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The Role of NF-${\kappa}B$ in the TNF-$\alpha$-induced Apoptosis of Lung Cancer Cell Line (폐암세포주의 TNF-$\alpha$ 유발 apoptosis에서 NF-${\kappa}B$의 역할)

  • Kim, J.Y.;Lee, S.H.;HwangBo, B.;Lee, C.T.;Kim, O.H.;Han, S.K.;Shim, O.S.;Yoo, C.G.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.166-179
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    • 2000
  • Background: The main reason for the failure of anti-cancer chemotherapy is the build up of resistance by cancer cells to apoptosis. The activation of NF-${\kappa}B$ in many cancer cell lines is reported to be underlying mechanism behind the build up of resistance of cancer cells to apoptosis. However, this relationship varied depending on the cells used in the experiments. In this study, the role of NF-${\kappa}B$ activation in the TNF-$\alpha$-induced apoptosis in lung cancer cell line was evaluated. Methods: NCI-H157 cells were used in all experiments. Cells were exposed to a high dose of TNF-$\alpha$(20 ng/ml) for 24 or 48 hours with or without blocking NF-${\kappa}B$ activation. TNF-$\alpha$-induced activation of NF-${\kappa}B$ was inhibited either by overexpression of $I{\kappa}B{\alpha}$-super repressor($I{\kappa}B{\alpha}$-SR) or by pre-treatment with proteasome inhibitor. Cell viability and apoptosis were evaluated with MTT assay and Western blot analysis for PARP fragment, respectively. Results: Cell viability of NCI-H157 cells was not affected by TNF-$\alpha$ treatment alone; however, combined treatment with TNF-$\alpha$ and cycloheximide reduced cell viability significantly, indicating that resistance to TNF-$\alpha$ is mediated by the new proteins synthesized after TNF-$\alpha$ stimulation. To evaluate the role of NF-${\kappa}B$ in the transcription of anti-apoptotic proteins. delete NF-${\kappa}B$ activation was inhibited before TNF-$\alpha$ stimulation. as described above. $AD5I{\kappa}B{\alpha}$-SR-transduction inhibited TNF-$\alpha$-induced nuclear translocation of p65. TNF-$\alpha$-induced cell death and apoptosis increased after inhibition of TNF-$\alpha$-induced activation of NF-${\kappa}$ by methods. Conclusion: These results suggest that TNF-$\alpha$-induced activation of NF-${\kappa}B$ may be closely related to the acquisition of the resistance to TNF-$\alpha$-induced apoptosis in lung cancer cells. Therefore. blocking of NF-${\kappa}B$ pathway can be a useful therapeutic modality in the treatment of lung cancer.

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Dressing Effect of Phosphorus Fetilizer on the Growth of Soil Improving Species (비료목생장(肥料木生長)에 미치는 인산비료(燐酸肥料)의 시비효과(施肥效果))

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.45 no.1
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    • pp.26-36
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    • 1979
  • Through several trials that has done for making the fertilizing-counter plan on the soil improving species, some results have been got as follows; 1. In the non-phosphorus dressing plots soil improving species have very poor survial ratio and show us to be died step by step. It may be resons that root can not make the nodule in case of non-phosphorus dressing and so tree could not absorb the nitrogen nutrient fixed by the nodule. And root competition with the weedy speces for utilizing the nutrient and oxygen in the soil could be reasons when planting in the heavy weedy rooting site. 2. Triple super phosphate, Fused Mg Phosphate and Fused super phosphate have showed the remarkable effects on the growth of soil improving species within 3rd year after planting. But Koreaan tablet fertilizer(9-12-4) for forest purpose have reacted considerably lower effect in comparision with the above powder and grain type phosphorous fertilizer. 3. In case of tablet type fertilizer tree root will have very little phosphorus absorbing surface because phosphorus can be utilized only from the tablet surface and root can not penetrate into the tablet. This my be reson to show the poor dressing reaction of tablet fertilizer but tablet fertilizer has a possibility to be utilized during long years as a sympton in photo 6. So tablet fertilizer can have a recommendation to dress much fertilizer at p]anting year and then tree root can get much more chance for absorbing the phosphorus that could keep the high survival and for utilizing it during many years without after dressing. 4. The granurar and powder type phosphate can develop the dense root mat like photo 8 because of giving the large surface for absorbing the phosphorus and weedy root can approch to the nodule for taking the nitrogen element. So this type seems to present better effect than tablet type to control the soil movement, stem weight as 200g per meter(l meter long${\times}$0.1m width). When added the lime any effect could not be found and rather give the negative effect. So Lespedeza seed sowing and phosphorus dressing system seems us to be very reasonable method for covering the raw material of basket making, fodder and fuel wood supply. 7. Fused Mg phosphate and Fused super phosphate are good fertilizer to the soil improving species and dressing more than 30g per seedling can be recommendable amount. 5. In the unproductive and dry soil with phosphorus fertilizer Robinia pseudoacacia and Alnus firnui can grow more than 2.3m in height at 3rd year and Alnus inokumae have the rapid height growth that is more than 1.8m at 2nd year. Depending on the growth situation like the above example minirotated management has possibilities and rapid covering of erosed land can be done with the soil improving species and phosphorus fertilizer. 6. In the Lespedeza sowing plot with 40g Fused Mg phosphate dressing per meter in the eroded and unproductive forest soil Lespedeza have completely covered this poor land and produced the green.

