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박해심,정기석,Kian Fan Chung,Felicia Allen-Ramey,Ryan Pollard,Richard Perry,David Price 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.1
Purpose: Smoking has detrimental effects on asthma symptom control and response to treatment and is prevalent among asthma patients in South Korea. The aim of this study is to determine the prevalence of smoking among asthma patients in South Korea and to compare the medication regimens of asthma patients who do and do not smoke. Methods: A cross-sectional survey was conducted from August 2010 to January 2011. Participating physicians (N=25) recorded demographic and clinical data on all asthma patients presenting during the study period (N=2,032), and then recruited a subset of patients (N=500) for the survey such that half were self-reported current smokers. Recruited patients were between the ages of 18 and 60. Results: Among presenting asthma patients, 17.3% were current smokers, 19.2% were former smokers, and 63.5% had never smoked. Within the analyzable study population (N=471), 212 patients reported smoking currently, 79 smoking formerly, and 180 never smoking. Among current and former smokers, 79.7% and 81.0%, respectively, were men, while women represented 80.5% of patients who had never smoked. Agreement was strong between physician-determined smoking status and patient-reported smoking status (κ=0.82; P<0.001). However, asthma medication regimens examined according to GINA treatment steps did not differ by smoking status. In addition, mean quality of life scores and level of asthma control did not differ by smoking status. Conclusions: In South Korea, physicians are well aware of the smoking status of their patients. However, smoking status did not affect the prescribed medication regimens of this population of asthma patients.
Spinal Growth Modulation with Use of a Tether in an Immature Porcine Model :
Newton, Peter O,Upasani, Vidyadhar V,Farnsworth, Christine L,Oka, Richard,Chambers, Reid C,Dwek, Jerry,Kim, Jung Ryul,Perry, Andrew,Mahar, Andrew T Journal of Bone and Joint Surgery 2008 Journal of bone and joint surgery Vol.90 No.12
<P>BACKGROUND: Spinal growth modulation by tethering the anterolateral aspect of the spine, as previously demonstrated in a nonscoliotic calf model, may be a viable fusionless treatment method for idiopathic scoliosis. The purpose of the present study was to evaluate the radiographic, histologic, and biomechanical results after six and twelve months of spinal growth modulation in a porcine model with a growth rate similar to that of adolescent patients. METHODS: Twelve seven-month-old mini-pigs underwent instrumentation with a vertebral staple-screw construct connected by a polyethylene tether over four consecutive thoracic vertebrae. The spines were harvested after six (n = 6) or twelve months (n = 6) of growth. Monthly radiographs, computed tomography and magnetic resonance imaging scans (made after the spines were harvested), histologic findings, and biomechanical findings were evaluated. Analysis of variance was used to compare preoperative, six-month postoperative, and twelve-month postoperative data. RESULTS: Radiographs demonstrated 14 degrees +/- 4 degrees of coronal deformity after six months and 30 degrees +/- 13 degrees after twelve months of growth. Coronal vertebral wedging was observed in all four tethered vertebrae and progressed throughout each animal's survival period. Disc wedging was also created; however, in contrast to the findings associated with vertebral wedging, the tethered side was taller than the untethered side. Magnetic resonance images revealed no evidence of disc degeneration; however, the nucleus pulposus had shifted toward the side of the tethering. Midcoronal undecalcified histologic sections showed intact bone-screw interfaces with no evidence of implant failure or loosening. With the tether cut, stiffness decreased and range of motion increased in lateral bending away from the tether at both time-points (p < 0.05). CONCLUSIONS: In this porcine model, mechanical tethering during growth altered spinal morphology in the coronal and sagittal planes, leading to vertebral and disc wedging proportional to the duration of tethering. The resulting concave thickening of the disc in response to the tether was not anticipated and may suggest a capacity for the nucleus pulposus to respond to the compressive loads created by growth against the tether.</P>