BACKGROUND: Infiltration of eosinophils and activated T cells into the airway is a characteristic feature of allergic inflammation such as asthma. IL-4 has been shown to mediate adhesion of eosinophils and T cells to endothelial cells by inducing VCAM-1 expression on endothelial surface. IL-13 shares a number of biologic properties with IL-4. OBJECTIVE: We aimed to investigate the effects of IL-13 on the adhesion of eosinophils to human umbilical vein endothelial cells (HUVEC) and on the expression of VCAM-1 in HUVEC. METHOD: HUVEC was incubated for 24h with IL-13 (10ng/ml), IL-4 (10ng/ml) and TNF-a (10ng/ml). Surface expression of VCAM-1 in HUVEC was detected using irnmuno-cytochemical stain and reverse transcription-polymearse chain reaction (RT-PCR), and the adhesion of eosinophils to HUVEC was quantitated using eosinophil peroxidase (EPO) assay. RESULTS: The VCAM-1 expression on IL-13-treated HUVEC increased more than in the expression on medium-treated HUVEC (p<0.05). The adhesion of eosinophil to IL-13- treated HUVEC also increased more than in the adhesion to medium-treated HUVEC (p<0.05). The VCAM-1 expression was synergistically induced by TNF-a and IL-13 (p<0.05). IL-13 induced VCAM-1 expression and adhesion of eosinophils to HUVEC, similar to IL-4. IL-13 also induced VCAM-1 mRNA expression, with greater expression than with medium and TNF-a(p<0.05). IL-13-induced surface VCAM-1 was associated with expression of mRNA transcripts and adhesion of eosinophils to HUVEC(r=0.89, r=0.93, p<0.05). CONCLUSION: These findings demonstrate that IL-13 stimulates HUVEC to express surface VCAM-1 and has a possible role in promoting VCAM-1/VLA-4 dependent accumulation of eosinophils during allergic and other inflammatory responses.
Asthma ; Endothelial Cells* ; Eosinophil Peroxidase ; Eosinophils* ; Human Umbilical Vein Endothelial Cells ; Inflammation ; Interleukin-13* ; Interleukin-4 ; RNA, Messenger ; T-Lymphocytes ; Vascular Cell Adhesion Molecule-1

BACKGROUND: The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during as asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. METHOD: A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age-and sex-matched subjects with stable asthma. RESULTS: The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma (233±175 pg/ml) than in the 48 subjects with stable asthma(169±74 pg/ml). A tread toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids (332±225 pg/ml) than in those who were not (214±159 pg/ml) and higher levels were found in those admitted to the hospital (275±212 pg/ml) than in those discharged after receiving only emergency treatment (190±115 pg/ml). The eotaxin levels inversely correlated with the FEV1 (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent (323±256 pg/ml) and severe persistent asthmatics (276±170 pg/ml) than in mild intermittent asthmatics (160±60 pg/ml). CONCLUSION: Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.
Asthma* ; Case-Control Studies ; Emergency Treatment ; Eosinophils ; Humans ; Plasma* ; Steroids

PURPOSE: This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model. METHODS: The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life. RESULTS: Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (beta00=79.92, p <.001; beta01= - 12.64, p <.001) and the change rate of quality of life (beta10= - 1.66, p =.020; beta11=2.88, p =.014). Symptom severity (beta20= - 1.81, p =.004), depression (beta30= - 0.58, p =.001), social dependency (beta40= - 0.35, p =.165), and loneliness (beta50= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life. CONCLUSION: According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.
Adult ; Aged ; Dependency (Psychology) ; Depression ; Female ; *Hematopoietic Stem Cell Transplantation ; Humans ; Loneliness ; Longitudinal Studies ; Male ; Middle Aged ; Multilevel Analysis ; Neoplasms/therapy ; Prospective Studies ; *Quality of Life ; Severity of Illness Index ; Surveys and Questionnaires ; Transplantation, Homologous

Lymphangioleiomyomatosis(LAM) is a rare disease of unknown etiology that occurs mainly in woman in her reproductive age. We recently experienced two cases of bilateral diffuse cystic lesion of the lung on chest X-ray and HRCT. The first case, a 26-year-old female, who had been diagnosed with tuberous sclerosis be the presence of clinical manifestation such as mental retardation, bilateral renal angiomyolipoma, adenoma sebaceum and generalized seizure, was admitted due to recently developed hemoptysis. Chest PA showed diffuse ground-glass opacity with radiolucent cystic lesions of various sizes on both lung fields. HRCT showed innumerable small cystic lesions with suspicious diffuse ground-glass opacity on both lung fields. The second case, a 30-year-old female was admitted due to dyspnea and spewing of blood-tinged sputum for 2 weeks, shortly after delivery. Chest PA showed diffuse reticular and ground-glass opacities on both lung field. HRCT showed multiple well-difined and relatively uniform size air cysts with a uniform wall thickness on entire both lung fields, with small amount of right pleural effusion. By thoracoscopic lung biopsy she was diagnosed with pulmonary lymphangioleiomyomatosis. We report these cases with a brief review of the literatures.
Adult ; Angiomyolipoma ; Biopsy ; Dyspnea ; Female ; Hemoptysis ; Humans ; Intellectual Disability ; Lung ; Lymphangioleiomyomatosis ; Pleural Effusion ; Rare Diseases ; Seizures ; Sputum ; Thorax ; Tuberous Sclerosis

