• Journal of Chest Surgery
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• v.42 no.5
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• pp.624-629
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• 2009

Background: Making the histologic diagnosis of small pulmonary nodules and ground glass opacity (GGO) lesions is difficult. CT-guided percutaneous needle biopsies often fail to provide enough specimen for making the diagnosis. Video-assisted thoracoscopic surgery (VATS) can be inefficient for treating non-palpable lesions. Preoperative localization of small intrapulmonary lesions provides a more obvious target to facilitate performing intraoperative. resection. We evaluated the efficacy of CT-guided localization with using a hook wire and this was followed by VATS for making the histologic diagnosis of small intrapulmonary nodules and GGO lesions. Material and Method: Eighteen patients (13 males) were included in this study from August 2005 to March 2008. 18 intrapulmonary lesions underwent preoperative localization by using a CT-guided a hook wire system prior to performing VATS resection for intrapulmonary lesions and GGO lesions. The clinical data such as the accuracy of localization, the rate of conversion-to-thoracotomy, the operation time, the postoperative complications and the histology of the pulmonary lesion were retrospectively collected. Result: Eighteen VATS resections were performed in 18 patients. Preoperative CT-guided localization with a hook-wire was successful in all the patients. Dislodgement of a hook wire was observed in one case. There was no conversion to thoracotomy, The median diameter of lesions was 8 mm (range: $3{\sim}15\;mm$). The median depth of the lesions from the pleural surfaces was 5.5 mm (range: $1{\sim}30\;mm$). The median interval between preoperative CT-guided with a hook-wire and VATS was 34.5 min (range: ($10{\sim}226$ min). The median operative time was 43.5.min (range: $26{\sim}83$ min). In two patients, clinically insignificant pneumothorax developed after CT-guided localization with a hook-wire and there were no other complications. Histological examinations confirmed 8 primary lung cancers, 3 cases of metastases, 3 cases of inflammation, 2 intrapulmonary lymph nodes and 2 other benign lesions. Conclusion: CT-guided localization with a hook-wire followed by VATS for treating small intrapulmonary nodules and GGO lesions provided a low conversion thoracotomy rate, a short operation time and few localization-related or postoperative complications. This procedure was efficient to confirm intrapulmonary lesions and GGO lesions.

• Journal of Food Hygiene and Safety
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• v.26 no.2
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• pp.107-113
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• 2011

Plantago asiatica L. (PA), which is widely distributed in Korea, Japan and China, has traditionally been used as a popular folk medicine for the treatment of liver diseases. A variety of activities of PA was reported, that is hepatoprotective, anti-inflammatory, anti-glycation and anti-oxidant effect. Ferric nitrilotriacetate (Fe-NTA) is a potent nephrotoxic agent and has been reported to induce renal proximal tubular necrosis. In the present study, pre-treatment with PA extract (PAE) in Wistar rat followed by Fe-NTA i.p. treatment (13.5 mg Fe/kg body weight) was performed to detect the renal protective effect of PAE. Only Fe-NTA treated group showed increases in the level of serum blood urea nitrogen (BUN) and serum creatinine (Cr), and renal tissue malondialdehyde (MDA), product of lipid peroxidation. Moreover, the level of biomarkers indicate the antioxidants status, reduced glutathione (GSH), glutathione-S-transferase (GST) and glutathione reductase (GR) were decreased. However, PAE pre-treated group showed decreases in the levels of serum BUN, serum Cr and renal tissue MDA in concentration dependent manner and increases in the level of GSH, GST and GR. These results are significantly different (p < 0.05) to the other groups. Our data suggest that PAE may be used as an chemopreventive material against Fe-NTA-mediated renal oxidative stress.

• The Korean Journal of Food And Nutrition
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• v.26 no.4
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• pp.841-849
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• 2013

The aim of this study was to investigate the quality characteristics of Kimchi, prepared with seasoning fluid, vinegar, and mustard extract to inhibit the proliferation of microorganisms and extend the edible period during fermentation at $25^{\circ}C$. We also added perilla leaf, endive, and mustard leaf to Kimchi to improve the flavor. The pH of control Kimchi fluid over 1 day after Kimchi processing, was $5.40{\pm}0.01$ and that of the experimental groups in which vinegar and mustard extract were added was $4.51{\pm}0.01{\sim}4.52{\pm}0.01$, which was lower than that of the control. As the fermentation progresses, the pH of the control decreased rapidly and that of the experimental groups decreased slowly. The initial titratible acidity of the control was low and 3 days later reached $0.95{\pm}0.04$. However, that of the experimental groups was $0.42{\pm}0.01{\sim}0.43{\pm}0.02$ and 5 days later reached a level similar to that of the control. The salinities of the Kimchi juice of both the control and the experimental groups were $2.67{\pm}0.06{\sim}2.80{\pm}0.10$% after 1 day and decreased during fermentation. The amount of lactic acid bacteria of the control was $8.17{\pm}4.01{\times}10^8cfu/g$, 1 day after the Kimchi processing and that of the experimental groups was $2.70{\pm}2.08{\times}10^7{\sim}3.63{\pm}2.80{\times}10^7cfu/g$. After 3 days, these were $3.13{\pm}1.94{\times}10^{11}cfu/g$ and $2.47{\pm}2.23{\times}10^9{\sim}8.03{\pm}3.71{\times}10^9cfu/g$, respectively. According to the result of sensory evaluation, throughout the entire period of the experiment, all sensory items such as color, odor, taste, texture, and total acceptability of the experimental groups were better than those of the control group (p<0.05). Especially, Kimchi in which perilla leaf was added was the best. With the addition of vinegar and mustard extract to the Kimchi, microorganism proliferation was inhibited and the edible period was extended. The minerals, vitamins and antioxidants of leaf vegetables could therefore be obtained.