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A Survey on the Dietary Behavior of High School Students -About Regularity of Meal and Number of Meal Per Day- (남녀 고등학생의 식생활태도에 관한 조사 -식사의 규칙성과 1일 식사횟수에 대하여-)

  • Kim, Geum-Ran;Kim, Mi-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.2
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    • pp.183-195
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    • 2011
  • This study was conducted to investigate dietary behavior patterns of high school students. As for regularity of meal, female students were significantly more regular than those of the male students in a day. They answered 'between 4th and 6th grades in elementary school' as 'the time for formation about number of meal intake'. As for a highly influential meal, males were higher answered 'lunch (41.0%)' while females were higher answered 'breakfast (39.8%)'. About 'number of meals per day by the grade', they ate 3 times per day mostly. As for the time for formation about number of meal intake: 'before 4th to 6th in elementary school'> 'before elementary school'. In the result of regularity of meal and general characteristics, a family of 5 was higher in regularity and those with pocket money showed lower regularity in meal. As for the person who prepares a meal, mothers prepared meals regularly. Also, higher parents age and education level resulted in more regularity in meals. In number of meals per day and general characteristics, they were eating 3 times; moreover, this trend was evident as parents' age and education level and the household income was higher. Students answered generally regularity in meal in family where parents' jobs were administrative assistant (father job (56.9%)) and housewife (mother (56.9%). In the formation time of meal intake number and general characteristics, they answered order 'middle school'> 'before elementary school'. A highly influential meal, they answered as the highest 'lunch' (37.6%). This study may provide information on dietary behavior of high school students, suggesting that nutrition education or counseling can improve food habits and develop positive behavior.

Radiosynthesis of $[^{11}C]6-OH-BTA-1$ in Different Media and Confirmation of Reaction By-products. ($[^{11}C]6-OH-BTA-1$ 조제 시 생성되는 부산물 규명과 반응용매에 따른 표지 효율 비교)

