Splenocyte-mediated immune enhancing activity of Sargassum horneri extracts / 한국영양학회지

PURPOSE: This study examined the immunological activity and optimized the mixture conditions of Sargassum horneri (S. horneri) extracts in vitro and in vivo models.METHODS: S. horneri was extracted using three different methods: hot water extraction (HWE), 50% ethanol extraction (EE), and supercritical fluid extraction (SFE). Splenocyte proliferation and cytokine production (Interleukin-2 and Interferon-γ) were measured using a WST-1 assay and enzyme-linked immunosorbent assay, respectively. The levels of nitric oxide and T cell activation production were measured using a Griess assay and flow cytometry, respectively. The natural killer (NK) cell activity was determined using an EZ-LDH kit.RESULTS: Among the three different types of extracts, HWE showed the highest levels of splenocyte proliferation and cytokine production in vitro. In the animal model, three different types of extracts were administrated for 14 days (once/day) at 50 and 100 mg/kg body weight. HWE and SFE showed a high level of splenocyte proliferation and cytokine production in the with and without mitogen-treated groups, whereas EE administration did not induce the splenocyte activation. When RAW264.7 macrophage cells were treated with different mixtures (HWE with 5, 10, 15, 20% of SFE) to determine the optimal mixture ratio of HWE and SFE, the levels of nitric oxide and cytokine production increased strongly in the HWE with 5% and 10% of SFE containing group. In the animal model, HWE with 5% and 10% of SFE mixture administration increased the levels of splenocyte proliferation, cytokine production, and activated CD4⁺ cell population significantly, with the highest level observed in the HWE with 5% of SFE group. Moreover, the NK cell activity was increased significantly in the HWE with 5% of SFE mixture-treated group compared to the control group.CONCLUSION: The optimal mixture condition of S. horneri with immune-enhancing activity is the HWE with 5% of SFE mixture. These results confirmed that the extracts of S. horneri and its mixtures are potential candidate materials for immune enhancement.

Symptomatic isolated superior mesenteric artery dissection: focusing on the morphologic type associated with invasive treatment

OBJECTIVE: This study was conducted to investigate the relationship between invasive treatments and computed tomographic (CT) classification or findings in symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). METHODS: This retrospective observational study included 30 patients with SISMAD from Jan 2012 to Dec 2016. Demographic data, risk factor, treatment modalities, and CT findings including morphological classification, dissection length, and true lumen relative diameter (TLRD) were reviewed. The enrolled patients were classified into two groups (conservative management group, CG; invasive management group, IG). RESULTS: Based on CT classifications, one patient was type I (CG, n=1; IG, n=0), two were type IIa (CG, n=2; IG, n=0), five were type IIIa (CG, n=5; IG, n=0), 10 were type IIIb (CG, n=9; IG, n=1), and 12 were type IIIc (CG, n=1; IG, n=11). There was a high tendency to undergo invasive treatment among type IIIc (P < 0.001). The TLRD, distance from the aorta to dissection point, and dissection length were 18.3% (range, 0%–29.8%), 1.7 cm (range, 0–3.5 cm), and 7.3 cm (range, 4.9–10.0 cm), respectively. There TLRD (CG, 26.8% [range, 22.2%–48.8%]; IG, 0%; P < 0.001) and distance from the aorta to dissection point (CG, 1.0 cm [range, 0–2.1 cm]; IG, 3.5 cm [range, 0.8–5.4 cm]; P=0.024) differed significantly between groups. However, there was no significant difference in dissection length between CG and IG (P=0.527). CONCLUSION: The TLRD, distance from the aorta to dissection point, and CT classification such as type IIIc were associated with invasive management. Further studies on extended natural course of the disease from a larger number of subjects are necessary to draw a strong conclusion.

