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Factors Related to Serum Level of Carbohydrate Antigen 19-9 and Cancer Antigen 125 in Healthy Rural Populations in Korea (일부 농촌지역 주민에서 혈청 CA19-9 및 CA125 농도에 영향을 미치는 인자에 관한 연구)

  • Lee, SK;Yoo, KY;Park, SK;Kang, DH;Kim, JQ;Chung, JK;Lee, MC
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.71-80
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    • 1998
  • This study examines the levels of carbohydrate antigen 19-9(CA19-9) and cancer antigen 125(CA125) in serum and its related factors in healthy Korean population. Although CA19-9 and CA125 have been widely used tumor markers for gastroenteric cancers and ovarian cancer in Western countries, there are no information available on the serum levels of CA19-9 and CA125 in healthy population and the factors affecting the levels of these tumor markers in Korea. A cross-sectional study was performed to measure CA19-9 and CA125 among 76 healthy males and 95 healthy females in Korea. CA19-9 and CA125 were quantitated using solid-phase radioimmunoassay kits. Informations on the factors which might be related to the levels of these markers were collected by questionnaire(e.g., smoking, alcohol consumption, menstruation, oral pill use, breast-feeding history, etc.). There was no statistically significant difference in the mean of CA19-9 concentration between men(10.4 u/ml) and women(10.1 u/ml), whereas the mean of CA125 levels(11.2 u/ml) was higher in women than that(2.5 u/ml) in men. Although there was a statistically significant association between CA19-9 and average number of cigarette consumed per day(r=0.59, p=0.026) and total number of cigarettes consumed in women(r=0.74, p=0.003), the significance disappeared by multiple regression analysis after adjusting age and body mass index. Later age of menopause(p=0.035) and longer duration of breast-feeding(p=0.050) were significant predictors for CA125 levels in women by multiple regression analysis after adjusting age and body mass index. In conclusion, CA19-9 can be used as a stable tumor marker in clinical practices, however, menstruation and breast-feeding should be considered when CA125 is used in women.

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Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images (사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Park, Hee-Chul;Ahn, Jong-Ho;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jin-Sung;Han, Young-Yih;Lim, Do-Hoon;Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.155-165
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    • 2010
  • Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

Comparison of marginal fit before and after porcelain build-up of two kinds of CAD/CAM zirconia all-ceramic restorations (두 종류의 CAD/CAM 지르코니아 전부도재관의 도재 축성 전후의 변연적합도 비교)

  • Shin, Ho-Sik;Kim, Seok-Gyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.528-534
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    • 2008
  • Purpose: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as $LAVA^{(R)}$ (3M ESPE, St.Paul, MN) and $EVEREST^{(R)}$ (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up Material and methods: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were $LAVA^{(R)}$, $EVEREST^{(R)}$, and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with $Microhiscope^{(R)}$ system (HIROX KH-1000 ING-Plus, Seoul, Korea. X300 magnification). After porcelain build-up, the marginal openings of $LAVA^{(R)}$, $EVEREST^{(R)}$,and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. Results: In coping states, the mean marginal opening for $EVEREST^{(R)}$ restorations was $52.00{\pm}11.94\;{\mu}m$ for $LAVA^{(R)}$ restorations $56.97{\pm}10.00\;{\mu}m$, and for ceramometal restorations $97.38{\pm}18.54\;{\mu}m$. After porcelain build-up, the mean marginal opening for $EVEREST^{(R)}$ restorations was $61.69{\pm}19.33\;{\mu}m$, for $LAVA^{(R)}$ restorations $70.81{\pm}12.99\;{\mu}m$, and for ceramometal restorations $1115.25{\pm}23.86\;{\mu}m$. Conclusion: 1. $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P < 0.05) in coping state and also after porcelain build-up . 2. The mean marginal opening values between $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations did not showed significant differences after porcelain build-up as well as in coping state (P > .05). 3. $EVEREST^{(R)}$, $LAVA^{(R)}$ and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

Neuroprotective Effect of Cyclosporin A on Spinal Cord Ischemic Injury in Rabbits (토끼를 이용한 척수 허혈 손상 모델에서 Cyclosporin A의 척수 손상에 대한 보호 효과)

  • Shin Yoon-Cheol;Choe Ghee-Young;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.739-748
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    • 2006
  • Background: The purpose of this study is to ascertain the neuroprotective effect of cyclosporin A on the 25-min surgical ischemia model in the spinal cords of rabbits with neuropathological correlation and histoimmunochemical analyses, Material and Method: Thirty-two New Zealand white rabbits were randomly divided into four groups: Rabbits were randomly divided into four groups: the control 12 group (n=8), the control 17 group (n=8), the cyclosporin Cs2 group (n=8), and the cyclosporin Cs7 group (n=8). The 12 group underwent a 25-min aortic cross- clamp without intervention and were sacrificed on the 2nd day postoperatively, while the 17 group underwent a 25- min of aortic cross-clamp without intervention and were sacrificed on the 7th day postoperatively. The Cs2 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the End day postoperatively, while the Cs7 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the 7th day postoperatively. The rabbits underwent 25-min surgical aortic cross-clamp. Neurologic functions were evaluated on the 2nd day and 7th postoperative day using Tarlov scoring system. After scoring neurologic function, all rabbits were sacrificed for histopathologic observation. Result: All rabbits survived the experimental procedure. The values of Tarlov score did not show any differences between the control and cyclosporin groups on the 2nd day. The scores of group Cs7 ($2.75{\pm}0.89$) were significantly higher than those of group 17 ($1.25{\pm}1.39$) on the 7th day (p<0,05). On the histologic exanminations, specimens of the spinal cord showed necrosis and apoptosis. The pathologic scores of group Cs7 ($1,0{\pm}0.53$) was less than those of group 17 ($2.13{\pm}1.36$, p<0.05). TUNEL staing showed apoptosis of the specimen in group 12 and Cs2 but there was no stastically significant difference between groups on the score. There were more overexpression of HSP70 and nNOS in cyclosporine group than in control group. Conclusion: We think that cyclosporin A may decrease neuronal cell death with induced upregulation of HSP70 against 25-min ischemia of the spiral cord in the rabbit.

Studies on Characteristics of Sprouting and Occurrence on paddy field of Water Chestnut(Eleocharis Kuroguwai Ohwi) (올방개 괴경(塊莖)의 맹아(萌芽) 특성(特性)과 본답(本畓)에서의 발생(發生)에 관한 연구(硏究))

  • Kim, H.D.;Park, J.S.;Park, K.Y.;Choi, Y.J.;Yu, C.J.;Rho, Y.D.;Kwon, Y.W.
    • Korean Journal of Weed Science
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    • v.16 no.4
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    • pp.264-281
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    • 1996
  • As a consequence of wide use of herbicides, Eleocharis kuroguwai Ohwi became a dorminant problem weed for rice cultivation in Korea. To understand the establishment of the weed, experiments on physio-ecological characteristics were carried out sprouting and occurrence, the results could be summarized as follows: Sprouting percentage remained 68 to 73% until the time of field emergence, indicating many of the them are still dormant. The proportion of the dormant tubers were greater for the smaller than the bigger tubers. Apical dominance was apparent in sprouting, with 84% of tuber sprouted from only one of the apical buds. Tubers sprouted from 2 or 3 buds were less than 20%, and were mostly from the bigger tubers. When the shoot growth was compared, by controlling the others, ones from apical and the next 3 buds showed similar vigorous growth, but the later ones showed poorer growth. For the longevity of tubers, deep soil storage appeared to be better than storage in temperature controlled room to 2~$3^{\circ}C$. Emergence of E. kuroguwai was better in clay soil than in sand, and the possible depth for emergence in clay soil appeared to be up to 21cm, but was 15cm in sand. When tubers were exposed to salt solutions before emergence tests, E. kuroguwai appeared to be much sensitive to salts than S.planiculmis. Among the tubers formed in previous year, 12.7% remained still viable until the end of next crop season, but with relatively strong dormancy. The first emergence was about 10 days after planting at ordinary cropping seasons, and the days to the maximum shoot number stage were 60~90 from planting. The duration was extended at early transplanting, and shoot number, leaves per shoot, and tubers developed per plant were also greater at early plantings. The 6th order offshoots were developing when E. kuroguwai was planted at early season. When planted at later seasons, generation and the number of offshoots was reduced planted at early season. When planted at later seasons, generation and the number of offshoots was reduced and the number of tubers, runner and rhizome lengths was also reduced.

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Stable Isotope and Fluid Inclusion Studies of the Daebong Gold-silver Deposit, Republic of Korea (대봉 금-은광상에 대한 유체포유물 및 안정동위원소 연구)

