• Title/Summary/Keyword: 자가 면역성 질환

Search Result 155, Processing Time 0.028 seconds

Availability of Cardiac Troponin T as a Marker for Detecting Perioperative Myocardial Damage in Patients with Open Heart Surgery (개심술후 발생한 심근손상에서 진단 표지자로서의 Troponin T의 임상적 유용성)

  • 김태이;정태은;이동협;이정철;한승세
    • Journal of Chest Surgery
    • /
    • v.31 no.1
    • /
    • pp.20-27
    • /
    • 1998
  • It is well known that troponin T(below TnT) is present in the myocardial cells and released during myocardial damage, so it`s very specific enzyme to myocardium. Availability of cardiac specific TnT in assessing perioperatively myocardial damage was evaluated from 34 open heart surgery patients. They consisted of 11 ischemic heart, 13 acquired valvular heart and 10 congenital heart cases. Patients were divided into two groups, group A(patients with myocardial damage) and group B(patients without myocardial damage), according to the symptom of chest pain suspecting angina and the ECG findings of ST segment and T wave changes which show myocardial ischemia and injury. Serum TnT levels were measured by enzyme immunoassay method preoperatively, immediately postoperatively, postoperative day 1, day 2, day 3, and day 7. We observed and analyzed the changes of serum TnT levels in two groups and compared the serum TnT levels with CK-MB levels measured at the same time. In group A, serum TnT levels showed 1.37$\pm$0.26$\mu$g/L, 3.16$\pm$0.66$\mu$g/L, 2.39$\pm$0.74$\mu$g/L, 2.49$\pm$0.76$\mu$g/L, and 1.23$\pm$0.60$\mu$g/L, immediate postoperatively, postoperatively day1, day2, day3, and day7, respectively. It was observed there were significant differences compared with those of group B(0.38$\pm$0.04$\mu$g/L, 0.34$\pm$0.05$\mu$g/L, 0.25$\pm$0.03$\mu$g/L, 0.24$\pm$0.04$\mu$g/L, and 0.11$\pm$0.03$\mu$g/L) during identical periods(P<0.01). Serum CK-MB level in group A significantly elevated to 145.04$\pm$35.08 IU/L on the postoperative day 1 compared to group B(31.28$\pm$5.87 IU/L, P<0.05), However, it stiffly decreased from day 2 and returned to preoperative level at day 3. When serum TnT level more than 1.0$\mu$g/L is thought to reflect myocardial damage, serum TnT had 100% of sensitivity and 87% of specificity in diagnosing the postoperative myocardial damage(p<0.01). I conclusion, serum TnT levels increased significantly at very early stage of myocardial damage and persisted much longer period than CK-MB. This suggests that serum TnT has more advantage and availability in assessing the perioperatively myocardial damage than any other tests.

  • PDF

Hepatic glycogenosis in a patient with poorly controlled type 1 diabetes mellitus (혈당 조절이 불량한 제1형 당뇨병 환자에서 발생한 간의 당원축적증)

  • Jin, Hye-Young;Kang, Dae-Young;Choi, Jin-Ho
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.11
    • /
    • pp.1279-1282
    • /
    • 2009
  • Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

The Processing of Irregular Verbals in Korean : Shown in Aphasics (한국어 불규칙 용언의 형태 정보 : 실어증 환자를 중심으로)