Molecular Detection of Fluoroquinolone Resistance in Multidrug-Resistant Mycobacterium tuberculosis Isolates / 대한임상미생물학회지

BACKGROUND: Fluoroquinolones (FQs) are important drugs for treating multidrug-resistant tuberculosis (MDR-TB). However, due to widespread use of FQs, the resistance rates to FQs have been increasing among Mycobacterium tuberculosis. Rapid and reliable FQ drug susceptibility testing (DST) is crucial for successful treatment of MDR-TB. In this study, the feasibility of molecular detection of FQ resistance was evaluated. METHODS: A total of 95 MDR-TB isolates were collected from Jan through Oct 2009 at the Korean Institute of Tuberculosis. DST for ofloxacin (OFL), levofloxacin, and moxifloxacin was performed using the Lowenstein-Jensen media absolute concentration method. Minimum inhibitory concentrations (MIC) of these were determined using the broth microdilution method. DNA was extracted from cultured isolates using bead beating method. The quinolone resistance-determining region (QRDR) of gyrA and gyrB were amplified and those sequences were analyzed. RESULTS: Of 95 isolates, 79 were resistant to at least one of FQs. Of these, 71 (89.9%) harbored mutation in the QRDR of gyrA or gyrB. None of FQ susceptible strains possessed any mutation in gyrA or gyrB. Mutations in codon 94 of gyrA were most common; only two isolates had mutation in only the gyrB gene. OFL MICs for isolates with gyrA mutation ranged from 1 to 32 microg/mL, but FQ susceptible isolates showed MICs ranging from < or =0.06 to 0.5 microg/mL. CONCLUSION: Mutation analysis of QRDR of gyrA and gyrB showed 89.9% sensitivity and 100% specificity for detecting FQ resistance in MDR-TB. Therefore, molecular DST can be useful for rapid detection of FQ resistance in MDR-TB.

Characterization of Immune Responses to Mycobacterium tuberculosis Rv2041c Protein

Tuberculosis, which is caused by Mycobacterium tuberculosis (M. tb), is one of the most important infectious diseases in the world. Although many functional studies have been conducted on M. tb proteins in the post-genomic era, little is known about the function of many proteins expressed specifically during latency. Previously, we reported that Rv2041c from M. tb H37Rv is highly expressed under conditions of low pH and hypoxia, which represent the in vitro mimicry of latent tuberculosis. In the present study, increased expression levels of Rv2041c under hypoxia and low pH in vitro culture was confirmed by RT-PCR. Interestingly, Rv2041c showed significantly increased expression among genes of the same operon and genes belonging to the same functional group. Finally, the immune responses elicited by the recombinant (r) Rv2041c protein were investigated using ex vivo and in vivo models of M. tb infection. A significantly high level of pro-inflammatory cytokines such as TNF-alpha, IL-6, and IL-12p40 was detected in a dose-dependent manner by treatment of murine bone marrow-derived macrophages with rRv2041c protein. In addition, IFN-gamma and TNF-alpha secretion increased after stimulation with purified Rv2041c protein to lymphocytes from latent and active TB mice in a modified Cornell model. In conclusion, our findings suggest that Rv2041c is a new T-cell antigen and could be a potential vaccine candidate against M. tb infection by inducing a strong cellular immune response.

Cytokine Profiles of Macrophages by Mycobacterium abscessus Conditional Morphotype Variants and Comparison of Their Extracellular-Protein Expressions

Mycobacterium abscessus has been identified as an emerging pulmonary pathogen in humans. Previously, it was documented that a spontaneously formed rough variant of M. abscessus causes persistent and invasive infection in mice, while a smooth isogenic variant does not. However, little is known for immune responses elicited by M. abscessus variants artificially induced by culture conditions and their culture filtrate antigens. Thus, morphological variants of M. abscessus type strain (ATCC19977T) were generated by an acidic and low oxygen culture conditions. Overall comparison between the variant and its original smooth strain showed that the rough variant was less virulent than original smooth strain in murine bone-marrow derived macrophage. To understand the basis for the difference, the protein expression pattern in the culture filtrates of each strain was analyzed by 1-dimensional electrophoresis. Generally, the protein expressions were more influenced by pH conditions than oxygen pressures. Interestingly, several proteins, mainly lower than 30 kDa molecular weight, were uniquely expressed in normal culture conditions. In contrast, several high molecular weight proteins (>55 kDa) were induced by acidic and low oxygen culture conditions. These findings not only provide new insights of association between morphological change and the virulence, but may also be useful in the design of immunological diagnosis and vaccines for M. abscessus infection.

