No abstract available.
Leiomyoma*

The aim of this study was to determine the effect of partial liquid ventilation (PLV) using a perfluorocarbon (PFC) on gas exchange and lung inflammatory response in a canine acute lung injury model. After inducing severe lung injury by oleic acid infusion, beagle dogs were randomized to receive either gas ventilation only (control group, n = 6) or PLV (PLV group, n = 7) by sequential instillation of 10 mL/kg of perfluorodecalin (PFC) at 30 min intervals till functional residual capacity was attained. Measurements were made every 30 min till 210 min. Then the lungs were removed and bronchoalveolar lavage (BAL) (35 mL/kg) was performed on the right lung and the left lung was submitted for histologic analysis. There was significant improvement in PaO2 and PaCO2 in the PLV group compared to the control group (p < 0.05) which was associated with a significant decrease in shunt (p < 0.05). There was no significant difference in parameters of lung mechanics and hemodynamics. There was a significant decrease in cell count and neutrophil percentage in BAL fluid and significantly less inflammation and exudate scores in histology in the PLV group (p < 0.05). We conclude that PLV with perfluorodecalin improves gas exchange and decreases inflammatory response in the acutely-injured lung.
Animal ; Blood Cell Count ; Bronchoalveolar Lavage Fluid ; Carbon Dioxide/analysis ; Disease Models, Animal ; Dogs ; Female ; Fluorocarbons/pharmacology* ; Hemodynamics ; Histocytochemistry ; Inflammation/prevention & control ; Lung Diseases/physiopathology* ; Lung Diseases/chemically induced ; Male ; Oleic Acid ; Oxygen/analysis ; Pulmonary Gas Exchange/drug effects* ; Pulmonary Ventilation/physiology* ; Respiratory Function Tests ; Ventilators, Mechanical

BACKGROUND: The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patientventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. METHODS: Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume(VT,LOW)(6-8 ml/kg) or high tidal volume(VT,HIGH)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume(VT) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, VT, minute ventilation(VE), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. RESULTS: The mean VE and RR were not different between PCV and VCV during study period. The Ppeak was significantly lower in PCV than in VCV during VT,HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both VT (p<0.05). During VT,LOW ventilation, WOBp and PTP in PCV(0.80?0.37 J/min, 164.5?74.4 cmH2O.S) were significantly lower than in VCV(1.06+/-0.39J /min, 256.4+/-107.5 cmH2O.S)(p<0.05). During VT,HIGH ventilation, WOBp and PTP in PCV(0.33+/-0.14 J/min, 65.7+/-26.3 cmH2O.S) were also significantly lower than in VCV(0.40+/-0.14 J/min, 83.4+/-35.1 cmH2O.S)(p<0.05). CONCLUSION: During assisted ventilation, PCV with deccelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.
Humans ; Respiratory Insufficiency ; Ventilation* ; Ventilators, Mechanical ; Work of Breathing*

The complications of endotracheal intubation are inevitable, of which postintubation tracheal stenosis may be required for surgical resection with primary reconstruction. Before surgery, several less invasive therapeutic modalites including bougie dilatation, stenting, and Nd-YAG laser incision are still available in use. Especially, good results were noted in selected patients with lengthy scars of less than 1cm and without tracheomalacia using endoscopic laser incision and dilatation. We report a case of a 54 yr-old woman with postintubation tracheal stenosis who was successfully treated by endoscopic Nd-YAG laser incision and esophageal balloon catheter.
Catheters* ; Cicatrix ; Dilatation ; Female ; Humans ; Intubation, Intratracheal ; Lasers, Solid-State* ; Stents ; Tracheal Stenosis* ; Tracheomalacia

BACKGROUND: Isoniazid(INH) and rifampicin(RFP) are potent antituberculous drugs which have made tuberculous disease become decreasing. In Korea, prescribed doses of INH and RFP have been different from those recommended by American Thoracic Society. In fact they were determined by clinical experience rather than by scientific basis. Even there has been. few reports about pharmacokintic parameters of INH and RFP in healthy Koreans. METHOD: Oral pharmacokinetics of INH were studied in 22 healthy native Koreans after administration of 300mg and 400mg of INH to each same person successively at least 2 weeks apart. After an overnight fast, subjects received medication and blood samples were drawn at scheduled times over a 24-hour period. Urine college lion was also done for 24 hours. Pharmacokinetics of RFP were studied in 20 subjects in a same fashion with 450mg and 600mg of RFP. Plasma and urinary concentrations of INH and RFP were determined by high-performance liquid chromatography(HPLC). RESULTS: Time to reach peak serum concentration (Tmax) of INH was 1.05α0.34 hrs at 300mg dose and 0.98α0.59 hrs at 400mg dose. Half-life was 2.49α0.88 hrs and 2.80α0.75 hrs, respectively. They were not different significantly(p>0.05) Peak serum concentration(Cmax) after administration of 400mg of INH was 7.14α 1.95mcg/mL which was significantly higher than Cmax (4.37α1.28mcg/mL) by 300mg of INH(p<0.01). Total clearance(CLtot) of INH at 300mg dose was 26.76α11.80mL/hr. At 400mg dose it was 21.09α8.31mL/hr which was significantly lower(p<0.01) than by 300mg dose. While renal clearance(CLr) was not different among two groups nonrenal clearance(CLnr) at 400mg dose (18.18α8.36mL/hr) was significantly lower than CLnr (23.71α11.52mL/hr) by 300mg dose(p<0.01). Tmax of RFP was 1.11α0.41 tut at 450mg dose and 1.15 α0.43 hrs at 600mg dose. Half-life was 4.20α0.73 hrs and 4.95α2.25 hrs, respectively. They were not different significantly(p>0.05). Cmax after administration of 600mg of RFP was 13.61 α3.43mcg/mL which was significantly higher than Cmax(10.12α2.25mcg/mL) by 450mg of RFP(p<0.01). CLtot of RFP at 450mg dose was 7.60α1.34mL/hr. At 600mg dose it was 7.05α 1.20mL/hr which was significantly lower(p<0.05) than by 450mg dose. While CLr was not different among two groups, CLnr at 600mg dose(5.36α1.20mL/hr) was significantly lower than CLnr(6.19α 1.56mL/hr) by 450mg dose(p<0.01). CONCLUSION: Considering Cmax and CLnr, 300mg, of INH and 450mg RFP might be sufficient doses for the treatment of tuberculosis in Koreans. But it remains to be clarified in the patients with tuberculosis.
Half-Life ; Humans ; Isoniazid* ; Korea ; Lions ; Pharmacokinetics ; Plasma ; Rifampin* ; Tuberculosis ; Volunteers*

