• Title/Summary/Keyword: peripheral resistance

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Effector Memory CD8+ and CD4+ T Cell Immunity Associated with Metabolic Syndrome in Obese Children

  • Yang, Da-Hee;Lee, Hyunju;Lee, Naeun;Shin, Min Sun;Kang, Insoo;Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.4
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    • pp.377-383
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    • 2021
  • Purpose: We investigated the association of effector memory (EM) CD8+ T cell and CD4+ T cell immunity with metabolic syndrome (MS). Methods: Surface and intracellular staining of peripheral blood mononuclear cells was performed. Anti-interleukin-7 receptor-alpha (IL-7Rα) and CX3CR1 antibodies were used to stain the subsets of EM CD8+ T cells, while anti-interferon-gamma (IFN-γ), interleukin-17 (IL-17), and forkhead box P3 (FOXP3) antibodies were used for CD4+ T cell subsets. Results: Of the 47 obese children, 11 were female. Children with MS had significantly higher levels of serum insulin (34.8±13.8 vs. 16.4±6.3 µU/mL, p<0.001) and homeostasis model assessment of insulin resistance (8.9±4.1 vs. 3.9±1.5, p<0.001) than children without MS. Children with MS revealed significantly higher frequencies of IL-7Rαlow CD8+ T cells (60.1±19.1% vs. 48.4±11.5%, p=0.047) and IL-7RαlowCX3CR1+ CD8+ T cells (53.8±20.1% vs. 41.5±11.9%, p=0.036) than children without MS. As the serum triglyceride levels increased, the frequency of IL-7RαlowCX3CR1+ and IL-7RαhighCX3CR1- CD8+ T cells increased and decreased, respectively (r=0.335, p=0.014 and r=-0.350, p=0.010, respectively), in 47 children. However, no CD4+ T cell subset parameters were significantly different between children with and without MS. Conclusion: In obese children with MS, the changes in immunity due to changes in EM CD8+ T cells might be related to the morbidity of obesity.

Study of Spectral Doppler Waveform Interpretation and Nomenclature in Peripheral Artery (말초 동맥 분광 도플러 파형 해석 및 명명법에 대한 고찰)

  • Ji, Myeong-Hoon;Seoung, Youl-Hun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.649-660
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    • 2022
  • In 1959, Satomura used spectral Doppler ultrasound to express the velocity of red blood cells according to time change, and Kato defined a zero-base line that could tell the direction of blood flow, making it possible to know the direction of blood flow. This became the basis for the widely used classifications of Triphasic, Biphasic, and Monophasic. However, the above classification has limitations that confuse users with the meaning and timing of use in a clinical environment. As a result, the American Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU) A consensus document on Doppler waveform analysis was declared by the joint committee. This study tried to review this consensus and to suggest nomenclature and modifiers that can be used in the domestic vascular ultrasound clinical field. The joint committee formed by SVM and SVU recommended that the use of the triphasic waveform and the biphasic waveform be used as a multiphasic waveform rather than being used due to the ambiguity of interpretation. In addition, it was agreed to name the hybrid-type waveform, which is a monophasic and high-resistance waveform, which has always been a problem of interpretation in a clinical environment, as an intermediate resistive waveform. In addition, in order to increase the communication efficiency between the interpreter and the sonographer, waveform analysis was classified into a main descriptor and a modifier, and it was recommended to use a single nomenclature by unifying various synonyms. It is expected that this literature review will provide accurate arterial spectral Doppler waveform interpretation and an agreed-upon nomenclature to radiologists performing vascular ultrasound examination in clinical practice, and will be utilized as basic data that can contribute to the improvement of public health.

Studies on the Hemodynamic Changes in Cirrhosis of the Liver (간경변증(肝硬變症)에서의 혈역학적(血力學的) 변화(變化)에 관(關)한 연구(硏究))

  • Kim, Jung-Il;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.11-27
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    • 1970
  • Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

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Clinical Significance of Extended-Spectrum ${\beta}$-Lactamase Producing $Escherichia$ $coli$ in Pediatric Patients with Febrile Urinary Tract Infection (발열성 소아 요로감염에서 Extended-Spectrum ${\beta}$-Lactamase 생성 $Escherichia$ $coli$의 임상적 의의)

