OBJECTIVES: We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 exsmokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.
Adult ; Carbon Monoxide/*analysis/metabolism ; Cotinine/metabolism/*urine ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Sensitivity and Specificity ; Smoking/*metabolism/urine

OBJECTIVETo compare the distribution of heme oxygenase-2 and concentration of carbon monoxide in rat penile tissue of 8, 16 and 24 months and investigate the relationship between the system of HO-2/CO and aging.

METHODSUsing SABC immunohistochemistry staining, image analysis system and the method of carboxyhemoglobin standard curve, the distribution of heme oxygenase-2 and concentration of carbon monoxide in different month rat penile tissues were investigated.

RESULTSThe penile arteries were surrounded by HO-2 positive cells, which were also seen in the trabecular meshwork of smooth muscle. Compared with other part of penile, the penile arteries adventitia and the endothelial cells of cavernous exhibited darker staining. With the increasing of rat's living month the staining of penile tissues turned faint and the concentration of carbon monoxide in tissue decreased( P < 0.05 ). The imaging analysis system showed that the older the rat was the less HO-2 positive compositions contained (P < 0.05).

CONCLUSIONWith aging the decreasing concentration of HO-2 leads to the downfgt-regulation in rat penile tissue.

Aging ; metabolism ; Animals ; Carbon Monoxide ; analysis ; metabolism ; Down-Regulation ; Heme Oxygenase (Decyclizing) ; analysis ; metabolism ; Image Processing, Computer-Assisted ; Immunohistochemistry ; Male ; Penis ; chemistry ; metabolism ; Rats ; Rats, Wistar ; Staining and Labeling

AIMTo study the protective role of endogenous carbon monoxide to lung and kidney tissues during septic shock and its mechanism.

METHODSA rat model of CLP was built by using the method of CLP. The malondialdehyde (MDA) content and the activity of superoxide dematase (SOD) in blood, lung and kidney were detected by immunohistochemical technique and light microscope.

RESULTSPathological changes of lung and kidney in CLP + Hemin group were lighter than CLP group, inflammatory reaction and lipid peroxidation were also lighter.

CONCLUSIONEndogenous CO can protect lung and kidney from the oxidative injury. It can suppress in flammation and the oxidative injury caused by activated inflammatory cells, it is probably an important mechanism of its protective effects.

Animals ; Carbon Monoxide ; physiology ; Hemin ; pharmacology ; Kidney ; metabolism ; pathology ; Lipid Peroxidation ; Lung ; metabolism ; pathology ; Male ; Malondialdehyde ; analysis ; Rats ; Rats, Sprague-Dawley ; Shock, Septic ; metabolism ; pathology ; Superoxide Dismutase ; metabolism

To investigate the role of endogenous heme oxygenase (HO)/carbon monoxide (CO) system in the lung injury as assessed by lung histology, polymorphonuclear count, malondialdehyde content and wet-to-dry weight ratio following ischemia-reperfusion (I/R) of hind limbs, zinc protoporphyrin (ZnPP), an inhibitor of HO activity, was used, and the lung HO activity and blood carboxyhemoglobin (COHb) level were measured. The results showed that HO activity and COHb level were increased significantly and lung injury occurred after limb I/R. After administration of ZnPP, the lung injury was further aggravated while the HO activity and COHb level were significantly decreased. These findings suggest that upregulation of HO activity followed by subsequent CO production attenuates the lung injury induced by limb I/R in rats.
Animals ; Carbon Monoxide ; physiology ; Carboxyhemoglobin ; analysis ; Heme Oxygenase (Decyclizing) ; analysis ; physiology ; Hindlimb ; Lung Diseases ; etiology ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; complications ; metabolism

OBJECTIVETo investigate the role of endogenous carbon monoxide (CO) in hypoxia.

METHODSAfter rats were inhaled with hypoxic gases and the heme oxygenase inhibitor ZnPPIX was administered, we measured the CO levels in plasma, liver, lung and kidney. Meanwhile plasma cGMP levels were observed. Furthermore, we recorded the change of hemodynamic and blood gases.

