• Title/Summary/Keyword: Sensitivity test

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The Role of T1-201 Brain SPECT in the Differentiating Recurrent Tumor from Radiation Necrosis (뇌종양의 재발과 방사선 괴사의 감별을 위한 탈륨 SPECT의 역할)

  • Won, Kyoung-Sook;Ryu, Jin-Sook;Moon, Dae-Hyuk;Yang, Seoung-Oh;Lee, Hee-Kyung;Lee, Jung-Kyo;Kwun, Byung-Duk
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.476-483
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    • 1996
  • Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging rrere calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.

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Detection of Spinal Metastases: Comparison of Bone Scan and MR Imaging (전이성 척추 악성 종양의 진단 : 골스캔과 자기공명영상의 비교)

  • Kim, Ki-Jun;Sohn, Hyung-Sun;Park, Jeong-Mi;Chung, Soo-Kyo;Lee, Jae-Moon;Kim, Choon-Yul;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.384-390
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    • 1994
  • Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

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B-type Natriuretic Peptide (BNP) as a Predictive Marker after Heart Transplantation (심장이식 후 예측인자로서 B-type Natriuretic Peptide (BNP)의 역할)

  • Shin, Hong-Ju;Kim, Hee-Jung;Choo, Suk-Jung;Kim, Jae-Joong;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.552-557
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    • 2007
  • Background: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. Material and Method: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: ${\le}290$ pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. Result: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: $0.900{\pm}0.045$, p<0.001). Conclusion: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.

ANTIMICROBIAL EFFECT OF ANTIBIOTICS AND ROOT CANAL CEMENTS ON THE PREDOMINANT PATHOGENIC ANAEROBIC MICROFLORA IN ROOT CANALS (근관내 주요 혐기성 병인균에 대한 수종 항생제와 근관충전용 세멘트의 항균효과에 관한 연구)

  • Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.18 no.2
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    • pp.515-525
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    • 1993
  • The purpose of this study was to evaluate the susceptibility of anaerobic microorganisms to certain antibiotics and root canal cements. Prevotella intermedia(Bacteroides intermedius) ATCC 25611(serotype A), Fusobacterium nucleatum ATCC 25586, Actinomyces viscosus ATCC 15987 which are the predominant pathogenic anaerobes in dental root canals were cultured in BHI for 48 hours(Fig.1). After each $200{\mu}l$ of those broths with microorganisms was streaked on each surface of blood agar plate, 2 to 5 antibiotic discs which are impregnated with Tetrncycline, Erythromycin, Ampicillin, Clindamycin, or Vancomycin were applied on each surface of blood agar plate and cultured for 5 days anaerobically in the anaerobic chamber (Fig.2). 15 antibiotic discs for each kind of antibiotics and each species of microorganisms were tested. Also each kind of root canal cement tubes which include Zinc oxide eugenol cement, Zinc phosphate cement, Calcium hydroxide powder+DD.W., Calcium hydroxide paste(Pulpdent Tempcanal), or Vitapex(Table 1) were applied on the inoculated BAPs after $200{\mu}l$ of each experimental species of microorganisms was streaked on the surface of blood agar plates, and they were cultured for 5 days anaerobically in the anaerobic chamber(Fig.3). The sensitivity(antimicrobial effect) was determined by the diameter of the inhibition zone. The results are as follows: 1. The results of antibiotic susceptibility test(Table 2) 1) All of the tested antibiotics had antimicrobial activity with various degrees. 2) In Prevotella intermedia (old Bacteroides intermedius), the diameter of inhibition zone to Erythromycin($37.87mm{\pm}2.20$) was largest, those to Tetracycline($26.20mm{\pm}2.96$), Vancomycin($21.53mm{\pm}1.96$), Clindamycin($18.73mm{\pm}0.96$) was smaller than former orderly, and That to Ampicillin ($7.87mm{\pm}0.83$) was smallest. 3) In Actinomyces viscosus, the diameter of inhibition zone to Erythromycin($28.73mm{\pm}1.22$) was largest, those to Ampicillin($21.73mm{\pm}1.03$), Clindamycin($21.33mm{\pm}1.59$) was similarly next order, that to Vancomycin($19.00mm{\pm}1.96$) was smaller than Clindamycin, and that to Tetracycline($11.93mm{\pm}0.70$) was smallest. 4) In Fusobacterium nucleatum, the diameter of inhibition zone to Ampicillin($31.07mm{\pm}1.91$) was largest, that to Erythromycin($28.87mm{\pm}0.92$), Clindamycin($20.47mm{\pm}1.51$), Vancomycin ($16.73mm{\pm}0.96$), Tetracycline ($12.13mm{\pm}1.06$) are smaller than former orderly. 2. The results of root canal cements and pastes(Table 3) 1) The external diameter of tube is 4mm, so 4mm of the inhibition zone diameter means non-susceptable. Prevotella intermedia (old Bacteroides intermedius) was non-susceptable to Calcium hydroxide powder+D.D.W., Calcium hydroxide paste(pulpdent Tempcanal), and Actinomyces viscosus was non-susceptable to Zinc phosphate cement, Calcium hydroxide powder + D.D.W., Calcium hydroxide paste(pulpdent Tempcanal). 2) In Prevotella intermedia (old Bacteroides intermedius), the diameter of inhibition zone to Zinc oxide eugenol cement($13.67mm{\pm}3.30$) was largest, that to Vitapex($9.20mm{\pm}2.96$), Zinc phosphate cement($6.13mm{\pm}2.07$) was smaller than former. 3) In Actinomyces viscosus, the diameter of inhibition zone to Zinc oxide eugenol cement($17.40mm{\pm}5.20$) was largest and that to Vitapex($8.80mm{\pm}1.70$) was next order. 4) In Fusobacterium nucleatum, the diameter of inhibition zone to Vitapex($42.33mm{\pm}17.2$) was largest and those to Calcium hydroxide paste(Pulpdent Tempcanal)($14.47mm{\pm}3.72$) and Zinc oxide eugenol cement($8.93mm{\pm}2.71$), Zinc phosphate cement($8.20mm{\pm}2.27$), Calcium hydroxide powder+D.D.W.($5.53mm{\pm}2.10$)was next orderly. And then In Zinc oxide eugenol cement and Zinc phosphate cement group, two of fifteen samples showed no inhibition zone, in Calcium hydroxide powder + D.D.W. group, 8 of 15 samples showed no inhibition zone.

