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Serum Apolipoprotein A-I Predicts the Mortality in Patients with Idiopathic Pulmonary Fibrosis
( Ganghee Chae ),( Jin Woo Song ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background Dysregulation of lipid metabolism is implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF). However, the association between serum lipid profiles and prognosis of IPF is not well defined. The aim of this study was to investigate the prognostic values of serum lipid profiles in patents with IPF. Methods Clinical data including serum lipid profiles were retrospectively collected from 357 patients with IPF (biopsy-proven cases = 97) whose body measure index (BMI) were <25 kg/m2. Serum lipid profiles included total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-I (Apo-A1), and apolipoprotein B. The risk of mortality was analyzed using Cox proportional hazard model. Results Of total subjects, the mean age was 67.6 years and 80.4% were men. During the follow-up (median: 30 months), 199 (55.4%) patients died. The non-survivors had older age, lower BMI, forced vital capacity, and diffusing capacity, and shorter 6-minute walk distance (6MWD) than the survivors. Among serum lipid profiles, only Apo-A1 was significantly lower in the non-survivors compared with the survivors. In the receiver operating characteristic analysis, Apo-A1 levels were useful in predicting the mortality (area under the curve=0.674, p<0.001; the optimal cut-off value=121 mg/dl) in patients with IPF, and showed similar performance with GAP model. In the multivariable Cox analysis, low Apo-A1 level (≤121 mg/dl) was an independent prognostic factor for the mortality (HR, 1.594; 95% CI, 0.431-0.913; p=0.015) in patients with IPF, along with the GAP index and treatment. Low Apo-A1 group also showed worse survival than high Apo-A1 group (figure 1). Serum Apo-A1 levels were significantly correlated with diffusing capacity (r=0.171, p=0.012), and 6MWD (r=0.239, p<0.001). Conclusions Our Results suggest that serum Apo-A1 levels may be useful in predicting prognosis in patients with IPF.
( Ganghee Chae ),( Yea Eun Park ),( Yong Pil Chong ),( Hyun Joo Lee ),( Tae Sun Shim ),( Kyung-wook Jo ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background We investigated the treatment outcomes of patients with cavitary nodular bronchiectatic (C-NB) Mycobacterium avium complex (MAC) pulmonary disease (PD) by comparing the outcomes between patients with the fibrocavitary (FC) type and those with the C-NB type who received guideline-based therapy (GBT) composed of daily three-drug oral antibiotics with an injectable aminoglycoside. Additionally, we analysed whether treatment with oral antibiotics only would result in acceptable outcomes in the C-NB type. Methods Between 2002 and 2019, patients with cavitary MAC-PD who received three-drug oral antibiotics with or without injectable aminoglycoside for ≥1 year were enrolled at a tertiary referral centre in South Korea. We compared the 1-year microbiological cure rate according to the radiological type and treatment regimen. Results The overall 1-year microbiological cure rate of 154 patients with cavitary MAC-PD who received GBT was 75.3%. Among these, the microbiological cure rate of the 114 patients with the C-NB type was higher than that of the 40 patients with the FC type (80.7% vs. 60.0%, respectively; p = 0.009). Then, of the 166 patients with the C-NB type treated with oral medications with or without injectable drug, 83.7% achieved 1-year microbiological cure. The cure rate was similar between those who received oral medications only and those treated with the inclusion of an injectable aminoglycoside (90.4% vs. 80.7%, respectively; p = 0.117). Conclusions The outcomes of the C-NB type MAC-PD treated with GBT were significantly more favourable than the FC type. The C-NB type could be successfully treated with oral medications only.
( Ganghee Chae ),( Eun Jae Ko ),( Sei Won Lee ),( Sang Gyu Kwak ),( Donghwi Park ),( Jin Hyoung Kim ),( Byung Ju Kang ),( Taehoon Lee ),( Yangjin Jegal ),( Seung Won Ra ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background To assess functional capacity of COPD patients, 6-minute walk test (6MWT) and incremental shuttle walk test (ISWT) have been used. These field tests have a good correlation between walking distance and peak oxygen uptake (peak VO2) in cardiopulmonary exercise testing (CPET). Our aim was to investigate the correlation between peak VO2 and distance of 6MWT and ISWT in COPD patients via meta-analysis. Methods We searched PubMed, SCOPUS, Embase, and the Cochrane Library published up to June 30, 2020. Studies comparing the correlation of 6MWT, ISWT and peak VO2 measured by CPET in COPD patients were included. A meta-analysis was performed using the fixed- and random-effects model, and publication bias was evaluated by funnel plot and Egger's test. Results Our findings included data from 12 studies involving 746 patients. A meta-analysis showed that there was a significant predictor between ISWT and peak VO2 (correlation coefficient = 0.81; 95% CI: 0.74 to 0.85, p-value <0.0001). Also, 6MWT was a significant predictor of peak VO2 (correlation coefficient = 0.65; 95% CI: 0.57 to 0.72, p-value <0.0001) (Figure 1). These Results may suggest that ISWT reflects a stronger correlation with peak VO2 level than 6MWT. Conclusions This meta-analysis provided further evidence that 6MWT and ISWT were correlated significantly with peak VO2 measured by CPET in COPD patients and ISWT had a stronger correlation than 6MWT. These Results may suggest that ISWT can be considered a valid and reliable test to assess maximal functional capacity in COPD patients.