RESULTSAcute mild hypoxia (10% O2) significantly increaed CO levels in plasma as well as liver, kidney and lung, while acute severe hypoxia (5% O2) significantly decreased CO levels in plasma as well as liver, kidney and lung. In addition, the former significantly elevated cGMP levels in plasma while the latter markedly reduced cGMP levels in plasma. The hemodynamic change occurred in accordance with the changes carbon monoxide.

CONCLUSIONOur results indicate, for the first time, that the endogenous carbon monoxide plays an important role in regulating the vessel tone during hypoxia.

Acute Disease ; Animals ; Blood Gas Analysis ; Carbon Monoxide ; blood ; metabolism ; Cyclic GMP ; blood ; Heme Oxygenase (Decyclizing) ; antagonists & inhibitors ; Hemodynamics ; Hypoxia ; metabolism ; physiopathology ; Kidney ; metabolism ; Liver ; metabolism ; Lung ; metabolism ; Rats ; Rats, Wistar

Carbon monoxide (CO), a metabolite of heme catalysis by heme oxygenase (HO), has been proposed to have anti-oxidative, anti-inflammatory and anti-apoptotic functions. Lipopolysaccharide (LPS)-induced lung injury (LI) is characterized by oxidative stress, inflammatory reaction and excessive pulmonary cell apoptosis. So we supposed that CO might have protection against LI. LI in rats was induced by intravenous injection of LPS (5 mg/kg). To observe the effect of CO inhalation, LI rats were exposed to 2.5 x 10(-4) (V/V) CO for 3 h. CO-induced changes of lung oxidative stress parameters, inflammatory cytokines, cell apoptosis, HO-1 expression and histology were examined. Results revealed that expressions of the tumor necrosis factor-alpha (TNF-alpha) and interlukin-6 (IL-6), activities of maleic dialdehyde (MDA) and myeloperoxidase (MPO), and cell apoptosis in LPS injection + CO inhalation group were (0.91+/-0.25) pg/mg protein, (0.64+/-0.05) pg/mg protein, (1.02+/-0.23) nmol/mg protein, (7.18+/-1.62) U/mg protein and (1.60+/-0.34)%, respectively, significantly lower than the corresponding values in LI group [(1.48+/-0.23) pg/mg protein, (1.16+/-0.26) pg/mg protein, (1.27+/-0.33) nmol/mg protein, (8.16+/-1.49) U/mg protein and (3.18+/-0.51) %, P<0.05]. Moreover, CO inhalation obviously increased the expressions of HO-1 and interlukin-10 (IL-10) and activity of superoxide dismutase (SOD) [(5.43+/-0.92), (0.26+/-0.07) pg/mg protein and (60.09+/-10.21) U/mg protein in LPS injection + CO inhalation group vs (3.08+/-0.82), (0.15+/-0.03) pg/mg protein and (50.98+/-6.88) U/mg protein in LI group, P<0.05]. LI was attenuated by CO inhalation. Our study demonstrates that inhalation of low concentration of CO protects lung against LPS-induced injury via anti-oxidant, anti-inflammation, anti-apoptosis and up-regulation of HO-1 expression.
Administration, Inhalation ; Animals ; Apoptosis ; drug effects ; Carbon Monoxide ; administration & dosage ; Carboxyhemoglobin ; analysis ; Cytokines ; biosynthesis ; Heme Oxygenase-1 ; genetics ; Lipopolysaccharides ; toxicity ; Lung ; drug effects ; metabolism ; pathology ; Male ; Oxidative Stress ; drug effects ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVEIn order to get the method to improve the salt resistance of seeds and seedlings for Cassia obtusbifolia under NaCl stress, seed germination and physiological characteristics of C. obtusifolia seedlings were studied.

METHODSeveral physiological indexes of C. obtusifolia seeds treated with exogenous carbon monoxide donor hematin under NaCl stress like the germination vigor, germination rate, germination index and vigor index were measured. And other indexes like the relative water content, the contents of photosynthetic pigment, chlorophyll fluorescence parameters, the contents of soluble sugar, protein and proline, malondialdehyde (MDA), the activities of superoxide (SOD), peroxidase (POD) and catalase (CAT) were also measured.

