers was significantly lower(p<0.05) than that of nonsmokers, whereas other lipid levels were not significantly different. Serum vitamin C level was also significantly lower(p<0.05) in adolescent smokers than in nonsmokers. In addition, serum vitamin E level, which was 7.85㎎/1 in smokers, was lower than that of 9.20㎎/1 in nonsmokers(p<0.05) while serum vitamin A level was not significantly different between the two groups. These results indicate that cigarette smoking in adolescence decreases serum levels of HDL-cholesterol, vitamin C and vitamin E even thoughth their smoking history is very short. (Korean J Community Nutrition 3(3) : 349∼357, 1998)
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.30
no.2
/
pp.107-111
/
2019
Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.
For the purpose of evaluating the effect of noise induced hearing loss on the blood pressure, a cross-sectional study was conducted in 481 manufacturing industrial workers in Pusan area consisted of 275 workers from noisier plant (over 90 dB(A), high exposed group) and 206 workers from less noisy plant (below 85 dB(A), low exposed group) from April to Decepmber in 1985. The summarized results were as follows; 1) The degree of hearing loss according to the audible frequency was most notable in 4,000 Hz. 2) The prevalence of hypertension was 14.8% in total examined subjects. And also in 40 dB(A) hearing lost workers, there was no significant difference between high exposed group as 15.5% and low exposed group as 15.8%. 3) In 3 models analyzed by multiple regression technique to obtain the complexed extents of risk factors related to the diastolic blood pressure, especially model III which contain age, body mass index, smoking, alcohol and family history of hypertension, duration of work, noise exposure level and degree of hearing loss in high exposed group was most remarkable compared to the others. 4) The most potential predictor related to the diastolic pressure in high exposed group was the degree of hearing loss. And the next were body mass index, familial history of hypertension and age in order. But in the case of low exposed group, the potential predictors were body mass index, age and familial history of hypertension.
Northeastern India is a major nasopharyngeal carcinoma (NPC) high risk-area although the rest of the country has very low incidence. A case-control study of 105 NPC cases and 115 controls was conducted to identify the potential risk factors for NPC development in this region. Information was collected by interviewer about socio-demographic characteristics, cigarette smoking, alcohol consumption, dietary history, occupational history, and a family history of cancer. Epstein-Barr viral load was assayed from the blood DNA by real time PCR. Associations between GSTs genotypes, cytochrome P450 family including CYP1A1, CYP2E1 and CYP2A6 polymorphisms and susceptibility to relationship between the diseases were studied using PCR-RFLP assay. Results indicate that Epstein-Barr virus load was significantly higher in patients compared to controls (p<0.0001). Furthermore, concentration of blood EBV-DNA was significantly higher in advanced stage disease (Stage III and IV) than in early stage disease (Stage I and II) (p<0.05). Presence of CYP2A6 variants that reduced the enzyme activity was significantly less frequent in cases than controls. Smoked meat consumption, exposure to smoke, living in poorly ventilated house and alcohol consumption were associated with NPC development among the population of Northeastern India. Thus, overall our study revealed that EBV viral load and genetic polymorphism of CYP2A6 along with living practices which include smoked meat consumption, exposure to smoke, living in poorly ventilated houses and alcohol consumption are the potential risk factors of NPC in north eastern region of India. Understanding of the risk factors and their role in the etiology of NPC are helpful forpreventive measures and screening.
Background: Several potential risk factors have been identified for diffuse large B-cell lymphoma (DLBCL); however, epidemiological studies investigating the association between these risk factors and DLBCL have yielded inconsistent results. Objectives: To investigate potential medical, lifestyle, and environmental risk factors of DLBCL in Shanghai, China through a hospital-based case-control study. Method: One-hundred-and-forty-seven newly diagnosed DLBCL patients and 294 sex- and age-matched controls were recruited from 11 hospitals in Shanghai between 2003 and 2007. A standardized structured questionnaire was used to obtain patient data on demographics, medical history, family history, lifestyle, and environmental exposures. Conditional logistic regression models were used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), for risk associated with each data category. Results: History of tuberculosis (TB) infection and "living on a farm" were positively associated with DLBCL (TB: OR=3.05, 95% CI: 1.19-7.80; farm: OR=1.82, 95% CI: 1.21-2.73). In contrast, taking traditional Chinese medicine was negatively associated with DLBCL (OR=0.36, 95% CI: 0.14-0.89). No significant correlation with DLBCL risk was found for any of the other potential risk factors (p>0.05), including but not limited to hair dyes, alcohol drinking, smoking, and home/workplace renovation within one year. Conclusions: Consistent with results from previous studies in other DLBCL case populations, traditional Chinese medicine appeared to have a direct or indirect protective effect against DLBCL. However, this study also identified a possible predisposition for DLBCL in TB sufferers and farmers.
We studied daily micronutrient intake from vitamin-mineral supplements, health-related life style, clinical case of diseases and food frequency of the Korean middle-aged (40-59 yr, n = 404) to compare the characteristics of non-user (n = 270) and user (n = 134) of vitamin-mineral supplements. Rate of supplement use of the middle-aged was 33.2% and there was significant difference in education level (p = 0.0084) and family income (p = 0.0476) of user and nonuser. Smoking habit (p = 0.0844) and drinking frequency (p = 0.0606) tended to be lower in a supplement user than a non-user. The medical history of a case was significantly higher in users (67.9%) than in non-users (44.4%) (p = 0.001), which suggests that medical history is one of the important motivations of supplement use. Supplement users had the medical history of digestive disease (34.1%), anemia (11.0%) and hypertension (9.9%) in order. Vitamin C was the most frequently supplemented nutrient (81.3%) among vitamin-mineral supplement, and the next orders were vitamins E (73.1%), B$_2$(68.7%) and B$_{6}$ (60.4%). Mean intakes of vitamin B$_1$, iron, selenium, vitamin E, and vitamin C from supplement was 4,260%, 4,030%, 1,660% and 1,330% of RDA, respectively. The supplement users tended to consume most food items including milk & milk products (p < 0.01), rice (p < 0.01), grains (p < 0.05) and cookies (p < 0.01) less frequently than non-users. Conclusively, nutrient intake of vitamin B$_1$, iron, selenium, vitamin E, and vitamin C from supplement was excessively high compared to RDA. We suggest that the toxic effect of excessive supplementation should he informed to supplement user and nutritional education should be focused on the optimal supplement dose.e.
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