The Characteristics of Korean Smoker, Enrolled in'5 day Smoking Cessation4 School' and The Effect of Inpatient Smoking Cessation Program / 결핵및호흡기질환

BACKGROUND: Cigarette smoking is the single biggest avoidable cause of death and disability in most countries. Effective prevention of cigarette Smoking and help for those wishing to quit can therefore yield enormous health benefits for populations and individuals. Although most of smokers try to stop smoking for themselves, the success rate of quitting smoking is very low. Promoting and supporting smoking cessation should be an important health policy priority for healthcare professionals in all clinical settings. In this study, we tried to evaluate the effect of the educational program for smoking cessation of our hospital, the smoking pattern, and characteristics of adult smokers enrolled in the program. METHODS: We enrolled 640 smokers, who has visited the '5 day stop smoking school' for smoking cessation from Jan 1998 to 2001. we evaluated the characteristics of the smokers based on the self report questionnaire at the beginning of the program and we also checked 100 smokers, enrolled in Inpatient Smoking Cessation Educational program, their smoking behavior and the cessation rate with postal questionnaire after finishing this program from Nov 2002 to Jan 2003. RESULTS: The health was most common motivation for smoking cessation. The stress was the most important motivation of smoking. The overall smoking cessation rate of the smokers enrolled in inpatient smoking cessation school was 60%. The age of starting smoking and the kind of occupation have a significant difference between the success group and failure group of smoking cessation. CONCLUSION: The inpatient smoking cessation program was effective smoking cessation intervention in the adult smokers who enrolled in '5 day stop smoking school'.

A Case of Atypical McCune-Albright Syndrome Associated with Hyperthyroidism and Hypersecretion of Growth Hormone / 대한내분비학회지

McCune-Albright syndrome is characterized by polyostotic fibrous dysplasia, Caf -au-lait pigmentation and precocious puberty or other endocrinopathy. It can be caused by substitution of His, Cys or Gly for Arg 201st amino acid of the Gs protein subunit. The case of a 32-year-old woman, with atypical McCune-Albright syndrome, is reported. She had no skin lesion or precocity puberty. The polyostotic fibrous dysplasia was examined by a simple radiological image and whole body scan. She developed hyperthyroidism, with a multinodular toxic goiter. No thyroid related autoantibodies were detected. The cause of hyperthyroidism was thought to be a non- autoimmune thyroid hyperfunction. The level of growth hormone was not suppressed by oral glucose load. After a bromocriptine suppression test, the level of growth hormone decreased. There was no mass in the pituitary gland on a sellar MRI. A case of atypical McCune-Albright syndrome, including hyperthyroidism and hypersecretion of growth hormone, is reported.

A case of abnormally exposed nodular shaped-bronchial vessel occurred massive hemorrhage during bronchoscopy / 결핵

A 43 years old woman with a previous history of healed tuberculosis presented with a recurrent hemoptysis. On a broncoscopy inspection, three nodular shaped mass-like lesions (0.5cm in diameter) were found on the right lower lobar bronchus. Massive hemoptysis occurred when the specimen were taken during bronchoscopy. The bleeding could not be controlled by non-surgical treatment. Consequently, she underwent a right lower lobectomy in order to control the bleeding. The patient died of respiratory failure 3 days later. A brochoscopic biopsy revealed an abnormal blood vessel just beneath the bronchial respiratory epithelium.

A case of abnormally exposed nodular shaped-bronchial vessel occurred massive hemorrhage during bronchoscopy / 결핵

A 43 years old woman with a previous history of healed tuberculosis presented with a recurrent hemoptysis. On a broncoscopy inspection, three nodular shaped mass-like lesions (0.5cm in diameter) were found on the right lower lobar bronchus. Massive hemoptysis occurred when the specimen were taken during bronchoscopy. The bleeding could not be controlled by non-surgical treatment. Consequently, she underwent a right lower lobectomy in order to control the bleeding. The patient died of respiratory failure 3 days later. A brochoscopic biopsy revealed an abnormal blood vessel just beneath the bronchial respiratory epithelium.

