BACKGROUND: Mixed obstructive and restrictive pattern of spirometry can not be concluded in the presence of true restrictive disorders because pure obstructive disorders can also shoy reduced vital ca pacity. However, it is not known how many patients with mixed spirometric pattern really have restrictive disorders in Korea whose pattern of pulmonary diseases is somewhat different from foreign countries. To answer this question, I performed this study and tried to answer it according to diseases in addtion. METHOD: Test results from 413 patients who undergone both spirometry and lung volume measurements on the same visit from August 1, 1998 to July 31, 1999 were included. Spirometry data were classified as mixed obstructive-restrictive pattern when spirometry showed 'FEV1/FNC <70% (<65% if age >or= 60)' and FVC <80% of predicted value. TLC by the method of nitrogen washout was considered as gold standard to diagnose restrictive disorders in which TLC is less than 80% of predicted value. RESULTS: Out of 404 patients who could be evaluated, 58 had mixed pattern of spirometry. 58 patients were suffered from airway diseases (39 patients) such as COPD (22 patients, 38%), asthma (11,19%), bronchiectasis (6,10%), and sequelae of pulmonary tuberculosis (15,26%) or other diseases (4,7%). Only 18 out of 58 (31%) were confirmed to have true restrictive disorders by TLC. The proportion of true restrictive disorders was different according to diseases, 20.5%(8/39 patients) in patients with airway diseases and 53.5%(8/15) with sequelae of pulmonary tuberculosis (p<0.05). CONCLUSION: Many patients whose spirometry showed mixed pattern didn't have restrictive disoders but had pure obstructive disorders. This was true for more patients with airway diseases. Therefore it would be prudent that lung volume be tested to diagnose restrictive disorders in patients with mixed spirometric pattern.
Asthma ; Bronchiectasis ; Humans ; Korea ; Lung ; Lung Diseases ; Lung Volume Measurements ; Nitrogen ; Pulmonary Disease, Chronic Obstructive ; Spirometry ; Tuberculosis, Pulmonary

BACKGROUND: It is well known that rifampin decreases the hypoprothrombinemic effect of warfarin by induction of cytochrome p-450 enzyme in healthy volunteer. However, in patients the dosage schedule o f warfarin during rifampin therapy is not established. Therefore, patients taking both rifampin and warfarin were reviewed to find out the adequate dosage schedule of warfafin in addition to side effects by interaction of two drugs. METHOD: Patients taking both rifampin and warfarin were retrieved from patients who were admitted due to heart disease and tuberculosis at Boochun Sejong Hospital from January of 1995 to August of 1999. To decide the adequate dosage of warfarin, the dosage of warfarin before, during, and after rifampin was evaluated in patients who kept adequate hypoprothrombinemic effect of warfarin during rifampin. To decide the adequate dosage schedule of warfarin, the time interval from the beginning of rifampin to normalization of prothrombin time(INR Appointments and Schedules ; Cerebral Hemorrhage ; Cytochrome P-450 Enzyme System ; Healthy Volunteers ; Heart Diseases ; Humans ; Intracranial Embolism ; Prothrombin ; Prothrombin Time ; Rifampin* ; Tuberculosis ; Warfarin*

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

No abstract available.
Nebulizers and Vaporizers ; Pulmonary Disease, Chronic Obstructive ; Spirometry

No abstract available.
Pulmonary Disease, Chronic Obstructive*

There is no therapy currently available that influences the natural history of disease progression in patients with chronic obstructive pulmonary disease (COPD). Although stem cell therapy is considered a potential therapeutic option in COPD, there are no clinical trials proving definitive therapeutic effects in patients with COPD. Recently, it was reported that pioglitazone might potentiate the therapeutic effects of stem cells in patients with heart or liver disease. To test the capacity of pioglitazone pretreatment of stem cells for emphysema repair, we evaluated the therapeutic effects of pioglitazone-pretreated human adipose-derived mesenchymal stem cells (ASCs) on elastase-induced or cigarette smoke-induced emphysema in mice. We also investigated the mechanisms of action of pioglitazone-pretreated ASCs. Pioglitazone-pretreated ASCs had a more potent therapeutic effect than non-pretreated ASCs in the repair of both elastase-induced and smoke-induced emphysema models (mean linear intercept, 78.1±2.5 μm vs 83.2±2.6 μm in elastase models and 75.6±1.4 μm vs 80.5±3.2 μm in smoke models, P<0.05). Furthermore, we showed that pioglitazone-pretreated ASCs increased vascular endothelial growth factor (VEGF) production both in vitro and in mouse lungs in the smoke-induced emphysema model. Pioglitazone-pretreated ASCs may have more potent therapeutic effects than non-pretreated ASCs in emphysema mouse models.
Animals ; Disease Progression ; Emphysema* ; Heart ; Humans ; In Vitro Techniques ; Liver Diseases ; Lung ; Mesenchymal Stromal Cells ; Mice* ; Natural History ; Pancreatic Elastase ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Stem Cells* ; Therapeutic Uses* ; Tobacco Products ; Vascular Endothelial Growth Factor A

