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We aimed to evaluate the efficacy of postoperative adjuvant pemetrexed plus cisplatin (Pem-Cis) in pathologic stage IB-IIIA lung adenocarcinoma (LUAD) patients.A prospective, phase II study was performed in seven institutions in South Korea. Patients with completely resected stage IB-IIIA LUAD received pemetrexed (500 mg/mBetween August 2015 and February 2018, 105 patients were enrolled in this study. Approximately 31.4% (n=33), 43.8% (n=46), and 24.8% (n=26) of patients had pathologic stage IB, II, and IIIA, respectively. Most of the patients underwent lobectomy (n=98, 93.3%). Moreover, 41.1% and 12.1% of the patients had epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase rearrangement. Four cycles of Pem-Cis were administered in 99 patients (94.3%). At a median follow-up of 57.7 months, the 2-year DFSR was 78.1%. Multivariable analysis showed that pathologic stage IIIA and EGFR mutation were significant risk factors for DFS. Grade 3 adverse events occurred in 10 patients (9.5%), and leukopenia (n=3, 2.9%) was the most common adverse event.Adjuvant Pem-Cis is superior to historical control without adjuvant treatment in terms of 2-year DFSR; the proportion of patients with stage IB and driver mutations were higher than that of patients in previous trials. Pem-Cis showed favorable tolerability as adjuvant chemotherapy (clinicaltrial.gov; Identifier: NCT02498860).

Purpose The usefulness of rehabilitation in patients with reduced lung function before lung surgery remains unclear, and there is no adequate method for evaluating the effect of rehabilitation. We aimed to evaluate the usefulness of rehabilitation in patients with non-small cell lung cancer (NSCLC) undergoing lung cancer surgery.Materials and Methods We retrospectively analyzed the medical records of NSCLC patients at Korea University Guro Hospital between 2018 and 2020. Patients were divided into two groups depending on whether they underwent rehabilitation. Pulmonary function test (PFT) data and muscle determined using chest computed tomography (CT) images were analyzed. Because the baseline characteristics were different between the two groups, propensity score matching was performed.Results Of 325 patients, 75 (23.1%) and 250 (76.9%) were included in the rehabilitation and non-rehabilitation (control) groups, respectively. The rehabilitation group had a worse general condition at baseline. After propensity score matching, 45 patients remained in each group. Pulmonary function (forced expiratory volume in 1 second, %) (p=0.001) and the Hounsfield unit of erector spinae muscle (p=0.001) were better preserved in the rehabilitation group. Muscle loss of 3.4% and 0.6% was observed in the control and rehabilitation groups, respectively (p=0.003). In addition, the incidence of embolic events was lower in the rehabilitation group (p=0.044).Conclusion Pulmonary rehabilitation is useful in patients with NSCLC undergoing lung surgery. Pulmonary rehabilitation preserves lung function, muscle and reduces embolic events after surgery. Pulmonary rehabilitation is recommended for patients with NSCLC undergoing surgery.

The COVID-19 pandemic has imposed many communication challenges for public health authorities, especially communicating the safety, effectiveness, and importance of the COVID-19 vaccine. This study takes an integrative approach that includes a content analysis of COVID-19 vaccine-related messages from the CDC Facebook page and an experimental test of the effectiveness of the same types of vaccine-related messages on participants' attitudes toward the COVID-19 vaccine. Our findings from the content analysis show that gain-frame was used significantly more than loss-frame, and statistical evidence was more prevalent than narrative evidence in the CDC's COVID-19 vaccine-related messaging. Results from the experiment indicated that loss-framed, and messages with statistical evidence, may be more successful in promoting positive attitudes toward the COVID-19 vaccine.

