결핵은 일차적으로 폐에 주로 발생하지만 혈행성 전파를 통하여 모든 기관에 나타날 수 있으며 면역 억제자의 경우 특 히 가능성이 높다. 저자들은 평소 건강했던 속립성 폐결핵 환자에서 간, 비장, 신장, 뇌막 및 뇌실질에 동시에 나타난 다발성 결핵을 보고한다. (Tuberc Respir Dis 2007; 63: 67-71)Key Words: Miliary tuberculosis, Multiorgan, Immunocompetent.Address for Correspondence: Dong Jib Na, M.D. Division of Pulmonary Medicine, Department of Internal Medicine, Eulji University School of Medicine, 1036 Dunsan 2-dong, Seo-gu, Daejeon, 302-799, Korea. Phone: 82-42-611-3154, Fax: 82-42-611-3853 E-mail: djna13@gmail.comReceived: Apr. 20. 2007Accepted: Jun. 14. 2007
Ubiquitously transcribed tetratricopeptide repeat, X chromosome (UTX) is involved in the epigenetic regulation. A previous mouse xenograft study revealed that UTX knockdown is associated with downregulated expression of matrix metalloproteinase-11 (MMP-11). The authors investigated 224 cases of breast cancer from Kangbuk Samsung Medical Center between 2000 and 2005. Nuclear UTX and cytoplasmic MMP-11 expressions were assessed using immunohistochemistry of tumor tissue microarray specimens. The relationships between the expression of UTX, MMP-11, and patients' outcomes were analyzed. UTX expression was significantly associated with high histologic grade, lymphatic invasion, vascular invasion, and tumoral expression of MMP-11. Survival analysis revealed that patients with UTX expression had a poorer overall survival rate (P=0.010) as well as diminished disease-free survival rate (P=0.001). The prognostic power of UTX expression was significant in patients with luminal-type breast cancer (P=0.027, overall survival; P=0.008, disease-free survival). Validation of UTX can provide further prognostic information beyond traditional indicators and represents a potential therapeutic target for breast cancer.
A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
This study aimed to evaluate the 1-year mortality rate among older patients with COVID-19 discharged from hospital and to identify risk factors associated with this outcome. Using a COVID-19 dataset from the Korean National Health Insurance System, this study's evaluation period spanned from October 8, 2020, through December 31, 2021. The primary outcome was the 1-year mortality rate following hospital discharge. A logistic regression model was employed for multivariable analysis to estimate the odds ratios for the outcomes, and the Kaplan-Meier method was used to analyze differences in 1-year survival rates. Among the 66,810 COVID-19 patients aged 60 years or older who were hospitalized during the study period, the in-hospital mortality rate was 4.8% (n = 3219). Among the survivors (n = 63,369), the 1-year mortality rate was 4.9% (n = 3093). Non-survivors, compared to survivors, were significantly older (79.2 ± 9.5 vs. 68.9 ± 7.8, P < 0.001) and exhibited a lower rate of COVID-19 vaccination (63.0% vs. 91.7%, P < 0.001). Additionally, non-survivors experienced a higher incidence of organ dysfunction, along with a greater proportion of required mechanical ventilation (14.6% vs. 1.0%, P < 0.001) and extracorporeal membrane oxygenation (4.0% vs. 0.1%, P < 0.001). Multivariable logistic regression analysis identified older age, male sex, cardiovascular disease, immunosuppression, organ dysfunction, illness severity, and corticosteroid use during hospitalization as factors associated with death within 1 year after hospital discharge. However, vaccination was found to have a long-term protective effect against death among COVID-19 survivors. The 1-year mortality rate after hospital discharge for older COVID-19 patients was comparable to the in-hospital mortality rate for these patients in Korea. The long-term mortality rate among hospitalized older COVID-19 patients was influenced by demographic factors and the severity of illness experienced during hospitalization.
Spontaneous isolated dissection of the superior mesenteric artery (SMA) is uncommon. Because of its rarity, the risk factors, aetiology and natural history are unclear, and there is no consensus on the optimal treatment strategy.Seven consecutive patients with symptomatic spontaneous isolated SMA dissection who received conservative treatment between March 2003 and February 2008 were included in this study. Their clinical characteristics, treatment methods and outcomes were analysed retrospectively.Acute abdominal pain was the most common clinical manifestation. Initial contrast-enhanced dynamic computed tomography (CT) showed isolated SMA dissection with partial thrombosis in all seven patients. Full anticoagulation was carried out immediately after the diagnosis. Clinical symptoms disappeared within 14 days and follow-up CT showed complete resolution of the dissection in four patients. After a mean follow-up of 23 months, there was no mortality or morbidity related to the dissection.In patients with symptomatic spontaneous isolated dissection of the SMA, conservative management is feasible if there is no evidence of bowel infarction or bleeding.