The Effect of Cryoablation in a Pig Model with Induced Benign Tracheal Stenosis
( Jin Hyoung Kim ),( Ganghee Chae ),( Hwa Sik Jung ),( Chui Yong Park ),( Byung Ju Kang ),( Hyeon Hui Kang ),( Seung Won Ra ),( Kwang Won Seo ),( Yangjin Jegal ),( Jong Joon Ahn ),( Hee Jeong Cha ),( 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background There have been reports that cryotherapy-based treatment is effective for benign central airway stenosis. However, the pathophysiologic mechanism of this modality is not well known. Objectives The purpose of this study was to investigate whether cryoablation has the effect of preventing stenosis recurrence in a pig model of induced benign tracheal stenosis, and to explore the mechanism behind it. Method After inducing airway stenosis in 6 pigs, 3 pigs treated with balloon dilatation, and other 3 treated with balloon dilatation and cryoablation. They were then observed for 3 weeks and underwent post-mortem tissue analysis. Results: Pigs treated with cryoablation showed fewer sudden deaths (1/3 vs 2/3) and less progression of stenosis (on day 14: 80-84% vs 97%). In addition, they had less fibrosis, granulation tissue formation, and epithelial denudation in tissue analysis. Conclusion Cryotherapy (cryoablation) showed to be effective in preventing the progression of stenosis, and its mechanism is thought to be through inhibition of fibrosis, granulation tissue formation, and epithelial denudation.
( Jang Ho Lee ),( Eun Jae Ko ),( Ganghee Chae ),( Sei Won Lee ),( Seung Won Ra ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background/aims Assessment of exercise capacity in patients with chronic obstructive pulmonary disease (COPD) is important. Although the incremental shuttle walking test (ISWT) has many strengths, it has not yet been widely introduced in clinical settings. The aim of our study was to investigate the validity and reliability of ISWT, analyzing the correlation between the distance of 6-minute walking test (6MWT) and the peak oxygen consumption (VO2) of cardiopulmonary exercise test (CPET) in patients with COPD. Methods This was a prospective observational correlation study. Patients with COPD were recruited between May 2020 and December 2020 from two hospitals. Three assessments (ISWT, 6MWT, and CPET) were performed with 2-day intervals for all patients. Pearson’s correlation was used for all correlation analyses. The ISWT and 6MWT were repeated twice in Hospital 1 (UUH) to evaluate reliability using intraclass correlation coefficients (ICCs). Results A total of 15 patients were enrolled from Hospital 1 (UUH), and 14 patients were enrolled from Hospital 2 (AMC). Both the distances of the ISWT and 6MWT were significantly correlated with the peak VO2 with Pearson’s r of 0.782 (p<0.001) and 0.512 (p=0.005), respectively. The ICC of both ISWT and 6MWT was high: ISWT with 0.988 (95% CI: 0.965-0.996, p<0.001) and 6MWT with 0.959 (95% CI: 0.871-0.987, p<0.001), respectively. Conclusion The ISWT showed a higher correlation with the peak VO2 than the 6MWT and had excellent test-retest reliability in COPD patients. The ISWT can be considered a useful alternative to the CPET to evaluate the exercise capacity.
( Jin Hyoung Kim ),( Hwa Sik Jung ),( Ganghee Chae ),( Chui Yong Park ),( Seung Won Ra ),( Taehoon Lee ),( Byung Ju Kang ),( Yangjin Jegal ),( Jong Joon Ahn ),( Hyeon Hui Kang ),( Kwang Won Seo ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Purpose Toxocariasis is known to be one of the common causes of peripheral blood eosinophilia and eosinophilic infiltration of various organs. In this study, the prevalence, demographic characteristics of lung and ocular toxocariasis were investigated, and clinical implications were evaluated. Methods From July 1, 2017 to May 8, 2019, a retrospective data collection was conducted on 604 people who had a parasite antibody test out of 138,059 subjects who performed blood tests at a single tertiary hospital. Results Of the 604 people who underwent parasite antibody tests, 540 (89.4%) people were tested for the Toxocara antibody, 245 (45.4%) subjects showed positive for the Toxocara antibody. Among the Toxocara antibody-positive subjects, 49 (20.0%) patients were diagnosed with lung toxocariasis, 44 (89.8%) were male, and 39 (79.6%) urban residency. Among the 49 patients with lung toxocariasis, 44 of them had medical records for raw food ingestion and 43 out of 44 cases had raw food ingestion history. They had raw cow liver, meat, and fish ingestion history. Nineteen patients were diagnosed with ocular toxocariasis, 17 (89.5%) were male, and 15 (83.3%) lived in urban. Raw food ingestion was found in 13 (92.9%) out of 14 cases with medical records. There was no difference between the lung and ocular toxocariasis groups in age, sex, residency, smoking and alcohol history, and underlying diseases. In this study, 33 (67.3%) of 49 lung toxocariasis patients were referred to an ophthalmologist, and 3 (9.1%) of them were diagnosed with ocular toxocariasis. Conclusions It has long been known that lung toxocariasis is a self-limiting disease, whereas ocular toxocariasis, which can be a fatal effect on vision. Therefore, it is recommended that patients who have lung toxocariasis should undergo an ophthalmological examination.