RESULTThe germination indexes of C. obtusifolia seeds under NaCl stress had been inhibited obviously. But after the treatment of hematin, every germination indexes were all increased. The result showed that the treatment of exogenous CO donor hematin obviously improved the germination vigor, germination rate, germination index and vigor index, increased the content of chlorophyll a, chlorophyll b, total chlorophyll, improved the photochemical efficiency of photosystem II (Fv/Fm), photochemical efficiency (Fv'/Fm'), PS II actual photochemical efficiency (phiPS II), photochemical quench coefficient (qP), decreased non-photochemical quenching coefficient (NPQ) and the content of malondialdehyde (MDA) , increased the relative water content of leaves and the content of soluble surge, protein and proline. Meanwhile, the results also indicated that CO improved the activities of superoxide (SOD), peroxidase (POD) and catalase (CAT). The effects of CO could be reversed when CO scavenger Hb is added.

CONCLUSIONExogenous CO donor hematin with appropriate concentration could significantly alleviate the damages to the seeds and seedlings of C. obtusifolia under NaCl stress and promote the salt resistance of the seeds and seedlings through improving the germination indexes, the photochemical efficiency and the antioxidase activities of the seedlings.

Carbohydrates ; analysis ; Carbon Monoxide ; metabolism ; Cassia ; drug effects ; growth & development ; metabolism ; Catalase ; metabolism ; Chlorophyll ; metabolism ; Germination ; drug effects ; physiology ; Hemin ; metabolism ; pharmacology ; Malondialdehyde ; metabolism ; Peroxidase ; metabolism ; Photosystem II Protein Complex ; metabolism ; Plant Proteins ; metabolism ; Proline ; metabolism ; Seedlings ; drug effects ; growth & development ; metabolism ; Seeds ; growth & development ; Sodium Chloride ; pharmacology ; Superoxide Dismutase ; metabolism ; Time Factors ; Water ; metabolism

BACKGROUNDSuccessful lung transplantation has been limited by the scarcity of donors. Brain death (BD) donors are major source of lung transplantation. Whereas BD process induces acute lung injury and aggravates lung ischemia reperfusion injury. Carbon monoxide (CO) inhalation at 50-500 parts per million (ppm) can ameliorate lung injury in several models. We examined in rats whether CO inhalation in BD donor would show favorable effects on lung grafts.

METHODSRats were randomly divided into 4 groups. In sham group, donor rats received insertion of a balloon catheter into the cranial cavity, but the balloon was not inflated. In BD-only group, donor rats were ventilated with 40% oxygen after BD confirmation. In BD+CO250 and BD+CO500 groups, donor rats inhaled, after BD confirmation, 250 ppm or 500 ppm CO for 120 minutes prior to lung procurement, and orthotopic lung transplantation was performed. The rats were sacrificed 120 minutes after the lung transplantation by exsanguination, and their blood and lung graft samples were obtained. A total of 8 rats fulfilling the criteria were included in each group.

RESULTSThe inhalation decreased the severity of lung injury in grafts from BD donors checked by histological examination. CO pretreatment reversed the aggravation of PaO2/FiO2 in recipients from BD donors. The CO inhalation down-regulated pro-inflammatory cytokines (TNF-alpha, IL-6) along with the increase of anti-inflammatory cytokine (IL-10) in recipient serum, and inhibited the activity of myeloperoxidase in grafts tissue. The inhalation significantly decreased cell apoptosis in lung grafts, inhibiting mRNA and protein expression of intercellular adhesion molecule-1 (ICAM-1) and caspase-3 in lung grafts. Further, the inhalation activated phosphorylation of p38 expression and inhibited phosphorylation of anti-extracellular signal-regulated kinase (ERK) expression in lung grafts. The effects of CO at 500 ppm were greater than those at 250 ppm.

CONCLUSIONSCO exerts potent protective effects on lung grafts from BD donor, exhibiting anti-inflammatory and anti-apoptosis functions by modulating the mitogen-activated protein kinase (MAPK) signal transduction.