  • 김윤정;김수정;김희정;남기춘
    • Proceedings of the Korean Society for Cognitive Science Conference
    • /
    • 2000.05a
    • /
    • pp.303-308
    • /
    • 2000
  • 용언은 그 어간이 여러 문법소와 결합하면서 자동적 음운 변동을 제외한 형태 변동이 있는가, 없는가에 의해 규칙 용언/불규칙 용언으로 구분할 수 있다. 이러한 불규칙 용언은 심성 어휘집에 어떤 형태로 저장되어 있으며, 규칙 용언과는 어떠한 관계가 있는지, 나아가 실어증 환자의 경우에는 정상인에 비해 어떤 행동장애를 보이며, 장애가 있다면 어느 경로의 손상으로 인한 장애인지를 알아보는 것이 본 연구의 목적이다. 이를 위해 이해성 실어증 환자 한 명과 음어적 실행증 현상을 동반한 경미한 정도의 실어증 환자를 피험자로 하였다. 실험 과제는 단어 채워 넣기 과제(word completion task)를 사용하였다. 즉 주어진 기본형 용언을 검사 문장의 문맥에 맞게 활용하여 채워 넣는 것이다. 실험 결과에 의하면 환자들은 규칙용언의 활용(예. 먹다/먹는)과 불규칙 용언 중 형태를 유지한 채로 활용하는 경우(예. 줍다/줍고)에는 거의 오류가 없었으나, 불규칙 용언이 형태 변화를 겪어야 할 경우(예. 줍다/주워)에는 대부분 오류를 보였다. 또 이때는 기본형(basic form)을 그대로 유지하는 오류 방향성을 관찰할 수 있었다. 이는 그간 문법으로 구분되어 오던 규칙 용언/불규칙 용언의 정보 처리보다는 형태 유지/형태 변화 정보 처리의 영향이 크다는 것을 알 수 있다. 특히 이해성 실어증 환자는 전체적인 오류율이 매우 높았는데, 규칙 용언의 경우에도 오류를 보였다. 이때, 용언의 어간에 해당하는 부분에는 오류가 없고, 뒤에 따르는 내용과의 관계를 파악해야 하는 문법 기능소, 즉 연결 어미에서 오류를 보여 정보의 유지, 통합에 문제가 있다는 기존의 연구와도 일치하는 결과를 나타냈다.환자는 시제 선어말 어미를 선택하는데도 어려움을 보임이 확인되었다. 실험 3 역시 실험 1과 실험2에서와 동일하게 처리의 어려움을 보였다. 이러한 실험 결과들은 국어의 존칭과 시제 선어말 어미가 통사부에서 구(XP)와 결합하여 새로운 구를 형성하는 통사적 접사로 해석할 수 있으며 Grodzinsky의 가설을 지지하는 결과를 보여 줌으로서 국어에서도 AgrP, TP, CP 사이의 통사적 위계가 있음을 뒷받침하는 증거가 된다.전처리한 Group 3에서는 IL-2와 IL-4의 수준이 유의성있게 억제되어 발현되었다 (p < 0.05). 이러한 결과를 통하여 T. denticola에서 추출된 면역억제 단백질이 Th1과 Th2의 cytokine 분비 기능을 억제하는 것으로 확인 되었으며 이 기전이 감염 근관에서 발견되는 T. denticola의 치수 및 치근단 질환에 대한 병인기전과 관련이 있는 것으로 사료된다.을 보였다. 본 실험 결과, $Depulpin^{\circledR}은{\;}Tempcanal^{\circledR}와{\;}Vitapex^{\circledR}$에 비해 높은 세포 독성을 보여주공 있으나, 좀 더 많은 임상적 검증이 필요할 것으로 사료된다.중요한 역할을 하는 것으로 추론할 수 있다.근관벽을 처리하는 것이 필요하다고 사료된다.크기에 의존하며, 또한 이러한 영향은 $(Ti_{1-x}AI_{x})N$ 피막에 존재하는 AI의 함량이 높고, 초기에 증착된 막의 업자 크기가 작을 수록 클 것으로 여겨진다. 그리고 환경의 의미의 차이에 따라 경관의 미학적 평가가 달라진 것으로 나타났다.corner$적 의도에 의한 경관구성의 일면을 확인

  • PDF

Effects of Anti-thyroglobulin Antibody on the Measurement of Thyroglobulin : Differences Between Immunoradiometric Assay Kits Available (면역방사계수법을 이용한 Thyroglobulin 측정시 항 Thyroglobulin 항체의 존재가 미치는 영향: Thyroglobulin 측정 키트에 따른 차이)