• Food Science of Animal Resources
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• v.27 no.3
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• pp.267-276
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• 2007

This study was conducted to determine the effect of cryoprotectants (sugar, sorbitol, polyphosphate) on the physico-chemical characteristics of chicken breast surimi manufactured by pH adjustment (pH 11.0) during freezing storage. The final surimi was divided into experimental units to which the following treatments were randomly assigned: C (Alaska pollack surimi: two washings, 4% sugar +5% sorbitol ${\pounds}'$ 0.3% polyphosphate additive): T1 (chicken breast surimi: pH 11.0 adjusted, 0.3% polyphosphate additive): T2 (chicken breast surimi pH 11.0 adjusted, 5% sorbitol +0.3% polyphosphate additive); T3 (chicken breast surimi: pH 11.0 adjusted, 4% sugar +5% sorbitol +0.3% polyphosphate additive). The crude protein content of the control was higher than all treated samples, however the moisture, crude fat and crude ash of T3 were higher than the control (p<0.05). The pH, WHC and collagen content of the control were higher than all of the treated samples, and these values decreased with storage time for all treatments and the control (p<0.05). The cholesterol content of the control was lower than all treated samples, but the myofibrillar protein contents of all treated samples were higher than the control (p<0.05). The cooking loss of T2 was lower than the control and the other two treatments (p<0.05). The $L^*,\;a^*\;and\;b^*$ values of all treated samples were higher than those of the control during freezing storage (p<0.05). The W value of T3 at 1.5 and 3 months of freezing storage was higher than the control and T1 (p<0.05). The myoglobin and met-Mb contents of the control were similar to all treated samples, and the met-Mb content of the control and all treated samples increased with storage time (p<0.05). Immediately after freezing, the hardness of the control was higher than all treated samples, however it was lower after 1.5 and 3 months of frozen storage (p<0.05). The cohesiveness and gumminess of the control were higher than all treated samples immediately after freezing, however the values for T3 were higher than those of the control and the other two treatments during frozen storage for 1.5 and 3 months (p<0.05).

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.332-342
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• 2000

Background : The importance of pro-inflammatory cytokines, especially tumor necrosis factor $\alpha$ (INF-$\alpha$) and interleukin-1$\beta$ (IL-1$\beta$), have been extensively documented in the generation of inflammatory lung disease. Lung epithelial cells are also actively involved in initiating and maintaining inflammation by producing pro-inflammatory mediators. Understanding the mechanism of pro-inflammatory cytokine expression in lung epithelial cells is crucial to the development of new therapeutic modalities for inflammatory lung disease. Transcription of most pro-inflammatory cytokines is dependent on the activation of NF-${\kappa}B$. However, the relationship between pro-inflammatory cytokine expression and NF-${\kappa}B/I{\kappa}B$ pathway in lung epithelial cells is not clear. Methods : BEAS-2B, A549, Na-H157, NCI-H719 cells were stimulated with IL-$1{\beta}$ or TNF-$\alpha$ at various times, and then IL-8 and TNF-$\alpha$mRNA expressions were assayed by Northern blot analysis. IL-$1{\beta}$ or TNF-$\alpha$-induced NF-${\kappa}B$ activation was assessed by the nuclear translocation of p65 NF-${\kappa}B$ subunit. The degradation of $I{\kappa}B{\alpha}$ and $I{\kappa}B{\beta}$ by IL-$1{\beta}$ or TNF-$\alpha$stimulation was assayed by Western blot analysis. The phosphorylation of $I{\kappa}B{\alpha}$ was evaluated by Western blot analysis after pre-treating cells with proteasome inhibitor followed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation. The basal level of IKK $\alpha$ expression was evaluated by Western blot analysis. Results: $I{\kappa}B{\alpha}$ and $I{\kappa}B{\alpha}$ was rapidly degraded after 5 minutes of incubation with IL-$1{\beta}$ or TNF-$\alpha$ in BEAS-2B, A549, and NCI-H157 cells. The activation of NF-${\kappa}B{\alpha}$ and the induction of IL-8 and TNF-$\alpha$ mRNA expression were observed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in these cells. In contrast, neither the changes in NF-${\kappa}B/I{\kappa}B$ pathway nor IL-8 and TNF-$\alpha$mRNA expression was induced by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in NCI-H719 cells. IL-$1{\beta}$ and TNF-$\alpha$-induced $I{\kappa}B$ phosphorylation was observed in BEAS-2B, A549, and NCI-H157 cells, but not in NCI-H719 cells. The basal level of IKK$\alpha$ expression was not different between cell. Conclusion : NF-${\kappa}B/I{\kappa}B$ pathway plays an important role in the expression of pro-inflammatory cytokine in most lung epithelial cells. The absence of the effect on NF-${\kappa}B/I{\kappa}B$ pathway in NCI-H719 cells sæms to be due to the defect in the intracellular signal transduction pathway upstream to IKK.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.323-331
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• 2000

Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.129-136
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• 2006

Background: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the $FEV_1$/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. Methods: We obtained the age, gender, height, weight, $FEV_1$, FVC, and $FEV_1$/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the $FEV_1$/FVC' was evaluated in reference to the $5^{th}$ percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. Results: 1) The sensitivity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. Conclusion: The sensitivity and specificity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.54-61
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• 2005

Purpose: The granulocytic sarcoma which developed in leukemic patients are quite rare and it will have bad prognosis, but it's tumor pathogenesis and also their treatment are not yet established. Through this study we have tried to know their clinical course, prognosis and their end result of recent treatment. Material and Methods: Total 20 patients of granulocytic sarcoma which were developed in total 2,197 leukemic patients from April, 1998 to September, 2004 were treated at the leukemic center and the orthopaedic department of St. Mary's hospital, Catholic University of Korea, and followed them for 1~78 months(average 18 months). Results: Total 20 cases of granulocytic sarcoma was found in 14 cases of total 1,331 acute myelocytic leukemic patients(AML), 4 cases of total 744 of chronic myelocytic leukemic patients(CML), and only one case in total 122 of acute biphenotype of leukemia. And so their occurrence rate in leukmic patients are actually 0.91%, total 20 cases of granulocytic sarcoma in total 2,197 leukemic patients at same period. Their ages are average 28.3 years(4~52 years), and male are predominant(13 cases) than female(7 cases). Single involvement was found in 11 cases but multiple lesions are in 9 cases, and spine, brain, extremities, chest, and pelvic bone are involved in frequency. The granulocytic sarcoma was developed in various stages of the leukemia, ie, 8 cases in complete remission of leukemia, and 12 cases in the treatment process of AML. The pathohistologic evaluation of granulocytic sarcoma was done in 6 cases which was developed in their extremities, and confirmed numerous immature myeloblasts and lymphocytes mixed. The treatment of these granulocytic sarcoma was mainly limited for the treatment of leukemia by Glivac and massive steroid therapy(19cases) and also combined with the bone marrow transplantation(13 cases), but radiation therapy with average 3,500 rads in 15 cases out of total 20 sarcomas was also done, and followed them for average 17.5 months after development of granulocytic sarcomas. Finally their prognosis was so bad that 12 patients(60%) out of total 20 granulocytic sarcoma were dead in 6.5 months after sarcoma developed and we found the granulocytic sarcoma was more fatal if they are developed during the process of CML(mortality: 100%(4/4cases). Conclusion: The prognosis of granulocytic sarcomas in leukemic patients are quite fatal, and much more studies for their pathogenesis and ways of treatment should be performed continuously.

• The Korean Journal of Air & Space Law and Policy
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• v.29 no.2
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• pp.109-134
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• 2014

Regulation (EC) No 261/2004 of the European Parliament and of the Council of 11 February 2004 establishing common rules on compensation of assistance to passengers in the event of denied boarding and of cancellation or long delay of flights (Regulation No 261/2004) provides extra protection to air passengers in circumstances of denied boarding, cancellation and long-delay. The Regulation intends to provide a high level of protection to air passengers by imposing obligations on air carriers and, at the same time, offering extensive rights to air passengers. If denied boarding, cancellation and long-delay are caused by reasons other than extraordinary circumstances, passengers are entitled for compensation under Article 7 of Regulation No 261/2004. In Wallentin-Hermann v Alitalia-Linee Aeree Italiane SpA(Case C-549/07, [2008] ECR I-11061), the Court did, however, emphasize that this does not mean that it is never possible for technical problems to constitute extraordinary circumstances. It cited specific examples of where: an aircraft manufacturer or competent authority revealed that there was a hidden manufacturing defect on an aircraft which impacts on safety; or damage was caused to an aircraft as a result of an act of sabotage or terrorism. Such events are not inherent in the normal exercise of the activity of the air carrier concerned and is beyond the actual control of that carrier on account of its nature or origin. One further point arising out of the court's decision is worth mentioning. It is not just necessary to satisfy the extraordinary circumstances test for the airline to be excused from paying compensation. It must also show that the circumstances could not have been avoided even if all reasonable measures had been taken. It is clear from the language of the Court's decision that this is a tough test to meet: the airline will have to establish that, even if it had deployed all its resources in terms of staff or equipment and the financial means at its disposal, it would clearly not have been able - unless it had made intolerable sacrifices in the light of the capacities of its undertaking at the relevant time - to prevent the extraordinary circumstances with which it was confronted from leading to the cancellation of the flight.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.32-42
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• 1996

Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.