Chronic obstructive pulmonary disease (COPD) is one of the highest ranking diseases with regard to prevalence and mortality in Korea and also worldwide. In the past decade, effective inhaler medications for COPD treatment have been developed or approved. These inhaler medications have been proven to have beneficial effects on symptoms, lung function, quality of life, exercise capacity, and exacerbation. The inhalers used widely are long-acting anticholinergics, long-acting beta2-agonists, and combined inhalers of a corticosteroid and long-acting beta2-agonist. These inhaler medications are more effective than oral medications and less likely to produce adverse events. However, the inhaler medications should be used appropriately to achieve the desired effect. For COPD patients with a forced expiratory volume in 1 second (FEV1) less than 80% of the predicted value, a long-acting anticholinergic or long-acting beta2-agonist is usually the medication of first choice. If a COPD patient with a FEV1 less than 60% of the predicted value suffers frequent exacerbations, a combined inhaler of corticosteroid and long-acting beta2-agonist is a good choice. To prescribe an inhaler medication for COPD patients, spirometry should be performed, not only to confirm the diagnosis but also to define severity. These effective inhaler medications should be used widely for COPD patients in Korea.
Adrenal Cortex Hormones ; Cholinergic Antagonists ; Diagnosis ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Mortality ; Nebulizers and Vaporizers* ; Prevalence ; Pulmonary Disease, Chronic Obstructive* ; Quality of Life ; Spirometry

Elderly asthma should be taken much care of because it tends to be underdiagnosed and undertreated despite its high morbidity and mortality. The principle of diagnosis and treatment in elderly asthma is basically the same as the general principle in adult asthma. Although spirometry and inhaler device, the necessary tools of diagnosis and treatment in asthma, are difficult to be performed or used by the elderly asthmatics, spirometry and inhaler device should be done adequately with encouragement and education. Other diseases with symptoms similar to elderly asthma are COPD, tuberculous destroyed lung, heart disease, lung cancer, etc. and should be differentiated from asthma. The key drug for the treatment in elderly asthmatics is inhaled glucocorticoid, which is exactly the same in general adult asthmatics. Vaccinations of influenza and pneumococcus are recommended to the elderly asthmatics.
Adult ; Aged ; Asthma ; Heart Diseases ; Humans ; Influenza, Human ; Lung ; Lung Neoplasms ; Nebulizers and Vaporizers ; Pulmonary Disease, Chronic Obstructive ; Spirometry ; Streptococcus pneumoniae ; Vaccination

BACKGROUND: Tumor necrosis factor(TNF) has been considered as an important candidate for cancer gene therapy based on it9 potent anti-tumor activity. However, since the efficiency of current techniques of gene transfer is not satisfactory, the majorities of current protocols is aiming the in vitro gene transfer to cancer cells and re-introducing genetically modified cancer cells to host In previous study, it was shown that TNF-sensitive cancer cells transfected with TNF-α CDNA would become highly resistant to TNF. Understanding the mechanisms of TNF-resistance in TNF-α gene transfected cancer cells would be an important step for improving the efficacy of cancer gene therapy as we]1 as for better understandings of tumor biology. This study was designed to evaluate the role of new protective protein synthesis in the acquired resistance to TNF of TNF-α gene transfected cancer cells. METHOD: We transfected TNF-α c-DNA to WEHI l64, a murine fibrosarcoma cell line, using retroviral vector (pLT12SN(TNF)) and confirm the expression of TNF with PCRf ELISA, MTT assay. Then we determined the TNF resistance of TNF gene transfected cells(WEHI 164-TNF) and the changes of TNF sensitivities after treatments with actinomycin D(transcription inhibitor) and cycloheximide(translation inhibitor). RESULTS: WEHI 164 which was sensitive to TNF became resistant to TNF after being trsnsfected with TNF-α gene and the resistance to TNF was partially reversed after treatment with actinomycin D, but not with cycloheximide. CONCLUSION: The acquired resistance to TNF after TNF-α gene transfection may be associated with synthesis of some protective proteins.
Biology ; Cell Line ; Cycloheximide ; Dactinomycin ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Fibrosarcoma ; Genes, Neoplasm ; Necrosis ; Transfection ; Tumor Necrosis Factor-alpha* ; Zidovudine*