A case of combined deficiency of antithrombin III and protein C complicated by recurrent venous thrombosis / 대한내과학회지

Primary venous thrombosis caused by deficiency or qualitative abnormality of antithrombin III, protein C and protein S is usually inherited as an autosomal dominant trait. Usually, deep vein thrombosis or pulmonary thromboembolism is developed by such abnormalities, however, mesenteric vein thrombosis is rarely reported. A 27-year-old man with previous history of deep vein thrombosis underwent segmental resection of jejunum due to mesenteric vein thrombosis complicated by necrosis of jejunum. Postoperative investigation disclosed combined deficiency of antithrombin III and protein C. His son also showed deficiency of antithrombin III. Postoperatively, he is on life-long warfarin therapy without experiencing recurrence of venous thrombosis.

The psychological characteristics of functional dyspepsia patients by MMPI

BACKGROUND: The functional dyspepsia gives rise to such a symptom similar to peptic ulcer without showing a noticeable lesion(e.g, gastric or duodenal ulcer) by endoscopy or upper GI serises, and it has been known that this is about twice as many as the peptic ulcer. However, there is no exact theory about its pathophysiology and it is suggested that multiple factors including genetic, physiologic, psychologic, environmental factors are engaged. Especially, in respect to the occurrence of functional dyspepsia and psychological factors, there have been many clinical studies over the world. But, we still need more studies in this country, therefore, this study has been initiated to give help patients of functional dyspepsia, invest.igating their characteristic traits through MMPI. METHODS: From March to September in 1996, the patients who visited the family medicine out-patients department of St. Marys hospital of Catholic Medical College were sampled in this study. There were 46 patients having a similar symptoms to peptic ulcer without showing pathologic lesions by endoscopy. Through an interview and some basic tests, the 41 controls who had no dyspeptic symptoms and were not affected to a noticeable physical or physiological disorders were selected for the normal reference group. The standardized MMPI of our country was applied to the whole object groups to get a result. Then each average value of the measure(mean T-score) was calculated, and the differences of the average value were analyzed by the t-test and chi-square test. And the psychological pattern analysis was done. RESULTS: In demographic aspects, there were no significant differences between the two groups. The mean T score for each measure of the two groups falls within the normal ranges with their values being of between 30 to 70. And the average of L, F, and K measure, known as the validity measure, did not give a significant differences between the two groups. The measure of Hs, D, and Hy have appeared significantly high in the patients group(p<0.01) and the Pd measure, too(p<0.05). While Mf, Pa, and Ma measure have not shown a significant differences, Pt, Sc, and Si measure have very significant differences(p<0.01). CONCLUSIONS: In the patient group with the functional dyspepsia, the measures of Hs, D, and Hy where they indicate a neurotic pattern have shown a very significantly high point as well as those of Pd, Pt, Sc, and Si where they indicate a psychotic pattern. This reveals that in the group of the functional dyspepsia neurotic or psychotic trends to attribute. However, it is very hard to define the characteristics of a group with just one test, so further study with more variable test will be necessary.

Extramammary Paget`s Disease of the Penis and Scrotum Report of 2 Cases / 대한비뇨기과학회지

Extramammary Paget`s disease of the penis and scrotum is a rare clinicopathologic entity often associated with an underlying carcinoma of anorectal origin. But it is rarely considered in the differential diagnosis of genital lesions. For this reason, emphasis is placed on the need for early biopsy of skin lesions in the genital area. We present two cases of penoscrotal extramammary Paget`s disease with unique clinical presentation and brief review of relevant literature.

Milk of Calcium in Renal Caliceal Diverticulum / 대한비뇨기과학회지

A Milk of calcium is a well known finding in the extrahepatic biliary tree, particulary in the gallbladder, but rarely occurred in the kidneys. A caliceal diverticulum is a saccular structure containing urine and connect to an adjacent calyx by a narrow isthmus. They are lined with transitional epithelium continuous with that of calyx. Their origin is still unknown, but is generally attributes either to a developmental malformation or to prior infection. The diagnostic appearance may be lacking when the condition is present, since an errect or decubitus projection is frequently not a standard part of each roentgenologic examination of the abdomen or urinary tract. The management and treatment of Milk of Calcium in renal caliceal diverticulum is based on subjective and objective findings. Surgery should consist of eradication of the diverticulum lining and obliteration of communicating channel. We explored the kidney for the impression of renal stone, but could not find the stone, Retrospective review turned out to be the Milk of Calcium. We report our experience here in with review of literatures.