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Role of PI3K/Akt Pathway in the Activation of IκB/NF-κB Pathway in Lung Epithelial Cells (폐 상피세포에서 PI3K/Akt 경로가 IκB/NF-κB 경로의 활성화에 미치는 영향)

  • Lee, Sang-Min;Kim, Yoon Kyung;Hwang, Yoon-Ha;Lee, Chang-Hoon;Lee, Hee-Seok;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.551-562
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    • 2003
  • Background : NF-${\kappa}B$ is a characteristic transcriptional factor which has been shown to regulate production of acute inflammatory mediators and to be involved in the pathogenesis of many inflammatory lung diseases. There has been some evidence that PI3K/Akt pathway could activate NF-${\kappa}B$ in human cell lines. However, the effect of PI3K/Akt pathway on the activation of NF-${\kappa}B$ varied depending on the cell lines used in the experiments. In this study we evaluated the effect of PI3K/Akt pathway on the activation of NF-${\kappa}B$ in human respiratory epithelial cell lines. Methods : BEAS-2B, A549 and NCI-H157 cell lines were used in this experiment. To evaluate the activation of Akt activation and I${\kappa}B$ degradation, cells were analysed by western blot assay using phospho-specific Akt Ab and $I{\kappa}B$ Ab. To block PI3K/Akt pathway, cells were pretreated with wortmannin or LY294002 and transfected with dominant negative Akt (DN-Akt). For IKK activity, immune complex kinase assay was performed. To evaluate the DNA binding affinity and transcriptional activity of NF-${\kappa}B$, electrophoretic mobility shift assay (EMSA) and luciferase assay were performed, respectively. Results : In BEAS-2B, A549 and NCI-H157 cell lines, Akt was activated by TNF-$\alpha$ and insulin. Activation of Akt by insulin did not induce $I{\kappa}B{\alpha}$ degradation. Blocking of PI3K/Akt pathway via wortmannin/LY294002 or DN-Akt did not inhibit TNF-$\alpha$-induced $I{\kappa}B{\alpha}$ degradation or IKK activation. Inhibition of PI3K/Akt did not affect TNF-$\alpha$-induced NF-${\kappa}B$ activation. Overexpression of DN-Akt did not block TNF-$\alpha$-induced transcriptional activation of NF-${\kappa}B$, but wortmannin enhanced TNF-$\alpha$-induced in NF-${\kappa}B$ transcriptional activity. Conclusion : PI3K/Akt was not involved in TNF-$\alpha$-induced $I{\kappa}B{\alpha}$ degradation or transcriptional activity of NF-${\kappa}B$ in human respiratory epithelial cell lines.

Development of Formulas for the Estimation of Renal Depth and Application in the Measurement of Glomerular Filtration Rate in Koreans (사구체 여과율 측정을 위한 한국인의 신장 깊이에 관한 방정식 도출과 이용)

  • Yoo, Ie-Ryung;Kim, Sung-Hoon;Chung, Yong-An;Jung, Hyun-Seok;Lee, Hae-Giu;Park, Young-Ha;Lee, Sung-Yong;Sohn, Hyung-Seon;Chung, Soo-Kyo;Kim, Hyun-Mi;Lee, Hyung-Goo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.418-425
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    • 2000
  • Purpose: There is no established formula for estimating renal depths in Korean. As a result, we undertook this study to develop a new formula, and to apply this formula in the calculation of glomerular filtration rate (GFR). Materials and Methods: We measured the renal depth (RD) on the abdominal CT obtained in 300 adults (M:F: 167:133, mean age 50.9 years) without known renal diseases. The RDs measured by CT were compared with the estimated RDs based on the Tonnesen and Taylor equations. New formulas were derived from the measured RDs in 200 out of 300 patients based on several variables such as sex, age, weight, and height by multiple regression analysis. The RDs estimated from the new formulas were compared with the measured RDs in the remaining 100 patients as a control. In 48 patients who underwent Tc-99m DTPA renal scintigraphy, GFR was measured with three equations (new formula, Tonnesen and Taylor equations), respectively, and compared with each other. Results: The mean values of the RDs measured from CT were 6.9 cm for right kidney of the men (MRK), 6.7 cm for left kidney of the men (MLK), 6.7 cm for right kidney of the women (WRK), and 6.6 cm for left kidney of the women (WLK). The RDs estimated from Tonnesen equation were shorter than the ones measured from CT significantly. The newly derived formulas were 12.813 (weight/height)+0.002 (age)+ 2.264 for MRK, 15.344 (weight/height)+0.011 (age)+0.557 for MLK, 12.936 (weight/height)+ 0.014 (age)+1.462 for WRK and 13.488 (weight/height)+0.019 (age)+0.762 for WLK. The correlation coefficients of the RD measured from CT and estimated from the new formula were 0.529 in MRK, 0.729 in MLK, 0.601 in WRK, and 0.724 in WLK, respectively. The GFRs from the new formula were significantly higher than those from the Tonnesen equation significantly, which was the most similar to normal GFR values. Conclusion: We generated new formulas for estimating RD in Korean from the data by CT. By adopting these formulas, we expect that GFR can be measured by the Gates method accurately in Korean.

