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Non-tuberculous Mycobacterial Lung Disease Presenting as a Solitary Pulmonary Nodule (고립성 폐결절로 발현된 비결핵성 마이코박테리움 폐질환 1예)

  • Kim, Song-Yee;Lee, Kyung-Jong;Lee, Sang-Hoon;Lee, Sang-Kook;Park, Byung-Hoon;Jung, Ji-Ye;Son, Ji-Young;Yoon, Yoe-Wun;Shim, Hyo-Sup;Kang, Young-Ae;Park, Moo-Suk;Kim, Young-Sam;Chang, Joon;Kim, Se-Kyu;Moon, Jin-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.1
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    • pp.43-47
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    • 2010
  • We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

Human $CD103^+$ dendritic cells promote the differentiation of Porphyromonas gingivalis heat shock protein peptide-specific regulatory T cells

  • Kim, Myung-Jin;Jeong, Eui-Kyong;Kwon, Eun-Young;Joo, Ji-Young;Lee, Ju-Youn;Choi, Jeomil
    • Journal of Periodontal and Implant Science
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    • v.44 no.5
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    • pp.235-241
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    • 2014
  • Purpose: Regulatory T cells (Tregs), expressing CD4 and CD25 as well as Foxp3, are known to play a pivotal role in immunoregulatory function in autoimmune diseases, cancers, and graft rejection. Dendritic cells (DCs) are considered the major antigen-presenting cells (APCs) for initiating these T-cell immune responses, of which $CD103^+$ DCs are derived from precursor human peripheral blood mononuclear cells (PBMCs). The aim of the present study was to evaluate the capacity of these PBMC-derived $CD103^+$ DCs to promote the differentiation of antigen-specific Tregs. Methods: Monocyte-derived DCs were induced from $CD14^+$ monocytes from the PBMCs of 10 healthy subjects. Once the $CD103^+$ DCs were purified, the cell population was enriched by adding retinoic acid (RA). Peptide numbers 14 and 19 of Porphyromonas gingivalis heat shock protein 60 (HSP60) were synthesized to pulse $CD103^+$ DCs as a tool for presenting the peptide antigens to stimulate $CD3^+$ T cells that were isolated from human PBMC. Exogenous interleukin 2 was added as a coculture supplement. The antigen-specific T-cell lines established were phenotypically identified for their expression of CD4, CD25, or Foxp3. Results: When PBMCs were used as APCs, they demonstrated only a marginal capacity to stimulate peptide-specific Tregs, whereas $CD103^+$ DCs showed a potent antigen presenting capability to promote the peptide-specific Tregs, especially for peptide 14. RA enhanced the conversion of $CD103^+$ DCs, which paralleled the antigen-specific Treg-stimulating effect, though the differences failed to reach statistical significance. Conclusions: We demonstrated that $CD103^+$ DCs can promote antigen-specific Tregs from naive T cells, when used as APCs for an epitope peptide from P. gingivalis HSP60. RA was an effective reagent that induces mature DCs with the typical phenotypic expression of CD103 that demonstrated the functional capability to promote antigen-specific Tregs.

Clinical analysis of febrile infants and children presenting to the pediatric emergency department (소아응급실에 내원한 발열 환아에 대한 연구 분석)

  • Kwak, Byeong Gon;Jang, Hyun Oh
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.839-844
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    • 2006
  • Purpose : We studied clinical patterns of the febrile infants and children presenting to the Pediatric Emergency Department(ED) in the general pediatric population. Method : We analyzed 1,764 infants and children who had a history of measured body temperature of $38.3^{\circ}C$ or higher, before or after arrival at Pediatric ED of Ilsan Paik Hospital from September 2004 to August 2005. We analyzed their clinical patterns, such as the frequency of febrile illness, age distribution, monthly distribution, diagnosis. Result : The frequency of the febrile illness at Pediatirc ED was 19.9 percent (1,764/8,881 cases). The percentage of admission into hospital was 26.4 percent. The most common age group presenting to Pediatric ED with febrile illness was the 12-23 months group(22.8 percent) followed by the 4-11 months group and the 2 years group. In May, the most numerous patients presented to the Pediatric ED with febrile illness. The frequency of febrile illness was significant higher in the 'Spring & Summer group' compared to the 'Autumn & Winter group'. The ratio of male to femal was 1.4:1. The most common diagnosis was acute pharyngitis(42.5 percent), followed by acute gastroenteritis (15.3 percent), pneumonia(7.0 percent). Conclusion : The frequency of the febrile illness at Pediatirc ED was 19.9 percent. The most numerous patients visited Pediatric ED in May. And, the most common age group was 12-23 months. The proportion of non-urgent disease, such as acute pharyngitis, acute gastroenteritis, acute nasopharyngitis and acute bronchitis, was high. There is a need to educate parents and improve the medical system in Korea.

Expression of Antigen Presenting Function-Associated Surface Molecules on $Interferon{\gamma}$-Treated Gingival Fibroblasts and Periodontal Ligament Fibroblasts (($Interferon{\gamma}$)로 자극된 치은섬유아세포와 치주인대섬유아세 포에서 항원제시기능과 관련된 세포 표면분자의 발현)

