• Title/Summary/Keyword: critical evidence

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Lack of Association between Inhaled Corticosteroid Use Based on the Exhaled Nitric Oxide and Acute Exacerbation of Chronic Obstructive Pulmonary Disease

  • Bo-Guen Kim;Sun Hye Shin;Jung-Wan Yoo;Yong Suk Jo;Hye Yun Park
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.329-337
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    • 2024
  • Background: Fractional exhaled nitric oxide (FeNO) is known to useful biomarker for detecting eosinophilic airway inflammation. However, there is a lack of evidence regarding the role of FeNO in chronic obstructive pulmonary disease (COPD). We aimed to assess whether elevated FeNO and its impact on treatment change into an inhaled corticosteroid (ICS)-containing regimen and association with acute exacerbation (AE) in patients with COPD. Methods: We retrospectively analyzed 107 COPD patients without a history of asthma from March 2016 to December 2019. The patients whose FeNO value was more than 50 parts per billion (ppb) were defined into the high FeNO group. Multivariable analysis with logistic regression was used to identify factors associated with AE in COPD. Results: The median FeNO value was 32 ppb (interquartile range, 19 to 45) and 34 (20.0%) patients were classified as high FeNO group (median 74 ppb). In the high FeNO group, changes in inhaler treatment into an ICS-containing regimen occurred in 23 of 34 patients after the measurement of FeNO. In multivariate analysis, high FeNO was not a contributing factor for AE, but only the high blood eosinophil count (≥300 cells/µL) was associated with AE (adjusted odds ratio, 2.63; 95% confidence interval, 1.01 to 6.91; p=0.049). Conclusion: High FeNO value had a significant impact on the prescription of ICSs in COPD patients, but it did not show a significant association with AE either on its own or with changes in treatment.

Bronchoscopic Findings of Pulmonary Paragonimiasis

  • Jeon, Kyeongman;Song, Jae-Uk;Um, Sang-Won;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kwon, O Jung;Han, Joungho;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.512-516
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    • 2009
  • Background: Pulmonary paragonimiasis is a subacute to chronic inflammatory disease of the lung caused by lung flukes that result in prolonged inflammation and mechanical injury to the bronchi. However, there are few reports on the bronchoscopic findings of pulmonary paragonimiasis. This report describes the bronchoscopic findings of pulmonary paragonimiasis. Methods: The bronchosocpic findings of 30 patients (20 males, median age 50 years) with pulmonary paragonimiasis between May 1995 and December 2007 were reviewed retrospectively. Results: The diagnoses were based on a positive serologic test results for Paragonimus-specific antibodies in 13 patients (43%), or the detection of Paragonimus eggs in the sputum, bronchial washing fluid, or lung biopsy specimens in 17 patients (57%). The bronchoscopic examinations revealed endobronchial lesions in 17 patients (57%), which were located within the segmental bronchi in 10 patients (59%), lobar bronchi in 6 patients (35%) and main bronchi in 1 patient (6%). The bronchoscopic characteristics of endobronchial lesions were edematous swelling of the mucosa (16/17, 94%) and mucosal nodularity (4/17, 24%), accompanied by bronchial stenosis in 16 patients (94%). Paragonimus eggs were detected in the bronchial washing fluid of 9 out of the 17 patients with endobronchial lesions. The bronchial mucosal biopsy specimens showed evidence of chronic inflammation with eosinophilic infiltration in 6 out of 11 patients (55%). However, no adult fluke or ova were found in the bronchial tissue. Conclusion: Bronchial stenosis with mucosal changes including edematous swelling and mucosal nodularity is the most common bronchoscopic finding of pulmonary paragonimiasis.

Review of Sarcoidosis in a Province of South Korea from 1996 to 2014

  • Kim, Min-Seok;Park, Cheol-Kyu;Shin, Hong-Joon;Seo, Hyeong-Won;Chang, Jinsun;Ahn, Seong;Kim, Tae-Ok;Lim, Jung-Hwan;Oh, In-Jae;Kwon, Yong-Soo;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.291-295
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    • 2017
  • Background: Since the introduction of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods: The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results: Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion: Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.

