• Journal of Chest Surgery
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• v.32 no.12
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• pp.1078-1086
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• 1999

배경 :폐포내 fibronectin(FN)의 분포와 역할은 많은 연구자에 의하여 연구되어왔다. 흰주에서 폐의 분화시 FN은 태자에서 폐포의 기저막에 주로 분포되고 간엽조직에서도 관찰되면 분화가 진행되면 폐포막의 간질조직에 FN의 함량이 높아진다. 또 FN은 일반적으로 폐포대식세포(alveolar macrophage)에서 분비되고 폐에 질병이 발생하였을 때 다량의 FN이 폐포대식세포에서 분비된다고 보고되어 있다(Schoenberger 등 1984: Ozaki 등 1990; Rom 등 1987 ; Cordier 등 1990) 저자는 흰쥐의 폐포발생이 진행중인 폐포기 후반에서의 폐포막내 정상적인 FN이니 분포의 변화와폐포를 구성하는 큰 폐포세포(type II pneumocyte)에서의 FN의 분비여부를 면역조직염색법과 전자현미경을 이용하여 추적하고자하였다 실험대상 및 방법: 청정동물실에서 사육한 SPF 흰쥐(Sprague-Dawley 계)를 임신시켜 질도말법을 이용하여 태령을 정한 뒤 태아제 17일 및 20일 출생 제 1일, 2일, 3일, 5일, 및 7일의 신생흰쥐를 실험동물로 사용하였으며 대조군의 흰쥐는 체중 200ㅎ의 건강한 수컷을 사용하였다 흰쥐의 폐조직은 면역조직염색을 위해 rabbit anti rat fibronectin polyclonal antibody를 일차항체로 biotinylated goat anti rabbit IgG를 이차항체로 사용하여 폐실질세포내 FN의 분포를 LM으로 관찰하였고 한편 폐포막을 구성하는 세포 중 큰폐포세포가 FN을 분비하는 세포인지를 추적하기 위해 금과립을 첨가한 항체를 사용하여 큰 폐포세포내 FN의 분포를 EM을 이용해서 추적한 결과 다음과 같은 결과를 얻었다 결과 : 제 17일 및 20일 태아시기의 폐에서의 혈관주위에 강한 FN반응이 관찰되었다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.

• RED RIBBON
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• s.63
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• pp.8-9
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• 2005

폐포자충 폐렴은 과거 에이즈 환자의 표지질환이었으나 최근 적절한 항바이러스제의 병합요법(HAART)과 예방요법으로 환자들이 많이 감소하였다. 적절한 병합요법과 예방요법을 시행하면 폐포자충 폐렴의 발생률은 $0\%$에 가깝다. 그러므로 적절한 시기에 HAART와 같은 예방요법을 시행하는 것이 발생의 예방을 위해 가장 중요하다.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.46-53
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• 1996

Background: Endotoxin or lipopolysaccharide(LPS) can prime phagocytic cells such as polymorphonuclear leukocytes, monocytes or animal peritoneal macrophages to generate increased amounts of secretory products such as oxygen free radicals and tumor necrosis factor, which play an important role in developing adult respiratory distress syndrome in gram negative sepsis. Human alveolar macrophages(HAM) are continuously exposed to various stimuli inhaled into the alveoli, and the response to LPS might be different in HAM. Therefore, we investigated the effect of LPS pre-exposure on HAM adhered to plastic surface and A549 cell(type II human alveolar epithelial cell line) monolayer. Methods: HAM were isolated from bronchoalveolar lavage fluid from normal lung of the patients with localized lung cancer and esophageal cancer. LPS was exposed to HAM for 2hrs before or after adherence to plastic surface of 24-well Linbro plate and A549 cell monolayer. And then HAM was stimulated with PMA(phorbol myristate acetate) or fMLP(N-formyl-methionylleucyl-phenylalanine). The amount of hydrogen peroxide($H_2O_2$) production in the supernatant was measured on the principle of peroxidase-dependent oxidation of phenol red by hydrogen peroxide. Results: LPS pre-exposure could not enhance $H_2O_2$ production in neither HAM adhered to plastic surface nor one to A549 cell monolayer. But LPS even in the absence of PMA or fMLP stimulation directly increased $H_2O_2$ release in HAM if added after the adherence to A549 cell monolayer. Conclusion: Endotoxin does not prime HAM, but may directly activate HAM adhered to alveolar epithelial cells. Further investagation will be necessary.