  • 유봉철;이현구;김상중
    • Economic and Environmental Geology
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    • v.36 no.6
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    • pp.391-405
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    • 2003
  • The Daebong gold-silver deposit consists of mesothermal massive quartz veins thar are filling the fractures along fault shear (NE, NW) Bones within banded or granitic gneiss of Precambrian Gyeonggi massif. Based on vein mineralogy, ore textures and paragenesis, ore mineralization of this deposits is composed of massive white quartz vein(stage I) which was formed in the same stage by multiple episodes of fracturing and healing, and transparent quartz vein(stage II) which is separated by a major faulting event. Stage I is divided into the 3 substages. Ore minerals of each substages are as follows: 1) early stage I=magnetite, pyrrhotite, arsenopyrite, pyrite, sphalerite, chalcopyrite, 2) middle stage I=pyrrhotite, arsenopyrite, pyrite, marcasite, sphalerite, chalcopyrite, galena, electrum and 3) late stage I=pyrite, sphalerite, chalcopyrite, galena, electrum, argentite, respectively. Ore minerals of the stage II are composed of pyrite, sphalerite, chalcopyrite, galena and electrum. Systematic studies (petrography and microthermometry) of fluid inclusions in stage I and II quartz veins show fluids from contrasting physical-chemical conditions: 1) $H_2O-CO_2-CH_4-NaCl{\pm}N-2$ fluid(early stage I=homogenization temperature: 203∼3$88^{\circ}C$, pressure: 1082∼2092 bar, salinity: 0.6∼13.4 wt.%, middle stage I=homogenization temperature: 215∼28$0^{\circ}C$, salinity: 0.2∼2.8 wt.%) related to the stage I sulfide deposition, 2) $H_2O-NaCl{\pm}CO_2$ fluid (late stage I=homogenization temperature: 205∼2$88^{\circ}C$, pressure: 670 bar, salinity: 4.5∼6.7 wt.%, stage II=homogenization temperature: 201-3$58^{\circ}C$, salinity: 0.4-4.2 wt.%) related to the late stage I and II sulfide deposition. $H_2O-CO_2-CH_4-NaCl{\pm}N_2$ fluid of early stage I is evolved to $H_2O-NaCl{\pm}CO_2$ fluid represented by the $CO_2$ unmixing due to decrease in fluid pressure and is diluted and cooled by the mixing of deep circulated meteoric waters ($H_2O$-NaCl fluid) possibly related to uplift and unloading of the mineralizing suites. $H_2O-NaCl{\pm}CO_2$ fluid of stage II was hotter than that of late stage I and occurred partly unmixing, mainly dilution and cooling for sulfide deposition. Calculated sulfur isotope compositions ({\gamma}^{34}S_{H2S}$) of hydrothermal fluids (3.5∼7.9%o) indicate that ore sulfur was derived from mainly an igneous source and partly sulfur of host rock. Measured and calculated oxygen and hydrogen isotope compositions ({\gamma}^{18}O_{H_2O}$, {\gamma}$D) of ore fluids (stage I: 1.1∼9.0$\textperthousand$, -92∼-86{\textperthansand}$, stage II: 0.3{\textperthansand}$, -93{\textperthansand}$) and ribbon-banded structure (graphitic lamination) indicate that mesothermal auriferous fluids of Daebong deposit were two different origin and their evolution. 1) Fluids of this deposit were likely mixtures of $H_2O$-rich, isotopically less evolved meteoric water and magmatic fluids and 2) were likely mixtures of $H_2O$-rich. isotopically heavier $\delta$D meteoric water and magmaticmetamorphic fluids.

Changes in Distribution and Morphology of Rat Alveolar Macrophage Subpopulations in Acute Hyperoxic Lung Injury Model (고농도 산소로 유발한 흰쥐의 급성폐손상모델에서 폐포대식세포 아형군의 분포와 형태 변화)

  • Shin, Yoon;Lee, Sang-Haak;Yoon, Hyoung-Kyu;Lee, Sook-Young;Kim, Seok-Chan;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.478-486
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    • 2000
  • Background : In acute lung injury, alveolar macrophages play a pivotal role in the inflammatory process during the initiation phase and in the reconstruction and fibrosis process during the later phase. Recently, it has been proven that alveolar macrophages are constituted by morphologically, biochemically and immunologically heterogenous cell subpopulations. The possibility of alterations to these characteristics of the alveolar macrophage population during lung disease has been raised. To investigate such a possibility a hyperoxic rat lung model was made to check the distributional and morphological changes of rat alveolar macrophage subpopulation in acute hyperoxic lung injury. Method : Alveolar macrophage were lavaged from normal and hyperoxic lung injury rats and separated by discontinuous gradients of percoll. After cell counts of each density fraction were accessed, the morphomeric analysis of alveolar macrophages was performed on cytocentrifuged preparations by transmission electron micrograph. Result : 1. The total alveolar macrophage cell count significantly increased up to 24 hours after hyperoxic challenge (normal control group $171.6{\pm}24.1{\times}10^5$, 12 hour group $194.8{\pm}17.9{\times}10^5$, 24 hour group $207.6{\pm}27.1{\times}10^5$, p<0.05). oHoHH However the 48 hour group ($200.0{\pm}77.8{\times}10^5$) did not show a significant difference. 2. Alveolar septal thickness significantly increased up to 24 hours after hyperoxic challenge(normal control group $0.7{\pm}0.2{\mu}m$, 12 hour group $1.5{\pm}0.4{\mu}m$, 24 hour group $2.3{\pm}0.4{\mu}m$, p<0.05). However the 48 hour group did not show further change ($2.5{\pm}0.4{\mu}m$). Number of interstitial macrophage markedly increased at 24 hour group. 3. Hypodense fraction(fraction 1 and fraction 2) of alveolar macrophage showed a significant increase following hyperoxic challenge ($\beta=0.379$.$\beta=0.694$. p<0.05) ; however, fraction 3 was rather decreased following the hyperoxic challenge($\beta=0.815$. p<0.05), and fraction 4 showed an irregular pattern. 4. Electron microscopic observation of alveolar macrophage from each fraction revealed considerable morphologic heterogeneity. Cells of the most dense subfraction(fraction 4) were small, round, and typically highly ruffled with small membrane pseudopods. Cells of the least dense fraction (fraction 1) were large and showed irregular eccentric nucleus and high number of heterogenous inclusions. Conclusion : In conclusion, these results suggest that specific hypodense alveolar macrophage subpopulation may play a an important role in an acute hyperoxic lung injury model But further study, including biochemical and immunological function of these subpopulations, is needed.

