Roles of Inflammatory Biomarkers in Exhaled Breath Condensates in Respiratory Clinical Fields

Background Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated. Methods We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively. Results Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George’s Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV1)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV1 exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017). Conclusion Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed

Normal Ambulatory 24-Hour Esophageal pH Values in Koreans -A Multicenter Study-

Ambulatory 24-hr esophageal pH monitoring is considered the gold standard for diagnosing gastroesophageal reflux disease. The aim of this study was to establish normal values for gastroesophageal acid exposure in healthy Koreans. Fifty healthy volunteers (24 males and 26 females; mean age, 45 yr) without reflux symptoms and without reflux esophagitis or hiatal hernia on upper endoscopy underwent ambulatory 24-hr esophageal pH monitoring after esophageal manometry. The 95th percentiles for the reflux parameters were: the percent total time pH <4, 3.7%; the percent upright time pH <4, 5.7%; the percent supine time pH <4, 1.0%; the number of reflux episodes with pH <4, 76.5; the number of reflux episodes with pH <4 for >5 min, 1.5; the duration of the longest episode, 12.5 min; and the composite score, 14.2. Age and gender were not associated with any of the pH parameters. In conclusion, physiological gastroesophageal reflux occurs in healthy Koreans. These normal esophageal pH values will provide reference data for clinical and research studies in Korea

Determinants of respiratory symptom development in patients with chronic airflow obstruction

SummaryBackgroundThis study was undertaken to identify the determinants of respiratory symptom development in patients with chronic airflow obstruction (CAO).MethodsCategories of symptomatic and asymptomatic CAO were defined using questionnaire responses and spirometric results. We analyzed data obtained as part of the second South Korean National Health and Nutrition Examination Survey (Korean NHANES II).ResultsAmong 187 patients with CAO, 69 had no respiratory symptoms. CAO patients with symptoms were significantly older than those without symptoms (P=0.026), and hypertension was more common among symptomatic CAO patients than among asymptomatic CAO patients (P=0.005). According to questionnaire responses, symptomatic CAO patients had more difficulty in walking or lifting (P<0.001), required more help with personal care (P=0.01), and had poorer general health than asymptomatic CAO patients (P=0.008). Symptomatic CAO patients had higher fasting blood glucose levels than asymptomatic CAO patients (P=0.028). Symptomatic CAO patients had significantly lower forced expiratory volume in 1s (FEV1) (P=0.001), forced vital capacity (FVC) (P=0.008), and a ratio of FEV1/FVC than asymptomatic CAO patients (P<0.001). Statistically significant predictors of symptom development were as follows: age (odds ratio (OR) 1.04, P=0.028), hypertension (OR 4.41, P=0.008), fasting blood glucose (OR 1.02, P=0.034), FEV1 (OR 0.07, P=0.002), FVC (OR 0.08, P=0.009), FEV1/FVC (OR 0.00, P=0.001). Multiple logistic regression analyses revealed two independent factors associated with symptom development: FEV1/FVC (OR 0.001, P=0.002) and hypertension (OR 5.95, P=0.005).ConclusionsIn CAO, respiratory symptom development is significantly associated with low FEV1/FVC and the presence of hypertension

Large Superficial Basal Cell Carcinoma Arising in the Scalp

Superficial basal cell carcinoma (sBCC), a rare sub-type of basal cell carcinoma, can frequently occur in younger patients. This cancer type preferentially develops on the trunk. However, other subtypes of BCC can occur in the head and neck, probably secondary to sunlight exposure. Especially, sBCC on the scalp has been rarely-reported, accounting for 0.7~0.8% of all sBCC cases. We report a case of 71-year-old female with a large sBCC of the scalp, an unusual site of sBCC

The Effect of Infliximab on Patients with Ulcerative Colitis in Korea

Background/AimsInfliximab was introduced recently as a rescue therapy for ulcerative colitis (UC) patients refractory to conventional treatments such as therapy with 5-amiono salicylic acids (5-ASA), immune modulators, and corticosteroids. However, there is insufficient data about its efficacy and safety in Korea.MethodsFrom 7 tertiary referral hospitals, 33 patients who were treated with infliximab for moderate to severe (Mayo score 6-12) UC refractory to conventional treatment were recruited to this study. Clinical remission was defined as a total Mayo score of 2 or lower and every subscore less than 2. Partial response was defined as a decrease of Mayo score at least 3 points from baseline.ResultsTwenty-three patients (69.7%) showed clinical remission and 29 patients (87.8%) showed partial response in the observation period. When the remission and non-remission groups were compared in univariate analysis, only a higher total Mayo score at base line (11.0±0.9 vs. 9.9±1.5; P=0.04) was related to remission. The remission maintenance rate decreased with time in the Kaplan-Meier analysis. Two patients experienced re-remission after the first remission followed by aggravation during infliximab treatment. Three patients stopped infliximab treatment owing to adverse events including rhabdomyolysis, pneumonia, and fever of unknown origin.ConclusionsIf there is no choice except surgery for UC patients refractory to conventional treatment, infliximab is an effective and relatively safe treatment option for these patients in Korea

Impacts of coexisting bronchial asthma on severe exacerbations in mild-to-moderate COPD : results from a national database

Acknowledgments The authors would like to thank Kyungjoo Kim for the confident statistical analyses in this work. This study was supported by a grant (2014P3300300) from the Korea Centers for Disease Control and Prevention. The abstract of this paper was presented at the Asian Pacific Society of Respirology 20th Congress as an oral presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Respirology.Peer reviewedPublisher PD

Prognostic Implication of Telomerase Activity in Patients with Brain Tumors

Telomerase adds telomeric repeats to the ends of telomeres to compensate for their progressive loss. A favorable prognosis is associated with low or no telomerase in some tumors. The authors investigated whether telomerase activity is associated with survival of patients with brain tumors. Sixty-two consecutive patients with brain tumors underwent surgery, and their surgical specimens were investigated. The patients were pathologically categorized as group I (aggressive group) and group II (non-aggressive group). Telomerase activity was examined by the telomeric repeat amplification protocol (TRAP) assay. The median time was calculated in association with overall survival and progression-free survival in each group. The significant difference was noted in telomerase activity between high-grade gliomas and low-grade gliomas (p=0.022). Telomerase activity was significantly associated with the median overall survival and progression-free survival in all tumors of the aggressive group. On the other hand, the median overall survival in the non-aggressive group was not dependent on telomerase activity, while the median progression-free survival was. Our data suggests that telomerase is an important prognostic indicator of survival in patients with brain tumors