• Applied Microscopy
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• v.33 no.4
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• pp.275-282
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• 2003

This study was undertaken to investigate paraquat-induced pulmonary injuries and effects of colchicine on pulmonary fibrosis by paraquat. Fifteen Sprague-Dawley rats were intraperitoneally injected 10 mg/kg of paraquat and repeatedly with 2 days interval. Another 15 rats were injected paraquat as same manner and simultaneously injected 10 mg/kg of colchicine in a week. Five rats in each group were sacrificed 1, 2, and 4 weeks after initial injections, and lungs extracted were observed by light and electron microscopes. On light microscopy, there was mild infiltration of neutrophils, macrophages, and lymphocytes in alveolar spaces and walls at 1 week after paraquat injection. The cellularity of alveolar wall was increased with time. However, the cellularity was not so prominent in paraquat and colchicine simultaneously injected group. On electron microscopy, there was marked swelling or excoriation of type I epithelial cells and alveolar capillary endothelium with infiltration of neutrophils, macrophages and monocytes, and lymphocytes in alveolar walls. Such findings were persisted with time. In addition, fibroblastic proliferation and deposition of collagen fibers were prominent at 4 weeks after paraquat injection. Fibrosis also occurred at 4 weeks after paraquat and colchicine simultaneous injection. It was not proninent than that of paraquat injected group. According to the above result, it would be concluded that the type I pneumocytes and alveolar capillary endothelial cells are most vulnerable on paraquat poisoning, and that the colchicine is effective on inhibition of paraquat-induced pulmonary fibrosis.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.860-862
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• 2005

We describe a case of pulmonary alveolar proteinosis in a male adult with lung cancer To achieve the successful operation of lung cancer, we used percutaneous veno-venous extracorporeal membrane oxygenation (ECMO) during whole lung lavage (WLL) of the contralateral lung. We performed successful WLL under ECMO support.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.512-522
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• 1999

Background: Due to the paucity of suitable donor organs for lung allotransplantation, a number of techniques have been developed to improve the lung preservation. Ultrastructural studies of the morphologic changes of the flushing, preservation and reperfusion injury in donor lungs have rarely been reported. Methods: Adult dogs (n=46) were matched as donors and recipients for the single lung transplantation. The donor lungs were preserved after flushing with preservation solution and transplanted after 20-hours of preservation at $10^{\circ}C$. Ultrastructural features of the lung were examined after flushing, preservation and 2 hours after lung transplantation (reperfusion) respectively. Results: Electron microscopy after flushing showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. The endothelial cells showed protrusion of tactile-like structures into the lumina, blebs or vacuoles of the cytoplasm After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. Scanning electron microscopic examination of the pulmonary parenchyma showed focally alveolar collapse and focal consolidation after the preservation and more prominent changes after the reperfusion procedure. The lungs preserved with low potassium dextran glucose solution, with additional prostaglandin $E_1(PGE_1)$ and verapamil(VP) showed relatively well preserved ultrastructures compared with those which were preserved with modified Euro-Collins or University of Wisconsin, and with additional $PGE_1$ and/or VP. Conclusion: The ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage was occurred during the reperfusion. The reperfusion injury resulted in prominent pulmonary parenchymal alterations with a pattern of acute lung injury.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.176-183
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• 1998

Background: The total and differential cell count of bronchoalveolar lavage(BAL) fluid are useful assessing activity, prognosis and response to therapy in diffuse interstitial lung disease. But controversy exist as to the appropriate method in processing BAL fluid. Therefore we investigated the effect of gauze filtration, centrifugation and different storage time of BAL fluid on the total and differential cell count. Methods: We obtained BAL fluid from 6 persons with no active lung lesion and divided pooled BAL fluid into several siliconized glass tubes and filtered through 0, 1, 2, 4 folds of cotton guaze(pore size: 1mm), and compared total cell count using hemocytometer after trypan blue staining and differential cell count after Wright-Giemsa staining of cytocentrifuged preparations. And we also counted total and differential cell count after centrifugation(400g for 30 min) and various storage time(2hr, 24hr, and 48hr). Results: There was no difference in total and differential cell count according to folds of gauze filtraion. But without gauze filtration, mucus threads that hampered total and differential cell count were found in 2 cases (33%). Centrifugation resulted in loss of total cell count($24{\pm}18%$) without change in differential cell count. There was no change in total cell count after 2hr storage but significant cell loss was found after 24hr storage time(24hr : $28{\pm}21%$, 48hr : $41{\pm}24%$). However there was no change in differential cell count with 48hr storage time. Conclusion: Total and differential cell count of BAL fluid may be best performed after cotton gauze filtration without centrifugation and within 2 hours.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.36-44
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• 1998