Background It is important to assess the prognosis of patients with chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD). Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD. Methods We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD patients by severity of DLCO and FEV1 (≤ vs. > 50% predicted). We tested the association of FEV1 and DLCO with the following outcomes: in-hospital mortality, need for mechanical ventilation, need for intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis. Results In multivariate analyses, DLCO was associated with mortality (odds ratio = 4.408; 95% CI 1.070–18.167; P = 0.040) and need for mechanical ventilation (odds ratio = 2.855; 95% CI 1.216–6.704; P = 0.016) and ICU care (odds ratios = 2.685; 95% CI 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In multivariate linear regression analyses, DLCO (B = − 0.542 ± 0.121, P 1 (B = − 0.106 ± 0.106, P = 0.006) were negatively associated with length of hospital stay. In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68. Conclusion DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.

Purpose Histone deacetylase inhibitors (HDACis) are epigenetic regulators and used clinically for hematopoietic malignancies. Recently, HDACis have received attention as a factor that modulates the immune system. In this study, the role of histone deacetylase (HDAC) expression as a predictive marker in lung cancer patients who were treated with immune checkpoint inhibitors (ICIs) and the role of HDACi and ICI combination treatment in the mouse tumor model were analyzed.Materials and Methods The overall response rate (ORR) and progression-free survival (PFS) were analyzed by the expression of HDAC. In vitro assay, the mRNA and protein expression levels of cytokines and programmed death-ligand 1 (PD-L1) were analyzed after HDACi treatment. In vivo assay, TC-1 tumor-bearing mice were treated with HDACi and mouse programmed cell death 1 (PD-1) inhibitor.Results The HDAC6 low expression group showed high ORR and prolonged PFS. When the selective HDAC6 inhibitor was administered to the A549 cell line, the levels of interleukin-1β and interleukin-6 decreased and the expression of PD-L1 was reduced. Mice that received both the mouse PD-1 inhibitor and pan-HDACi had a smaller tumor size than that of the mice from the control group. Moreover, mice treated with the mouse PD-1 inhibitor and pan-HDACi generated greater numbers of E7-specific CD8+ T cells.Conclusion HDAC6 expression can predict the prognosis of non–small cell lung cancerpatients who were treated with ICIs. Furthermore, co-treatment with HDACi and PD-1 inhibitor was shown to decrease the tumor growth rate and create a favorable tumor microenvironment for cytotoxic T lymphocytes in the TC-1 mouse model.

Additional file 1 Table S1. EGFR mutation subtypes.

Additional file 3 Table S3. Drug-related serious adverse events.

Additional file 2 Table S2. Univariate and multivariate Cox proportional hazard analysis for progression-free survival in patients harboring epidermal growth factor receptor mutation and received tyrosine kinase inhibitors.

Background Epidermal growth factor receptor (EGFR) mutations in non–small-cell lung cancer predict sensitivity to EGFR tyrosine kinase inhibitors (TKIs). EGFR mutation types are associated with efficacy of EGFR TKIs. We investigated the clinical outcomes of afatinib, erlotinib, and gefitinib according to EGFR mutation type in patients with lung adenocarcinoma. Methods Between May 2010 and December 2018, we investigated 363 patients with advanced lung adenocarcinoma harboring EGFR mutations who received EGFR TKIs. Efficacies of EGFR TKIs such as response rate, progression-free survival (PFS), and overall survival (OS) were retrospectively evaluated according to exon 19 deletion (E19del), L858R point mutation (L858R) and uncommon mutations. Results The frequency of E19del was 48.2%, that of L858R was 42.4%, and that of uncommon mutations was 9.4%. E19del and L858R were associated with superior PFS and OS compared with uncommon mutations. Erlotinib showed significantly inferior OS than other TKIs (30.8 ± 3.3 in erlotinib vs. 39.1 ± 4.3 in afatinib vs. 48.4 ± 6.3 in gefitinib; p = 0.031) in patients with L858R. Gefitinib showed significantly inferior PFS (4.6 ± 1.1 in gefitinib vs. 11.6 ± 2.7 in afatinib vs. 10.6 ± 2.7 in erlotinib; p = 0.049) in patients with uncommon mutations. Conclusion Afatinib was significantly associated with a longer PFS, presenting constant effectiveness in all EGFR mutation types. Caution may be needed on the use of erlotinib for L858R and the use of gefitinib for uncommon EGFR mutations.

Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.