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The Usefulness of Mammography and Scintimammography in Differential Diagnosis of Breast Tumor (유방 종괴에서 악성 감별을 위한 유방촬영술과 유방스캔의 유용성 연구)

  • Kang, Bong-Joo;Chung, Young-An;Jung, Hyun-Seok;Jung, Jung-Im;Yoo, Ie-Ryung;Kim, Sung-Hoon;Sohn, Hyung-Sun;Chung, Soo-Kyo;Hahn, Seong-Tai;Lee, Jae-Mun
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.492-497
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    • 2004
  • Purpose: it is very important to differentiate breast cancer from benign mass. There are many reports to evaluate the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings. Materials and Methods: This study included 80 patients (a8e: 24-72, mean: 48.4) who underwent mammography and Tc-99m MIBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections) were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MIBI. four specialists in diagnostic radioloay and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and we statistically analyzed the correlations between pathologic results and imaging findings under the mammography and Tc-99m MIBI scintimammography by chi-square and correlation test. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%, 75.0%), and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively. The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean T/B ratio in 10 minutes was $1.409{\pm}0.30$, and that in 2 hours was $1.267{\pm}0.42$. The maximal T/B ratio of benign mass in 10 minutes was $1.604{\pm}0.42$, and that in 2 hours was $1.476{\pm}0.50$. In the malignant mass, the mean T/B ratio in 10 minutes was $2.220{\pm}1.07$, and that in 2 hours was $1.842{\pm}0.75$. The maximal T/B ratio of malignant mass was $2.993{\pm}1.94$, and that in 2 hours was $2.480{\pm}1.34$. And the T/B ratio under the early and delayed images were meaningful. Conclusion: The scintimammography is useful diagnostic tool to differentiate breast cancer from benign mass, although the sensitivity of mammography for detection of breast mass is high. Especially, the use of the T/B ratio is helpful to diagnose breast cancer.

Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging (급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측)

  • Choi, Joon-Young;Yang, You-Jung;Choi, Seung-Jin;Yeo, Jeong-Seok;Park, Seong-Wook;Song, Jae-Kwan;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.219-228
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    • 2003
  • Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

Usefulness of Troponin-I, Lactate, C-reactive protein as a Prognostic Markers in Critically Ill Non-cardiac Patients (비 순환기계 중환자의 예후 인자로서의 Troponin-I, Lactate, C-reactive protein의 유용성)

  • Cho, Yu Ji;Ham, Hyeon Seok;Kim, Hwi Jong;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.562-569
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    • 2005
  • Background : The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. Methods : From September 2003 to June 2004, 139 patients(Age: $63.3{\pm}14.7$, M:F = 88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health EvaluationII, Simplified Acute Physiologic ScoreII and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. Results : There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day($1.018{\pm}2.58ng/ml$, $98.48{\pm}69.24mg/L$ vs. $4.208{\pm}10.23ng/ml$, $137.69{\pm}70.18mg/L$) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day ($0.99{\pm}2.66ng/ml$, $8.02{\pm}9.54ng/dl$, $96.87{\pm}68.83mg/L$ vs. $3.36{\pm}8.74ng/ml$, $15.42{\pm}20.57ng/dl$, $131.28{\pm}71.23mg/L$) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score($r^2=0.254$, 0.365, p<0.05). Conclusion : Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.