A Case of Primary Choriocarcinoma of the Lung (원발성 폐 융모막암종 1예)

  • Cho, Young-Jae;Lee, Sei Won;Lee, Sang Min;Yim, Jae-Joon;Yoo, Chul-Gyu;Han, Sung Koo;Shim, Young-Soo;Kim, Young Whan
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.578-584
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    • 2006
  • A primary choriocarcinoma of the lung is extremely rare, and difficult to distinguish from a metastatic choriocarcinoma considering that the lung is also one of the most frequent sites of metastasis. We report a 28-year-old woman patient who was initially misdiagnosed with an ectopic pregnancy and was operated on under the impression of an unidentified malignancy of the lung, which was finally proven to be a choriocarcinoma of the lung. A pelvic examination by a gynecologist, pelvic magnetic resonance imaging and whole body fluorodeoxyglucose positron emission tomography-computed tomography was performed in order to rule out a metastatic choriocarcinoma of the lung. After a curative operation, her serum ${\beta}$-human chorionic gonadotropin (HCG) level, which was highly elevated in the initial evaluation, had decreased dramatically to the normal range. She is currently being followed up regularly without any evidence of recurrence or elevation of her ${\beta}$-HCG level.

Clinical Effect of Traditional Chinese Medicine Shenhuang Granule in Critically Ill Patients with COVID-19: A Single-Centered, Retrospective, Observational Study

  • Feng, Jun;Fang, Bangjiang;Zhou, Daixing;Wang, Junshuai;Zou, Dengxiu;Yu, Gang;Fen, Yikuan;Peng, Dan;Hu, Jifa;Zhan, Daqian
    • Journal of Microbiology and Biotechnology
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    • v.31 no.3
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    • pp.380-386
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    • 2021
  • The coronavirus disease 2019 (COVID-19) pandemic has become a public health emergency of global concern. In China, traditional Chinese medicine has been widely administered to COVID-19 patients without sufficient evidence. To evaluate the efficacy of Shenhuang Granule (SHG) for treating critically ill patients with COVID-19, we included in this study 118 patients who were admitted to the ICU of Tongji Hospital between January 28, 2020 and March 28, 2020. Among these patients, 33 (27.9%) received standard care plus SHG (treatment group) and 85 (72.1%) received standard care alone (control group). Enrolled patients had a median (IQR) age of 68 (57-75) years, and most (79 [67.1%]) were men. At end point of this study, 83 (70.3%) had died in ICU, 29 (24.5%) had been discharged from ICU, and 6 patients (5.2%) were still in ICU. Compared with control group, mortality was significantly lower in treatment group (45.4% vs. 80%, p < .001). Patients in treatment group were less likely to develop acute respiratory distress syndrome (ARDS) (12 [36.3%] vs. 54 [63.5%], p = 0.012) and cardiac injury (5 [15.1%] vs. 32 [37.6%], p = 0.026), and less likely to receive mechanical ventilation (22 [66.7%] vs. 72 [84.7%], p = 0.028) than those in control group. The median time from ICU admission to discharge was shorter in treatment group (32 [20-73] days vs. 76 [63-79] days, p = 0.0074). These findings suggest that SHG treatment as a complementary therapy might be effective for critically ill adults with COVID-19 and warrant further clinical trials.

Inhibition of Store-Operated Calcium Entry Protects Endothelial Progenitor Cells from H2O2-Induced Apoptosis

  • Wang, Yan-Wei;Zhang, Ji-Hang;Yu, Yang;Yu, Jie;Huang, Lan
    • Biomolecules & Therapeutics
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    • v.24 no.4
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    • pp.371-379
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    • 2016
  • Store-operated calcium entry (SOCE), a major mode of extracellular calcium entry, plays roles in a variety of cell activities. Accumulating evidence indicates that the intracellular calcium ion concentration and calcium signaling are critical for the responses induced by oxidative stress. The present study was designed to investigate the potential effect of SOCE inhibition on $H_2O_2$-induced apoptosis in endothelial progenitor cells (EPCs), which are the predominant cells involved in endothelial repair. The results showed that $H_2O_2$-induced EPC apoptosis was reversed by SOCE inhibition induced either using the SOCE antagonist ML-9 or via silencing of stromal interaction molecule 1 (STIM1), a component of SOCE. Furthermore, SOCE inhibition repressed the increases in intracellular reactive oxygen species (ROS) levels and endoplasmic reticulum (ER) stress and ameliorated the mitochondrial dysfunction caused by $H_2O_2$. Our findings provide evidence that SOCE inhibition exerts a protective effect on EPCs in response to oxidative stress induced by $H_2O_2$ and may serve as a potential therapeutic strategy against vascular endothelial injury.