Purpose. Particulate matter (PM) is increasing every year in Asia. It is not fully understood how the airway is affected when inhaling PM. We investigated the correlation between particulate matter with a diameter of less than 10 μm (PM10) and fractional exhaled nitric oxide (FeNO) to determine whether PM causes airway inflammation. Material and Methods. We analyzed patients who visited our outpatient clinic and tested FeNO from January 2016 to December 2017 at the Korea University Guro Hospital. PM10 data were provided by the government of the Republic of South Korea, and measuring station of PM10 is located 800 meters from the hospital. We analyzed the correlation between PM10 and FeNO by a Pearson correlation analysis and by a multivariate linear regression analysis. To identify the most correlated times, we analyzed the correlation between the FeNO and PM10 daily average from the day of visit to 4 days before visit. Results. FeNO positively correlated with PM10 at two days before hospital visit in the Pearson correlation (Pearson correlation coefficient = 0.057; P-value = 0.023) and in the multivariate linear regression analysis (B = 0.051, P-value = 0.026). If the PM10 increased by 100 μg/m3, the FeNO result was expected to rise to 8.3 ppb in healthy people without respiratory disease. Conclusion. The positive correlation was found in both healthy people and asthmatic patients. Therefore, PM10 can increase airway inflammation.

Background Docetaxel is one of the standard treatments for advanced non-small cell lung cancer. Docetaxel is usually administered in a 3-week schedule, but there is significant toxicity. In this phase II clinical study, we investigated the efficacy and safety of a 4-weekly schedule of docetaxel monotherapy, as first-line chemotherapy for advanced squamous cell carcinoma in elderly lung cancer patients. Methods Patients with stage IIIB/ IV lung squamous-cell carcinoma age 70 or older, that had not undergone cytotoxic chemotherapy were enrolled. Patients received docetaxel 25 mg/m² on days 1, 8, and 15, every 4 weeks. Primary endpoint was the objective response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity profiles. Results A total of 19 patients were enrolled. Among 19 patients, 17 were for evaluated efficacy and safety. In the intent-to-treat population, ORR and disease control rate (DCR) were 11.8% and 47.1%, respectively. In the response evaluable population, ORR was 16.7% and DCR was 66.7%. Median PFS and OS were 3.1 months and 3.3 months, respectively. There were three adverse grade 3/4 events. Grade 1 neutropenia was reported in one patient. Conclusion Our data failed to demonstrate efficacy of a 4-weekly docetaxel regimen, in elderly patients with a poor performance status. However, incidence of side effects, including neutropenia, was lower than with a 3-week docetaxel regimen, as previously reported.

Juwhan Choi, Jee Youn Oh, Young Seok Lee, Gyu Young Hur, Sung Yong Lee, Jae Jeong Shim, Kyung Ho Kang, Kyung Hoon Min Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea Introduction: Acute exacerbation of COPD (AECOPD) leads to rapid deterioration of pulmonary function and quality of life. It is unclear whether the prognosis for AECOPD differs depending on the bacterium or virus identified. The purpose of this study is to determine whether readmission of patients with severe AECOPD varies according to the bacterium or virus identified.Methods: We performed a retrospective review of medical records of 704 severe AECOPD events at Korea University Guro Hospital from January 2011 to May 2017. We divided events into two groups, one in which patients were readmitted within 30 days after discharge and the other in which there was no readmission.Results: Of the 704 events, 65 were followed by readmission within 30 days. Before propensity score matching, the readmission group showed a higher rate of bacterial identification with no viral identification and a higher rate of identification with the Pseudomonas aeruginosa (P=0.003 and P=0.007, respectively). Using propensity score matching, the readmission group still showed a higher P. aeruginosa identification rate (P=0.030), but there was no significant difference in the rate of bacterial identification, with no viral identification (P=0.210). In multivariate analysis, the readmission group showed a higher P. aeruginosa identification rate than the no-readmission group (odds ratio, 4.749; 95% confidence interval, 1.296–17.041; P=0.019).Conclusion: P. aeruginosa identification is associated with a higher readmission rate in AECOPD patients. Keywords: acute exacerbation of COPD, Pseudomonas aeruginosa, readmission, bacterium, virus

