• Title/Summary/Keyword: 삼출

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Soluble Interleukin-2 Receptor(sIL-2R) Levels in Patients Tuberculous Pleurisy VS Nontuberculous Pleurisy (결핵성 늑막삼출과 비결핵성 늑막삼출에서의 가용성 Interleukin-2 수용체의 농도)

  • Lim, Hyun-Oak;Ham, Jong-Yeol;Shim, Dae-Seok;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.135-143
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    • 1994
  • Background: The cell mediated immunity has an important role in the pathogenesis of tuberculosis. sIL-2R has been known as a sensitive marker of T lymphocyte activation Elevated serum levels of sIL-2R have been found in patients with lymphoproliferative disorders, organ transplantation, autoimmune diseases, and various granulomatous diseases. Elevated levels of sIL-2R have been also found in the serum and pleural fluid of the patients with tuberculosis. To evaluate the diagnostic value of sIL-2R in the differentiation of tuberculous pleurisy and nontuberculous pleurisy. We measured the level of sIL-2R in the sera and pleural fluids of 12 patients with tuberculous pleurisy and 32 patients with nontuberculous pleurisy. Method: Samples of pleural fluid and serum were centrifuged at 2500 rpm for 10 min to remove cell pellets. Soluble IL-2R was measured with a sandwitch enzyme immunoassay using the Cellfree(r) Interleukin-2 Receptor Test kit(T-cell science,Inc. Cambridge, MA). Results: The results obtained were as follows: 1) The sIL-2R level in pleural fluid of the patients with tuberculous pleurisy was higher than that of patients with nontuberculous pleurisy(P<0.005). 2) When the sIL-2R level above 5,000 u/ml in pleural fluid was used as the cut-off value to diagnose tuberculous pleurisy, it had a sensitivity of 84.6% and a specificity of 90.9%. 3) The sIL-2R level in the sera of the patients with tuberculous pleurisy was higher than that of patients with bacterial pleural effusions and normal control group(P<0.05) and there was no difference of levels compared with malignant pleural effusions and transudative pleural effusions(P>0.05). 4) In patients with tuberculous pleurisy, the mean concentration of sIL-2R in pleural fluid was higher than that in serum(P<0.005). Conclusion: These findings suggest that the measurement of elevated levels of pleural fluid sIL-2R in tuberculous pleurisy may be useful in the differential diagnosis between patients with tuberculous pleurisy and nontuberculous pleurisy.

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Umbilical venous line-related pleural and pericardial effusion causing cardiac tamponade in a premature neonate : A case report (제대정맥도관으로 인한 흉막삼출 및 심장압전을 동반한 심낭삼출 1례)

  • Hong, Eun Jeong;Lee, Kyung A;Bae, Il-Heon;Kim, Mi-Jung;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.686-690
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    • 2006
  • Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.

Clinical Significance of the Combined Assay of Pleural Fluid ADA Activity and CEA Level in the Various Pleural Effusions (흉막삼출 원인질환의 감별진단에 있어서 흉막액 Adenosine Deaminase 활성도 및 Carcinoembryonic Antigen 병행측정의 임상적 의의)

  • Lee, Jang-Hoon;Jang, Sang-Ho;Lee, Hong-Lyeol;Kwak, Seung-Min;Chang, Jung-Hyun;Kim, Byung-Il;Cheon, Sun-Hee;Kim, Se-Kyu;Chang, Joong;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.35-42
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    • 1993
  • Background: In order to establish the etiology of the pleural effusion, routine analysis of the fluid, bacteriologic studies, cytologic tests and pleural biopsies are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in approximately 10-20% of cases. The purpose of our study is to determine the diagnostic value of measuring ADA activity and CEA simultaneously in various pleural fluids which their etiologies have confirmed Methods: We have studied 61 cases of tuberculous pleural effusions, 17 cases of suspected tuberculous pleural effusions, 17 cases of malignant pleural effusions, 22 cases of suspected malignant pleural effusions, and 7 cases of parapneumonic pleural effusions. We have measured the ADA activity and CEA level simultaneously in pleural fluid samples in each cases. Results: 1) The ADA activity in tuberculous pleural effusion was significantly higher than that in malignant effusion. 2) The CEA level in malignant pleural effusion was significantly higher than that in tuberculous effusion. 3) With the cut-off values of the pleural fluid ADA activity more than 40 U/L and the CEA level less than 12 ng/mL, the sensitivity was 86.9%, and the specificity was 100% in the diagnosis of tuberculous effusion. With the cut-off values of the pleural fluid CEA level more than 12 g/mL and the ADA activity less than 40 U/L, the sensitivity was 76.5%, and the specificity was 100% in the diagnosis of malignant effusion. Conclusion: It is suggested that the combined assay of pleural fluid ADA activity and CEA level is very useful in the differential diagnosis of tuberculous and malignant pleural effusion.

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Diagnostic value of C-reactive Protein and Vascular Endothelial Growth Factor in Differentiation of Pleural Effusions (흉막액 감별에 있어서 C-반응성단백과 혈관내피성장인자의 유용성)

  • Kim, Sang Ha;Lee, Won Yeon;Park, Joo Young;Park, Hyun Sook;Han, Hye-Kyoung;Ju, Hun Su;Hong, Tae Won;Lee, Nak Won;Shin, Kye Chul;Yong, Suk Joong
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.467-477
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    • 2003
  • Background : Pleural effusions are generally divided into transudates and exudates. If it is exudative, more diagnostic tests are required in order to determine the cause of the local disease. A malignancy is a common and important cause of exudative pleural effusions. Because the pleural fluid cytology and pleural biopsy specimens do not provide a diagnosis in a high percentage of malignant effusions, several tumor markers have been examined. In order to overcome this limitation, this study hypothesized that C-reactive protein(CRP) and vascular endothelial growth factor(VEGF) measurements would be useful for differentiating trasudates from exudates and determining the differences between a benign and malignant effusion. Methods : Eighty consecutive patients with a pleural effusion (tuberculous 20, parapneumonic 20, malignant 20, transudative 20) were examined prospectively: 60 of them were classified according to Light's criteria as having an exudative fluid and 20 had a transudative fluid. The standard parameters of a pleural effusion were examined and the serum and pleural effusion VEGF levels were measured using enzyme linked immunosorbent assay(ELISA). CRP in the serum and pleural fluid was determined by a turbidimetric immunoassay. Results : The pleural CRP levels in the exudates were significantly higher than those in the transudates, $4.19{\pm}4.22mg/d{\ell}$ and $1.29{\pm}1.45mg/d{\ell}$, respectively. The VEGF levels in the pleural effusions were significantly elevated in the exudates compared to the transudate, $1,011{\pm}1,055pg/m{\ell}$ and $389{\pm}325pg/m{\ell}$, respectively. The VEGF ratio in the exudative effusion is significantly higher than a transudative effusions, $3.9{\pm}4.7$ and $1.6{\pm}0.9$, respectively. The pleural CRP levels in the patients with a benign effusion($4.15{\pm}4.20mg/d{\ell}$) were significantly higher than those in the malignant effusion($1.43{\pm}1.91mg/d{\ell}$). The VEGF ratio is significantly higher in malignant effusions($4.9{\pm}5.5$) than in benign effusions($2.8{\pm}3.6$). Conclusion : In conclusion, the CRP and VEGF levels in the serum and pleural effusion can distinguish between transudates and exudates. Moreover it can differentiate between benign and malignant pleural effusions.