  • Ahn, Byeong-Cheol;Seo, Ji-Hyeong;Bae, Jin-Ho;Jeong, Shin-Young;Yoo, Jeong-Soo;Jung, Jin-Hyang;Park, Ho-Yong;Kim, Jung-Guk;Ha, Sung-Woo;Sohn, Jin-Ho;Lee, In-Kyu;Lee, Jae-Tae;Kim, Bo-Wan
    • The Korean Journal of Nuclear Medicine
    • /
    • v.39 no.4
    • /
    • pp.252-256
    • /
    • 2005
  • Purpose: Thyroglobulin (Tg) is a valuable and sensitive tool as a marker for diagnosis and follow-up for several thyroid disorders, especially, in the follow-up of patients with differentiated thyroid cancer (DTC). Often, clinical decisions rely entirely on the serum Tg concentration. But the Tg assay is one of the most challenging laboratory measurements to perform accurately owing to antithyroglobulin antibody (Anti-Tg). In this study, we have compared the degree of Anti-Tg effects on the measurement of Tg between availale Tg measuring kits. Materials and Methods: Measurement of Tg levels for standard Tg solution was performed with two different kits commercially available (A/B kits) using immunoradiometric assay technique either with absence or presence of three different concentrations of Anti-Tg. Measurement of Tg for patient's serum was also performed with the same kits. Patient's serum samples were prepared with mixtures of a serum containing high Tg levels and a serum containg high Anti-Tg concentrations. Results: In the measurements of standard Tg solution, presence of Anti-Tg resulted in falsely lower Tg level by both A and B kits. Degree of Tg underestimation by h kit was more prominent than B kit. The degree of underestimation by B kit was trivial therefore clinically insignificant, but statistically significant. Addition of Anti-Tg to patient serum resulted in falsely lower Tg levels with only A kit. Conclusion: Tg level could be underestimated in the presence of anti-Tg. Anti-Tg effect on Tg measurement was variable according to assay kit used. Therefore, accuracy test must be performed for individual Tg-assay kit.

Analysis of Acute Kidney Injury in Pediatric Patients with Stem Cell Transplantation (소아에서 조혈모세포이식 후 급성 신질환의 분석)

  • Kim, Sae-Yoon;Choi, Jung-Youn;Ha, Jeong-Ok;Park, Yong-Hoon
    • Childhood Kidney Diseases
    • /
    • v.13 no.2
    • /
    • pp.130-137
    • /
    • 2009
  • Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.

Studies on the Seroimmunodiagnosis of Parasitic Diseases (기생충질환(寄生蟲疾患)의 면역혈청학적(免疫血淸學的) 진단(診斷)에 관한 연구(硏究))

  • Rim, Han-Jong;Lee, Joon-Sang;Joo, Kyoung-Hwan;Eam, Kee-Seon;Chung, Myung-Sook
    • Journal of agricultural medicine and community health
    • /
    • v.13 no.1
    • /
    • pp.41-59
    • /
    • 1988
  • In many of the helminthic infections, diagnosis is accomplished by the demonstration of the eggs or, occasionally the adult worms or their parts. Diagnosis can be made by the identification of larval stage obtained from stool or surgically extracted materials too. However some kinds of parasitic disease can not be diagnosed by above mentioned procedure alone. Brain cysticercosis, ectopic paragonimiasis, Capillaria hepatica infection in liver is a good example. In such a case, immunologic method would be helpful for the decision of physician. In this paper, immunologic tools such as indirect hemagglutination test, indirect fluorescent antibody test, circumoval precipitation test, ELISA, western blot were applied for the diagnosis of Clonorchis sinenisis, Cysticercosis and C. hepatica a infection and their efficacy was evaluated. The results obtained were as follows ; 1) In the diagnosis of clonorchiasis, ELISA revealed sensitiveity of 83.3%, but cross reaction against antibody of Paragonimus westermani and Taenia species were observed. For the identification of cross reaction and species specific band of Ag-Ab reaction, western blot was applied. 59Kd relative molecular weight and 21Kd band were identified as a Clonorchis sinensis specific band. OD values of ELISA performed with sera of 18 months after praziquantel treatment decreased to half level compared to that of before treatment. Negative conversion rate of ELISA after 18 months of treatment was 60%. 2) In the diagnosis of cysticercosis, IFAT disclosed 95.8%(23/24) of sensitivity and reaction was most strongly occurred in inner membrane. ELISA revealed 90.0% (36/40) of sensitivity, but cross reaction was observed in both technique. In western blot, 91, 63 and 21Kd Mw bands were identified as a strongly positive band. Among them 63Kd band showed positive reaction against almost all sera of cysticercosis patient. 3) Circumoval precipitation, ELISA, IFAT, showed 85.0% of sensitivity in the diagnosis of C. hepatica infection in rat. The antigenic localities were inner membrane of sectioned egg antigen on the prectipitates around the mucoid plugs which were induced by circumoval precipitation reaction. Sera from rats infected with 2000eggs were collected periodically to observe the changing patterns of antibody titers by IFAT and ELISA, which showed that high titers were detected at weeks 3 and 5, then gradually declined through weeks 9until to negatively converted at weeks 13.

