• Title/Summary/Keyword: Disease Progression

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Reconstruction of Mainstem Bronchus Obstructed by Endobronchial Tuberculosis (결핵성 주기관지협착에 대한 주기관지재건술)

  • Kim Su Wan;Kim Jhingook;Shim Young Mog;Kim Kwhanmien;Choi Yong Soo;I Hoseok;Kim Hojoong;Chang Jee Won
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.622-626
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    • 2005
  • Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

Increased procalcitonin level is a risk factor for prolonged fever in children with Mycoplasma pneumonia

  • Jeong, Ji Eun;Soh, Ji Eun;Kwak, Ji Hee;Jung, Hye Lim;Shim, Jae Won;Kim, Deok Soo;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.61 no.8
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    • pp.258-263
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    • 2018
  • Purpose: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile. Results: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ${\leq}3days$ after admission and hospital stay ${\leq}6days$. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ${\leq}3days$. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. Conclusion: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.

Preliminary Phantom Experiments to Map Amino Acids and Neurotransmitters Using MRI

  • Oh, Jang-Hoon;Kim, Hyug-Gi;Woo, Dong-Cheol;Rhee, Sun Jung;Lee, Soo Yeol;Jahng, Geon-Ho
    • Progress in Medical Physics
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    • v.29 no.1
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    • pp.29-41
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    • 2018
  • The objective of this study was to evaluate the chemical exchange saturation transfer (CEST) effect of amino acids and neurotransmitters, which exist in the human brain, depending on the concentration, pH, and amplitude of the saturation radiofrequency field. Phantoms were developed with asparagine (Asn), ${\gamma}-aminobutyric$ acid (GABA), glutamate (Glu), glycine (Gly), and myoinositol (MI). Each chemical had three different concentrations of 10, 30, and 50 mM and three different pH values of 5.6, 6.2, and 7.4. Full Z-spectrum CEST images for each phantom were acquired with a continuous-wave radiofrequency (RF) saturation pulse with two different $B_1$ amplitudes of $2{\mu}T$ and $4{\mu}T$ using an animal 9.4T MRI system. A voxel-based CEST asymmetry was mapped to evaluate exchangeable protons based on amide (-NH), amine ($-NH_2$), and hydroxyl (-OH) groups for the five target molecules. For all target molecules, the CEST effect was increased with increasing concentration and B1 amplitude; however, the CEST effect with varying pH displayed a different trend depending on the characteristics of the molecule. On CEST asymmetric maps, Glu and MI were well visualized around 3.0 and 0.9 ppm, respectively, and were well separated macroscopically at a pH of 7.4. The exchange rates of Asn, Glu, BABA, and Gly usually decreased with increasing pH. The CEST effect was dependent on the concentration, acidity of the target molecules, and B1 amplitude of the saturation RF pulse. The CEST effect for Asn can be observed in a 9.4T MRI system. The results of this study are based on applying the CEST technique in patients with neurodegenerative diseases when proteins in the brain are increased with disease progression.

Lateral Supramalleolar Fasciocutaneous Island Flap for Reconstruction of the Foot and Ankle Soft Tissue Defect (외측 복사뼈 상부 근막-피부 섬피판을 이용한 발 및 발목관절 연부조직 결손의 재건)

  • Choi, Jae Hoon;Kim, Nam Gyun;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Joon Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.784-788
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    • 2006
  • Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

Production of the Novel Disease Animal Model by Used Tet-off System

  • Park, Jun-Hong;Kim, Kil-Soo;Lee, Eun-Ju;Kim, Myoung-Ok;Kim, Sung-Hyun;Kyoungin-Cho;Jung, Boo-Kyung;Kim, Hee-Chul;Sol ha Hwang
    • Proceedings of the KSAR Conference
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    • 2003.06a
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    • pp.54-54
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    • 2003
  • The activation of protooncogenes or the inactivation of their gene products may be a specific and effective functional study for human neoplasia. To examine this possibility, we have used the tetracycline regulatory system to generate transgenic mice that conditionally express the HccR-2 protooncogene in vivo. The new human cervical cancer protooncogene (HccR-2) was detected from cervical cancer cell line. To elucidate its biological functions, we generated transgenic mice that expressed the HccR-2 gene. The sustained expression of the HccR-2 transgene culminated chronic neutrophilic leukemia (CNL). CNL is a rare chronic myeloproliferative disorder that presents as a sustained, mature neutrophilic leukocytosis with few or no circulating immature granulocytes, the absence of peripheral blood monocytosis, basophilia, or eosinophilia, and infiltration of neutrophils at the liver, spleen and kidney. Mice expressing the HccR-2 and tetracycline-transactivating protein (tTa) transgene were found to have altered myeloid development that was characterized by increased percentages of mature neutrophil and band form neutrophil in the peripheral blood, liver and spleen. Activation of the transgene causes CNL. In our model, expression of HccR-2 transgene mice was similar in many respects to the human CNL. This model will be valuable not only for investigating the biological properties of the HccR-2 and other protooncogenes in vivo but also for analyzing the mechanism involved in the progression of CNL.

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Induction of Heat Shock Protein 70 Inhibits Tumor Necrosis $Factor{\alpha}-induced$ Lipid Peroxidation in Rat Mesangial Cells (Heat Shock Protein 70이 흰쥐 배양 혈관간 세포에서 관찰되는 $TNF{\alpha}$에 의한 지질과산화에 미치는 보호 효과)

  • Ha, Hun-Joo;Park, Young-Mee;Ahn, Young-Soo;Kim, Kyung-Hwan
    • The Korean Journal of Pharmacology
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    • v.31 no.3
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    • pp.323-331
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    • 1995
  • Monocyte/macrophage infiltration is the well known initial features associated with the development of glomerular disease including non-immune mediated nephropathy. Tumor necrosis factor ${\alpha}(TNF{\alpha})$, a cytokine produced primarily by monocyte/macrophage, exhibits similar effects as observed at the initial stages and during the progression of glomerular injury. Because the mesangial cells are target cells for glomerular injury, the present study examined the effect of $TNF{\alpha}$ on glomerular mesangial cell membrane lipid peroxidation as an index of cytotoxicity attributing to $TNF{\alpha}$. Primary culture of rat mesangial cell was established by incubation of glomeruli isolated from male Sprague-Dawley rat kidneys utilizing a standard sieving method. The levels of lipid peroxides in the mesangial cells were quantitated by malondialdehyde- thiobarbituric acid adduct formation. During an 8 hour incubation at $37^{\circ}C$, $TNF{\alpha}$ at 10 to 10,000 units/ml increased the levels of lipid peroxides dose dependently. Western blot analysis demonstrated that a short thermal stress induced heat shock response and the synthesis of heat shock protein 70(hsp70) in this mesangial cells. Further, this induction of hsp 70 prevented increase of lipid peroxides in the mesangial cells exposed to $TNF{\alpha}$. These data suggest that $TNF{\alpha}-induced$ lipid peroxidation in the mesangial cells may have pathophysiological relevance to glomerular injury and prior induction of heat shock response may play a role in the cellular resistance against $TNF{\alpha}-induced$ glomerular injury.

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The Therapeutic Effect of Neoadjuvant Chemotherapy in Locally Advanced Oral Cavity Cancer (국소 진행성 구강암에서 선행 항암 화학 요법의 효과)

  • Joh Yo-Han;Choi In-Sil;Lee Keun-Wook;Oh Do-Youn;Kim Byung-Su;Lee Dae-Ho;Kim Tae-You;Bang Yung-Jue;Wu Hong-Gyun;Sung Myung-Whun;Lee Chul-Hee;Kim Kwang-Hyun;Heo Dae-Seog
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.179-184
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    • 2001
  • Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

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Comparison of various methods of glomerular filtration rate measurements in children (소아 환아에서 다양한 사구체 여과율 측정법의 비교)

  • Lee, Na Mi;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.999-1004
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    • 2009
  • Purpose : Glomerular filtration rate (GFR) is a fundamental parameter in assessing renal function and predicting the progression of chronic renal disease. Because the use of serum creatinine has several disadvantages, many studies have investigated the use of cystatin C for estimating GFR. We compared creatinine clearance and GFR with formulas using serum creatinine and cystatin C. Methods : We retrospectively analyzed 211 patients with various renal diseases and classified them into two groups according to creatinine clearance (Group 1: CrCl >$90mL/min/1.73m^2$, Group 2: CrCl <$90mL/min/1.73m^2$). We measured serum creatinine, cystatin C, and creatinine clearance. We calculated GFR using the Schwartz, Counahan, Filler and Lepage, Bokencamp et al, and Grubb et al formulas. Results : GFR determined by the Schwartz formula had the highest correlation to creatinine clearance (r=0.415, P=0.00). GFR determined by various formulas using cystatin C had lower correlation to creatinine clearance (r=0.187, r=0.187, r=0.291). The Schwartz and Counahan formulas showed greater diagnostic accuracy in detecting decreased GFR than cystatin C in group 2 (areas under the curve: Schwartz, 0.596; Counahan, 0.572; Filler, 0.512; Bokencamp, 0.508; and Grubb, 0.514). Conclusion : GFR determined by the Schwartz and Counahan formulas using serum creatinine showed higher correlation coefficient than that determined by formulas using cystatin C. The formulas using cystatin C were not superior to those using serum creatinine in detecting decreased GFR. Cystatin C measurement was not satisfactory for assessing GFR in patients whose renal function was not severely decreased.

Study on the Changes in Enzyme and Insulin-like Growth Factor-1 Concentrations in Blood Serum and Growth Characteristics of Velvet Antler during the Antler Growth Period in Sika Deer (Cervus nippon)

  • Park, Jaehyun;Jeon, Byongtae;Kang, Sungki;Oh, Mirae;Kim, Myonghwa;Jang, Seyoung;Park, Pyojam;Kim, Sangwoo;Moon, Sangho
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.9
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    • pp.1303-1308
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    • 2015
  • This study was conducted to investigate changes in blood enzyme parameters and to evaluate the relationship between insulin-like growth factor-1 (IGF-1), antler growth and body weight during the antler growth of sika deer (Cervus nippon). Serum enzyme activity and IGF-1 concentrations were measured in blood samples collected from the jugular and femoral veins at regular intervals during the antler growth period. Blood samples were taken in the morning from fasted stags (n = 12) which were healthy and showed no clinical signs of disease. Alfalfa was available ad libitum and concentrates were given at 1% of body weight to all stags. The experimental diet was provided at 9 am with water available at all times. There were no significant differences in alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase during antler growth, but alkaline phosphatase concentrations increased with antler growth progression, and the highest alkaline phosphatase concentration was obtained 55 days after antler casting. Serum IGF-1 concentrations measured from blood samples taken from the jugular vein during antler growth, determined that levels of IGF-1 was associated with body weight and antler growth patterns. Serum IGF-1 concentrations were higher at the antler cutting date than other sampling dates. Antler length increased significantly during antler growth (p<0.001), and there was a similar trend to between right and left beams. Body weight increased with antler growth but was not significant. Consequently it appeared that serum alkaline phosphatase concentration was related to antler growth and both antler growth and body weight were associated positively with IGF-1 concentrations during antler growth.

Osteopontin Levels in Patients with Papillary Thyroid Cancer According to the Presence of Hashimoto's Thyroiditis

  • Park, So-Hyun;Park, Chan-Sung;Kim, Young-Il;Nam-Goong, Il-Seong;Kim, Yon-Seon;Lee, Jong-Cheol;Choi, Jung-Il;Park, Jeong-Woo;Kim, Eun-Sook
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2447-2451
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    • 2015
  • Background: Human papillary thyroid carcinoma (PTC) is often associated with Hashimoto's thyroiditis (HT); their coexistence improves PTC prognosis. Osteopontin, a secreted glycoprotein, plays a role in cell survival, immunity, and tumor progression, its expression being associated with a poor prognosis and metastasis in several malignancies. Osteopontin overexpression correlates with aggressive clinicopathological features in PTC. Lymph node metastases and large tumor size positively correlate with osteopontin positivity. This study aimed to: (1) confirm osteopontin overexpression in human PTC samples; (2) compare osteopontin expression levels in PTC cases with and without HT; and (3) identify correlations between tumor aggressiveness and osteopontin expression levels. Materials and Methods: Plasma osteopontin was assessed in 45 patients with PTC, 22 patients with PTC and HT, and 24 healthy controls by enzyme-linked immunosorbent assay. Thyroid tissue osteopontin mRNA and protein levels were analyzed by reverse transcription-polymerase chain reaction and Western blotting, respectively. Results: Plasma osteopontin levels were significantly higher in PTC patients than in healthy controls. Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone. In advanced disease stage cases, osteopontin mRNA and protein expression levels were lower in patients with PTC and HT than in those with PTC alone. However, the osteopontin expression level was not significantly associated with the TNM stage. Conclusions: Plasma osteopontin, tissue osteopontin mRNA, and tissue osteopontin protein levels were significantly lower in patients with PTC and HT than in those with PTC alone, suggesting that HT attenuates PTC aggressiveness through negative regulation of osteopontin expression.