The Ontology Based, the Movie Contents Recommendation Scheme, Using Relations of Movie Metadata (온톨로지 기반 영화 메타데이터간 연관성을 활용한 영화 추천 기법)

  • Kim, Jaeyoung;Lee, Seok-Won
    • Journal of Intelligence and Information Systems
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    • v.19 no.3
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    • pp.25-44
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    • 2013
  • Accessing movie contents has become easier and increased with the advent of smart TV, IPTV and web services that are able to be used to search and watch movies. In this situation, there are increasing search for preference movie contents of users. However, since the amount of provided movie contents is too large, the user needs more effort and time for searching the movie contents. Hence, there are a lot of researches for recommendations of personalized item through analysis and clustering of the user preferences and user profiles. In this study, we propose recommendation system which uses ontology based knowledge base. Our ontology can represent not only relations between metadata of movies but also relations between metadata and profile of user. The relation of each metadata can show similarity between movies. In order to build, the knowledge base our ontology model is considered two aspects which are the movie metadata model and the user model. On the part of build the movie metadata model based on ontology, we decide main metadata that are genre, actor/actress, keywords and synopsis. Those affect that users choose the interested movie. And there are demographic information of user and relation between user and movie metadata in user model. In our model, movie ontology model consists of seven concepts (Movie, Genre, Keywords, Synopsis Keywords, Character, and Person), eight attributes (title, rating, limit, description, character name, character description, person job, person name) and ten relations between concepts. For our knowledge base, we input individual data of 14,374 movies for each concept in contents ontology model. This movie metadata knowledge base is used to search the movie that is related to interesting metadata of user. And it can search the similar movie through relations between concepts. We also propose the architecture for movie recommendation. The proposed architecture consists of four components. The first component search candidate movies based the demographic information of the user. In this component, we decide the group of users according to demographic information to recommend the movie for each group and define the rule to decide the group of users. We generate the query that be used to search the candidate movie for recommendation in this component. The second component search candidate movies based user preference. When users choose the movie, users consider metadata such as genre, actor/actress, synopsis, keywords. Users input their preference and then in this component, system search the movie based on users preferences. The proposed system can search the similar movie through relation between concepts, unlike existing movie recommendation systems. Each metadata of recommended candidate movies have weight that will be used for deciding recommendation order. The third component the merges results of first component and second component. In this step, we calculate the weight of movies using the weight value of metadata for each movie. Then we sort movies order by the weight value. The fourth component analyzes result of third component, and then it decides level of the contribution of metadata. And we apply contribution weight to metadata. Finally, we use the result of this step as recommendation for users. We test the usability of the proposed scheme by using web application. We implement that web application for experimental process by using JSP, Java Script and prot$\acute{e}$g$\acute{e}$ API. In our experiment, we collect results of 20 men and woman, ranging in age from 20 to 29. And we use 7,418 movies with rating that is not fewer than 7.0. In order to experiment, we provide Top-5, Top-10 and Top-20 recommended movies to user, and then users choose interested movies. The result of experiment is that average number of to choose interested movie are 2.1 in Top-5, 3.35 in Top-10, 6.35 in Top-20. It is better than results that are yielded by for each metadata.