  • Lee, Hak-Jeong;Jeong, Jae-Min;Lee, Yun-Sang;Kim, Hyung-Woo;Lee, Eun-Kyoung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.241-246
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    • 2007
  • Purpose: $[^{11}C]6-OH-BTA-1$ ([N-methyl-$^{11}C$]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole, 1), a -amyloid imaging agent for the diagnosis of Alzheimer's disease in PET, can be labeled with higher yield by a simple loop method. During the synthesis of $[^{11}C]1$, we found the formation of by-products in various solvents, e.g., methylethylketone (MEK), cyclohexanone (CHO), diethylketone (DEK), and dimethylformamide (DMF). Materials and Methods: In Automated radiosynthesis module, 1 mg of 4-aminophenyl-6-hydroxybenzothiazole (4) in 100 l of each solvent was reacted with $[^{11}C]methyl$ triflate in HPLC loop at room temperature (RT). The reaction mixture was separated by semi-preparative HPLC. Aliquots eluted at 14.4, 16.3 and 17.6 min were collected and analyzed by analytical HPLC and LC/MS spectrometer. Results: The labeling efficiencies of $[^{11}C]1$ were $86.0{\pm}5.5%$, $59.7{\pm}2.4%$, $29.9{\pm}1.8%$, and $7.6{\pm}0.5%$ in MEK, CHO, DEK and DMF, respectively. The LC/MS spectra of three products eluted at 14.4, 16.3 and 17.6 mins showed m/z peaks at 257.3 (M+1), 257.3 (M+1) and 271.3 (M+1), respectively, indicating their structures as 1, 2-(4'-aminophenyl)-6-methoxybenzothiazole (2) and by-product (3), respectively. Ratios of labeling efficiencies for the three products $([^{11}C]1:[^{11}C]2:[^{11}C]3)$ were $86.0{\pm}5.5%:5.0{\pm}3.4%:1.5{\pm}1.3%$ in MEK, $59.7{\pm}2.4%:4.7{\pm}3.2%:1.3{\pm}0.5%$ in CHO, $9.9{\pm}1.8%:2.0{\pm}0.7%:0.3{\pm}0.1%$ in DEK and $7.6{\pm}0.5%:0.0%:0.0%$ in DMF, respectively. Conclusion: The labeling efficiency of $[^{11}C]1$ was the highest when MEK was used as a reaction solvent. As results of mass spectrometry, 1 and 2 were conformed. 3 was presumed.

A Comparative Study of Subset Construction Methods in OSEM Algorithms using Simulated Projection Data of Compton Camera (모사된 컴프턴 카메라 투사데이터의 재구성을 위한 OSEM 알고리즘의 부분집합 구성법 비교 연구)

  • Kim, Soo-Mee;Lee, Jae-Sung;Lee, Mi-No;Lee, Ju-Hahn;Kim, Joong-Hyun;Kim, Chan-Hyeong;Lee, Chun-Sik;Lee, Dong-Soo;Lee, Soo-Jin
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.234-240
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    • 2007
  • Purpose: In this study we propose a block-iterative method for reconstructing Compton scattered data. This study shows that the well-known expectation maximization (EM) approach along with its accelerated version based on the ordered subsets principle can be applied to the problem of image reconstruction for Compton camera. This study also compares several methods of constructing subsets for optimal performance of our algorithms. Materials and Methods: Three reconstruction algorithms were implemented; simple backprojection (SBP), EM, and ordered subset EM (OSEM). For OSEM, the projection data were grouped into subsets in a predefined order. Three different schemes for choosing nonoverlapping subsets were considered; scatter angle-based subsets, detector position-based subsets, and both scatter angle- and detector position-based subsets. EM and OSEM with 16 subsets were performed with 64 and 4 iterations, respectively. The performance of each algorithm was evaluated in terms of computation time and normalized mean-squared error. Results: Both EM and OSEM clearly outperformed SBP in all aspects of accuracy. The OSEM with 16 subsets and 4 iterations, which is equivalent to the standard EM with 64 iterations, was approximately 14 times faster in computation time than the standard EM. In OSEM, all of the three schemes for choosing subsets yielded similar results in computation time as well as normalized mean-squared error. Conclusion: Our results show that the OSEM algorithm, which have proven useful in emission tomography, can also be applied to the problem of image reconstruction for Compton camera. With properly chosen subset construction methods and moderate numbers of subsets, our OSEM algorithm significantly improves the computational efficiency while keeping the original quality of the standard EM reconstruction. The OSEM algorithm with scatter angle- and detector position-based subsets is most available.

