• Title/Summary/Keyword: Serum albumin

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Differential Diagnosis By Analysis of Pleural Effusion (흉수분석에 의한 질병의 감별진단)

  • Ko, Won-Ki;Lee, Jun-Gu;Jung, Jae-Ho;Park, Mu-Suk;Jeong, Nak-Yeong;Kim, Young-Sam;Yang, Dong-Gyoo;Yoo, Nae-Choon;Ahn, Chul-Min;Kim, Sung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.559-569
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    • 2001
  • Background : Pleural effusion is one of the most common clinical manifestations associated with a variety of pulmonary diseases such as malignancy, tuberculosis, and pneumonia. However, there are no useful laboratory tests to determine the specific cause of pleural effusion. Therefore, an attempt was made to analyze the various types of pleural effusion and search for useful laboratory tests for pleural effusion in order to differentiate between the diseases, especially between a malignant pleural effusion and a non-malignant pleural effusion. Methods : 93 patients with a pleural effusion, who visited the Severance hospital from January 1998 to August 1999, were enrolled in this study. Ultrasound-guided thoracentesis was done and a confirmational diagnosis was made by a gram stain, bacterial culture, Ziehl-Neelsen stain, a mycobacterial culture, a pleural biopsy and cytology. Results : The male to female ratio was 56 : 37 and the average age was $47.1{\pm}21.8$ years. There were 16 cases with a malignant effusion, 12 cases with a para-malignant effusion, 36 cases with tuberculosis, 22 cases with a para-pneumonic effusion, and 7 cases with transudate. The LDH2 fraction was significantly higher in the para-malignant effusion group compared to the para-pneumonic effusion group [$30.6{\pm}6.4%$ and $20.2{\pm}7.5%$, respectively (p<0.05)] and both the LDH1 and LDH2 fraction was significantly in the para-malignant effusion group compared to those with tuberculosis [$16.4{\pm}7.2%$ vs. $7.6{\pm}4.7%$, and $30.6{\pm}6.4%$ vs.$17.6{\pm}6.3%$, respectively (p<0.05)]. The pleural effusion/serum LDH4 fraction ratio was significantly lower in the malignant effusion group compared to those with tuberculosis [$1.5{\pm}0.8$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. The LDH4 fraction and the pleural effusion/serum LDH4 fraction ratio was significantly lower in the para-malignant effusion group compared to those with tuberculosis [$17.0{\pm}5.8%$ vs. $23.5{\pm}4.6%$ and $1.3{\pm}0.4$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. Conclusion : These results suggest that the LDH isoenzyme was the only useful biochemical test for a differential diagnosis of the various diseases. In particular, the most useful test was the pleural effusion/serum LDH4 fraction ratio to distinguish between a para-malignant effusion and a tuberculous effusion.

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Prospective Study of the Immunologic Factors Affecting the Prognosis of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴환자의 예후에 영향을 미치는 면역지표에 대한 연구)