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Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

Simultaneous Detection of Major Pathogens Causing Bovine Diarrhea by Multiplex Real-time PCR Panel (Multiplex real-time PCR을 이용한 송아지 설사병 원인 주요 병원체의 동시검출)

  • Kim, Won-Il;Cho, Yong-Il;Kang, Seog-Jin;Hur, Tai-Young;Jung, Young-Hun;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.377-383
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    • 2012
  • Bovine diarrhea is a major economical burden to the bovine industry in Korea. Since multiple infectious agents can be involved in bovine diarrhea, differential diagnosis is essential for effective treatment. Therefore, a panel of two multiplex real-time PCR assays which can simultaneously detect six major bovine enteric pathogens [i.e., bovine viral diarrhea virus (BVDV), bovine coronavirus (BCoV), group A bovine rotavirus (BRV), Salmonella spp., Escherichia coli (E. coli) $K99^+$, and Cryptosporidium parvum] was developed and applied to test 97 fecal samples collected from cattle farms in Korea. In addition, microscopic examination was also preformed on the samples to detect Coccidium oocyst. The estimated sensitivity of the multiplex PCR was 0.1 $TCID_{50}$ for BVDV, BCoV and group A BRV, 5 and 0.5 CFU for E. coli $K99^+$ and Salmonella, respectively, and 50 oocysts for Cryptosporidium. The amplification efficiency of the multiplex PCR ranged between 0.97 and 0.99 for each pathogen. Among 97 samples, 36 samples were positive for at least one of the 6 major pathogens and 6 samples were simultaneously positive for 2 pathogens by the multiplex PCR assay. Coccidium oocysts were also detected in 48 samples, which were all collected from over 1 month old calves. In conclusion, the multiplex real-time PCR panel can be a useful tool for fast and accurate diagnosis of calf diarrhea associated with BVDV, BCoV, group A BRV, E. coli $K99^+$, Salmonella, and/or Cryptosporidium and Coccidium may be an important target which needs to be included in the multiplex PCR panel in the future.