  • Park, Cheol;Kim, Min-Sang;Kim, Mi-Kyung;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.38-45
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    • 2012
  • Purpose: The incidence of community-acquired urinary tract infection (UTI) due to extended-spectrum ${\beta}$-lactamase producing $Escherichia$ $coli$ (ESBL(+) $E.$ $coli$) has increased worldwide. ESBL causes resistance to various types of the newer ${\beta}$-lactam antibiotics, including the expanded spectrum cephalosporins and monobactams. We aimed to investigate the severity of UTI and associated genitourinary malformations in children with febrile UTI caused by ESBL(+) $E.$ $coli$. Methods: We retrospectively reviewed the medical records of 290 patients diagnosed as febrile UTI caused by $E.$ $coli$ between January 2008 and October 2010 at Korea University Medical center. We classified the patients into two groups with ESBL(+) and ESBL(-) $E.$ $coli$ group according to the sensitivity of urine culture. Fever duration, admission period, white blood cell (WBC) counts and C-reactive protein (CRP) in peripheral blood, the presence of hydronephrosis, cortical defects, vesicoureteral reflux (VUR) and renal scar were compared between the two groups. Results: Patients with ESBL(+) $E.$ $coli$ were 32, and those with ESBL(-) $E.$ $coli$ were 258. If we excluded those tested with a sterile urine bag, patients with ESBL(+) $E.$ $coli$ were 22, and those with ESBL(-) $E.$ $coli$ were 212. Whether the results of sterile urine bag tests were included or not, there was no significant difference in all parameters between the two groups statistically. Conclusion: Our data shows that ESBL(+) $E.$ $coli$ may not be related to the severity of UTI and associated genitourinary malformations.

Evaluation of the Cell-Mediated Immunity in Treatment Failure Pulmonary Tuberculosis (치료실패 폐결핵 환자의 세포성면역반응에 관한 연구)

  • Park, Jeong-Kyu;Park, Jang-Seo;Kim, Hwa-Jung;Jo, Eun-Gyeong;Min, Dul-Lel;Lim, Jae-Hyun;Suhr, Ji-Won;Paik, Tae-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.13-25
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    • 1999
  • Background: Ineffective cell-mediated immune response in human tuberculosis is associated with a depressed Thl cytokine response and reduced production of IFN-$\gamma$. Most persons infected with Mycobacterium tuberculosis are healthy tuberculin reactors with protective immunity, but a minority with ineffective immunity develop extensive pulmonary tuberculosis. The cell-mediated immune response is an important aspect of host resistance to mycobacterial infection and is believed to be tightly regulated by a balance between Th1 cytokines including IFN-$\gamma$, IL-12, IL-18, regulated on activation, normal T cell expressed and secreted (RANTES) and Th2 counterparts such as IL-4, monocyte chemoattractant protein-l (MCP-l). Methods: Proliferation and mRNA expression of IFN-$\gamma$, RANTES and MCP-l by RT-PCR in peripheral blood mononuclear cells (PBMCs) in response to in vitro stimulation with mycobacterial antigens were compared in pulmonary tuberculosis patients with cured and treatment failure and in tuberculin-positive and tuberculin-negative healthy subjects. Results: Defective proliferative responsiveness to aqueous TSP antigen was involved with treatment failure tuberculosis patients. Aqueous TSP antigen-induced IFN-$\gamma$ and RANTES mRNA expression was decreased in treatment failure tuberculosis patients compared with healthy tuberculin reactors and cured tuberculosis patients (23.1 % versus 90.0% for IFN-$\gamma$ and 46.2% versus 70.0% versus 46.2% for RANTES). The frequency of MCP-l mRNA expression to aqueous TSP antigen in treatment failure tuberculosis patients was greater than in healthy tuberculin reactors and cured tuberculosis patients (76.9% versus 40.0%). Conclusion: The increasing expression of MCP-1 mRNA in response to aqueous TSP antigen might be predicted to favor Th1 responses and restricted Th1 responses in treatment failure of pulmonary tuberculosis.

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Arginine Vasopressin Therapy of Vasodilatory Shock after Cardiac Surgery (심장 수술 후 혈관 확장성 쇼크가 발생한 환자에서 바소프레신 투여 요법)

