• Title/Summary/Keyword: 면역 억제 치료

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P53 Overexpression and Outcome of Radiation Therapy in Head & Neck Cancers (두경부종양 환자에서 p53의 과발현과 방사선치료결과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Ji Young;Kim Kyung Mi;Park Kyung Shin;Young Shin Kim;Kang Chang Suk;Cho Seung Ho;Kim Hyung Tae
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.1-8
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    • 1999
  • Purpose : Experimental studies have implicated the wild type p53 In cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancels. Methods : Immunohistochemical analysis with a mouse monoclonal antibody (DO-7) specific for human p53 was used to detect to overexpression of protein in formalin fixed, paraffin-embedded tumor sample from 55 head and neck cancer patients treated with curative radiation therapy (median dose of 7020 cGy) from February 1988 to March 1996 at 51. Mary's Hospital. Overexpression of p53 was correlated with locoregional control and survival using Kaplan-Meier method. A Cox regression multi-variate analysis was peformed that included all clinical variables and status of p53 expression. Results : Thirty-seven (67.2$\%$) patients showed overexpression of p53 by immunohistochemical staining in their tumor. One hundred percent of oral cavity, 70$\%$ of laryngeal, 66.7$\%$ of oropharyngeal, 66.7$\%$ of hypopharyngeal cancer showed p53 overexpression (P=0.05). The status of p53 had significant relationship with stage of disease (P=0.03) and history of smoking (P=0.001). The overexpression of p53 was not predictive of response rate to radiation therapy. The locoregional control was not significantly affected by p53 status. Overexpression of p53 didn't have any prognostic implication for disease free survival and overall survival. Primary site and stage of disease were significant prognostic factors for survival. Conclusions : The p53 overexpression as detected by immunohistochemical staining had significant correlation with stage, primary site of disease and smoking habit of patients. The p53 overexpression didn't have any predictive value for outcome of curative radiation therapy in a group of head and neck cancers.

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Oral Health Status and Dental Treatment Need of Liver Transplant Candidates (간 이식 예정 환자의 구강건강상태 및 치과치료 요구도에 관한 연구)

  • Park, Tae-Jun;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.1-9
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    • 2009
  • Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

Expression of Osteopontin and Transforming Growth Factor- ${\beta}$ in Childhood Minimal Change Nephrotic Syndrome After Cyclosporine Treatment (미세변화 신증후군 환아에서 사이클로스포린 치료 후 Osteopontin과 Transforming Growth Factor-${\beta}$의 발현)

  • Lim Beom-Jin;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.142-154
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    • 2002
  • Purpose : One of the most important adverse effects of long-term cyclosporine therapy is nephrotoxicity, the morphologic changes of which include interstitial fibrosis and arteriolar hyalinization. Recently, several authors have shown that osteopontin plays an important role in the development of interstitial fibrosis by acting as a macrophage chemoattractant and stimulating the production of $TGF-{\beta}$ in experimental cyclosporine nephrotoxicity. However, the relationship between osteopontin and $TGF-{\beta}$ in humans has not been clearly documented so far. We studied the expression of osteopontin and $TGF-{\beta}$ in children with minimal change nephrotic syndrome treated with cyclosporine to demonstrate whether there is a relationship between cyclosporine toxicity and osteopontin expression as previously shown in animal models. Materials and methods : Nineteen children (15 males and 4 females) were the subject of this study. Renal biopsies had been performed before and after the cyclosporine therapy (mean duration: 15.9 months). In 5 patients, additional biopsies were performed after completing the cyclosporine treatment (mean; 26 months). The expressions of osteopontin and $TGF-{\beta}$ were evaluated by immunohistochemistry in the glomeruli and tubulointerstitium. Results : Osteopontin expression was significantly increased in the glomerular mesangium and tubules after cyclosporine treatment. But there was no statistically significant increase of $TGF-{\beta}$ in the interstitium. There was no significant increase in tubular osteopontin and interstitial $TGF-{\beta}$ expression in those cases developing interstitial fibrosis after cyclosporine treatment compared with cases those not developing interstitial fibrosis. No significant changes in osteopontin or $TGF-{\beta}$ expression were observed in subsequent 5 biopsy samples after discontinuation of cyclosporine compared with the first follow up biopsies. Conclusion : These results suggest that osteopontin is a nonspecific marker of renal injury rather than a mediator of interstitial fibrosis in cyclosporine nephrotoxicity of human.

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Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma (만성 B형간질환에서 HBV백신 및 항바이러스치료가 간세포암종 발생에 미치는 효과)

  • Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.1-18
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    • 2008
  • Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of $10^4$ copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the $21^{st}$ century.