A Comparative Study of Effect of Secondary Anti-tuberculosis Drugs in the Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 이차항결핵제 복합처방의 효과에 관한 비교 연구)

  • Ha, Hyun-Cheol;Kwon, Eun-Soo;Choi, In-Hwan;Hwang, Su-Hee;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1154-1166
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    • 1998
  • Background : In the management of patients whose primary chemotherapy has failed, careful assessment is essential. It is important to find out as accurate a chemotherapy history as possible. Preferably it should contain the drugs which has never used before. The purpose of present study is establishment of retreatment regimen for pulmonary tuberculosis. The present report concerns the results of retreatment of pulmonary tuberculosis patients treated at National Masan Tuberculosis Hospital. Methods : Retrospective cohort study was made of 104 drug-resistant pulmonary tuberculosis patients who were treated by five regimens between Jan. 1994 and Nov. 1996. All the patients taken medicine for second anti-tuberculosis regimens for the first time. We separated the patients by three groups(Group I ; OFX+PTA+CS+PAS+Aminoglycoside, Group II : PZA+PTA+CS+PAS+Aminoglycoside, Group III : PZA+OFX+PTA+PAS+Aminoglycoside). Results : The age distribution was most frequent in fourth decade(36patients, 34.6%) and the mean age was 42.6 year. The sex distribution was more frequent in the males(81 patients, 85.7%). There was 31 patients(29.8%) with combined diseaes, 18 patients with complication and 24 patients(27.9%) with family history. Primary chemotherapy regimens were HERZ(S or K) in 48 patients (46.2%), HER(S or K) in 41 patients(39.4%) and others in 15 patients(14.4%). Result of drug sensitivity test showed that the resistance to INH and RFP is in 68 patients(65.4%), RFP is 12 patients(11.5%), INH is in 3 patients(2.9%) and all sensitive to INH and RFP is 3 patients(2.9%). The clinical symptoms on admission were coughing(89.4%), sputum(69.2%), dyspnea on exertion(37.5%), weight loss(33.7%) blood tinged sputum(15.4%) and others. The extent of disease on the radiograph was far-advanced in 73 patients(70.2%), moderate in 28 patients(26.9%) and minimal in 3 patients(2.9%). The side effects for drugs were gastrointestinal troubles in 31 patients(29.8%), arthralgia in 22 patients(21.2%), skin rash in 12 patients(11.5%) and others. The negative conversion rate on sputum AFB smear was 85.6%(87.5% in Group I, 80.0% in Group II and 90.5% in Group III). The average negative conversion time on sputum was 4 month(4.0 month in Group I, 4.6 month in Group II and 3.0 month in Group III). Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and combination of PZA and OFX can be use effectively substituting for CS.

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Diagnostic Value of Serum Cytokeratin 8, 18 and 19 in Lung Cancer (폐암에서 혈중 Cytokeratin 8, 18, 19의 진단적 가치)

  • Choi, Chang Min;Kim, Woo Jin;Oh, Jin Young;Kang, Young Ae;Yoo, Chul Gyu;Lee, Choon Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.388-394
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    • 2003
  • Background : Monoclonal antibodies directed against well-known epitopes on cytokeratin (CK) 8, 18 and 19 (Monototal) have been used in the development of a new diagnostic tool for lung cancer. In the mid-1990s, CK 19 fragments (Cyfra 21-1) became popular and widely used for such diagnosis. This is the first study specifically designed to compare these two markers. Method : The serum levels of CK 8, 18 and 19 were measured using two-site monoclonal/polyclonal immunoradiometric assay kit in 57 healthy adults and 289 patients who were admitted to Seoul National University Hospital from May to September, 2002. The lung cancer group comprised 129 primary lung cancer patients; 116 with non-small cell lung cancer(NSCLC) and 13 with small cell lung cancer (SCLC). The control group comprised 160 non-malignant pulmonary lung disease patients and 57 healthy adults. A total of 166 twin Monototal and Cyfra 21-1 serum assays were obtained; 76 with lung cancer, 70 with non-malignant pulmonary lung disease and 20 healthy adults. Results : The mean serum value of Monototal was $412.47{\pm}455.45U/L$ in NSCLC, $237.08{\pm}145.15U/L$ in SCLC, $126.54{\pm}95.72U/L$ in non-malignant pulmonary lung disease, and $63.68{\pm}31.66U/L$ in healthy adults. The serum values of the lung cancer groups were significantly higher than those of the control group (p<0.01). Using a cut off value of 188U/L, sensitivity and specificity was 66.4% and 81.9% in NSCLC, and 43.8% and 81.9% in SCLC, respectively. The serum levels of CK 8, 18 and 19 were higher in advanced NSCLC than in early stage disease. Conclusion : The serum levels of CK 8, 18 and 19 may be useful in the diagnosis of NSCLC.