Background: Adenocarcinoma is the most common type of non-small cell lung cancer (NSCLC). Some causative genomicalterations, including deletion of exon (E) 19 and point mutation of E 21, are known to have a favourable prognoses due to sensitivity to tyrosine kinase inhibitors (TKIs); however, the prognoses of other uncommon mutations are unclear. The goal of this study was to analyse the clinical significance of epidermal growth factor receptor (EGFR)mutation subtypes in lung adenocarcinoma. Methods: We retrospectively reviewed 1,020 subjects (mean age: 66.8 years, female: 41.7%) who were diagnosed with advanced (stage III–IV) lung adenocarcinoma, had EGFR mutation data, and did not undergo surgery from five medical institutes between 2010 and 2016. Subjects were classified according to EGFR mutation status, particularly for exon-specific mutations. It was defined to EGFR positivity for the presence of mutation or insertion/deletion and EGFR negativity for wild type EGFR. Results: The median follow-up period was 13.3 months. EGFR positivity was 38.0%, with the incidence of mutations in E 18, 19, 20, and 21 being 3.6%, 51.0%, 3.4%, and 42.0%, respectively. The EGFR positive group survived significantly longer than the negative group (p

Purpose The most common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is respiratory infection. Most studies of bacterial or viral cause in AECOPD have been conducted in Western countries. We investigated bacterial and viral identification rates in AECOPD in Korea. Materials and Methods We reviewed and analyzed medical records of 736 cases of AECOPD at the Korea University Guro Hospital. We analyzed bacterial and viral identification rates and classified infections according to epidemiological factors, such as Global Initiative for Chronic Obstructive Lung Disease stage, mortality, and seasonal variation. Results The numbers of AECOPD events involving only bacterial identification, only viral identification, bacterial-viral co-identification, and no identification were 200 (27.2%), 159 (21.6%), 107 (14.5%), and 270 (36.7%), respectively. The most common infectious bacteria identified were Pseudomonas aeruginosa (13.0%), Streptococcus pneumoniae (11.4%), and Haemophilus influenzae (5.3%); the most common viruses identified were influenza virus (12.4%), rhinovirus (9.4%), parainfluenza virus (5.2%), and metapneumovirus (4.9%). The bacterial identification rate tended to be higher at more advanced stages of chronic obstructive pulmonary disease (p=0.020 overall, p=0.011 for P. aeruginosa, p=0.048 for S. pneumoniae). Staphylococcus aureus and Klebsiella pneumoniae were identified more in mortality group (p=0.003 for S. aureus, p=0.009 for K. pneumoniae). All viruses were seasonal (i.e., greater prevalence in a particular season; p

Recently, Immune checkpoint inhibitor (ICI) has been widely applied to various types of cancer therapies and it is used as a treatment in clinical application. ICI has a higher effect on lung cancer than other cancers; however, the treatment efficiency is only about 25%. Therefore, many research groups are making efforts to improve treatment efficiency with co-treatment therapy using chemical medications and ICIs. We evaluated the efficacy of a new PAN-HDAC inhibitor (M166) and ICI. M166 showed growth inhibition in mouse lung cancer cell (TC-1) line, mouse lung carcinoma (LLC) and human lung cancer cell (A549) line compared with normal epithelial cell lines (NIH3T3 and HEK293. Also, we checked ten kinds of immune-related cytokines and chemokines in mRNA level by treated with M166 using RT-PCR methods. CCL2 and CXCL10 chemokines are significantly increased by dose-dependently. These results indicate that M166 regulates immune response by CCL2 and CXCL10 chemokine related pathways. In order to check the synergistic effect of ICI plus HDACi co-treatment, we explored the employment of M166 in combination with ICI in a preclinical mouse model. For in vivo experiment, the mice were divided into four groups: group 1 received no treatment after the E7-expressing TC-1 tumor challenge, group 2 was treated with M166, group 3 was treated with mouse PD-1 antibody, and group 4 was both treated with M166 and mouse PD-1 antibody. The combination therapy of M166 and mouse PD-1 antibody significantly inhibited tumor growth. These results indicate that ICI plus HDACi treatment induces tumor growth inhibition through an immune response. These findings have important implications for future clinical translation. Citation Format: Sung Yong Lee, Hyun-Seock Shin, Juwhan Choi. New HDAC inhibitor (M166) has a synergistic effect with immune checkpoint inhibitor in lung cancer treatment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4458.