Medistinal Teratoma with Pleural and Pericardial Effusion Teratoma with Pleural and Pericardial Effusion (늑막 삼출 및 심막 삼출을 동반한 종격동 기형종)

  • Jeon, Yang-Bin;Sohn, Sang-Tae;Chun, Sun-Ho;Chung, Won-Sang;Kim, Young-Hak;Kim, Hyuk;Kang, Jung-Ho;Jee, Haeng-Ok
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.436-439
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    • 1998
  • Mediastinal teratoma is a tumor that thoracic surgeons made an operation much less commonly than other mediastinal masses and most of them are asymptomatic. But very rarely, this tumor invades the pleura and pericardium resulting in pleural effusion, pericardial effusion and cardiac tamponade in severe cases. The mechanism of invasion and perforation of the tumor is unknown and tumor-consisting tissue factor is suspected of a cause. In this case, we operated on a patient whose anterior mediastinal teratoma invaded and perforated pericardium and pleura resulting in pericardial effusion and pleural effusion. The patient was improved and discharged with no problem after resection of mass and involved pericardium.

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Diagnostic Significance of Cholesterol in Pleural Effusion (흉막액내 Cholesterol치 측정의 진단적 의의)

  • Yeo, Dong-Seung;Lee, Dong-Il;Lee, Soo-Keol;Moon, Chang-Hyung;Park, Soon-Kew;Shin, Young-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.248-254
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    • 1992
  • Background: Pleural effusion is one of the most common clinical problems in pulmonology because of high prevalence of pulmonary tuberculosis and bronchogenic carcinoma in Korea. The differential diagnosis between pleural transudate and exudate is very important, but it is very difficult in some cases. Methods: In order to assess the clinical usefulness of cholesterol levels for the differential diagnosis of pleural transudate and exudate, we measured pleural fluid cholesterol levels by enzymatic method in 45 patients who were admitted due to pleural effusion. Results: The mean cholesterol level of transudate was $33.1{\pm}12.9\;mg%$, tuberculous exudate was $97.3{\pm}28.2\;mg%$ and malignant exudate was $97.3{\pm}28.2mg%$. When the cut-off value of pleural cholesterol level was 60 mg%, one case (6.7%) of tuberculous exudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of transudate were classified correctly. When the cut-off value of pleural/serum cholesterol ratio was 0.3, one case (6.7%) of transudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of tuberculous exudate were classified correctly. When the cut-off value of pleural cholesterol level to differentiate pleural transudate from exudate was 60 mg%, sensitivity was 90% and specificity was 100%. When the cut-off value of pleural/serum cholesterol level to differentiate pleural transudate form exuidate was 0.3, sensitivity was 93% and specifiity was 93%. Conclusions: From the above results, it can be concluded that measurement of pleural fluid cholesterol levels is useful for the differential diagnosis between pleural transudate and exudate.

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Diagnostic Significance of Total Lactate Dehydrogenase(LD) and LD Isoenzyme Measurement in the Body Fluids (체강액에서 총 Lactate dehydrogenase 및 Lactate dehydrogenase 동위효소 측정의 진단학적 의의)

  • Jeon, Chang-Ho;Bae, Eun-Kyung;Hong, Seok-Il;Kim, Chung-Sook;Lee, Young-Hyun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.193-199
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    • 1986
  • Body fluid Lactate dehydrogenase and its isoenzyme measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudate in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudate and the activity of LD4 isoenzyme was also increased compared with that of serum(P<0.05). 3. The inflammatory exudate of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity stastistically compared with that of serum and malignant exudate(P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.

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Passive Transfer of Immunity against Clonoychis sinensis by Peritoneal Exudate Cells in Mice (복강삼출세포를 이입받은 마우스에서의 간흡충에 대한 면증응답)