Background: IFN-$\gamma$ is known to activate mononuclear phagocytes and to mediate host defense mechanism against some intracellular microorganisms, but little is known about anti-mycobacterial activity and mechanism of IFN-$\gamma$ in human. In this study, we investigated the role of IFN-$\gamma$ in the pathogenesis of tuberculosis by observing the effect of IFN-$\gamma$ on the phagocytosis of M.tuberculosis(MTB) and on the production of TNF-$\alpha$ by human pulmonary alveolar macrophage. Method: Pulmonary alveolar macrophage(PAM) were prepared with adhesion purification method from bronchoalveolar lavage fluid obtained from 8 persorn without active lung lesion and cultured($1{\times}10^6cells/ml$) with MTB($3{\times}10^7$ bacteria/ml) with or without IFN-$\gamma$(300U/ml), LPS(0.5ug/ml) and autologous serum(10%). After 2 hours, the percentage of PAM-phagocytosed MTB was counted after AFB staining(modified Kynion method). TNF-$\alpha$ production by PAM stimulated by IFN-$\gamma$(300U/ml), MTB($1{\times}10^6bacteria/ml$) and LPS(0.5ug/ml) for 24hours was measured in culture supernatant using ELISA method. The degree of phagocytosis of MTB by PAM stimulated with IFN-$\gamma$(300U/ml) and LPS(0.5ug/ml) for 24hours was also investigated. Results: IFN-$\gamma$ did not influence the phagocytosis of MTB by PAM(percentage of PAM-phagocytosed MTB: control: $22.1{\pm}4.9$, IFN-$\gamma$: $20.3{\pm}5.3$) and did not increase TNF-$\alpha$ production by PAM (control: $21{\pm}38pg/ml$, IFN-$\gamma$: $87{\pm}106pg/ml$), and the degree of phagocytosis of MTB by PAM pre-stimulated with IFN-$\gamma$ for 24 hours, was not increased (control: $24.5{\pm}9.5$, IFN-$\gamma$: $23.4{\pm}10.1$). Conclusion: IFN-$\gamma$ does not influence on the phagocytosis of MTB and TNF-$\alpha$ production by PAM.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.526-535
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• 1992

Background: The oxygen radicals released by alveolar macrophages contribute to killing of microorganisms including M. tuberculosis. Macrophages are "primrd" for enhanced oxygen radical release by macrophage activator like IFN-$\gamma$ and LPS, which do not themselves cause release of oxygen radicals. Actural production of oxygen radicals is "triggered" by phagocytosis or by exposure to chemical stimuli like PMA or FMLP. There has been debates about the priming effect of alveolar macro phages because they are exposed to usual environmental particles unlike blood monocytes. Therefore we examined priming effect of IFN-$\gamma$ in human alveolar macrophages comparing with that in blood monocytes and rat alveolar macrophages. And we observed the alterations of superoxide production in both human and rat alveolar macrophages after exposure to M. tuberculosis H37Ra bacilli itself and its lysate. Methods: Bronchoalveolar lavage fluid was processed to isolate alveolar macrophages by adherence and the adherent cells were removed by cold shock method. After exposure to M. tuberculosis H37Ra strain, alveolar macrophages were incubated for 24 hours with IFN-$\gamma$. The amount of superoxide production stimulated with PMA was measured by ferricytochrome C reduction method. Results: 1) The priming effect in human alveolar macrophages was not observed even with high concentration of IFN-$\gamma$ while it was observed in blood monocytes and rat alveolar macrophages. 2) Both human and rat alveolar macrophages exposed to avirulent H37Ra strain showed triggering of superoxide release and similar results were shown with the exposure to H37Ra lysate. Conclusion: The priming effect in human alveolar macrophages is not observed because of its usual exposure to environmental particles and avirulent H37Ra strain does not inhibit the activation of alveolar macrophages.

• Applied Microscopy
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• v.31 no.3
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• pp.275-285
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• 2001

The pulmonary alveolar macrophage is thought to play an important role in the mediation of acute inflammatory lung injury by secretory products including degraded enzymes, cytokines, and reactive oxygen metabolites . This study was conceived to understand the role of alveolar macrophage in oxidative stress induced acute lung injury. To examine the alveolar macrophages and xanthine oxidase (XO) activity in bronchoalveolar lavage fluid (BALF), time-dependent changes of numbers of alveolar macrophages, monocytes and neutrophils in alveolar cavity were counted in association with ultrastructural and cytochemical observations of lung tissue and alveolar cells. The number of monocytes was increased (p<0.001) at 1h after IL-1 treatment compared with that of sham. At 2h after instillation of IL-1, the number of alveolar macrophages was the highest, XO activity in BALF was elevated at 2h after IL-1 instillation and the activity was markedly elevated(p<0.05) at 3h after IL-1 treatment. On the basis of these experimental results, it is suggested that, during early phase of acute lung injury induced by IL-1, alveolar macrophage-derived XO contributes to lung injury earlier than the neutrophilic respiratory burst.