The Effects of Pergola Wisteria floribunda's LAI on Thermal Environment (그늘시렁 Wisteria floribunda의 엽면적지수가 온열환경에 미치는 영향)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.6
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    • pp.115-125
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    • 2017
  • This study was to investigate the user's thermal environments under the pergola($L\;7,200{\times}W\;4,200{\times}H\;2,700mn$) covered with Wisteria floribunda(Willd.) DC. according to the variation of leaf area index(LAI). We carried out detailed measurements with two human-biometeorological stations on a popular square Jinju, Korea($N35^{\circ}10^{\prime}59.8^{{\prime}{\prime}}$, $E\;128^{\circ}05^{\prime}32.0^{{\prime}{\prime}}$, elevation: 38m). One of the stations stood under a pergola, while the other in the sun. The measurement spots were instrumented with microclimate monitoring stations to continuously measure air temperature and relative humidity, wind speed, shortwave and longwave radiation from the six cardinal directions at the height of 0.6m so as to calculate the Universal Thermal Climate Index(UTCI) from $9^{th}$ April to $27^{th}$ September 2017. The LAI was measured using the LAI-2200C Plant Canopy Analyzer. The analysis results of 18 day's 1 minute term human-biometeorological data absorbed by a man in sitting position from 10am to 4pm showed the following. During the whole observation period, daily average air temperatures under the pergola were respectively $0.7{\sim}2.3^{\circ}C$ lower compared with those in the sun, daily average wind speed and relative humidity under the pergola were respectively 0.17~0.38m/s and 0.4~3.1% higher compared with those in the sun. There was significant relationship in LAI, Julian day number and were expressed in the equation $y=-0.0004x^2+0.1719x-11.765(R^2=0.9897)$. The average $T_{mrt}$ under the pergola were $11.9{\sim}25.4^{\circ}C$ lower and maximum ${\Delta}T_{mrt}$ under the pergola were $24.1{\sim}30.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average $T_{mrt}$ compared with those in the sun and was expressed in the equation $y=0.0678{\ln}(x)+0.3036(R^2=0.9454)$. The average UTCI under the pergola were $4.1{\sim}8.3^{\circ}C$ lower and maximum ${\Delta}UTCI$ under the pergola were $7.8{\sim}10.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average UTCI compared with those in the sun and were expressed in the equation $y=0.0322{\ln}(x)+0.1538(R^2=0.8946)$. The shading by the pergola covered with vines was very effective for reducing daytime UTCI absorbed by a man in sitting position at summer largely through a reduction in mean radiant temperature from sun protection, lowering thermal stress from very strong(UTCI >$38^{\circ}C$) and strong(UTCI >$32^{\circ}C$) down to strong(UTCI >$32^{\circ}C$) and moderate(UTCI >$26^{\circ}C$). Therefore the pergola covered with vines used for shading outdoor spaces is essential to mitigate heat stress and can create better human thermal comfort especially in cities during summer. But the thermal environments under the pergola covered with vines during the heat wave supposed to user "very strong heat stress(UTCI>$38^{\circ}C$)". Therefore users must restrain themselves from outdoor activities during the heat waves.

A Study on the Yousang-Dae Goksuro(Curve-Waterway) in Gangneung, Yungok-Myun, Yoodung Ri (강릉 연곡면 유등리 '유상대(流觴臺)' 곡수로(曲水路)의 조명(照明))

  • Rho, Jae-Hyun;Shin, Sang-Sup;Lee, Jung-Han;Huh, Jun;Park, Joo-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.14-21
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    • 2012
  • The object of the study, Yousang-Dae(流觴臺) and engraved Go broad text on the flat rock in Gangneung-si Yungok-myun Yoodung-ri Baemgol, reveals that the place was for appreciating arts like Yusang Goksu and Taoist hermit's games. three times of detail reconnaissance survey brought about the results as follows. There is a the text, Manwolsan(滿月山) Baegundongcheon(白雲洞天), engraved on the rock in Baegunsa(白雲寺) that had been built by Doun at the first year of King Hungang(in 875) of the United Shilla, became in ruins in the middle of Joseon, and then was rebuilt in 1954. The text is an invaluable evidence indicating that the tradition of Taoist hermit and Sunbee(classical scholars) culture has been generated in Baemgol Valley. According to the 2nd vol. of Donghoseungram(東湖勝覽), the chronicle of Gangneung published by Choi Baeksoon in 1934, there is a record saying that 'Baegunsa in Namjeonhyeon is the classroom where famous teachers like Yulgok Lee Yi or Seongje Choi Ok were teaching' that verifies the historic property of the place. In addition, the management of Nujeong(樓亭) and Dongcheon can be traced through Baegunjeong(白雲亭) constructed by Kim Yoonkyung(金潤卿) in Muo year, the 9th year of Cheoljong(1858) according to Donghoseungram and the completed version of Jeungboyimyoungji(增補臨瀛誌). Also, Baegundongdongcheon(白雲亭洞天), the text engraved on the standing stone across the stream from Yousang-Dae stone, was created 3 years after the Baegunjeong construction in the 12th year of Cheoljong(1861), which refers a symbolic sign closely related with Yousang-Dae. Based on this premise and circumstance, with careful studying the remains of 'Yusang-dae' Goksuro, we discovered that the Sebun-seok(細分石) controling the amount and the speed of moving water and the remains of furrows of Keumbae-soek(擒盃石) and Yubae-gong(留盃孔) containing water stream with cups through the mountain stream and rocks around Yusang-Dae. In addition, as 21 people's names engraved under the statement of 'Oh-Seong(午星)' were discovered on the bottom of the rock, this clearly confirms that the place was one of the main cultural footholds of tasting the arts which have characteristics of Yu-Sang-Gok-Su-Yeon(流觴曲水宴) until the middle of the 20th century. It implies that the arts tasting culture of Sunbees had been inherited centering on Yusang-dae in this particular place until the middle of the 20th century. It is necessary to be studied in depth because the place is a historic and unique cultural place where 'Confucianism, Buddhism, and Zen'were combined together. Based on the result of the study, the identification of 23 people as well as the writer of Yusang-Dae text should be carefully studied in depth in terms of the characteristics of the place through gathering data about appreciation of arts like Yusanggoksu. Likewise, we should make efforts to discover the chess board engraved on the rock described on the documents, thus we should consider to establish plans to recover the original shape of the place, for example, breaking the cement pavement of the road, additional excavation, changing the existing route, and so fourth.

Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암에 대한 기관지 소매 절제술의 성적)

  • Kim, Dae-Hyun;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Cho, Kyu-Seok;Kwak, Young-Tae;Hwang, En-Gu;Kim, Dong-Won;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.37-44
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    • 2007
  • Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.

Changes of Brain Natriuretic Peptide Levels according to Right Ventricular HemodynaMics after a Pulmonary Resection (폐절제술 후 우심실의 혈역학적 변화에 따른 BNP의 변화)

  • Na, Myung-Hoon;Han, Jong-Hee;Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Choi, Jae-Sung;Yoon, Seok-Hwa;Choi, Si-Wan
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.593-599
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    • 2007
  • Background: The correlation between levels of brain natriuretic peptide (BNP) and the effect of pulmonary resection on the right ventricle of the heart is not yet widely known. This study aims to assess the relationship between the change in hemodynamic values of the right ventricle and increased BNP levels as a compensatory mechanism for right heart failure following pulmonary resection and to evaluate the role of the BNP level as an index of right heart failure after pulmonary resection. Material and Method: In 12 non small cell lung cancer patients that had received a lobectomy or pnemonectomy, the level of NT-proBNP was measured using the immunochemical method (Elecsys $1010^{(R)}$, Roche, Germany) which was compared with hemodynamic variables determined through the use of a Swan-Garz catheter prior to and following the surgery. Echocardiography was performed prior to and following the surgery, to measure changes in right ventricular and left ventricular pressures. For statistical analysis, the Wilcoxon rank sum test and linear regression analysis were conducted using SPSSWIN (version, 11.5). Result: The level of postoperative NT-proBNP (pg/mL) significantly increased for 6 hours, then for 1 day, 2 days, 3 days and 7 days after the surgery (p=0.003, 0.002, 0.002, 0.006, 0.004). Of the hemodynamic variables measured using the Swan-Ganz catheter, the mean pulmonary artery pressure after the surgery when compared with the pressure prior to surgery significantly increased at 0 hours, 6 hours, then 1 day, 2 days, and 3 days after the surgery (p=0.002, 0,002, 0.006, 0.007, 0.008). The right ventricular pressure significantly increased at 0 hours, 6 hours, then 1 day, and 3 days after the surgery (p=0.000, 0.009, 0.044, 0.032). The pulmonary vascular resistance index [pulmonary vascular resistance index=(mean pulmonary artery pressure-mean pulmonary capillary wedge pressure)/cardiac output index] significantly increased at 6 hours, then 2 days after the surgery (p=0.008, 0.028). When a regression analysis was conducted for changes in the mean pulmonary artery pressure and NT-proBNP levels after the surgery, significance was evident after 6 hours (r=0.602, p=0.038) and there was no significance thereafter. Echocardiography displayed no significant changes after the surgery. Conclusion: There was a significant correlation between changes in the mean pulmonary artery pressure and the NT-proBNP level 6 hours after a pulmonary resection. Therefore, it can be concluded that changes in NT-proBNP level after a pulmonary resection can serve as an index that reflects early hemodynamic changes in the right ventricle after a pulmonary resection.