BACKGROUND: Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. METHODS: Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. RESULTS: The forces vital capacity(FVC), forced expiratory volume in 1 second(FEV1)and maximal voluntary ventilation(MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity(DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption(VO2max), carbon dioxide production(VCO2), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. CONCLUSION: Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.
Carbon Dioxide ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Exercise Test ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Male ; Oxygen ; Prospective Studies ; Radiotherapy ; Respiratory Function Tests

BACKGROUND: With the increase of cigarette consumption by women and the young, the incidence of lung cancer is expected to increase during the next three or four decades in Korea. The purpose of this study was to analyze the smoking habits in patients with lung cancer and to identify the gender differences in terms of their susceptibility to cigarette related carcinogens. METHODS: This investigation was a hospital-based case control study, which included the data of 178 case subjects(72 females, 106 males) with lung cancer and 218 control subjects(97 females, 121 males) with diseases unrelated to smoking. The information was obtained through a direct personal interview and a questionnaire related to personal smoking history. RESULTS: The relative frequency of the squamous cell carcinoma was substantially higher in males than in females(61.3% in males, and 29.2% in females), while adenocarcinoma including bronchoalveolar cell carcinoma was higher in females(31.9% in females, 18.9% in males). Keryberg Ilung cancer was of relatively higher frequencies in males and smokers. while Kreyberg IIlung cancer was higher in females and never smokers. The odds ratios(ORs) at each exposure level were consistently higher in females than males. For all cell types, the risk of lung cancer was increased with the quantity of smoked cigarettes, duration of smoking, and depth of inhalation. Odds ratio was distinctly higher in Kreyberg Ilung cancer than in total lung cancer and a steeper gradient of risk with increased smoking was observed in females. CONCLUSION: The ralative risk for lung cancer was consistently higher in females than in males at every level of exposure to cigarette smoke. This is believed to be due to the higher susceptibility of females to tabacco carcinogens, such as gender associated differences of carcinogen activation and/or the elimination of smoking related metabolites.
Adenocarcinoma ; Carcinogens ; Carcinoma, Squamous Cell ; Case-Control Studies ; Female ; Humans ; Incidence ; Inhalation ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Odds Ratio ; Smoke* ; Smoking* ; Tobacco Products

No abstract available.
Carcinoma, Squamous Cell* ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma*

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

BACKGROUNDS: Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional (PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometirc data and polysomnographic recordings between the two types of sleep apnea syndrome. MATERIALS: Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometirc data and polysomnographic data were analyzed, statistically. RESULTS: Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6±46.0min, p<0.05). Sleep efficiency was high in the PP group(89.6± 6.4%, 85.6±9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower(17.0±10.6, 28.5±13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7 ±1.8%, p<0.05) than in the NPP group. CONCLUSION: Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.
Apnea ; Humans ; Obesity ; Oxygen ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

Inhalation induction of anesthesia is seldom used in a routine adult practice because of the long induction time and the prolonged excitement phase with the risk of laryngospasm and vomiting. So in modern practice, anesthesia is usually administered intravenously and produces unconsclousness pleasantly. However there are situaions where intravenous induction may not be ideal, and where rapid induction is still desired. The author wanted to evaluate the clinical application of inhalation induction of halothane using a vital capacity breath as a substitute for intravenous induction of anesthesia. The patients in this study had an ASA physical status of l or ll and presented no cardiopulmonary disease or abnormal laboratory data. The patients were divided into two group: a control group(n=30) and an experimental group(n=30). Control group: Intravenous induction with thiopental sodium. Experimental group: Inhalation induction with halothane using a vital capacity breath. The results are as follows: 1) The control group consisted of 14 males and 16 females. The mean age was 37.8+/-11.5years, and the ages ranged from 16 to 65 years. The mean body weight was 59.8+/-8.0kg, and body weights ranged from 44 to 75kg. in the experimental group, there were 17 males and 13 females. The mean age was 28.9+/-13.7 years, and the ages ranged from 18 to 65 years. The mean body weight was 57.4+/-8.1 kg, and body weight ranged from 43+/-75kg. 2) In the experimental group, the apnea time ranged from 20 to 105 sec, with a mean of 44.5+/-20.4 sec. The mean induction time was 76.7+/-32.1sec. and induction time ranged from 20 to 150 sec. There was no relationship between apnea time and induction time. 3) The hemodynamic changes were as follows: a. There were significantly greater changes in blood pressure and pulse rate during intubation and postintubation in the control group than in the experimental group(p<0.05). b. There were significant changes in blood pressure and pulse rate in the control group(p<0.05), but seemed not to be hazardous clinically. 4) Induction was impossible in two patients in the experimental group due to profuse secretion or excitement. 5) The side effects in the experimental group included coughs(5 cases), arrythmias(4), excitements(4) and secretion(1), respectively. 6) Postanesthetic comments in the experimental group:27 of the 28 patients remembered the anesthetic smells: 3 pleasantly, 20 moderately and 4 unpleasantly. In conclusion, inhalation induction of halothane using a vital capacity breath is a safe, acceptable and practical alternative to intravenous induction in cooperative adult patients.
Adult ; Anesthesia ; Apnea ; Blood Pressure ; Body Weight ; Female ; Halothane* ; Heart Rate ; Hemodynamics ; Humans ; Inhalation* ; Intubation ; Laryngismus ; Male ; Smell ; Thiopental ; Vital Capacity* ; Vomiting