  • Seo, Seok-Ran;Ryu, Sung-HunO;Oh, Gwi-Ok;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.895-913
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    • 2000
  • It is becoming increasingly clear that human gingival fibroblasts(HGF) may play a role in regulating immune responsiveness in inflammatory periodontal lesions. Stimulation of HGF with locally-secreted T cell cytokine $IFN_{\gamma}$ induces human leukocyte antigen class II(HLA II) expression on HGF, which is one of the characteristic feature of professional antigen presenting cells(pAPC). However, $IFN_{\gamma}$-treated HGF and other nonprofessional antigen presenting cells(npAPC) are known to be ineffective or less effective antigen presenter to resting T cells. This study, therefore, was undertaken in an effort to elucidate the differences in expression of cell surface molecules between npAPC in periodontal tissues, such as HGF and periodontal ligament fibroblasts(PDLF), and pAPC such as monocytes/macrophages. Using flow cytometry, the levels of cell surface expression of HLA-D, ICAM-1, LFA-3, and B7-1, which are involved in antigen presentation, were determined in HGF, PDLF and human myelomonocytic cell line THP-1. $IFN_{\gamma}$ clearly induced HLA-D expression on both of fibroblasts and monocytes dose dependently. However, expression level on monocytes were 4 to 5 times higher than that on fibroblasts, and induction rate was faster in monocytes than in fibroblasts. The levels of ICAM-1 expression on fibroblasts and monocytes were enhanced by $IFN_{\gamma}$ in a dose dependent manner. On the other hand, the expression of LFA-3 molecule, which could be detected in fibroblasts and monocytes without cytokine stimulation, was no more enhanced by addition of $IFN_{\gamma}$. B7-1, important costimulatory molecule in T cell activation and proliferation, was not detected on both of fibroblasts and monocytes even when stimulated with $IFN_{\gamma}$, except on monocytes fully differentiated by pretreatment of PMA and treated by $IFN_{\gamma}$. These results suggest that delayed expression of HLA-D and absence of B7-1 on $IFN_{\gamma}$ - treated fibroblasts may at least in part be involved in the ineffectiveness of fibroblasts as primary APC. And it is postulated that although periodontal fibroblasts may not serve as primary APC in normal periodontium, sustained expression of HLA II on ubiquitous fibroblasts in inflammatory lesions may perpetuate immune responses and produce chronic inflammation and tissue injury.

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Pseudonormal or Restrictive Filling Pattern of Left Ventricle Predicts Poor Prognosis in Patients with Ischemic Heart Disease Presenting as Acute Heart Failure

  • Lee, Jae-Geun;Beom, Jong Wook;Choi, Joon Hyouk;Kim, Song-Yi;Kim, Ki-Seok;Joo, Seung-Jae
    • Journal of Cardiovascular Imaging
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    • v.26 no.4
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    • pp.217-225
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    • 2018
  • BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.

NO-WAIT OR NO-IDLE PERMUTATION FLOWSHOP SCHEDULING WITH DOMINATING MACHINES

  • WANG JI BO;XIA ZUN QUAN
    • Journal of applied mathematics & informatics
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    • v.17 no.1_2_3
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    • pp.419-432
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    • 2005
  • In this paper we study the no-wait or no-idle permutation flowshop scheduling problem with an increasing and decreasing series of dominating machines. The objective is to minimize one of the five regular performance criteria, namely, total weighted completion time, maximum lateness, maximum tardiness, number of tardy jobs and makespan. We establish that these five cases are solvable by presenting a polynomial-time solution algorithm for each case.

Clinical Approach to Headache in Childhood (소아 두통의 임상적 접근)

  • Chae, Soo Ahn
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.349-354
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    • 2005
  • Headache is a common complaint in pediatric office practices as well as in children presenting to emergency departments. Children who complain of headache usually are brought to medical attention by their parents, who seek reassurance that the headaches are not a sign of a serious illness. The etiologies of headache range from school problems to brain tumors. A history taking, physical examination, and appropriate diagnostic testing will enable to distinguish primary headaches from those of a secondary etiology. The clinical, neuroimaging, and laboratory evaluation of the child with headache are reviewed here.

Intraluminal Esophageal Cyst (식도 근육내 낭종 1례)

  • 홍장수
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.95-97
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    • 1981
  • Cystic intrathoracic lesions of foregut origin are now well recognized and account for approximately 10% of lesions presenting as mediastinal tumors. The terminology used to describe mediastinal endodermal cysts has been confused and sometimes ambiguous. The embryological derivation of these lesions has been the cause of much speculation. It Is suggested that these lesions should be classified Into three main categories based on embryology bronchogenic cyst[resulting from a defect of lung budding], Intramural esophageal cyst[true duplication], and enteric cyst[resulting from the split notochord syndrome]. This communication describes a 26 year old man with intramural esophageal cyst who was diagnosed as posterior medlastlnai tumor preoperatively and cured with extirpation of the cyst.

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Simplified Module Based Self-collision Detection for Humanoid Robots (간략화 된 모듈 기반의 휴머노이드 로봇을 위한 자기충돌 탐지)

  • Kwak, Hwan-Joo;Park, Gwi-Tae
    • Proceedings of the KIEE Conference
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    • 2008.04a
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    • pp.240-241
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    • 2008
  • We are presenting the efficient and robust simplified module based self-collision detection of humanoid robot simulator. For safe and reliable operations of humanoid robot, the self-collision detection is essential and extremely important. The main methods of self-collision detection are inverse X-Y-Z fixed angles and module distance filtering (MDF). According to experiments on the humanoid robot simulator with the self-collision detection, we could have a confidence about the efficiency of the self-collision.

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NUMERICAL SOLUTION OF A CLASS OF THE NONLINEAR VOLTERRA INTEGRO-DIFFERENTIAL EQUATIONS

  • Saeedi, L.;Tari, A.;Masuleh, S.H. Momeni
    • Journal of applied mathematics & informatics
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    • v.31 no.1_2
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    • pp.65-77
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    • 2013
  • In this paper, we develop the operational Tau method for solving nonlinear Volterra integro-differential equations of the second kind. The existence and uniqueness of the problem is provided. Here, we show that the nonlinear system resulted from the operational Tau method has a semi triangular form, so it can be solved easily by the forward substitution method. Finally, the accuracy of the method is verified by presenting some numerical computations.