• Title/Summary/Keyword: Kidney inflammation

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Group A Streptococcal Bacteremia in Pediatric Patients: A Single-Center Study (소아환자에서의 A군 사슬알균 혈류감염: 단일기관 연구)

  • Kim, Dongsub
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.83-89
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    • 2020
  • Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.

Structure-Activity Relationships of Polyhydroxyursane-type Triterpenoids on the Cytoprotective and Anti-inflammatory Effects

  • Jung, Hyun-Ju;Nam, Jung-Hwan;Lee, Kyung-Tae;Lee, Yong-Sup;Choi, Jong-Won;Kim, Won-Bae;Chung, Won-Yoon;Park, Kwang-Kyun;Park, Hee-Juhn
    • Natural Product Sciences
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    • v.13 no.1
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    • pp.33-39
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    • 2007
  • Eleven polyhydroxyursane triterpenoids (PHUTs) were tested to determine their cytoprotective, immunosuppressive and anti-inflammatory effects. To compare the bioactivities of $19{\alpha}$-hydroxyursane-type triterpenoids {23-hydroxytormentic acid (6), its methyl ester (7), tormentic acid (8), niga-ichigoside $F_1$ (9),euscaphic acid (10) and kaji-ichigoside $F_1$ (11)} of the Rosaceae crude drugs (Rubi Fructus and Rosa rugosae Radix) with PHUTs possessing no $19{\alpha}-hydroxyl$ of Centella asiatica (Umbelliferae), the four PHUTs, asiaticoside (1), madecassoside (2), asiatic acid (3), and madecassic acid (4) were isolated from C. asiatica and 23-hydroxyursolic acid (5) from Cussonia bancoensis. Cytoprotective effects were assessed by measuring cell viabilities against cisplatin-induced cytotoxocity in $LLC-PK_1$, cells (proximal tubule, pig kidney) to determine whether these agents have protective effects against nephrotoxicity caused by cisplatin. The inhibitory effect of 11 PHUTS on nitric oxide (NO) and prostaglandin $E_2\;(PGE_2)$ were evaluated by measuring nitrite accumulation in lipopolysaccharide (LPS)-induced macrophage RAW 264.7 cells, and their anti-inflammatory effects were tested in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse ear edema model. Six MHUTs (compounds 1, 2, 4, 6, 10, and 11) exhibited higher cell viabilities during cisplatin-induced cytotoxicity testing even at a concentration of $200\;{\mu}g/ml$ than cisplatin only-treated group, suggesting that ese compounds have the potentcytoprotective efffcts. Compounds 1 and 3 of the C. asiatica and niga-ichigoside $F_1$ exhibited no inhibitory effect on NO and/or $PGE_2$ production whereas other PHUTs produced mild to significant NO and/or $PGE_2$ production.The four compounds (2, 5, 9, and 10) potently inhibited mouse ear edema induced by TPA whereas two compounds (1 and 3) had no activity in this test. These results suggest that many PHUTs are potentchemopreventives. Structure-activity relationship (SAR) was also discussed in each assay with regard to the significant role of OHs at the position of 2, 3, 6, 19, and 23 and to the glycoside linkage at the 28-carboxyl.

Expression of Some Adhesion Molecules on the Cultured Endothelial Cells of Human Umbilical Vein Infected with Hantaan Virus (한탄바이러스 감염 내피세포에서 부착분자의 발현 (II) -In Situ Hybridization-)

  • Chung, Sang-In;Shin, Sung-Il;Kim, Ki-Jeong;Kang, Eung-Taek;Yu, Suk-Hee;Choi, Chul-Soon;Yang, Yong-Tae
    • The Journal of Korean Society of Virology
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    • v.26 no.1
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    • pp.47-58
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    • 1996
  • Histopathological vascular changes in hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus include increased vascular permeability, disseminated intravascular coagulation, thrombocytopenia and changes in coagulation activity. Although vascular endothelial cells of main target organs such as kidney infected with Hantaan virus are not damaged but swelling of endothelial cells, perivascular exudates and infiltration of mononuclear cells and fresh interstitial hemorrhages are common. However, the pathogenesis of cell infiltration and hemorrhages around vascular endothelial cells are not well understood. Some endothelial cell molecules or vascular adhesins that acts as adhesion moleulces for leukocyte are expressed on endothelial cells close to site of inflammation. However, whether the expression of endothelial adhesion molecules such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule (ICAM-1) and endothelial leukocyte adhesion molecule (ELAM) on vascular endothelial cells are increased by infection with Hantaan virus has not been studied. In this study, the relationship between the expression of VCAM-1, ICAM-1 and ELAM and adhesion of mononuclear cells on endothelial cells of human blood vessels infected with Hantaan virus was investigated. The endothelial cells of umbilical vein was passaged three times in culture medium and the monolayered cells were infected with $10^5\;pfu/ml$ of Hantaan virus grown in Vera E6 cell cultures. The multiplication of virus in cultured endothelial cells was monitored by immunohistochemistry and the expression of adhesion molecules was demonstrated by immunohistochemistry using monoclonal antibodies against VCAM-1, ICAM-1 and ELAM. And in situ hybriditation against ICAM-1 was also performed. The endothelial adhesion molecules, VCAM and ICAM, were expressed after 6 hours postinfection, respectively, and their expressions lasted for 72 hours. Similar expression of VCAM and ICAM appeared on endothelial cells by infection with virus, but the expression of ELAM was not recognized up to 72 hours postinfection. Microscopically, it was noted that many monocuclear cells adhered on endothelial cells infected with viruses. In an electronmicroscopic study, the transendothelial migration of mononuclear cells was observed on monolayered endothelial cells infected with virus. This results suggested that the endothelial adhesion molecules, particulary VCAM and ICAM, might be expressed on endothelial cells by infection with Hantaan virus and these molecules play a key role in the adhesion and extravasation of inflammatory cells around blood vessels.

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Therapeutic Effects of Ephedra sinica Stapf Herb-Acupuncture on Adjuvant-induced Polyarthritis of Rat (흰쥐의 Adjuvant 유발 다발성 관절염에 대한 마황 약침의 치료 효과)

  • Lee Han-Chang;Yeom Mijung;Kim Gun-Ho;Shim In-Sop;Choi Kang-Duk;Lee Hye-Jung;Hahm Dae-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.346-351
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    • 2003
  • The current studies investigated the therapeutic effects of Ephedra sinica Stapf (ES) herb-acupuncture on the inflammatory responses of rat arthritic joint, which was induced by the intradermal injection of heat-killed Mycobacterium tuberculosis emulsified in squalene to the base of the tail. The measurements of body weight and articular index were exploited as the assessment methods addressing arthritic symptoms, and the expression profiles of cytokines such as TNF-α, IL-1β and IL-6 in the rat joint were analyzed using RT-PCR. The articular indexes of arthritic rats were significantly restored after the treatment with ES herb-acupuncture. Although the clinical symptoms of arthritic rats were apparently alleviated by the ES treatments, their body weights were not recovered. It maybe due to the weight-loss and energy enhancement effects of ES extracts. The expression of TNF-α, IL-1β and IL-6 genes, which were highly stimulated in the knee joints of arthritic rats, were restored to the levels of normal rats after the ES treatment. The therapeutic effect of ES herb-acupuncture was not observed in ES-treated, non-acupoint arthritic group as a sham control. The ES herb-acupuncture into an acupoint ST36 was found to be effective in alleviating the arthritic symptoms in adjuvant-induced arthritis rats as regards the body weight, joint appearance and the expression profiles of inflammatory cytokines.

Comparative study of serum levels of albumin and hs-CRPin hemodialysis patients according to protein intake levels (혈액투석 환자의 단백질 섭취량에 따른 혈중 albumin과 hs-CRP 농도의 비교 연구)

  • Lee, Ye Ji;Lee, Yeon Joo;Oh, Il Hwan;Lee, Chang Hwa;Lee, Sang Sun
    • Journal of Nutrition and Health
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    • v.46 no.6
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    • pp.521-530
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    • 2013
  • Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ${\geq}$ 1.0g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.

Osteomyelitis of Mandibular Condyle : A Case Report in 9-year-old Child (9세 소아에서 발생한 하악과두의 골수염)

  • Lee, Kyung-Eun;Choi, Soon-Jeong;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.333-340
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    • 2009
  • Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.

A Study about medical records in ${\ulcorner}$Gyojubuin-yangbang${\lrcorner}$ (${\ll}$교주부인양방(校注婦人良方)${\gg}$에 수재된 의무기록 의안(醫案)에 관한 연구)

  • Oh, Chang-Young;Kim, Ra-Young;Park, Young-Soo;Kim, Byoung-Hoe;Joh, Ho-Geun;Kim, Joong-Oh;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.226-239
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    • 2006
  • Background : Medical records are documents in files which consist of all diagnostic studies and medical treatments patients had received while they were hospitalized or treated as outpatients. A doctor or medical team can use medical records as a data for diagnosis, treatment, and education. In traditional eastern asian medicine, medical reports have different forms and contents. The most important thing in medical reports of traditional eastern asian medicine was how to express practitioner's medical ideas. So it has a weak point, for example, it has poor information about patient and clinical process, which make some trouble to understand it. Methods and Results : We studied medical records in Gyojubuin-yangbang, a commentary book of Chen-zi-ming's Obstetrics and Gynecology textbook done by Xue-ji in Ming dynasty, China. This book consists of 10 parts; treatment of menstruation disorders and leukorrhea, general gynecology, treatment of infertility, education for fetus, diagnosis of fetus and gravida, treatment of general and obstetrical disease in gravida, care for delivery, postpartum care and treatment, and treatment of mass and inflammation. It has 546 medical records about women's disease that commonly believed as Xue-ji's case reports. They are all review articles and made during about 23 years from A.D 1523 to 1546. Most patients of Xue-ji's case reports were common people, this fact is different from that of case reports in Chen-zi-ming's Obstetrics and Gynecology textbook. Conclusion : Xue-ji was a very famous Ob&Gy doctor who was from Suzhou Jingsu province in China. He was born in A.D 1468, died in A.D 1588. He emphasize emotional factors in pathology and to tonify spleen and kidney. We think Xue-ji's medical records are good references for us to treat psychosomatic Ob&Gy disease and chronic women's disease.

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Renal Manifestations and Imaging Studies of Kawasaki Disease (가와사키 질환에서의 신증상과 영상 검사 소견)

  • Oh, Ji Young;Park, Se Jin;Kim, Sun Jung;Jang, Gwang-Cheon;Kim, Uria;Shin, Jae Il;Kim, Kee Hyuck
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.86-91
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    • 2013
  • Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.

Protective effects of Sasa quelpaertensis Leaf Residue Extract against Potassium Oxonate-induced Hyperuricemia in Mice (생쥐에서 제주조릿대 잎 잔사 추출물의 고요산 혈증 저감 효과)

  • Jang, Mi Gyeong;Song, Hana;Lee, Ju Yeop;Ko, Hee Chul;Hur, Sung-Pyo;Kim, Se Jae
    • Journal of Life Science
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    • v.29 no.1
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    • pp.37-44
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    • 2019
  • Leaves of Sasa quelpaertensis Nakai are used in folk medicine for their anti-inflammatory, antipyretic, and diuretic properties. To ensure efficient utilization of S. quelpaertensis leaf, we previously reported a preparation method for phytochemical-rich extract (PRE) using the leaf residue, which was produced after hot water extraction. This study was undertaken to evaluate the hypouricemic potential of S. quelpaertensis leaf PRE in potassium oxonate (PO)-induced hyperuricemic mice. The administration of PRE significantly reduced serum uric acid (UA), blood urea nitrogen (BUN), and serum creatinine levels and increased urine UA and creatinine levels in the PO-induced hyperuricemic mice. It also reduced liver UA levels and xanthine oxidase (XA) activity. A histological analysis revealed that PRE administration protected against PO-induced liver damage, pointing to anti-inflammatory and cytoprotective effects in PO-induced hyperuricemic mice. We analyzed the transcriptome response to PRE administration in PO-induced hyperuricemic mice using RNA sequencing (RNA-Seq) in kidney tissues. The administration of PRE mainly enriched genes involved in mediating immune and inflammatory responses and the metabolic pathway. A Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the metabolic pathway, purine metabolism, and antibody biosynthesis were the major pathways altered in the PRE and PO groups. These results suggest a potential role for PRE in the prevention and treatment of hyperuricemia with inflammation.

Transcriptional regulation of chicken leukocyte cell-derived chemotaxin 2 in response to toll-like receptor 3 stimulation

  • Lee, Seokhyun;Lee, Ra Ham;Kim, Sung-Jo;Lee, Hak-Kyo;Na, Chong-Sam;Song, Ki-Duk
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.12
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    • pp.1942-1949
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    • 2019
  • Objective: Leukocyte cell-derived chemotaxin 2 (LECT2) is associated with several physiological processes including inflammation, tumorigenesis, and natural killer T cell generation. Chicken LECT2 (chLECT2) gene was originally identified as one of the differentially expressed genes in chicken kidney tissue, where the chickens were fed with different calcium doses. In this study, the molecular characteristics and gene expression of chLECT2 were analyzed under the stimulation of toll-like receptor 3 (TLR3) ligand to understand the involvement of chLECT2 expression in chicken metabolic disorders. Methods: Amino acid sequence of LECT2 proteins from various species including fowl, fish, and mammal were retrieved from the Ensembl database and subjected to Insilco analyses. In addition, the time- and dose-dependent expression of chLECT2 was examined in DF-1 cells which were stimulated with polyinosinic:polycytidylic acid (poly [I:C]), a TLR3 ligand. Further, to explore the transcription factors required for the transcription of chLECT2, DF-1 cells were treated with poly (I:C) in the presence or absence of the nuclear factor ${\kappa}B$ ($NF{\kappa}B$) and activated protein 1 (AP-1) inhibitors. Results: The amino acid sequence prediction of chLECT2 protein revealed that along with duck LECT2 (duLECT2), it has unique signal peptide different from other vertebrate orthologs, and only chLECT2 and duLECT2 have an additional 157 and 161 amino acids on their carboxyl terminus, respectively. Phylogenetic analysis suggested that chLECT2 is evolved from a common ancestor along with the actinopterygii hence, more closely related than to the mammals. Our quantitative polymerase chain reaction results showed that, the expression of chLECT2 was up-regulated significantly in DF-1 cells under the stimulation of poly (I:C) (p<0.05). However, in the presence of $NF{\kappa}B$ or AP-1 inhibitors, the expression of chLECT2 is suppressed suggesting that both $NF{\kappa}B$ and AP-1 transcription factors are required for the induction of chLECT2 expression. Conclusion: The present results suggest that chLECT2 gene might be a target gene of TLR3 signaling. For the future, the expression pattern or molecular mechanism of chLECT2 under stimulation of other innate immune receptors shall be studied. The protein function of chLECT2 will be more clearly understood if further investigation about the mechanism of LECT2 in TLR pathways is conducted.