Small Animal PET Imaging with [$^{124}I$]FIAU for Herpes Simplex Virus Type 1 Thymidine Kinase Gene Expression in a Hepatoma Model (간암 동물 모델에서 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabinofuranosyl-5-[$^{124}I$iodo-uracil ($[^{124}I]FIAU$) 소동물 PET 영상 연구)

  • Chae, Min-Jeong;Lee, Tae-Sup;Kim, June-Youp;Woo, Gwang-Sun;Jumg, Wee-Sup;Chun, Kwon-Soo;Kim, Jae-Hong;Lee, Ji-Sup;Ryu, Jin-Sook;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.235-245
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    • 2008
  • Purpose: The HSV1-tk gene has been extensively studied as a type of reporter gene. In hepatocellular carcinoma (HCC), only a small proportion of patients are eligible for surgical resection and there is limitation in palliative options. Therefore, there is a need for the development of new treatment modalities and gene therapy is a leading candidate. In the present study, we investigated the usefulness of substrate, 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabino-furanosyi-5-[$^{124/125}I$]iodo- uracil ([$I^{124/125}I$]FIAU) as a non-invasive imaging agent for HSV1-tk gene therapy in hepatoma model using small animal PET. Material and Methods: With the Morris hepatoma MCA cell line and MCA-tk cell line which was transduced with the HSV1-tk gene, in vitro uptake and correlation study between [$^{125}I$]FIAU uptake according to increasing numeric count of percentage of MCA-tk cell were performed. The biodistribution data and small animal PET images with [$^{124}I$]FIAU were obtained with Balb/c-nude mice bearing both MCA and MCA-tk tumors. Results:, Specific accumulation of [[$^{125}I$]FIAU was observed in MCA-tk cells but uptake was low in MCA cells. Uptake in MCA-tk cells was 15 times higher than that of MCA cells at 480 min. [$^{125}I$]FIAU uptake was linearly correlated (R2 =0.964, p =0.01) with increasing percentage of MCA-tk numeric cell count. Biodistribution results showed that [$^{125}I$]FIAU was mainly excreted via the renal system in the early phase. Ratios of MCA-tk tumor to blood acting were 10, 41, and 641 at 1 h, 4 h, and 24 h post-injection, respectively. The maximum ratio of MCA-tk to MCA tumor was 192.7 at 24 h. Ratios of MCA-tk tumor to liver were 13.8, 66.8, and 588.3 at 1 h, 4 h, and 24 h, respectively. On small animal PET, [$^{124}I$]FIAU accumulated in substantial higher levels in MCA-tk tumor and liver than MCA tumor. Conclusion: FIAU shows selective accumulation to HSV1-tk expressing hepatoma cell tumors with minimal uptake in normal liver. Therefore, radiolabelled FIAU is expected to be a useful substrate for non-invasive imaging of HSV1-tk gene therapy and therapeutic response monitoring of HCC.

Dietary Effects of an Animal Fat with High Free- Fatty Acid Content on Feed Utilization and Meat Quality in Broilers (고산가 동물성 지방의 첨가가 육계의 사료이용성과 육질에 미치는 영향)

  • 오미향;지규만;최인숙
    • Korean Journal of Poultry Science
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    • v.12 no.1
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    • pp.7-16
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    • 1985
  • Present experiment was undertaken to compare the effects of two dietary fats whose free fatty acid content was quite different on performances and on meat quality of broilers. Yellow grease or animal fat (trade name) containing 15 or 38.6% free fatty acid, respectively, was added to the broiler starter and finisher diets at levels of 3.0 and 5,0%, respectively. A total of 108, day old, male Maniker(Chunho) broiler chicks was alloted to 3 dietary treatments with 3 replications per treatment and 12 chicks per replication Though control diet was not supplemented with fat, the three dietary groups were made isocaloric and isonitrogenous. All the chicks were ad libitum fed the test diets for 8 weeks. Feed intake and body weight were measured every other week. Shank color was measured at the end of feeding trial by Roche Color Fan. To evaluate meat quality, 7 chicks of mean body weight were selected from each treatment group after the trial. Measurements were made for abdominal fat content, organoleptic scores for thigh and breast, and for contents of total lipids, free fatty acids, iodine values and peroxide values of the breasts. During the period from 0 to 4 weeks of age, the broilers fed the diets added with fats performed the same as those fed the control diet. However, the body weight gam (25%), feed intake (10.8%) and feed efficiency (11.3%) of chicks fed the fat-supplemented diets, during the finisher period (5-8 weeks), appeared significantly improved compared to those of control group (p<0.05). During overall period of 8 weeks, body weight gain, feed intake, and feed efficiency of chicks fed the diets added with fats were, on the average, 16.2. 8.8 and 6.8%, respectively, better than, those of control Monwhile the performance between the chicks fed diets added with the two different fat sources appeared to be of the same tendency. Though the shank pigmentation was not statistically different among the treatments, the chicks fed the fat-supple ented diets tended to have slightly less pigments than the control. Organoleptic scores of thigh or breast of chicks fed the animal fat diet were of the same range as those of the other two groups. The contents of total lipids, free fatty acids, iodine values and peroxide values of breasts from broilers fed the various diets appeared to be in the same ranges among the treatments. The values for control, yellow grease and animal fat groups were 7.77, 6.66 and 6.32% for total lipids, 9.23, 9.7 and 9.31mg oleic acid/g fat for free fatty acids, 65.36, 63.89 and 59.25g/ 100g fat for iodine values, and 9.62, 10.46 and 8.79 meq/kg fat for peroxide values, respect vely. Changes of free fatty acids contents of breast during a storage for 10 da s at 4$^{\circ}C$ were also not different among the dietary groups. From the observations n. this experiment, it seems possible to conclude that the animal fat containing 38.6% free fatty acid can be used as efficiently as yellow grease in broiler diets without any adverse effects on meat quality.