BACKGROUND: We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli wuggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therfore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. METHODS: Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes(OBM) were stimulated with LPS(10 micrograms/ml), H37Rv, or H37Ra(5X10(5) bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of TNFalpha and IL-1beta production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. RESULTS: TNFalpha and IL-1beta productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in TNFalpha and IL-1beta production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. CONCLUSION: Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.
Blotting, Northern ; Chemokine CCL5 ; Chemokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Healthy Volunteers ; Interleukin-8 ; Monocytes ; Phagocytosis ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha ; Virulence*

Novel coronavirus (SARS-CoV-2) has caused more than 100 million confirmed cases of human infectious disease (COVID-19) since December 2019 to paralyze our global community. However, only limited access has been allowed to COVID-19 vaccines and antiviral treatment options. Here, we report the efficacy of the anticancer drug pralatrexate against SARS-CoV-2. In Vero and human lung epithelial Calu-3 cells, pralatrexate reduced viral RNA copies of SARS-CoV-2 without detectable cytotoxicity, and viral replication was successfully inhibited in a dose-dependent manner. In a time-to-addition assay, pralatrexate treatment at almost half a day after infection also exhibited inhibitory effects on the replication of SARS-CoV-2 in Calu-3 cells. Taken together, these results suggest the potential of pralatrexate as a drug repurposing COVID-19 remedy.

Novel coronavirus (SARS-CoV-2) has caused more than 100 million confirmed cases of human infectious disease (COVID-19) since December 2019 to paralyze our global community. However, only limited access has been allowed to COVID-19 vaccines and antiviral treatment options. Here, we report the efficacy of the anticancer drug pralatrexate against SARS-CoV-2. In Vero and human lung epithelial Calu-3 cells, pralatrexate reduced viral RNA copies of SARS-CoV-2 without detectable cytotoxicity, and viral replication was successfully inhibited in a dose-dependent manner. In a time-to-addition assay, pralatrexate treatment at almost half a day after infection also exhibited inhibitory effects on the replication of SARS-CoV-2 in Calu-3 cells. Taken together, these results suggest the potential of pralatrexate as a drug repurposing COVID-19 remedy.

BACKGROUND: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this st udy is to observe the clinical course of untreated sarcoidosis. METHODS: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, FEV1, DLco) were evaluated every 3months compared between corticosteroid treated (n=5) and non-treated (n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test (2) worsening in the degree of dyspnea (3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. RESULTS: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved (13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. CONCLUSION: These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.
Diagnosis ; Dyspnea ; Follow-Up Studies ; Hand ; Humans ; Korea ; Respiratory Function Tests ; Sarcoidosis* ; Uveitis

BACKGROUND: The evaluation of candidates for successful lung resection is important. We studied to Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. METHOD: Between October 1, 1995 to August 31, 1997, 36 lung resection candidates with FEV1 of less than 2L or 60% predicted due to lung cancer were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for a successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo)pulmonary factors such as ppo-FEV1, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-FEV1% x ppo-DLco% and ppo-maximal O2 uptake(VO2max) were also measured. RESULTS: There were 31 men and 5 women with the median age of 65 years (range 44 to 82) and a mean FEV1 of 1.78 +/-0.06L. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients, cardiac complications in 3, other complications (empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-VO2max was less than 10 mg/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictors for the post operative death in this study.
Blood Gas Analysis ; Dyspnea ; Electrocardiography ; Female ; Hematocrit ; Humans ; Intensive Care Units ; Lung Neoplasms* ; Lung* ; Male ; Mortality* ; Pneumonectomy ; Pneumonia ; Prospective Studies ; Respiration ; Respiratory Function Tests ; Serum Albumin ; Smoke ; Smoking ; Weight Loss