BACKGROUND: The effects of chemotherapy on pulmonary function are mainly a reduced diffusion capacity and a restrictive ventilatory impairment. Exercise can expose cardiovascular and pulmonary abnormalities not evident at rest. Exercise related cardiopulmonary function is important in patients with malignant disease as a determinant of quality of life. We performed this study to evaluate the changes of body composition and cardiopulmonary exercise performance of patients with locally advanced, non-small cell, lung cancer (NSCLC) before and after chemotherapy. METHODS: We evaluated resting pulmonary function, body composition, physiologic performance status, and cardiopulmonary exercise function in 11 patients with locally advanced NSCLC, at diagnosis and prior to the fourth cycle of chemotherapy. RESULTS: After chemotherapy, 4 patients (36.4%) showed partial response and 7 (63.4%) had stable disease. After chemotherapy, diffusion capacity of the lung for carbon monoxide was reduced (89.7+/-34.1%, vs. 71.9+/-20.5%) but not significantly. There were no significant changes in body composition or the state of physiologic performance after chemotherapy. There was a significant impairment of cardiopulmonary exercise tolerance in patients with NSCLC, evidenced by a reduction of maximal oxygen uptake (VO2max, ml/kg/min, 17.9+/-2.6 : 12.6+/-6.1, <0.05) and O2 pulse (O2 pulse, ml/beat, 7.0+/-1.7, 5.2+/-2.1, <0.05). CONCLUSION: Systemic chemotherapy resulted in a loss of cardiopulmonary exercise function in patients with locally advanced NSCLC within the short-term period, but not a physiologic change of body composition within the same period.
Body Composition ; Carbon Monoxide ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Diffusion ; Drug Therapy* ; Exercise Test* ; Exercise Tolerance ; Humans ; Lung ; Lung Neoplasms ; Oxygen ; Quality of Life

BACKGROUND: Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. METHDOS: Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-alpha) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. RESULTS: Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (p<0.001). The plasma leptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3+/-30.9 pg/mL/kg vs. 70.9+/-17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r=0.866, p<0.001) but it was not correlated with the BMI in the emphysema patients. The serum TNF-alpha levels were higher in the stable COPD patients than those in the controls, but there was no statistical difference (10.7+/-18.6 pg/mL vs. 7.2+/-3.5 pg/mL, respectively, p>0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r=0.450, p=0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-alpha system. CONCLUSION: The interaction of leptin and the activity of the TNF-alpha system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients.
Aged ; Body Composition ; Bronchitis, Chronic ; Case-Control Studies ; Emphysema ; Energy Metabolism ; Humans ; Leptin/*blood/physiology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive/*physiopathology ; Respiratory Function Tests ; Tumor Necrosis Factor-alpha/*blood/physiology ; *Weight Loss

BACKGROUND: Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. METHOD: Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Reasearch INC. RESULTS: REE was greater in patients with OSA compared with controls, but there was no differences between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation(SaO2) but not related to REE%. CONCLUSION: This study suggests the following firstly patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin levels was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated levels of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.
Adipose Tissue ; Adult ; Apnea ; Body Weight ; Energy Metabolism* ; Feeding Behavior ; Homeostasis ; Humans ; Leptin* ; Motor Activity ; Obesity ; Oxygen ; Polysomnography ; Risk Factors ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive