Reference Respiratory Muscle Strength Values and a Prediction Equation Using Physical Functions for Pulmonary Rehabilitation in Korea

Background@#In Korea, tests for evaluating respiratory muscle strength are based on other countries’ clinical experience or standards, which can lead to subjective evaluations. When evaluating respiratory function based on the standards of other countries, several variables, such as the race and cultures of different countries, make it difficult to apply these standards. The purpose of this study was to propose objective respiratory muscle strength standards and predicted values for healthy Korean adults based on age, height, weight, and muscle strength, by measuring maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak cough flow (PCF). @*Methods@#This cross-sectional study analyzed MIP, MEP, and PCF in 360 people, each group comprising 30 adult men and women aged 20–70, diagnosed as healthy after undergoing medical check-ups at a general hospital. Hand grip strength (HGS) and the five times sitto-stand test (FTSST) results were also recorded. Correlations among respiratory muscle strength, participant demographics, and overall muscle strength were evaluated using Pearson’s correlation analysis. The predicted values of respiratory muscle strength were calculated using multiple regression analysis. @*Results@#Respiratory muscle strength differed from the values reported in studies from other countries. In the entire samples, both MIP and MEP had the highest correlations with peak HGS (r= 0.643, r = 0.693; P < 0.05), while PCF had the highest correlation with forced expiratory volume in 1 s (r = 0.753; P < 0.05). Age, body mass index, peak HGS, and FTSST results were independent variables affecting respiratory muscle strength. A predictive equation for respiratory muscle strength was developed using the multiple regression equation developed in this study. @*Conclusion@#Respiratory muscle strength index may differ by country. For more accurate diagnoses, standard values for each country are required. This study presents reference values for Korea, and a formula for estimation is proposed when no respiratory muscle strength measurement equipment is available.Trial Registration: Clinical Research Information Service Identifier: KCT0006778

Is Age-Predicted Maximal Heart Rate Applicable in Patients With Heart or Lung Disease?

Objective@#To compare the predicted and actual maximal heart rate (HRmax) values in the cardiopulmonary exercise test (CPET). @*Methods@#We retrospectively investigated 1,060 patients who underwent a CPET between January 2016 and April 2020 at our institution’s cardiopulmonary rehabilitation center. The following patients were included: those aged >20 years, those tested with a treadmill, and those who underwent symptom-limited maximum exercise testing— reaching ≥85% of the predicted HRmax (62% if taking beta-blockers) and highest respiratory exchange ratio ≥1.1. Ultimately, 827 patients were included in this study. Data on diagnosis, history of taking beta-blockers, age, body mass index (BMI), and CPET parameters were collected. Subgroup analysis was performed according to age, betablockers, BMI (low <18.5 kg/m2, normal, and high ≥25 kg/m2), and risk classification. @*Results@#There was a significant difference between the actual HRmax and the predicted value (p<0.001). Betablocker administration resulted in a significant difference in the actual HRmax (p<0.001). There were significant differences in the moderate-to-high-risk and low-risk groups and the normal BMI and high BMI groups (p<0.001). There was no significant difference between the elderly and younger groups. We suggest new formulae for HRmax of cardiopulmonary patients: estimated HRmax=183-0.76×age (the beta-blocker group) and etimated HRmax=210-0.91×age (the non-beta-blocker group). @*Conclusion@#Age-predicted HRmax was significantly different from the actual HRmax of patients with cardiopulmonary disease, especially in the beta-blocker group. For participants with high BMI and moderate-tosevere risk, the actual HRmax was significantly lower than the predicted HRmax.

Enhanced proliferation and differentiation of Oct4- and Sox2-overexpressing human adipose tissue mesenchymal stem cells

Mesenchymal stem cells (MSCs) are attractive candidates for clinical repair or regeneration of damaged tissues. Oct4 and Sox2, which are essential transcription factors for pluripotency and self-renewal, are naturally expressed in MSCs at low levels in early passages, and their levels gradually decrease as the passage number increases. Therefore, to improve MSC proliferation and stemness, we introduced human Oct4 and Sox2 for conferring higher expansion and differentiation capabilities. The Oct4-IRES-Sox2 vector was transfected into human adipose tissue MSCs (ATMSCs) by liposomal transfection and used directly. Oct4 and Sox2 were successfully transfected into ATMSCs, and we confirmed maintenance of MSC surface markers without alterations in both red fluorescent protein (RFP) (control) and Oct4/Sox2-ATMSCs. Enhanced proliferative activity of Oct4/Sox2-ATMSCs was shown by WST-1 assay, and this result was further confirmed by cell counting using trypan blue exclusion for a long period. In addition, FACs cell cycle analysis showed that there was a reduction in the fraction of Oct4/Sox2-ATMSCs in G1 with a concomitant increase in the fraction of cells in S, compared with RFP-ATMSCs. Increased levels of cyclin D1 were also seen in Oct4/Sox2-ATMSCs, indicating acceleration in the transition of cells from G1 to S phase. Furthermore, Oct4/Sox2-overexpressing ATMSCs showed higher differentiation abilities for adipocytes or osteoblasts than controls. The markers of adipogenic or osteogenic differentiation were also upregulated by Oct4/Sox2 overexpression. The improvement in cell proliferation and differentiation using Oct4/Sox2 expression in ATMSCs may be a useful method for expanding the population and increasing the stemness of ATMSCs.

Management of Healthcare Workers and Patients on Exposure to Pandemic Influenza A (H1N1 2009) Virus in a Hospital / 병원감염관리

BACKGROUND: This study is aimed at describing the outcomes of the management of the patients, caregivers, and healthcare workers (HCWs) who are exposed to the pandemic influenza (H1N1 2009) virus and at evaluating the adequacy in exposure management and infection control. METHODS: From July 2009 to January 2010, for 7 a month period, we managed patients and healthcare workers without any respiratory protective devices, who came within 1 m distance of H1N1-positive individuals for more than 1 h and performed a 1-week follow-up. RESULTS: The total of 157 cases with exposure to pandemic influenza (H1N1 2009) virus and exposed individuals of 907 were reported. Of the exposed individuals who were under management, 15 were confirmed to be infected with the infection rate being 1.7%. The confirmed individuals did not have a secondary infection after the exposure. Rates of infection of the exposed patients and healthcare workers were 1.8% and 1.6%, respectively, and these figures were not statistically significant. CONCLUSION: The exposure management results at the hospital revealed that the infection had spread by contact with individuals who were positive for the infection. The high incidence of early exposure to the virus warrants the need to ensure the use of protective equipment and the adoption of assertive teaching methods that have long lasting effects.

Experience with a Simulation Drill for Novel Influenza A (H1N1) / 병원감염관리

BACKGROUND: It is important that hospitals conduct disaster drills to ensure prompt response in case of a pandemic and thereby prevent a biological disaster. METHODS: In a university hospital of Seoul, a drill was arranged by the members of the drill preparation team who were a part of the response team for infection control of novel influenza A (H1N1). The drill preparation team designed the scenario for the drill, made plans to resolve the potential problems that could occur during that scenario, and organized a survey team and a survey methodology. The scenario consisted of 2 modules: (1) for an intensive care unit and (2) for an emergency care center. The surveyors and field participants were evaluated after the drill exercise. RESULTS: This drill was conducted to improve the response to outbreaks of new infectious diseases. The drill event showed that the communication among the members responsible for the infection control was effective. However, the drill revealed certain drawbacks in the process; this drawbacks involved availability of adequate quarantine space, education on using personal protective equipments, assignment of medical and nonmedical staff, management of visitors, and installment of air-conditioners, heaters, and ventilation units in the areas with H1N1 outbreak. CONCLUSION: This drill helped to improve the process of infection control and overcome the drawbacks in the current process, and thereby helped in achieving positive outcome during the actual pandemic situation when the number of hospital visits and admissions because of H1N1 pandemic had rapidly increased. Although disaster plans and drills are not actively performed, the drill for infection control is essential because the risk for an outbreak of a new infectious disease is increasing.

Effectiveness and Tolerance of Duodenoscopic Bowel Preparation for Colonoscopy / 대한소화기학회지

BACKGROUND/AIMS: Bowel preparation for colonoscopy remains an unpleasant experience because oral solutions have unpleasant tastes and may provoke abdominal pain, nausea, vomiting, and sleep disturbance. Duodenoscopic bowel preparation is an alternative method for patients who are unwilling to take oral preparation solution or for those who are supposed to have both gastroscopic and colonoscopic examination on the same day. We assessed the effectiveness and tolerance of duodenoscopic bowel preparation. METHODS: Patients in group OA (orally administered) ingested 45 mL of sodium phosphate (NaP) in the evening before the day of procedure and in the morning on the day of colonoscopy, whereas patients in group EA (endoscopically administered) were prepared for the procedure by duodenoscopic infusion of 90 mL of NaP diluted with 180 mL of water into the second portion of the duodenum. After 4 hours, we assessed the overall quality of colonic cleansing, using a range of excellent to inadequate. The patients completed a questionnaire on their preparation-associated symptoms, tolerance, and preference. RESULTS: In group EA, sleep disturbance (p<0.05) and nausea (p<0.05) occurred less frequently than in group OA. Overall, the tolerance rating for preparation was higher in group EA. However, the quality of colonic cleansing and cecum intubation time was not different between the two groups. Patients in group EA who had ingested NaP in the past preferred duodenoscopic bowel preparation. CONCLUSIONS: Duodenoscopic bowel preparation may play a role in colonic cleansing especially for patients who are scheduled to undergo gastroscopic and colonoscopic examination on the same day and for those who are unwilling to ingest NaP.

Effectiveness and Tolerance of Duodenoscopic Bowel Preparation for Colonoscopy / 대한소화기학회지

BACKGROUND/AIMS: Bowel preparation for colonoscopy remains an unpleasant experience because oral solutions have unpleasant tastes and may provoke abdominal pain, nausea, vomiting, and sleep disturbance. Duodenoscopic bowel preparation is an alternative method for patients who are unwilling to take oral preparation solution or for those who are supposed to have both gastroscopic and colonoscopic examination on the same day. We assessed the effectiveness and tolerance of duodenoscopic bowel preparation. METHODS: Patients in group OA (orally administered) ingested 45 mL of sodium phosphate (NaP) in the evening before the day of procedure and in the morning on the day of colonoscopy, whereas patients in group EA (endoscopically administered) were prepared for the procedure by duodenoscopic infusion of 90 mL of NaP diluted with 180 mL of water into the second portion of the duodenum. After 4 hours, we assessed the overall quality of colonic cleansing, using a range of excellent to inadequate. The patients completed a questionnaire on their preparation-associated symptoms, tolerance, and preference. RESULTS: In group EA, sleep disturbance (p<0.05) and nausea (p<0.05) occurred less frequently than in group OA. Overall, the tolerance rating for preparation was higher in group EA. However, the quality of colonic cleansing and cecum intubation time was not different between the two groups. Patients in group EA who had ingested NaP in the past preferred duodenoscopic bowel preparation. CONCLUSIONS: Duodenoscopic bowel preparation may play a role in colonic cleansing especially for patients who are scheduled to undergo gastroscopic and colonoscopic examination on the same day and for those who are unwilling to ingest NaP.

A Case of Malignant Pleural Effusion Treated by Chemical Pleurodesis in Ovarian Carcinoma / 대한부인종양콜포스코피학회잡지

Carcinomas of the lung, breast and lymphoma account for approximately 75% of malignant pleural effusions and the metastatic ovarian carcinoma is the fourth leading cause of malignant pleural effusions. The diagnosis of a malignant pleural effusion is established by demonstrating malignant cells in the pleural fluid or in the pleural biopsy. Chemical pleurodesis should be considered in cases of patients with malignant pleural effusion, who were not responded with systemic chemotherapy. We experienced a case of malignant pleural effusion treated by chemical pleurodesis, which was developed in a patient with ovarian carcinoma and we report it with the brief review or literatures.

Plasma Angiotensin / 대한내분비학회지

The purpose of the present study was to define the normal range of plasma concentration of angiotensin I-converting enzyme(ACE), N-acetyl-b-D-glucosaminidase(NAG), inactive and active renin, and atrial natriuretic peptide(ANP) in normal Korean adult male in terms of aging. Both plasma ACE activity and NAG concentration were measured by spectrofluorometry, and the plasma renin activity and ANP concentration were measured using radioimmunoassay. The ACE was 67.7+-3.6 nM His-Leu/min/ml and did not change in terms of age. The plasma NAG activity tended to decrease. Both plasma active and inactive renin activities were 2.1+-0.2 and 3.0+-0.3 ngAI/ml/h and tended to decrease in terms of aging. The percentage of inactive renin to total renin was 57.2+-2.9% at age 21-30 and also tended to decrease in terms of aging. Plasma ANP concentration at age 22 was 59.6+-2.9 pg/ml.

Effects of chronic cold exposure on renal function and atrial natriuretic peptide content / 대한내분비학회지

No abstract available.

Clinical analysis of cranioplasty

No abstract available.

Reconstruction of a lateral collateral ligament of the proximal interphalangeal joint of the fingers

No abstract available.