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Clinical Characteristics of Pulmonary Aspergilloma (폐국균종의 임상적 고찰)

  • Kang, Tae-Kyung;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Sohn, Jeong-Ho;Lee, Jun-Ho;Han, Seong-Beom;Jeon, Young-Jun;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Shin, Hyeon-Soo;Lee, Sang-Chae;Kweon, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1308-1317
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    • 1997
  • Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

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Incidence and outcome of congenital anomalies of the kidney and urinary tract detected by prenatal ultrasonography: a single center study (산전 초음파로 발견된 선천성 신 요로 기형의 발생률과 임상 결과: 단일 기관 연구)

  • Lim, Gina;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Won, Hye-Sung
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.464-470
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    • 2009
  • Purpose : This study assessed the incidence and outcome of congenital anomalies of the kidney and urinary tract (CAKUT) detected by prenatal ultrasonography Methods : There were 906 cases of CAKUT detected by prenatal ultrasonography and postnatally confirmed at the Asan Medical Center from October 1989 to October 2007. We investigated the incidence and outcome of these cases by reviewing medical records retrospectively. Results : The order of incidence was hydronephrosis, multicystic dysplastic kidney (MCDK), duplex kidney, vesico-ureteral reflux (VUR), single kidney, hydroureteronephrosis, ectopic kidney, polycystic kidney, ureterocele, and posterior urethral valve (PUV). There were 520 cases (57.4%) of hydronephrosis, and 20% of these needed an operation due to significant obstruction. MCDK was associated with other CAKUT in 25.4% of all cases. Approximately 57.9% of duplex kidney cases needed surgical treatment due to ureterocele and VUR. VUR had a male: female ratio of 10:1. Two out of seven cases of autosomal recessive polycystic kidney had progressed to chronic renal failure. Patients with PUV were relatively uncommon, and one out of nine cases progressed to end-stage renal disease. Conclusion : CAKUTs detected by prenatal ultrasonography were composed of various anomalies, and almost all of them had a good outcome without any intervention. However, in some cases, recurrent urinary tract infection or renal failure occurred, especially in bilateral cases. For further management, a long-term multicenter study is needed to investigate the precise incidence and outcome of each anomaly in the general population.

Clinical significance of loss of p16 protein by immunohistochemical staining in acute lymphoblastic leukemia (급성림프구성백혈병에서 면역조직화학염색에 의한 p16 단백질 소실의 의의)

  • Jin, Hye Young;Kang, Kyoung In;Kim, Sun Young;Youn, You Sook;Kang, Joon Won;Jo, Deog Yeon;Kwon, Kye Chul;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.73-77
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    • 2008
  • Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

Antibacterial and Therapeutic Effects of Houttuynia cordata Ethanol extract for Murine Salmonellosis (어성초 ethanol 추출물의 마우스 살모넬라 감염증에 대한 항균 및 치료효과 규명)

  • Kim, Dong-Hyeok;Lim, Jung-Ju;Lee, Jin-Ju;Jung, Won-Chul;Shin, Hyeon-Jin;Lee, Hu-Jang;Kim, Gon-Sup;Kim, Suk
    • Korean Journal of Environmental Agriculture
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    • v.27 no.2
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    • pp.156-162
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    • 2008
  • Salmonellosis is a major bacterial zoonosis that causes a variety of disease syndromes, self-limited enteritis to fatal infection in animals and food-borne infection and typhoid fever in humans. Recently, the emergence of multidrug resistant strains of Salmonella spp. causes more serious problems in environment and public health. The present study was investigated the antibacterial effect of Houttuynia cordata ethanol extract(HCEE) for murine salmonellosis. In the cytotoxic effect of HCEE on RAW 264.7 cells, there was no detectable effect with any concentrations between 25 and 100 ${\mu}g/ml$ after 8 h incubation. The bacteriocidal effect of HCEE was not showed on a Salmonella enterica serovar Typhimurium(S. typhimurium). HCEE makes morphological change of the RAW 264.7 cells, and there was significant decreased bacterial uptake and intracellular replication within Salmonella infected cells. And further nitric oxide(NO) production of Salmonella infected RAW 264.7 cells with HCEE was decreased comparing to RAW 264.7 cells without HCEE until 8 h post infection. Oral administration of HCEE showed a therapeutic effect for S. typhimurium infected BALB/c mice. The mortality of HCEE treated mouse was 80% until 12 days, while that of HCEE untreated mouse was 100 % until 8 days after lethal dose of S. typhimurium infection. These data suggested that HCEE has a potency treatment for intracellular replicative pathogen including salmonellosis, brucellosis, tuberculosis, listeriosis etc., and the application of HCEE makes new strategies for safety medicine development without antibiotic resistance bacterial appearance and residue problem in food and solves the public health problem from antibiotic mis- and over use.