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Spontaneous teeth migration after periodontal treatment in the patients with drug-induced gingival enlargement (약물성 치은비대로 인한 병적인 치아 이동이 있는 환자에서 치주치료 이후 자발적 치아 이동을 보인 증례)

  • Choi, Youn-Kyung;Jung, Kyoung-Hwa;Kim, So-Yeun;Jeon, Hye-Mi;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young;Kwon, Eun-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.34-41
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    • 2017
  • Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

A Case Report of Heart-Lung Transplantation (심장-폐 이식 증례 보고)

  • 노준량;허재학;오삼세;김영태;이정렬;이기봉;오병희;한성구
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.1004-1008
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    • 1998
  • We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.

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A Case of Posttransplant Lymphoproliferative Disease(PTLD) Following Renal Transplantation in a Child (소아에서 신이식후 발생한 Posttransplant Lymphoproliferative Disease(PTLD) 1례)

  • Eun, Byung-Wook;Park, Eun-Sil;Lee, Seong-Yong;Hahn, Hye-Won;Jang, Ju-Young;Park, Kyung-Mi;Kim, Chul-Woo;Kang, Gin-Han;Ko, Jae-Seong;Ha, Il-Soo;Lee, Hoan-Jong;Cheong, Hae-Il;Seo, Jeong-Kee
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.123-130
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    • 2002
  • Posttransplant lymphoproliferative disease (PTLD) represents a diverse lymphoproliferative disorder ranging front nonspecific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus (EBV) infection and high dose immunosuppression. PTLD after renal transplantation was reported at first in adult in Korea in 1997. In children there have been several cases of PTLD after liver transplantation but PTLD after renal transplantation has not been reported. This is a case report of PTLD developed 4 months after renal transplantation in a 9-year-old boy. The major clinical manifestations were fever, multiple lymph nodes enlargement and blood-tinged stool. EBV was detected by in-situ hybridization in the enlarged cervical lymph node and the colonic tissue. Histological examination revealed B-cell lineage. Use of ganciclovir and reduction of the immunosuppression level resulted in complete remission of PTLD. This is the first pediatric case report of PTLD following renal transplantation in Korea. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 123-30)

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Anti-inflammatory Effect of Boswellia sacra (Franckincense) Essential Oil in a Mouse Model of Allergic Asthma (알러지성 천식 모델 생쥐에서 프랑킨센스 에센셜 오일의 염증 억제 효과)

  • Lee, Hye-Youn;Yun, Mi-Young;Kang, Sang-Mo
    • Microbiology and Biotechnology Letters
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    • v.36 no.4
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    • pp.343-352
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    • 2008
  • Frankincense, the gum resin derived from Boswellia species, is complex mixtures composed of about $5{\sim}9%$ highly aromatic essential oil, $65{\sim}85%$ alcohol-soluble resins, and the remaining water-soluble gums. The anti-inflammatory properties of frankincense, alcohole-soluble resins, are well-recognized, but the question of whether aromatic essential oil also plays a role in the allergic asthma remains unanswered. This study was performed to evaluate anti-inflammatory effects of Boswellia sacra essential oil (BSEO) on ovalbumin (OVA)-induced asthma mouse model. BALB/c mice after intraperitoneal OVA sensitization were challenged with intratracheal OVA. One experimental group was inhaled with 0.3% BSEO for the later 8 weeks. BALB/c mice were sensitized and challenged with OVA and developed airway eosinophilia, mucus hypersecretion, and airway hyperresponsiveness. In contrast, the BSEO treated mice had reduced a number of eosinophils among BALF cells, goblet cell hyperplasia, and airway hyperresponsiveness. Cytokine analysis of BALF revealed that BSEO caused an increase in Th1 cytokine (interferon-$\gamma$ (IFN-$\gamma$)) and a decrease in Th2 cytokines (interleukin-4 (IL-4), IL-5 and IL-13) levels. In addition, the OVA-specific serum IgE and eotaxin levels were also reduced. In mice inhaled BSEO, $CD4^+$, $CD3^+/CCR3^+$, and $B220^+/CD23^+$ mediastinal lymph nodes cells were also decreased. These results suggest that inhaled BSEO as a immunomodulator in Th1/Th2 mediated asthma may have therapeutic potential for the treatment in allergic airway inflammation by a simple, cost-effective way.