Effect of Hog Millet Supplementation on Hepatic Steatosis and Insulin Resistance in Mice Fed a High-fat Diet (고지방식이로 유도한 지방간 마우스에서 기장 첨가식이가 지방간 및 인슐린 저항성에 미치는 영향)

  • Park, Mi-Young;Jang, Hwan-Hee;Lee, Jin-Young;Lee, Young-Min;Kim, Jae-Hyun;Park, Jae-Hak;Park, Dong-Sik
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.4
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    • pp.501-509
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    • 2012
  • The dietary intake of whole grains is known to reduce the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. In our previous study, hog millet (HM, $Panicum$ $miliaceum$ L.) water extract showed the highest anti-lipogenic activity among nine cereal types in 3T3-L1 cells. In this study, the effect of hog millet water extract on hepatic steatosis and lipid metabolism in mice fed a high fat diet was investigated. Mice were fed a normal-fat diet (ND), high-fat diet (HFD) or HFD containing 1% or 2% (w/w) HM for 7 weeks. Body weight and food intake were monitored during the study period. Insulin resistance by homeostasis model assessment (HOMA-IR), fasting lipid profile, hepatic fatty acid metabolism-related gene expression determined, and intraperitoneal glucose tolerance test (IGTT) were performed at the study's end. The results indicated that 1% and 2% HM diets effectively decreased liver weights, blood TG and T-cholesterol levels (p<0.05), while the HDL-cholesterol level was increased (p<0.05) compared to HFD-induced steatotsis mice. Hepatic lipogenic-related gene ($PPAR{\alpha}$, L-FABP, and SCD1) expressions decreased, whereas lipolysis- related gene (CPT1) expression increased in animals fed the 2% PME diet (p<0.05). In addition, mice fed 1% or 2% HM diet had markedly decreased IGTT and HOMA-IR, compared to the those of the HFD-induced hepatic steatosis control group (p<0.05). These results indicated that HM inhibited hepatic lipid accumulation by regulating fatty acid metabolism, and suggested that HM is useful in the chemoprevention or treatment of high fat-induced hepatic steatosis and hepatic steatosis-related disorders including hyperlipidemia, glucose sensitivity, and insulin resistance.

Plasma Transforming Growth Factor-$\beta$1 Levels of Cancer Patients (암 환자의 혈장 Transforming Growth Factor-$\beta$1 농도)

  • 전지현;이시은;이수진;박찬후;장정순;하우송;박순태;박병규
    • Biomedical Science Letters
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    • v.5 no.2
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    • pp.181-190
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    • 1999
  • To evaluate the usefulness of transforming growth factor-$\beta$1 (TGF-$\beta$1) as a new tumor marker, we determined the plasma TGF-$\beta$1 levels using sandwich ELISA assay in cancer patients. Patients with three most common adult cancers in Korea (stomach, liver and breast cancer) and children's cancers (leukemia and two kinds of solid tumor) were enrolled for the study. Furthermore, 39 individuals were subjected to age and sex-stratified plasma TGF-$\beta$1 analysis. No statistical difference was demonstrated with respect to age or sex. The mean plasma TGF-$\beta$1 level (16.0 ng/ ml) of stomach cancer patients was significantly higher than that (8.3 ng/ml) of controls. However, there was no difference among the mean plasma TGF-$\beta$1 levels of liver, breast cancer patients and controls. Seven of 16 patients (43.7%) with stomach cancer, one of 8 (12.5%) with liver cancer, and one of 7 (14.3%) with breast cancer showed higher TGF-$\beta$1 levels compared to controls. Plasma TGF-$\beta$1 concentrations of five leukemic children remained in the normal range regardless of the remission state. In contrast, initial high TGF-$\beta$1 levels from two children with solid tumors returned to normal range on surgical resection of tumors. From the above results, we could conclude that plasma TGF-$\beta$1 levels of apparently healthy individuals seem to be rather constant irrespective of difference in age or sex, and the plasma TGF-$\beta$1 has the limited value as a screening test for the diagnosis of aforementioned adult cancers because of its low sensitivity. Finally, additional studies need to be pursed for the large number of stomach cancer and pediatric solid tumor patients in order to reach a secure conclusion on the usefulness of plasma TGF-$\beta$1 as a tumor marker in these patients.

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