Clinical Significance of Plasma TGF-β1 in Coal Workers' Pneumoconiosis / 결핵

BACKGROUND: Coal workers' pneumoconiosis is a fibrotic lung disease resulting from chronic inhalation of coal dust. The precise mechanism of lung fibrosis in coal workers' pneumoconiosis is uncertain. However, a relationship between the stimulation of fibroblast proliferation and collagen production by mediators released from inflammatory and resident lung cells is thought to be a major factor. The transforming growth factor-β(TGF-β), a multifunctional cytokine and growth factor, plays a key role in the scarring and fibrotic processes due to its ability to induce extracellular matrix proteins and modulate the growth and immune function of many cell types. To determine the involvement of TGF-βin the development of lung fibrosis in coal workers' pneumoconiosis, the TGF-β1 level in plasma was measured in patients with coal workers' pneumoconiosis. METHODS: Plasma was collected from 40 patients with coal workers' pneumoconiosis (20 with simple coal workers' pneumoconiosis and 20 with complicated coal workers' pneumoconiosis) and from 10 normal controls. The ELISA method was used to measure the plasma TGF-β1 concentration. RESULTS: Compared to the control group (0.63±0.18 ng/mL), there was no significant difference in the plasma TGF-β1 level in patients with simple coal workers' pneumoconiosis (0.64±0.17 ng/mL) (p>.05). However, in patients with complicated coal workers' pneumoconiosis the plasma TGF-β1 level (0.79±0.18 ng/mL) was significantly higher than in patients with simple coal workers' pneumoconiosis and control group (p<0.05). CONCLUSION: The data suggests that TGF-β1 has some influence in the development of lung fibrosis in coal workers' pneumoconiosis.

Activity of Cytokines and Expression of CD62L in Patients with Bronchial Asthma / 결핵

BACKGROUND: The CD4+ T-helper cells comprise functionally distinct subsets of Th1 and Th2 cells that are distinguished on the basis of differential cytokines production. Th1 cells secrete interferon-gamma, lymphotoxin, interleukin-2. Th2 cells produce interleukin-4, interleukin-5, interleukin-10. A previous study shown that Th2 cells and their cytokines increased in patients with atopic asthma. We compared cytokines(IL-4, IFN-gamma) activity and subpopulation of T-lymphocytes in peripheral blood from atopic asthmatics versus non-asthmatics. METHOD: Fifteen patients with atopic asthma(nine men, six women), twelve patients with chronic bronchitis (six men, six women), five healthy persons(three men, two women) were studied. Activity of IL-4, IFN-gamma and T-cell subpopulation in peripheral blood were estimated. RESULTS: Patients had a median age of 55yr. The mean activity of IL-4 of asthmatics was significantly increased(control 0.75+/-1.1pmol/L, atopic asthmatics 3.50+/-0.75pmol/L, chronic bronchitis 2.01+/-1.2pmol/L), but IFN- was not significantly increased. In the T lymphocyte subsets the percent of CD62L+ T-lymphocytes of asthmatics was not significantly increased(control 16.7+/-16.4 %, atopic asthmatics 24.8+/-23.6 %, chronic bronchitis 17.0+/-16.9%). CONCLUSION: In this study elevated production of IL-4 was observed in atopic asthmatics. CD62L+ T-lymphocytes was not increased in atopic asthma.

A Case of Mixed Long Carcinoma Composed of Three Cell Type / 대한내과학회지

Carcinoma of lung is classified by histologic cell type, this is based on predominant major cell population by tissue specimen. But in fact a range of 13% to 63% of lung cancer has been appeared to be heterogeneous cell type at the light microscopic level. After treatment of the mixed lung cancer and/or with time there are reports that cell type is changed. Because it is possible that the tumor were pleomorphic and that the antitumor therapy eliminated the more sensitive cell population and permitted the subsequent emergence of the more resistant cell population. The authors reported here, a case of 32 year old female patient with mixed lung cancer composed of three cell type, and this is the first case in Korea.

Clinical Study on Adult Onset Still's Disease: Analysis in 15 Cases / 대한류마티스학회지

OBJECTIVE: To understand the clinical manifestations and disease course of adult onset Still' s disease (AOSD). METHODS: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. RESULTS: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia' Hgb <10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root joint arthritis and polyarthritis were factors associated with chronicity. CONCLUSION: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.

The Clinical Significance of gamma delta T lymphocytes with pleural tuberculosis / 결핵

BACKGROUND: The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(gamma delta T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. METHOD: To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,gamma delta T-lymphocytes) with anti-Leu4, anti-Leu3a, anti-Leu2a, anti HLA-DR and anti-TCR-gammadelta-1(Becton & Dickinson Co.). RESULTS: The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p= 0.04). The peripheral blood gammadelta T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood gammadelta T-lymphocytes and pleural gammadelta T-lymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). CONCLUSION: The percentage of gammadelta T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. gammadelta T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.

A case of tumorous type of endobronchial tuberculosis simulating bronchial adenoma / 결핵

The tumorous type of endobronchial tuberculosis was reported to be 5 to 10% in the bronchoscopic examination. It was protruding mass that tuberculous mediastinal lymph node ruptured into the bronchial lumen. Generally histologic examination has been performed for purpose of differentiation, because the tumorous type of endobronchial tuberculosis simulate lung cancer in bronchoscopic finding. A case considering operation similar to bronchial adenoma in the bronchoscopic finding was confirmed to endobronchial tuberculosis by positive AFB and disapperance of mass after antituberculosis medication. Case history was presented and reviewed.