A Study of Temporomandibular Disorders and Food Intake Ability among Dental Clinic Outpatients (일부 치과 외래환자의 측두하악장애 실태와 음식섭취능력에 관한 연구)

  • Han, Se-Young;Yu, Ji-Su
    • Journal of dental hygiene science
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    • v.11 no.3
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    • pp.285-292
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    • 2011
  • The purpose of this study was to analyze and investigate temporomandibular disorders(TMD) and dental clinic outpatients by food intake ability to improve the quality of life. A survey of questionnaires with 208 subjects visiting a dental clinics located in Daejeon city from January to September in 2010 was performed. Analysis were performed with survey results, in which a symptoms of TMD, parafunctional habits and abnormal functions, food intake ability : 1. The main symptoms of TMD showed pain on TMJ(45.7%), pain on joint sound(45.2%), pain during chewing(41.3%), pain during mouth opening(38.0%), pain during non chewing(19.7%) and pain on joint dislocation(13.0%) in turn. 2. The symptoms of TMD by gender showed joint dislocation of 18.0% for male and 8.3% for female(p=0.038); pain on chewing of 49.0% for male and 34.3% for female(p=0.031), which were statistically significant. 3. The parafunctional habits and abnormal functions by gender showed clenching habit of 35.0% for male and 22.0% for female; bruxism of 21.0% for male and 9.3% for female, which were statistically significant. 4. The symptoms of TMD by age showed 52.8% of 27.8% for often and 25.0% for sometimes of 21-30 age in pain on TMJ, which were statistically significant(p=0.001). 5. The parafunctional habits and abnormal functions by age showed over 31 age of 48.3%, which were statistically significant(p=0.003). 6. The food intake ability by symptoms of TMD showed no joint sound(p=0.000), no pain on chewing(p=0.000) and without pain on TMJ(p=0.000), which were statistically significant. 7. The food intake ability by parafunctional habits and abnormal functions showed no clenching habit(p=0.000), no bruxism(p=0.000) and no headache, which were statistically significant. 8. The distribution type of operation by symptoms of TMD showed 30.8% of rest, 24.0% of physical medicine and 16.4% of pharmacotherapy. The pain on chewing showed 36.0% of pharmacotherapy; 52.4% of pain on TMJ for often and 40.5% for sometimes, in which pharmacotherapy and physical medicine were statistically significant(p=0.000). These results showed that management run parallel with survey for multiple factors in TMD we consider aspect of physical, social, physiology to enhance quality of life to increase food intake, construction of program for treatment and prevention because the individual differences need to be multifaceted, further research is suggested to continue.

Effects of Different Physical Frequency on Food-Dependent Exercise Induced Allergy Anaphylaxis (FDEIA) and Related Mechanisms (운동빈도의 차이가 식이유도 운동알레르기 질환과 관련기전에 미치는 영향)

  • Kim, Cheol-Woo;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.22 no.7
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    • pp.897-903
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    • 2012
  • Food allergies have become a serious health concern in the past two decades, especially in developed countries. Foods associated with allergies include vegetables, some fruits, shellfish, wheat, egg, chicken, and nuts. To describe the specific fundamentals, etiological factors, and clinical manifestations, we analyzed the different physical frequency on spleen index in sensitized and regular exercise-trained mice. We also conducted a proliferation assay of lymphocytes to OVA, ROS, ASAS, and we determined the cytokine levels. Female BALB/c mice were bred in the animal laboratory of the P and D university under controlled conditions ($22{\pm}2^{\circ}C$, RH 45-55%, and a 12-hour photoperiod). The animals were 6 weeks old at the start of the study and were fed a standard commercial chow diet from 09:00 to 15:00 for the 8-week study period. All animals had access to distilled deionized water ad libitum. They were divided into four groups: a control group (S; control sensitized, n=25), a low-frequency training group (F2, n=25), a mid-frequency training group (F3, n=25), and a high-frequency training group (F5, n=25) following the treatment of exercise time per week. The results were as follows: The mice spleen index showed the highest grade in the F5 group compared with the other groups; this level showed in an exercise frequency-dependent manner. In the proliferation assay of OVA, the F5 group showed the highest grade compared with the other groups; this level was also showed in an exercise frequency-dependent manner. Peritoneal ROS and ASAS showed a statistically significant increase in the F5 group and decreased in the F2 group compared with the S group. However, there were no significant differences in the F3 group. The highest level of IL-4 was found in the F5 group compared with the other groups. However, the highest level of INF-${\gamma}$ was in the F2 group. The results suggest that FDEIA is positively correlated with the frequency of exercise due to the direct effect of physical exercise on peritoneal ROS and the cytokine profile. Further research is needed on the specific mechanism underlying the combined effects of exercise intensity and frequency on physical-induced allergy anaphylaxis.