  • Hwang, Jae-Kyung;Lee, Ho-Moeng;Song, Kwang-Sik;Park, Gye-Young;Park, Jeong-Woong;Park, Jae-Kyung;Jeong, Seong-Hwan;Ahn, Jeong-Yeal;Seo, Yiel-Hea;Nam, Gui-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.437-449
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    • 2001
  • Background : In the severe community-acquired pneumonia, it has been known that the immune status is occasionally suppressed. This study was performed to identify the immunologic markers related with the prognostic factors in severe community-acquired pneumonia. Methods : 23 patients with severe community-acquired pneumonia were involved in this study, and divided into survivor (16) and nonsurvivor (7) groups. In this study, the medical history, laboratory tests(complete blood counts, routine chemistry profile, immunoglobulins, complements, lymphocyte subsets, cytokines, sputum and blood culture, urine analysis), and chest radiographs were scrutinized. Results : 1) Both groups had lymphopenia(total lymphocyte count $995.6{\pm}505.7/mm^3$ in the survivor and $624.0{\pm}287.6/mm^3$ in the nonsurvivor group). 2) The T-lymphocyte count of the nonsurvivor group($295.9{\pm}203.0/mm^3$) was lower than the survivor group($723.6{\pm}406.5/mm^3$) (p<0.05). 3) The total serum protein(albumin) was $6.0{\pm}1.0(2.7{\pm}0.7)\;g/d{\ell}$ in the survivor and $5.2{\pm}1.5(2.3{\pm}0.8)g/d{\ell}$ in the nonsurvivor group. The BUN of the nonsurvivor group($41.7{\pm}30.0mg/d{\ell}$) was higher than that of the survivor group($18.9{\pm}9.8mg/d{\ell}$)(p<0.05). The creatinine concentration was higher in the nonsurvivor group($1.8{\pm}1.0mg/d{\ell}$) than that in the survivor group($1.0{\pm}0.3mg/d{\ell}$)(p<0.05). 4) The immunoglobulin G level was higher in the survivor group($1433.0{\pm}729.5mg/d{\ell}$) than in the nonsurvivor group($849.1{\pm}373.1mg/d{\ell}$) (p<0.05). 5) The complement $C_3$ level was $108.0{\pm}37.9mg/d{\ell}$ in the survivor group and $88.0{\pm}32.1mg/d{\ell}$ in the nonsurvivor group. 6) A cytokine study showed an insignificant difference in both groups. 7) Chronic liver disease, DM, and COPD were major underlying diseases in both groups. Conclusion : These results suggest that decreased a T-lymphocyte count and immunoglobulin G level, and an increased BUN and creatinine level may be associated with the poor prognosis of severe community-acquired pneumonia.

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A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Nutritional Status and Health Risks of Low Income Elderly Women in Gwangju Area (광주지역 저소득층 여자노인의 영양상태와 건강위험요인에 관한 연구)

  • Yang, Eun-Ju;Bang, Hee-Myung
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.65-76
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    • 2008
  • This study was performed to identify association between nutritional status and health risks of the elderly. This was a cross-sectional study involving low income elderly women in Gwangju, Korea (${\geq}$65y, n = 92). Socio-demographics, life style characteristics, health conditions, dietary intakes based on 24h-recall method, anthropometric measures, and clinical biochemistry parameters were examined. Anthropometric and clinical parameters included wt, ht, waist, hip, body protein, body fat, abdominal fat, total cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, hemoglobin, hematocrit, fasting blood glucose, ferritin, IL-2, IL-6, TNF-${\alpha}$, CRP, TAS, TBARS, systolic blood pressure, and diastolic blood pressure. The subjects were divided into three groups based on age (65-74y, 75-84y, 85y${\leq}$) and were divided into two groups according to the sum of the Nutrition Screening Initiative (NSI) checklist score (adequate nutritional status, NSI score ${\leq}$3; at risk of malnutrition, NSI score >3). Mean and frequency of variables were estimated. Analysis of Variance, Tukey test, Chi-square test, and Multiple linear regression analyses were performed. Mean BMI and body fat were 25.1 $kg/m^2$ and 40.0%, respectively. However, for over 80% of subjects, the intakes of energy, fiber, thiamin, riboflavin, niacin, folate, Ca, K, and Zn were less than the Korean DRI (EAR or AI). The subjects who had lower NSI score tended to have better health status, eat meals frequently, have less depression, and exercise regularly. The subjects who had higher NSI score tended to have tooth problems, to eat alone most of time, and to be physically unable to cook or feed. Serum IL-6 and TNF-${\alpha}$ were significantly related with nutritional status which suggested higher tendency of inflammatory response. Serum IL-2, TAS, and glucose were significantly correlated with body fat (%) or abdominal fat (%). These results suggest that improving the nutritional status, increasing regular exercise, maintaining normal weight are beneficial to health care of low income elderly women.