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Soil amendment for turfgrass vegetation of the Incheon International Airport runway side on the Yeongjong reclaimed land (인천국제공항 착륙대 잔디 식재 지반 조성을 위한 영종도 매립 토양 개량)

  • Yoo, Sun-Ho;Jeong, Yeong-Sang;Joo, Young-Kyu;Choi, Byung-Kwon;Wu, Heun-Young;Lee, Tae-Young
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.2
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    • pp.93-104
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    • 2002
  • A field survey and experiment was conducted from 1996 to 1998 to develop rational technology for turfgrass vegetation of runway side of Incheon International Airport on the reclaimed tidal land in Young-Jong Island. Backfill of the experimental site was finished on August 1995. The experimental site was 8 ha located in the middle of the construction place for the main parking lot in front of the terminal building construction. The experimental field was drained by main open ditch, and divided three main plots, no subsurface tile drain, subsurface tile drain spacing with 22.5m, and with 45 m, respectively. The 17 sub plots were designed to test the effect of soil covering with red earth loam by 5 cm and 20 cm depth, application of chemical compound fertilizers and livestock manures, dressing of artifical soils and hydrophylic soil conditioners. The tested turfgrasses were three transplanting indigenous turfgrasses, Zoysia koreana, Zoysia sinica and Zoysia japonica, and two hydroseeding mixed exotic turgrasses, cool type I(tall fescue 30%, kentucky blue grass 40%, perenial ryegrass 30%), and cool type II(tall fescue 40%, perenial ryegrass 20%, fine fescue 20%, alkaligrass 20%). The soil backfilled with dredged seasand was sand textured with high salt concentration and low fertility. The soil showed high pH, low organic matter and low available phophate contents. The percolation rate was fast with high hydraulic conductivity. Desalinization was fast after installation of the main open drainage system. No subsurface tile drainage effect was found showing little difference in turfgrass growth. The covering and visual growth of turfgrasses were the best in the 20-cm soil covering with compound fertilizer treatment. The covering and visual growth of turfgrasses were satisfactory in the 5 cm soil covering with compound fertilizer treatment and with livestock manure treatments. The hydrophillic soil conditioner treatments were effective but expensive at present. The coverage and visual quality of turfgrasses were good for Zoysia koreana and Zoysia japonica. The coverages of turfgrasses by the hydroseeding with the mixed exotic turfgrasses were less than transplanting of native turfgrasses. In conclusion, for the runway side vegetation purposes, the subsurface tile drainage might not necessary as main open ditch drainage be sufficient due to fast percolation rate of the backfilled dredged seasand. The 5 cm soil covering with red earth might be sufficient for the runway side, but the 20 cm soil covering might be necessary for the runway side where high density of turfgrass coverage was necessary to protect from the airplance air blow.