Signal Transduction Factors on the Modulation of Radiosusceptibility in K562 Cells (K562 세포의 방사선 감수성 변화에 영향을 미치는 신호전달인자)

  • Yang Kwang Mo;Youn Seon-Min;Jeong Soo-Jin;Jang Ji-Yeon;Jo Wol-Soom;Do Chang-Ho;Yoo Y대-Jin;Shin Young-Cheol;Lee Hyung Sik;Hur Won Joo;Lim Young-Jin;Jeong Min-Ho
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.227-237
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    • 2003
  • Purpose: The human chronic myelogenous leukemia cell line, K562, expresses the chimeric bcr-abl oncoprotein, whose deregulated protein tyrosine kinase activity antagonizes via DNA damaging agents. Previous experiments have shown that nanomolar concentrations of herbimycin A (HWA) coupled with X-irradiation have a synergistic effect in inducing apoptosis in the Ph-positive K562 leukemia cell line, but genistein, a PTK inhibitor, is non selective for the radiation-induced apoptosils on $p210^{bcr/abl}$ protected K562 cells. In these experiments, the cytoplasmic signal transduction pathways, the Induction on a number of transcription factors and the differential gene expression in this model were investigated. Materials and Methids: K562 cells in the exponential growth phase were used in this study. The cells were irradiated with 0.5-12 Gy, using a 6 Mev Linac (Clinac 1800, Varian, USA). Immediately after irradiation, the cells were treated with $0.25/muM$ of HMA and $25/muM$ of genistein, and the expressions and the activities of abl kinase, MAPK family, NF- kB, c-fos, c-myc, and thymidine kinase1 (TK1) were examined. The differential gene expressions induced by PTK inhibitors were also investigated. Results: The modulating effects of herbimycin A and genistein on the radiosensitivity of K562 cells were not related to the bcr-abl kinase activity. The signaling responses through the MAPK family of proteins, were not involved either in association with the radiation-induced apoptosis, which is accelerated by HMA, the expression of c-myc was increased. The combined treatment of genistein, with irradiation, enhanced NF- kB activity and the TK1 expression and activity. Conclusion: The effects of HMA and genistein on the radiosensitivity on the K562 cells were not related to the bcr-abl kinase activity in this study, another signaling pathway, besides the WAPK family responses to radiation to K562 cells, was found. Further evaluation using this model will provide valuable information for the optional radiosensitization or radioprotection.

The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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Effect of different light sources and ventilation on in vitro shoot growth and rooting of a rare and endangered species, Tsuru-rindo(Tripterospermum japonicum) (희귀 및 멸종위기 식물 덩굴용담의 기내생장에 미치는 광질 및 환기효과)

  • Moon, Heung-Kyu;Park, So-Young
    • Journal of Plant Biotechnology
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    • v.35 no.3
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    • pp.215-221
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    • 2008
  • Effects of light generated by LEDs on shoot growth and rooting of Tsuru-rindo(Tripterospermum japonicum) were evaluated. Apical shoots(one or two node with 3-4 leaves) were cultured on MS basal medium with 3% sucrose and maintained for four weeks under five different light qualities: fluorescent lamp(F), 100% red LED(R), 70% red LED+30% blue LED(R7B3), 50% red LED+50% blue(R5B5), or 100% blue LED(B). Rooting was promoted by both red light and fluorescent lamp, and the effect was further promoted under the ventilation. Red light enhanced shoot node elongation, whereas blue light appeared to suppress it. Growth of shoots and leaves were enhanced under the ventilation irrespective of the different light qualities. Under the ventilated condition, total fresh weight of plants was highest in R7B3 LED as 257.7 mg per plant. Dry matters, which are used for index of plant growth, were lowest under red light, whereas it was highest under blue light. The dry matter was inclined to getting higher by ascending the ratio of blue light and red light. Total chlorophyll content was highest in both R7B3 LED and R5B5 LED under ventilation as 29.5 and 31.2, respectively. Above results suggest that light quality optimization could be an important factor to foster in vitro growth of the species. Ventilation treatment appeared to be another important factor to induce normal shoot growth and rooting.

The Neonatal Follow up and Correlative Analysis of Fetal Hydronephrosis (산전 수신증의 생후 추적 관찰)

  • Yoon Ho-Young;Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil;Kim Myung-Joon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.60-68
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    • 1998
  • Purpose: To determine the various prenatal factors related to the prenatal hydronephrosis diagnosed on prenatal ultrasonography. We also attempted to correlate the prenatal and neonatal renal pelvic anteroposterior diameter with the outcome in infancy Methods: Between 1985 and 1997. We retrospectively reviewed 105 renal unit (75 patient) with fetal hydronphrosis persisting postnatally. Investigation consisted of renal ultrasonography, voiding cystourethrography, diurectic renogram, and DMSA scan. Results: The 75 patient assesed had the following underlying cause: UPJ(Ureteropelvic juction) obstruction(52%). multicystic dysplastic kidney(10%). UVJ (Ureterovesicai juction) obstruction (10%) and no underlying cause (25%). Of theses cases 36 cases (40 renal unit) underwent operation, while 28 cases (50 renal unit) resoled spontaneously. 12% of mild hydornephrosis deteriorated. whereas 50% of modrate hydrophrosis and 81% of severe hydronephrosis required surgical correction. Attempting to find the renal unit that were at risk for deterioration. our study showed that urinary tract infection group and calyceal blunting group had a predictive role. Conclusion: It is necessary to follow up after birth dilatation of caylx or urinary tract infection are present. Early operation is considered when prenatal pelvic AP diameter greater is than 22 mm and postnatal diameter greater than 17 mm. This may make it possible to prevent further progression of renal damage and prompt treatment of asymptomatic hydronephrosis before complications occur.

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