Juwhan Choi, Jee Youn Oh, Young Seok Lee, Kyung Hoon Min, Gyu Young Hur, Sung Yong Lee, Kyung Ho Kang, Jae Jeong Shim Division of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea Introduction: Particulate matter and air pollution in Korea are becoming worse. There is a lack of research regarding the impact of particulate matter on patients with COPD. Therefore, the purpose of this study was to investigate the effects of various air pollution factors, including particulate matter, on the incidence rate of severe acute exacerbations of COPD (AECOPD) events. Methods: We analyzed the relationship between air pollutants and AECOPD events that required hospitalization at Guro Hospital in Korea from January 1, 2015 to May 31, 2017. We used general linear models with Poisson distribution and log-transformation to obtain adjusted relative risk (RR). We conducted further analysis through the Comprehensive Air-quality Index (CAI) that is used in Korea. Results: Among various other air pollutants, particulate matter was identified as a major source of air pollution in Korea. When the CAI score was over 50, the incidence rate of severe AECOPD events was statistically significantly higher [RR 1.612, 95% CI, 1.065–2.440, P=0.024]. Additionally, the particulate matter levels 3 days before hospitalization were statistically significant [RR 1.003, 95% CI, 1.001–1.005, P=0.006]. Conclusion: Particulate matter and air pollution increase the incidence rate of severe AECOPD events. COPD patients should be cautioned against outdoor activities when particulate matter levels are high. Keywords: air pollution, particulate matter, air quality index, acute exacerbation, COPD

Repeated readmissions in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) lead to rapid deterioration of pulmonary function. The factors known to be associated with readmission are the chronic obstructive pulmonary disease (COPD) assessment test, 6-minute walk test, COPD stage, and inhaler compliance. The purpose of this study was to analyze another risk factor of readmission within a month after treatment of AECOPD. We retrospectively reviewed the medical records of AECOPD events admitted in Korea University Guro Hospital for 5 years. Clinical and laboratory parameters related to AECOPD were collected and analyzed. Of the total 588 of AECOPD events which needed hospitalization during the study period, 58 AECOPD events occurred within 30 days. The risk factors for readmission within 30 days were analyzed through comparison between the two groups (readmission group vs. non-readmission group). In univariate analysis, there were significant difference in length of hospital stay (P = 0.009), previous pneumococcal vaccination (P = 0.013), pseudomonas aeruginosa infection (P = 0.003), antibiotic usage before hospitalization (P = 0.025), and home oxygen therapy (P

Background/purpose As facial pore widening and its treatments have become common concerns in the beauty care field, the necessity for an objective pore-analyzing system has been increased. Conventional apparatuses lack in usability requiring strong light sources and a cumbersome photographing process, and they often yield unsatisfactory analysis results. This study was conducted to develop an image processing technique for automatic facial pore analysis. Methods The proposed method detects facial pores using multi-scale detection and optimal scale selection scheme and then extracts pore-related features such as total area, average size, depth, and the number of pores. Facial photographs of 50 subjects were graded by two expert dermatologists, and correlation analyses between the features and clinical grading were conducted. We also compared our analysis result with those of conventional pore-analyzing devices. Results The number of large pores and the average pore size were highly correlated with the severity of pore enlargement. In comparison with the conventional devices, the proposed analysis system achieved better performance showing stronger correlation with the clinical grading. Conclusion The proposed system is highly accurate and reliable for measuring the severity of skin pore enlargement. It can be suitably used for objective assessment of the pore tightening treatments.