  • Ahn, Young-Chan;Park, Chul-Hyun;Kim, Gun-Woo;Lee, Jae-Ik;Jun, Yang-Bin;Choi, Chang-Hyu;Hyun, Sung-Youl;Park, Kook-Yang
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.913-919
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    • 2006
  • Background: Vasodilatory shock has been implicated in life-threatening complications after open heart surgery, where the systemic inflammatory reaction is attributed to the cardiopulmonary bypass(CPB). The secretion of arginine vasopressin(AVP) has been found to be defective in a variety of vasodilatory shock states and administration of AVP markedly improves vasomotor tone and blood pressure. So we reviewed our experience of AVP therapy in patients with vasodilatory shock following heart surgery using CPB. Material and Method: From January 2004 to July 2006, we reviewed the records of patients who received AVP therapy for vasodilatory shock following heart surgery using CPB. Vasodilatory shock was defined as a mean arterial pressure lower(MAP) than 70 mmHg, a cardiac index greater than 2.5 $L/min/m^2$, peripheral vascular resistance lower than 800 $dyn/s/cm^5$, and vasopressor requirements. The hemodynamic responses of patients who received AVP therapy for vasodilatory shock after cardiac surgery were analyzed retrospectively. Result: One hundred ninety nine open cardiac surgery patients were consecutively included in this study. Twenty two patients(11.1%) met criteria for vasodilatory shock. Despite the administration of high dose catecholamine vasopressor, all patients were hypotensive with a mean arterial pressure less than 70 mmHg. AVP therapy increased MAP from $53.3{\pm}7.4\;to\;82.0{\pm}12.0$ mmHg at 1 hour (p<0.001) and decreased other vasopressor requirements from $25{\pm}7\;to\;18{\pm}6$ at 1 hour(p<0.001) and individually maintained it for 12 hours. Conclusion: Our date suggest that AVP may be a safe and an effective vasopressor in patients with vasodilatory shock. In patients exhibiting vasodilatory shock after heart surgery, replacement of AVP increases blood pressure and reduces catecholamine vasopressor requirements.

A Study on the Degree of Need of Human Structure and Function Knowledge in Clinical Nurses (기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, Smi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • v.1 no.1
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    • pp.1-24
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    • 1999
  • The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

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Cloning of a Glutathione S-Transferase Decreasing During Differentiation of HL60 Cell Line (HL6O 세포주의 분화 시 감소 특성을 보이는 Glutathione S-Transferase의 클로닝)

  • Kim Jae Chul;Park In Kyu;Lee Kyu Bo;Sohn Sang Kyun;Kim Moo Kyu;Kim Jung Chul
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.151-157
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    • 1999
  • Purpose : By sequencing the Erpressed Sequence Tags of human 걸ermal papilla CDNA library, we identified a clone named K872 of which the expression decreased during differentiation of HL6O cell line. Materials and Methods : K872 plasmid DNA was isolated according to QIA plasmid extraction kit (Qiagen GmbH, Germany). The nucleotide sequencing was performed by Sanger's method with K872 plasmid DNA. The most updated GenBank EMBL necleic acid banks were searched through the internet by using BLAST (Basic Local Alignment Search Tools) program. Nothern bots were performed using RNA isolated from various human tissues and cancer cell lines. The gene expression of the fusion protein was achieved by His-Patch Thiofusicn expression system and the protein product was identified on SDS-PAGE. Results : K872 clone is 1006 nucleotides long, and has a coding region of 675 nucleotides and a 3' non-coding region of 280 nucleotides. The presumed open reading frame starting at the 5' terminus of K872 encodes 226 amino acids, including the initiation methionine residue. The amino acid sequence deduced from the open reading frame of K872 shares $70\%$, identity with that of rat glutathione 5-transferase kappa 1 (rGSTKl). The transcripts were expressed in a variety of human tissues and cancer cells. The levels of transcript were relatively high in those tissues such as heart, skeletal muscle, and peripheral blood leukocyte. It is noteworthy that K872 was found to be abundantly expressed in coloreetal cancer and melanoma cell lines. Conclusion : Homology search result suggests that K872 clone is the human homolog of the rGSTK1 which is known to be involved in the resistance of cytotoxic therapy. We propose that meticulous functional analysis should be followed to confirm that.

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Effects of Exercise Training and Selenium on MCT1 and MCT4 Protein Levels in Skeletal Muscles of Diabetic Goto-Kakizaki Rats (지구성 운동과 셀레니움 투여가 당뇨 Goto-kakizaki 쥐의 골격근의 MCT1과 MCT4단백질 발현수준에 미치는 효과)