Accelerometer-based Gesture Recognition for Robot Interface (로봇 인터페이스 활용을 위한 가속도 센서 기반 제스처 인식)

  • Jang, Min-Su;Cho, Yong-Suk;Kim, Jae-Hong;Sohn, Joo-Chan
    • Journal of Intelligence and Information Systems
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    • v.17 no.1
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    • pp.53-69
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    • 2011
  • Vision and voice-based technologies are commonly utilized for human-robot interaction. But it is widely recognized that the performance of vision and voice-based interaction systems is deteriorated by a large margin in the real-world situations due to environmental and user variances. Human users need to be very cooperative to get reasonable performance, which significantly limits the usability of the vision and voice-based human-robot interaction technologies. As a result, touch screens are still the major medium of human-robot interaction for the real-world applications. To empower the usability of robots for various services, alternative interaction technologies should be developed to complement the problems of vision and voice-based technologies. In this paper, we propose the use of accelerometer-based gesture interface as one of the alternative technologies, because accelerometers are effective in detecting the movements of human body, while their performance is not limited by environmental contexts such as lighting conditions or camera's field-of-view. Moreover, accelerometers are widely available nowadays in many mobile devices. We tackle the problem of classifying acceleration signal patterns of 26 English alphabets, which is one of the essential repertoires for the realization of education services based on robots. Recognizing 26 English handwriting patterns based on accelerometers is a very difficult task to take over because of its large scale of pattern classes and the complexity of each pattern. The most difficult problem that has been undertaken which is similar to our problem was recognizing acceleration signal patterns of 10 handwritten digits. Most previous studies dealt with pattern sets of 8~10 simple and easily distinguishable gestures that are useful for controlling home appliances, computer applications, robots etc. Good features are essential for the success of pattern recognition. To promote the discriminative power upon complex English alphabet patterns, we extracted 'motion trajectories' out of input acceleration signal and used them as the main feature. Investigative experiments showed that classifiers based on trajectory performed 3%~5% better than those with raw features e.g. acceleration signal itself or statistical figures. To minimize the distortion of trajectories, we applied a simple but effective set of smoothing filters and band-pass filters. It is well known that acceleration patterns for the same gesture is very different among different performers. To tackle the problem, online incremental learning is applied for our system to make it adaptive to the users' distinctive motion properties. Our system is based on instance-based learning (IBL) where each training sample is memorized as a reference pattern. Brute-force incremental learning in IBL continuously accumulates reference patterns, which is a problem because it not only slows down the classification but also downgrades the recall performance. Regarding the latter phenomenon, we observed a tendency that as the number of reference patterns grows, some reference patterns contribute more to the false positive classification. Thus, we devised an algorithm for optimizing the reference pattern set based on the positive and negative contribution of each reference pattern. The algorithm is performed periodically to remove reference patterns that have a very low positive contribution or a high negative contribution. Experiments were performed on 6500 gesture patterns collected from 50 adults of 30~50 years old. Each alphabet was performed 5 times per participant using $Nintendo{(R)}$ $Wii^{TM}$ remote. Acceleration signal was sampled in 100hz on 3 axes. Mean recall rate for all the alphabets was 95.48%. Some alphabets recorded very low recall rate and exhibited very high pairwise confusion rate. Major confusion pairs are D(88%) and P(74%), I(81%) and U(75%), N(88%) and W(100%). Though W was recalled perfectly, it contributed much to the false positive classification of N. By comparison with major previous results from VTT (96% for 8 control gestures), CMU (97% for 10 control gestures) and Samsung Electronics(97% for 10 digits and a control gesture), we could find that the performance of our system is superior regarding the number of pattern classes and the complexity of patterns. Using our gesture interaction system, we conducted 2 case studies of robot-based edutainment services. The services were implemented on various robot platforms and mobile devices including $iPhone^{TM}$. The participating children exhibited improved concentration and active reaction on the service with our gesture interface. To prove the effectiveness of our gesture interface, a test was taken by the children after experiencing an English teaching service. The test result showed that those who played with the gesture interface-based robot content marked 10% better score than those with conventional teaching. We conclude that the accelerometer-based gesture interface is a promising technology for flourishing real-world robot-based services and content by complementing the limits of today's conventional interfaces e.g. touch screen, vision and voice.

The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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