Physical activity has been found to aid the maintenance of health in the elderly. Exercise-induced skeletal muscle contractions lead to the production and secretion of many small proteins and proteoglycan peptides called myokines. Thus, studies on myokines are necessary for ensuring the maintenance of skeletal muscle health in the elderly. This review summarizes 13 myokines regulated by physical activity that are affected by aging and aims to understand their potential roles in metabolic diseases. We categorized myokines into two groups based on regulation by aerobic and anaerobic exercise. With aging, the secretion of apelin, β-aminoisobutyric acid (BAIBA), bone morphogenetic protein 7 (BMP-7), decorin, insulin-like growth factor 1 (IGF-1), interleukin-15 (IL-15), irisin, stromal cell-derived factor 1 (SDF-1), sestrin, secreted protein acidic rich in cysteine (SPARC), and vascular endothelial growth factor A (VEGF-A) decreased, while that of IL-6 and myostatin increased. Aerobic exercise upregulates apelin, BAIBA, IL-15, IL-6, irisin, SDF-1, sestrin, SPARC, and VEGF-A expression, while anaerobic exercise upregulates BMP-7, decorin, IGF-1, IL-15, IL-6, irisin, and VEGF-A expression. Myostatin is downregulated by both aerobic and anaerobic exercise. This review provides a rationale for developing exercise programs or interventions that maintain a balance between aerobic and anaerobic exercise in the elderly.
Idiopathic pulmonary fibrosis(IPF) is a chronic progressive fibrotic interstitial pneumonia of unknown etiology. In some randomized trials, pirfenidone is an antifibrotic agent that has been shown to delay the progression of IPF. However, it isn9t easy to continue the full dose of pirfenidone used in clinical trials. Our study aimed to evaluate the efficacy of low-dose pirfenidone for patients with IPF. We retrospectively reviewed patients9 medical records with IPF at a single center from 2011 to 2021. Patients were divided into three groups: those not treated with pirfenidone(control) and those treated with pirfenidone at doses less than 1200 mg/day(low dose group) and more than 1200 mg/day(high dose group). Clinical features and pulmonary function were compared between the three groups. Of 118 patients, 64(54.2%) received pirfenidone and 54(45.8%) did not receive antifibrotic agents. Of the 64 patients treated with pirfenidone, 48(75.0%) and 16 (25.0%) received 773.79 and 1509.97 mg pirfenidone per day, respectively. Changes in forced vital capacity(FVC) for six months were -180, 80, and -10 mL in the control, low-dose, and high-dose groups(p<0.001). Changes in FVC over 12 months were -270, 30, and -250 mL in the control, low-dose, and high-dose groups(p=0.001). FVC was significantly decreased in the control group than in the low-dose and high-dose groups. There was no significant difference in FVC change between the low-dose and high-dose groups. Continuing administration of pirfenidone at low doses would effectively reduce disease progression of IPF in real-world practice.
Background: The management of patients with lung cancer has improved recently, and many of them will require admission to the medical intensive care unit (MICU).The aim of this study was to examine the clinical characteristics and to identify risk factors for mortality in patients with lung cancer admitted to the MICU.Methods: We conducted retrospective analysis on 88 patients with lung cancer admitted to the MICU between April 2004 and March 2008.Results: Of the 88 patients (mean age, 66 years), 71 patients (80.7%) had non-small cell lung cancer and 17 patients (19.3%) had small cell lung cancer.Distant metastasis were present in 79 patients (89.8%).The main reasons for MICU admission were acute respiratory failure (77.3%), sepsis (11.4%), and central nervous system dysfunction (4.5%).Mechanical ventilation was used in 54 patients (61.4%).Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of MICU stay, need for mechanical ventilation, source of MICU admission were correlated with MICU mortality.The type of lung cancer and metastasis were not predictive factors of death in MICU.Conclusion: Most common reason for ICU admission was acute respiratory failure.Mortality rate of lung cancer patients admitted to the MICU was 65.9%.APACHE II score, length of ICU stay, need for mechanical ventilation, source of MICU admission were predicted factors of death in the MICU.
We investigated the effect of endoplasmic reticulum (ER) protein 29 (ERp29) on thyroglobulin (Tg) secretion and its negative regulation by microRNAs (miRNAs). ERp29 overexpression promoted Tg secretion from thyrocytes of PCCL3 cells via activation of ER stress sensors, including activation of transcription factor 6 fragmentation, XBP1 mRNA splicing by inositol-requiring enzyme 1, and phosphorylation of eukaryotic initiation factor 2 alpha as downstream actions of RNA-dependent protein kinase-like ER kinase. Thyroid hormone receptor beta is a target gene of mir-331, one of the most abundant miRNAs observed in ERp29-overexpressing cells. mir-331 negatively regulated Tg expression and secretion by ~70% compared with the control. To overcome hypothyroidism, Tg secretion at the molecular level is required to counteract negative regulation of intracellular mir-331. Our findings may provide insight into the treatment of diseases caused by poor ER protein secretion, including ER storage disease.
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