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Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer (초기 유방암의 유방 보존수술 후 방사선 치료 결과)

  • Cho, Heung-Lae;Kim, Cheol-Jin;Park, Sung-Kwang;Oh, Min-Kyung;Lee, Jin-Yong;Ahn, Ki-Jung
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.204-212
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    • 2008
  • Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

Peripheral Neutrophil Count and Respiratory Failure in Preterm Infant (조산아에서 말초혈액 중성구수와 호흡 부전증과의 연관성)

  • Lee, Kum Joo;Yun, Soo Young;Lee, Ran;Hean, Jae Ho;Jung, Ghee Young;Park, Jin Hee;Park, Young Sun
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.596-602
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    • 2002
  • Purpose : The purpose of this study was to analyze the association of peripheral neutrophil count with the development of respiratory failure in preterm infants. Methods : A retrospective study was conducted from January 1993 to December 1999 on 44 preterm infants, who were admitted to the neonatal intensive care unit of St. Francisco hospital. Preterm infants(birth weight 500 to 1,350 gm) who had a complete blood count obtained within 2 hours after delivery. Patients in the lowest of neutrophil count(early neutropenia, < $1.0{\times}10^9/L$) were compared with patients in the remaining group. Results : Low neutrophil count were transient in early neutropenia group. The concentration the circulating neutrophil count rose from $0.85{\pm}0.11{\times}10^9/L$ at average of 2 hours after delivery to $5.3{\pm}2.7{\times}10^9/L$ at 24 hours after delivery in the early neutropenia group and from $3.6{\pm}1.6{\times}10^9/L$ to $5.8{\pm}3.2{\times}10^9/L$ in the non-neutropenia group during the same time period. Compare to the non-neutropenia group, the neutropenia group had a lower birth weight($1,046.50{\pm}180.76gm$ Vs $1,156.70{\pm}124.99gm$), a lower Apgar score(1 min : $3.41{\pm}1.18$ Vs $4.30{\pm}1.46$, 5 min : $5.41{\pm}0.87$ Vs $6.15{\pm}0.95$), and a higher incidence of bronchopulmonary dysplasia(27.27% Vs 7.0%). Patients who had early neutropenia were more likely to require mechanical ventilation, supplemental oxygen and hospital stay. Also, main effect factors for the two groups were birth weight(Odds ratio=5.457, 95% CI=1.551-27.525), initial peripheral blood white cells(odds ratio=8.308, 95% CI=2.054-52.699), and bronchopulmonary dysplasia(odds ratio=0.099, 95% CI=0.017-0.397). Conclusion : A low count of neutrophil in the systemic circulation of premature infants within 2 hours of birth is associated with more severe respiratory distress.

An Appreciation of Functional Role of Macrophage in the Acute Lung Injury in the Neutropenic Rat. (호중구 감소증을 보이는 백서의 급성폐손상에서 대식세포의 기능적 역할)

  • Kim, Yong-Hoon;Ki, Sin-Young;Im, Keon-Il;Moon, Seung-Hyug;Cheong, Seung-Whan;Kim, Hyeon-Tae;Uh, Soo-Taek;Park, Choon-Sik;Jin, Byung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.379-390
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    • 1997
  • Background : It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pulmonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutropenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. Method : The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cells was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. Results : The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA : More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells : In the ETX-group, the number of total cells (p < 0.01) and of macrophage and neutrophil (p < 0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC-group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and it took part in less than 0.1% of total BAL cells (p < 0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF : In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p < 0.05 and < 0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p < 0.05 vs NC-group), but the value was statistically not different from that of ETX-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p < 0.05), but showed still a higher value compared to that of NC-group (p < 0.05). A change of cytokine concentration in the BALF : TNF -alpha and IL-6 were elevated in the ETX - and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells : There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p < 0.0008 vs NC-group), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion : Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveolar macrophages.

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