Reduction of Allergenicity of Domestic Pork Ham and Bacon by Autoclave Treatment (가압가열 처리에 의한 시판 돈육 햄과 베이컨의 알레르겐성 저감화 효과)

  • Kim, Seo-Jin;Kim, Koth-Bong-Woo-Ri;Song, Eu-Jin;Lee, So-Young;Yoon, So-Young;Lee, So-Jeong;Lee, Chung-Jo;Kim, Kyu-Earn;Ahn, Dong-Hyun
    • Food Science of Animal Resources
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    • v.30 no.1
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    • pp.133-140
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    • 2010
  • The pork hams and bacon comprising the most popular processed pork were treated with autoclave to investigate application of hypoallergenic pork. Among pork hams and bacon, two products with the highest binding ability were selected for experiments. The results of ci-ELISA on pork hams treated with autoclave showed that the binding ability of p-IgG and pigallergic patient's sera (P2) to PSA (porcine serum albumin) from pork ham samples by autoclave treatment at $121^{\circ}C$ for 30 min was slightly decreased. The binding ability to p-IgG of b and c bacon treated with autoclave was declined to below 16% and 11% as compared with control sample that showed 60% and 91% binding ability. The binding ability to P2 of b and c bacon treated with autoclave decreased to below 22% and 34% as compared with control sample that showed 95% and 126% binding ability. A result of immunoblotting on bacon showed that p-IgG as well as pig patient's sera did not recognize PSA well in autoclave treatment. The results obtained from this work indicated that autoclave treatment was effective for a reduction of allergenicity of pork hams and bacon. Therefore the autoclave treatment may be applied to development of hypoallergenic pork.

Suppressive Effect of Administrated Glutathione-Enriched Saccharomyces cerevisiae FF-8 on the Oxidative Stress in Alcoholic Fatty Liver (알코올 투여 흰쥐의 간 조직 산화스트레스에 미치는 글루타티온 고함유 효모 Saccharomyces cerevisiae FF-8 균체의 영향)

  • Cha, Jae-Young;Park, Sang-Hyun;Heo, Jin-Sun;Cho, Young-Su
    • Journal of Life Science
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    • v.18 no.8
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    • pp.1053-1058
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    • 2008
  • Glutathione is a well known chemotherapeutic agent for liver disease and is a popular nutritional supplement in the United States. Previous our studies reported the suppressive effects of glutathione-enriched Saccharomyces cerevisiae FF-8 strain (FF-8GY) on carbon tetrachloride- and alcohol-induced hepatotoxicity. The primary objective of this study was to investigate the comparative effects of FF-8GY and commercially available glutathione-enriched yeast extract (GYE) against the oxidative stress in alcohol-induced fatty liver of rats. The lipid peroxidative index (thiobarbituric acid-reactive substances, TBARS) and antioxidant status (reduced glutathione level) were used to monitor those protective roles of FF-8GY or GYE treatment. When the rat was treated alcohol, the TBARS levels in the whole liver and the subfractions of microsomal and mitochondria were significantly increased but these were significantly decreased by FF-8GY treatment and tended to be lowered by GYE treatment. The concentration of hepatic glutathione is known to be closely associated with antioxidant system and this was slightly deplete in the alcohol-induced rats, but this was recovered by treating with FF-8GY. However, the glutathione concentration was more significantly decreased in the GYE supplementation in alcohol feeding rats. Alcohol treatment also negatively affected the serum total protein and albumin, but these were significantly increased near normal levels in FF-8GY coadministered rats. These results suggest that glutathione-enriched Saccharomyces cerevisiae FF-8 strain may have positively mediate the alcohol-induced oxidative stress, and this effect was more pronounced in FF-8GY compared to GYE.

A Clinical Review of Acute Respiratory Distress Syndrome (ARDS) Due to Miliary Tuberculosis (급성호흡곤란증후군으로 발현된 속립성 결핵의 임상적 고찰)

  • Ahn, Young-Soo;Lee, Sang-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.17-26
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    • 2002
  • Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

Monoclonal Antibody against leucocyte CD11b(MAb 1B6) increase the early mortality rate in Spraque Dawley with E. coli pneumonia (백혈구 CD11b에 대한 단 클론 항체 (MAb 1B6)는 Spraque Dawley의 E. coli 폐렴의 조기 사망률을 증가시킨다)