A Review of Scientific Evidence on Indoor Air of School Building: Pollutants, Sources, Health Effects and Management

  • Chithra, V.S;Shiva, Nagendra S.M
    • Asian Journal of Atmospheric Environment
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    • v.12 no.2
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    • pp.87-108
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    • 2018
  • Schools are one of the critical social infrastructures in a society, the first place for social activity and the most important indoor environment for children besides the home. Poor IAQ in classrooms can increase the chance of long-term and short-term health problems for students and staffs; affects productivity of teachers; and degrade the student learning environment and comfort levels. The primary objective of this paper is to review and summarize available scientific evidence on indoor air quality of schools and related health effects in children. It was found that the indoor air pollutant levels in school buildings varied over a wide range in different parts of the world depending on site characteristics, climatic conditions, outdoor pollution levels, occupant activities, ventilation type and building practices. Among the indoor air pollutants, particulate matter concentrations were found to be very high in many schools. Outdoor pollutant sources also play a major role in affecting the IAQ of the school building. Hence, scientific knowledge on sources of indoor pollutants, quantification of emissions, temporal and spatial dispersion of pollutants, toxicological properties, chemical and morphological characteristics of the pollutants and associated health risk among children in the school buildings are essential to evaluate the adequacy and cost effectiveness of control strategies for mitigating the IAQ issues.

Chronic Infections of the Urinary Tract and Bladder Cancer Risk: a Systematic Review

  • Anderson-Otunu, Oghenetejiri;Akhtar, Saeed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3805-3807
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    • 2016
  • Literature on the relationship between recurrent urinary tract infections and urinary bladder carcinoma risk has been inconsistent. Therefore, we carried out this systematic review of observational studies to ascertain if there is any association between chronic urinary tract infection and urinary bladder carcinoma. A total of 10 databases were searched using Boolean: CINAHL, PUBMED, Google Scholar, Medline, Science Direct, SCIRUS, Cochrane, UK PubMed central, NHS evidence and WHO-website. The search yielded an initial hit of 3,518 articles and after screening and critical appraisal, seven studies were included for this review. Four articles reported an association between chronic urinary tract infections and bladder cancer while three concluded a weak or no association at least in one gender. Main findings in this review were that most of the studies reported an association between chronic urinary tract infections and bladder cancer risk. However, inferences about the causal association between chronic urinary tract infections and bladder cancer risk should be drawn cautiously considering the methodological limitations of case-control studies included in this review. Therefore, more empirical evidence is needed to determine the causal nature of relationships between chronic urinary tract infections and bladder cancer risk.

SPaRe: Efficient SQLite Recovery Using Database Schema Patterns

  • Lee, Suchul;Lee, Sungil;Lee, Jun-Rak
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.11 no.3
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    • pp.1557-1569
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    • 2017
  • In recent times, the Internet of Things (IoT) has rapidly emerged as one of the most influential information and communication technologies (ICT). The various constituents of the IoT together offer novel technological opportunities by facilitating the so-called "hyper-connected world." The fundamental tasks that need to be performed to provide such a function involve the transceiving, storing, and analyzing of digital data. However, it is challenging to handle voluminous data with IoT devices because such devices generally lack sufficient computational capability. In this study, we examine the IoT from the perspective of security and digital forensics. SQLite is a light-weight database management system (DBMS) used in many IoT applications that stores private information. This information can be used in digital forensics as evidence. However, it is difficult to obtain critical evidence from IoT devices because the digital data stored in these devices is frequently deleted or updated. To address this issue, we propose Schema Pattern-based Recovery (SPaRe), an SQLite recovery scheme that leverages the pattern of a database schema. In particular, SPaRe exhaustively explores an SQLite database file and identifies all schematic patterns of a database record. We implemented SPaRe on an iPhone 6 running iOS 7 in order to test its performance. The results confirmed that SPaRe recovers an SQLite record at a high recovery rate.

Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

  • Chang, Young Pyo
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.101-109
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    • 2014
  • The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.