Nitric Oxide: The Pathophysiological Roles and Clinical Implications in Circulatory System (순환계에서 Nitric Oxide의 생리-병리학적 역할과 그 임상적 의의)

  • Lee, K.Y.
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.159-172
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    • 1996
  • 대기오염물질이면서 동시에 생체내 화학반응의 산물이기도 한 nitric oxide(NO)는 그 생체내 분포가 광범위하고 생리적 역할이 다양하여, 최근의 생명과학 분야에서 가장 크게 주목받는 몇가지 연구대상 중 하나이다. 세포에서의 NO 산생은 nitric oxide synthase (NOS)에 의해 촉매되는데, 이들은 brain form (bNOS, neuronal; nNOS, NOS I), inducible form (iNOS), 및 endothelial form(eNOS)로 구분되는데, 이중 bNOS(nNOS)와 eNOS는 inducible form에 대비되는 constitutive form(cNOS)에 해당하므로 각각 ncNOS 와 ecNOS로도 불리운다. NOS는 아미노산인 L-arginine을 산소와 결합시켜 L-citrulline으로 변환시키면서 NO를 유리하고, 이 NO는 세포내의 guanylate cyclase를 활성화하여 cyclic GMP를 생산하거나, superoxide(O2-) 및 수소이온과 차례로 결합하여 반응성이 매우 높은 수산화기(-OH)를 발생시켜 세포독작용을 유발하기도 한다. 정상상태에서 뇌혈관내피세포의 ecNOS로 부터 유리된 NO는 혈관을 확장시켜 신경세포에 대한 산소공급을 원활히 유지해 주지만, 순환장애를 일으켰을 때는 뇌조직내의 iNOS로부터 대량의 NO가 유출되어 신경세포의 손상을 가져온다. 호흡기에서는 NO가 기도평활근을 이완시키고 폐혈류를 개선하므로, 미숙아나 성인의 호흡장애시에 소량의 NO를 흡입시키면 oxygenation을 호전시킬 수 있다. 그러나 대기오염이나 흡연 등으로 대량의 NO를 흡입할 경우 치명적인 폐부종이나 methemoglobin혈종을 일으킬 수 있다. 순환계에서는 cNOS가 혈관을 확장시켜 조직의 혈류를 유지하는데 일익을 담당한다. 세균내 독소(lipopolysaccharide; LPS)나 각종 명역조절물질들이 혈관내피세포와 혈관평활근세포로 부터 과다한 NO를 유리시키면 혈압이 급격히 떨어져 순환허탈상태에 빠지게 된다. 심장에서는 관상혈관 내피세포의 eNOS가 심근의 혈류를 유지해 주지만 허혈이나 세균내독소 또는 면역조절물질 등에 의하여 심근세포나 침윤된 대식세포의 iNOS로 부터 과량의 NO가 유리되면 심근세포의 손상이 초래된다. 신장에서는 내피세포의 cNOS에 의하여 사구체여과가 조절되고 있는데, 세균내독소나 면역 조절물질 등에 의하여 사구체관막세포(mesangial cell)등의 iNOS로 부터 과량의 NO가 유리되면 신조직과 사구체의 손상을 초래한다. 위와 같이 대부분의 장기에서 ecNOS는 조직의 혈류를 유지하는 역할을 하며, iNOS는 애초 세균 등 침입자에 대한 세포독작용이 그 존재 목적이라고 풀이할 수 있겠으나 일종의 부작용으로 자체조직의 손상을 초래하게 되는 것으로 본다. 따라서 NO와 관련된 각종 병변의 치료를 위해서는 NOS의 비선택성 억제제인 arginine 유도체 보다는 iNOS에 대한 선택적 억제제인 S-methylisothiourea(SMT), aminoethylisothiourea(AETU), aminoguanidine (AMG), agmatine, L-canavanine, transforming growth factor b1(TGF-b1) 등의 사용을 검토해 보는 것이 타당할 것으로 사료된다.

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Biological Properties of Propolis Isolated from Honeybees (프로폴리스의 생물학적 특성)

  • Kim, Sung-Kuk;Woo, Soon-Ok;Chang, Jong-Soo
    • Journal of Life Science
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    • v.31 no.7
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    • pp.686-697
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    • 2021
  • Propolis is a resinous substance produced by honeybees, which they use to protect their hives. Honeybees produce propolis by mixing exudates from the various trees and plants with saliva and beeswax. It has been used since around 300 B.C. as a folk medicine to cure wounds. Propolis contains many physiologically active components, such as flavonoids, phenolic compounds, and beeswax. Because of its functional components, propolis has a wide spectrum of biological applications. The compounds in propolis and its biological activity can vary according to the location of nectar source and extraction method. Propolis is most commonly known for its anti-microorganism activity against bacteria, viruses, and fungi. Artepillin C and caffeic acid phenethyl ester (CAPE) have been identified as regulatory compounds that reduce inflammation and exert immunosuppressive reactions on T lymphocytes. Through its anti-inflammatory activity, propolis exhibits anti-tumor activity, including the inhibition of cancer cell proliferation, the blocking of tumor signaling cascades, and antiangiogenesis. However, for the more apply of propolis its analysis of nectar source, identifying of propolis compound, the molecular mechanism of propolis and the investigation of compounds synergistic effects are essential. In this study, we described the physiological activity of propolis isolated from honeybees.