PURPOSE: This study compared the effect of two oral care agents on preventing stomatitis and discomfort for acute leukemic patients. METHODS: A total of forty patients was enrolled and randomly assigned to sodium bicarbonate or chlorhexidine group. WHO oral toxicity scale was used for measuring stomatitis and Beck's subjective oral discomfort scale for evaluating oral comfort. Data was collected from August 2009 to February 2010. The data was analyzed using Chi-square test, Fisher's exact test, and Mann-Whitney test. RESULTS: Data analyzed was thirty five one. The incidence of stomatitis was 47.4%, 68.8% in sodium bicarbonate and chlohexidine group respectively. The onset of stomatitis was about the 10th and 9th day after chemotherapy initiation, and the duration was 8.0 and 8.67 day respectively. The severity of stomatitis was highest on the 21st day after chemotherapy initiation. There were no statistical differences in the status of stomatitis and the levels of oral comfort during treatment periods. CONCLUSION: Nurses should routinely assess oral cavity and encourage patients to do oral care actively from second to third week after chemotherapy initiation. Also sodium bicarbonate agent can be recommended to for preventing stomatitis.
Chlorhexidine ; Humans ; Incidence ; Mouth ; Sodium Bicarbonate ; Stomatitis

PURPOSE: This study was conducted to assess the reliability and validity of the Korean version of the Coping and Adaptation Processing Scale-Short-Form in patients with cancer. METHODS: The original scale was translated into Korean using Brislin's translation model. The Korean Short-Form and the Functional Assessment Cancer Therapy-General were administered to 164 Korean patients with cancer using convenience sampling method. The collected data were analyzed using SPSS 23.0 and AMOS 23.0. Construct validity, criterion validity, test-retest reliability, and internal consistency reliability of the Korean Coping and Adaptation Processing Scale-Short-Form were evaluated. RESULTS: Exploratory factor analysis supported the construct validity with a four-factor solution that explained 60.6% of the total variance. Factor loadings of the 15 items on the four subscales ranged .52~.86. The four-subscale model was validated by confirmatory factor analysis (Normed χ2=1.38 (p=.013), GFI=.92, SRMR=.02, RMSEA=.05, TLI=.94, and CFI=.95), and criterion validity was demonstrated with the Functional Assessment Cancer Therapy-General. Cronbach's alpha for internal consistency of the total scale was .83 and ranged .68~.81 for all subscales, demonstrating sufficient test-retest reliability. CONCLUSION: The Korean version showed satisfactory construct and criterion validity, as well as internal consistency and test-retest reliability.
Humans ; Methods ; Reproducibility of Results*

BACKGROUND: The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. METHODS: This study involved a review of 132 episodes of hypercapnic respiratory failure(PaCO2≥50mmHg and pH≤7.35). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. RESULTS: Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score (20±5 vs 14±4 ; p<0.01), a higher WBC, a higher serum BUM, and greater acidosis (pH, 7.23±0.11 vs 7.32±0.04 ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation (2±3 h). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation(97±121 h). The patients with a pH 7.21 to 7.25(4.1±2.9 day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35(2.2±3.1 day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. CONCLUSION: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This shold assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.
Acidosis ; Acidosis, Respiratory ; APACHE ; Humans ; Hydrogen-Ion Concentration ; Intubation* ; Noninvasive Ventilation ; Physiology ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency* ; Retrospective Studies

Adenocarcinoma of small intestine is rare disease, but its incidence of iluem is the least of small intestinal adenocarcinoma. Its rarity and vague symptoms results in delayed diagnosis, treatment and poor prognosis, Recently we experienced a 65 years old man of ileal adenocarcinoma with liver metastasis, which does not obstuct intestinal lumen, We treat the metastatic tumor with chemoembolization(lipiodol and doxorubicin) through the hepatic artery and so we report the case with review of literature.
Adenocarcinoma ; Aged ; Delayed Diagnosis ; Hepatic Artery ; Humans ; Incidence ; Intestine, Small ; Liver ; Neoplasm Metastasis* ; Prognosis ; Rare Diseases

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.
Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Hypertension, Portal ; Pancreatic Diseases ; Pancreatitis ; Splenectomy ; Splenic Vein ; Thrombosis