  • Kim, Hyung Jung;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.579-589
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    • 1996
  • Background : Activation of neutrophil is critical for the clearance of microorganisms and toxic host mediators during sepsis. Unfortunately the activated neutrophil and its toxic byproducts can produce tissue injury and organ dysfunction. The leucocyte CD11/18 adhesion complex regulates neutrophil-endothelial cell adhesion, the first step in neutrophil migration to sites of injection and inflammation. To investigate the potential of neutrophil inhibition as a treatment strategy for sepsis, we evaluated the effects of monoclonal antibody against CD11b (MAb 1B6) in rats intrabronchial challenged with Escherichia coli. Methods : Animals were randomly assigned to receive monoclonal antibody against CD11b (1 mg/kg, sc) and bovine serum albumin(BSA, 1 mg/kg, sc) 6 hr before, at 0 and 6 hr after intrabronchial challenge of $20x10^9$ CFU/kg E. coli 0111. Animals were randomized to treat either 24, 60 or 90% oxygen after bacterial challenge and begining 4 hr after inoculation, all animals were received 100 mg/kg ceftriaxone qd for 3 days. Peripheral and alveolar neutrophil(by bronchoalveolar lavage) counts and lung injury parameters such as alveolar-arte rial $PO_2$ difference, wet to dry lung weight ratio and protein concentration of alveolar fluid were measured in survived rats at 12 hr and 96 hr. Results : Monoclonal antibody against CD11b decreased circulating and alveolar neutrophil especially more in 12 hr than in 96 hr The lung injury parameters of antibody-treated animals were not different from those of BSA-treated animals. but It was meaningless due to small number of survived animals. The early(6 hr) mortality rate was significantly increased in antibody-treated group(51%) compared to BSA-treated group(31%) (P=0.02) but late(from 12 hr to 72 hr) mortality rate was not different in antibody-treated group(44%) from BSA-treated group(36%) (P =0.089). Conclusion : Leucocyte CD11b/18 adhesion molecule is known to regulate neutrophil migration to the site of infection and inflammation. The monoclonal antibody against CD11b decreased alveolar neutrophil in rats with pulmonary sepsis and increased early mortality rate. Therefore, we can speculate that monoclonal antibody against CD11b blocks of alveolar recruitment of neutrophils, impairs host defense mechanism and increases early mortality rate of pulmonary sepsis in rat.

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Specific antibody response of olive flounder Paralichthys olivaceus by water temperature (수온에 따른 넙치의 특이 항체 반응)

  • Kim, Wi-Sik;Jang, Min-Seok;Jung, Sung-Ju;Kim, Seok-Ryel;Park, Myoung-Ae;Lee, Jeong-Ho;Myeong, Jeong-In;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.24 no.1
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    • pp.39-45
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    • 2011
  • The specific antibody response of olive flounder, Paralichthys olivaceus to different water temperature were tested by enzyme-linked immunosorbent assay (ELISA). In the rearing temperature of $15^{\circ}C$, first anti-bovine serum albumin (BSA) antibody titer was appeared after 14 days of immunization, whereas 24~48 days post-immunization (PI) resulted maximum antibody titer in all 5 experimental fish with optical density (OD) values 1.94~3.04. At the end of the experiment (84 days), 0.03~1.28 OD values were observed. In the rearing temperature of $12{\sim}13^{\circ}C$, first antibody titer was found 28 days PI in 2 out of 5 fish. Three fish shown high OD titer (1.88~2.68) between 56 and 70 days and OD values of 0.49 to 2.35 were observed at 84 days. However, the anti-BSA antibodies of two fish showed less than 0.8 OD values until 84 days. In the rearing temperature of $10^{\circ}C$, specific antibody appeared at 56 days, maximum antibody titer was observed at 70 days in 2 out of 5 fish (OD values: 1.37~1.53) and 1.00 to 1.11 OD values were observed at 84 days. Rest 3 fish showed OD values of 0.12 to 0.68 much below to that of other 2 fish, throughout the experimental period. In conclusion, specific antibody response of olive flounder at high temperature was much faster, higher and longer than that at lower temperature.

Clinical Course of IgA Nephropathy in Children (소아 IgA 신병증의 추적 관찰)

  • Hong In-Hee;Lee Jun-Hwa;Go Cheol-Woo;Kwak Jung-Sik;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.153-160
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    • 1999
  • Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children. Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas. Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{\pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V. Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.

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