  • Kim, Seung-Seok;Kang, Eun-Bum;Eum, Hyun-Sub;Kim, Bum-Su;Lim, Yea-Hyun;Park, Joon-Young;Cho, In-Ho;Oh, Yoo-Sung;Kwak, Yi-Sub;Cho, Joon-Yong
    • Journal of Life Science
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    • v.18 no.1
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    • pp.1-8
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    • 2008
  • The purpose of this study was to determine the possible additive effects of endurance exercise training (EXER) and selenium (SELE) on the improvements of glucose and lactate transport capacities in diabetic Goto-kakizaki rats. Animals either remained sedentary control (SED) or performed EXER or received SELE [$5{\mu}mol$ kg body wt (-1) day (-1)], or underwent both EXER and SELE (COMBI), which lasted for 6 wk. Compared with sedentary control, EXER alone or the SELE alone group, or the combined treatment group had significant reduction in glucose response measured at 90 min and 120 min during an intraperitoneal glucose tolerance test (IPGTT) and body weight after 6week treatment. EXER alone, or combined group individually had significantly higher glycogen contents in liver compared with SED or SELE groups. EXER alone increased glycogen content in soleus and plantaris compared with SED, and this parameter was increased to greatest extent in the combined treatment groups compared with SED or SELE groups. EXER alone, SELE alone or COMBI, caused significant decreases in the plasma lactates, serum glucose, insulin, total cholesterol and HOMA-IR along with a significant increase in high-density lipoprotein cholesterol compared with SED. In addition, EXER or COMBI individually had significantly lower serum triacylglycerol compared with SED or SELE. With respect to protein expression related to glucose and lactate transport capacities, EXER alone, SELE alone, or COMBI increased in MCT1 and MCT4 protein level in soleus and plantaris. Furthermore, EXER alone, SELE alone or COMBI caused significant increases in mt MCT1 protein level in soleus and plantaris. The findings of the current study suggest that endurance exercise training and selenium treatment may provide therapeutic values to type II diabetic patients with peripheral insulin resistance and hyperlactatecemia by improving glucose and lactate transport capacities, leading to improvements in plasma lactate, serum glucose, insulin and lipid profiles (TC, TG, HDL).

The Clinical Effects of Leukocyte-Depleting Filter on Cardiopulmonary Bypass (체외순환 시 백혈구 제거필터 사용의 임상효과)

  • 박경택;최석철;최국렬;정석목;최강주
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.454-464
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    • 2001
  • Background: It has been recognized that systemic inflammatory reaction and oxygen free radical formed by activated leukocyte in the procedure of cardiopulmonary bypass(CPB) frequently produce postoperative cardiac and pulmonary dysfunction. The purpose of this study was to evaluate the efficacy of leukocyte-depleting filters in the cardiopulmonary bypass circuit for patients undergoing open heart surgery(OHS). Material and method: The study involved 15 patients who underwent OHS with a Leukoguard-6 leukocyte filter placed in the arterial limbs of the bypass circuit(filter group, n=15) and 15 patients who did not have the filter(control group, n=15). We analyzed the differences between the groups in intraoperative changes of peripheral blood leukocyte and platelet counts, pre- and postbypass changes of malondialdehyde(MDA), troponin-T(TnT), 5'-nucleotidase(5'-NT) in coronary sinus blood, spontaneous recovery rate of heart beat after CPB, pre-and postoperative cardiac index(Cl) and pulmonary vascular resistance(PVR), and the amounts of postoperative bleeding and sternal wound complication. Result: During CPB, total leukocyte count of the filter group(9,567$\pm$ 842/㎣) was significantly less than that of the control group(13,573+1,167/㎣) (p<0.01), but there was no significant difference in platelet count between the groups. Postoperative levels of MDA(3.78+0.32 $\mu$mol/L vs 5.86+0.65 $\mu$mo1/L, p<0.01), TnT(0.40$\pm$0.04 ng/mL vs 0.59$\pm$0.08 ng/mL, p<0.05) and 5'-NT(3.88$\pm$0.61 U/L vs 5.80$\pm$0.90 U/L, p<0.05) were all significantly lower in the filter group than the control group. Postoperative Cl was higher in the filter group than the control group(3.26$\pm$0.18 L/$m^2$min vs 2.75$\pm$0.17 L/$m^2$/min, p=0.05). PVR of the filter group was lower than that of the control group(65.87$\pm$7.59 dyne/sec/cm$^{5}$ vs 110.80+12.22 dyne/sec/cm$^{5}$ , p<0.01). Spontaneous recovery rate of heart beat in the filter group was higher than that in the control group(12 patients vs 8 patients, p<0.05). Postoperative wound infection occurred in one case in the filter group and 4 case in the control group(p<0.05). Postoperative 24 hour blood loss of the filter group was more than that of the control group (614$\pm$107 mL vs 380+71 mL, p=0.05).

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