  • Gwon, Tae-Chan;Gang, Jin-Mu;Choe, Dong-Ik
    • Parasites, Hosts and Diseases
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    • v.25 no.1
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    • pp.45-50
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    • 1987
  • This study was undertaken to evaluate the role of peritoneal exudate cells in the transfer of immunity against the liver cuke, Clonorchis sinensis in the inbred BALB/c mice. Ten donor mice were divided into 2 groups. One group consisted of 5 mice was infected orally with 20 metacercariae of C. siitensis, and the other group was injected intraperitoneally with 20 excysted larvae. Thirty days after immunization, the peritoneal exudate cells tore obtained from the donor mice. Twenty recipient mice were divided into 4 equal groups for the purpose of primary immunization. The mice of Group I were injected intraperitoneally with $2{\times}10^6$ peritoneal exudate cells of the donor mice infected orally, those of Group II were injected intraperitoneally with $2{\times}10^6$ peritoneal exudate cells of the donor mice injected intraperitoneally. Those of Group III were injected orally with 20 metacercariae of C. sinensis. The group IV mice served as controls. Four days after the primary iMmunization all recipient mice were challenged orally with 20 metacercariae of C. sinensis, and then killed 30 days after the challenging infection. When the peritoneal exudate cells were injected into the recipient mice, pronounced reduction in eggs per gram of the feces was found in the mice o( Group I and Group II, but no reduction in those of Group III. In the worm burdens of C. sinensis, the number of flukes found in the mice of Group II was only significantly less than those in the control group (IV). In addition the number of plaque forming cells per spleen in the mice of Group II was found larger than those in Group I. It is likely that donor peritoneal exudate cells transferred to the recipients might result in the production of relative immunity.

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Clinical Evaluation of Exudative Pleural Effusion (삼출성 늑막염의 임상적 고찰)

  • Kwon, Kyeong-Soon;Yang, Chang-Heon;Lee, Kwan-Ho;Lee, Yeung-Hyun;Chung, Jae-Chun;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.69-80
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    • 1989
  • From December 1987 to September 1988, clinical evaluation were performed at the Yeungnam University Hospital on 138 patients with exudative pleural effusion comparing with biochemical, bacteriologic, cytologic and pathologic studies. The results were as follows 1. Among thease 138 cases, Incidence of tuberculosis was 57.3%, neoplasm 26.8%. High tendency in malignant pleural effusion occured in elder age. 2. In tuberculosis pleural effusion, the rate of positive smear and culture for acid-fast bacilli in the pleural fluid was 3.7% and positive biopsy for granuloma 75%. 3. In malignant pleural effusion, the rate of positive cytology for cancer cell in the fluid was 42% and positive biopsy 60%. 4. Analysis in tuberculosis and malignancy showed the tendency of high pH, WBC, protein and of low glucose, but there were clinically not significant in differentiating malignant pleural effusion from tuberculous pleural effusion. 5. Among 23 cases in which the pleural tissue findings were chronic nonspecific reaction pathologically, tuberculosis(52.2%), malignancy(26%) and idiopathic(21.8%) eventually in follow up studies.

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Effect of Low Pressure Steam Explosion Treatment on Prevention of Resin Exudation from Wood under High Temperature Surroundings (저압증기폭쇄(低壓蒸氣爆碎)처리가 고온영역(高溫領域)하에서의 목재(木材) 수지삼출(樹脂渗出) 예방에 미치는 영향)

  • Lee, Nam-Ho;Park, Hee-Jun;Li, Chengyuan;Jin, Young-Moon
    • Journal of the Korean Wood Science and Technology
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    • v.32 no.2
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    • pp.9-18
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    • 2004
  • This study was carried out to find the efficient methods for preventing resin exudation from spruce board during high temperature environment service.In the dry-air oven test, in-use temperature related to resin exudation of 110℃ could be obtained by the appropriate kiln drying without any special treatment, and the in-use temperature of the radio-frequency/vacuum (RF/V)-dried boards was about 20℃ higher than that of the conventional kiln-dried boards.In the autoclave test, resin exudation was not found from any board dried in the conventional kiln and in the RF/V kiln after the low pressure steam explosion (SE) treating, while for the control resin exudations were more severe in the autoclave test above 130℃ than in the dry-air oven test. It, therefore, would be suggested that resin exudation during high temperature service condition can be prevented more effectively by super-heated steaming green boards than by high-temperature drying boards with low moisture.