Administration, Inhalation ; Animals ; Apoptosis ; Brain Death ; Carbon Monoxide ; administration & dosage ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; Inflammation ; prevention & control ; Intercellular Adhesion Molecule-1 ; analysis ; genetics ; Lung Transplantation ; methods ; Male ; Phosphorylation ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Tissue Donors ; p38 Mitogen-Activated Protein Kinases ; metabolism

The purpose of this study was to investigate risk factors of postoperative pneumonia (POP) after lung cancer surgery. The 417 lung cancer patients who underwent surgical resection in a tertiary referral hospital were included. Clinical, radiological and laboratory data were reviewed retrospectively. Male and female ratio was 267:150 (median age, 65 yr). The incidence of POP was 6.2% (26 of 417) and in-hospital mortality was 27% among those patients. By univariate analysis, age > or = 70 yr (P < 0.001), male sex (P = 0.002), ever-smoker (P < 0.001), anesthesia time > or = 4.2 hr (P = 0.043), intraoperative red blood cells (RBC) transfusion (P = 0.004), presence of postoperative complications other than pneumonia (P = 0.020), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 70% (P = 0.002), diffusing capacity of the lung for carbon monoxide < 80% predicted (P = 0.015) and preoperative levels of serum C-reactive protein > or = 0.15 mg/dL (P = 0.001) were related with risk of POP. Multivariate analysis showed that age > or = 70 yr (OR = 3.563, P = 0.014), intraoperative RBC transfusion (OR = 4.669, P = 0.033), the presence of postoperative complications other than pneumonia (OR = 3.032, P = 0.046), and FEV1/FVC < 70% (OR = 3.898, P = 0.011) were independent risk factors of POP. In conclusion, patients with advanced age, intraoperative RBC transfusion, postoperative complications other than pneumonia and a decreased FEV1/FVC ratio have a higher risk for pneumonia after lung cancer surgery.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; C-Reactive Protein/analysis ; Carbon Monoxide/metabolism ; Erythrocyte Transfusion ; Female ; Forced Expiratory Volume ; Hospital Mortality ; Humans ; Incidence ; Logistic Models ; Lung Neoplasms/pathology/*surgery ; Male ; Middle Aged ; Neoplasm Staging ; Odds Ratio ; Pneumonia/epidemiology/*etiology/mortality ; *Postoperative Complications ; Retrospective Studies ; Risk Factors ; Vital Capacity

Interstitial lung disease (ILD) is a major cause of death in patients with dermatomyositis (DM). This study was aimed to examine the utility of the erythrocyte sedimentation rate (ESR) as a predictor of ILD and prognostic marker of mortality in patients with DM. One hundred-and-fourteen patients with DM were examined, including 28 with clinically amyopathic DM (CADM). A diagnosis of ILD was made based on high resolution computed tomography (HRCT) scans. The association between elevated ESR and pulmonary impairment and mortality was then examined. ILD was diagnosed in 53 (46.5%) of 114 DM patients. Cancer was diagnosed in 2 (3.8%) of 53 DM patients with ILD and in 24 (92.3%) of those without ILD (P < 0.001). The median ESR (50.0 mm/hour) in patients with ILD was significantly higher than that in patients without ILD (29.0 mm/hour; P < 0.001). ESR was inversely correlated with forced vital capacity (Spearman rho = - 0.303; P = 0.007) and carbon monoxide diffusing capacity (rho = - 0.319; P = 0.006). DM patients with baseline ESR > or = 30 mm/hour had significantly higher mortality than those with ESR < 30 mm/hour (P = 0.002, log-rank test). Patients with a persistently high ESR despite immunosuppressive therapy was associated with higher mortality than those with a normalized ESR (P = 0.039, log-rank test). Elevated ESR is associated with increased mortality in patients with DM due to respiratory failure. Thus, monitoring ESR should be an integral part of the clinical care of DM patients.
Adult ; Asian Continental Ancestry Group ; Blood Sedimentation ; Carbon Monoxide/metabolism ; Cohort Studies ; Dermatomyositis/blood/*diagnosis/mortality ; Disease Progression ; Erythrocytes/*cytology ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/therapeutic use ; Lung Diseases, Interstitial/*complications/diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Republic of Korea ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors ; Survival Analysis