BACKGROUND: Respiratory infection is a common causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There were a few studies about a differential marker of viral or bacterial infection as a cause of AECOPD. AIMS AND OBJECTS: In this retrospective study, we evaluated serum eosinophil count and procalcitonin (PCT) level in patients with AECOPD according to laboratory confirmed the bacterial infection. METHODS: We analyzed the medical records of patients with AECOPD from January 2011 to June 2015. Patients with AECOPD were divided into two groups: patients with isolation of bacteria and those without isolation of bacteria. And white blood cell (WBC) count, eosinophil count, serum C-reactive protein (CRP) and PCT were compared among two groups. RESULTS: Among 237 patients with AECOPD, bacterial isolation group were 117. The mean value of eosinophil count was 83.74/mm 3 in bacterial isolation group and 188.81/mm 3 in non-bacterial isolation group. The eosinophil count was significantly lower in bacterial isolation group (P CONCLUSIONS: These findings suggest the combined serum eosinophil count and PCT level is a useful marker in evaluation of the cause of AECOPD and decision making of antibiotic use in patients with AECOPD.

BACKGROUND: Combined pulmonary fibrosis and emphysema (CPFE) is characterized by upper lung predominant emphysema and lower lung predominant fibrosis. However, optimal treatment of CPFE is not well known. AIMS AND OBJECTS: e reviewed the lung function change after CPFE treatment to evaluate treatment response. METHODS: We reviewed medical records of CPFE patients in Korea University Guro Hospital for 10 years. We evaluated pulmonary function test (FEV1, FVC, DLCO/VA, composite physiologic index [CPI; 91- (0.65×%predicted DLco) – (0.53×%predicted FVC) + (0.34×%predicted FEV1)] at baseline and after 24months) and treatment of CPFE patients. RESULTS: Thirty-nine CPFE patients treated as chronic obstructive pulmonary disease (COPD) or idiopathic pulmonary fibrosis (IPF) were analyzed. Among them, 13 patients were treated as COPD with long acting muscarinic antagonist (LAMA) and 12 patients were treated as IPF with steroid, other immunosuppressants or colchine. CPI changes within 24 months were lower with patients treated with COPD (17.99±13.70 with COPD treatment, 7.09±17.72 without COPD treatment, p=0.041). However, DLCO/VA change within 24 months (2.80±18.16 with IPF treatment, 24.25±17.10 without IPF treatment, p=0.002) and CPI change within 24 months (11.05±17.28 with IPF treatment, 21.81±8.37 without IPF treatment, p =0.048) were rather higher with patients treated with IPF. CONCLUSIONS: Patients treated as COPD with inhaled bronchodilator showed improvement in CPI. However, when treated as IPF with immunosuppressants, DLCO/VA and CPI after 24 months rather aggravated. Although this is a retrospective and limited data, patients with CPFE may get benefit when properly treated as COPD with proper long acting inhaled bronchodilator.

Background The association between irritable bowel syndrome (IBS) based on Rome III criteria and G protein β3 subunit (GNB3), interleukin (IL)-10, and tumor necrosis factor (TNF)-α gene polymorphisms is uncertain. Methods Case and control subjects were recruited from Korean visitors to the Health Promotion Center and Digestive Disease Center for gastrointestinal endoscopy. G protein β3 subunit, IL-10, and TNF-α gene polymorphisms were genotyped using a polymerase chain reaction-based method. Multifactor dimensionality reduction (MDR) analysis was used to assess gene–gene interactions. Key Results Genotype and allele frequencies of GNB3 showed marginal significance between the healthy controls and IBS patients (χ2 = 5.92, P = 0.052; χ2 = 3.76, P = 0.053). G protein β3 subunit T allele was more strongly correlated with IBS with constipation (12 of constipation-dominant type and 31 of mixed type) than with 51 diarrhea-dominant type and 88 normal subjects (χ2 = 13.91, P = 0.008). Multifactor dimensionality reduction analysis revealed that there were no significant interactions of GNB3, IL-10, and TNF-α gene variants with susceptibility to IBS (P > 0.05). Conclusions & Inferences The results suggest that GNB3 825T allele might be associated with IBS with constipation in Koreans.