  • PDF

Circulating Cytokine Levels and Changes During the Treatment in Patients with Active Tuberculosis in Korea (결핵 환자의 치료경과 중 혈청 내 Cytokine 분비와 변화)

  • Ryu, Yon-Ju;Kim, Yun-Jung;Kwon, Jung-Mi;Na, Youn-Ju;Jung, Yu-Jin;Seoh, Ju Young;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
    • /
    • v.55 no.2
    • /
    • pp.140-153
    • /
    • 2003
  • Background : The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. Method : Serum interleukin-1 beta(IL-$1{\beta}$), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-${\alpha}$), interferon-gamma(IFN-${\gamma}$) and transforming growth factor-beta(TGF-${\beta}$) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-${\alpha}$, IFN-${\gamma}$ and TGF-${\beta}$ levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. Results : 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-$1{\beta}$, IL-6(p<0.05), TNF-${\alpha}$, and IFN-${\gamma}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-2, Il-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-${\alpha}$ were elevated and TGF-${\beta}$ was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-${\gamma}$ level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 AND TNF-${\alpha}$ and between IL-12, Il-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-${\gamma}$ was significantly decreased(p<0.05). Conclusion : These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.

Improving effect of psoriasis dermatitis by yakuchinone A in the TNF-α stimulated HaCaT cells (TNF-α 자극에 활성화된 HaCaT 세포주에서 Yakuchinone-A에 의한 건선 피부염 개선 효과)

  • Kim, Min Young;Hwang, Hyung Seo
    • Journal of Applied Biological Chemistry
    • /
    • v.63 no.1
    • /
    • pp.95-101
    • /
    • 2020
  • Psoriasis is an autoimmune skin disease that is accompanied by hyper proliferation of the epidermis, erythema of various sizes, and ulceration. However, the mechanism of the development of psoriasis dermatitis is unclear. Recently, it is known that the inflammatory cytokines and Th17 cells as well as chemokine (CC motif) ligand 20 (CCL20) are involved in the process of keratinocytes hyper-differentiation, which is common in psoriasis dermatitis. Therefore, we studied the effects of yakuchinone-A, an active ingredient of Alpinia oxyphylla Miquel known for its anti-inflammatory activity, to improve psoriasis dermatitis. First, cytotoxicity of yakuchinone-A was observed in cell counting kit-8 assay and not observed in 10 ㎍/mL concentration on the human keratinocyte HaCaT cells. Yakuchinone-A in the presence of tumor necrosis factor-alpha (TNF-α) on HaCaT cells inhibited mRNA expression of IL-6, IL-8, and TNF-α by up to 61.4±7.5, 23.6±1.5, 46.0±4.8%. CCL20, a chemokine that attracts immune cells such Th17 cells to the inflammation location, was also significantly suppressed by yakuchinone-A. In addition, IκB and STAT3 phosphorylation involved in the CCL20 expression was inhibited by yakuchinone-A in a concentration-dependent manner up to the level of 79.1±5.0, 80.8±2.3%. Furthermore, yakuchinone-A downregulated CCL20 mRNA expression level on IL-17A-activated HaCaT cells as a concentration-dependent manner. Based on these results, yakuchinone-A is expected to be developed as a new material for improving psoriasis dermatitis in the future.

Expression of the Ki-67 antigen Using Monoclonal Antibody MIB-1 in Children with Glomerulonephritis (사구체신염에서 MIB-1을 이용한 Ki-67 항원의 발현)

  • Chung, Woo-Yeong;Song, Min-Seop;Kim, Young-Ju
    • Childhood Kidney Diseases
    • /
    • v.2 no.2
    • /
    • pp.104-109
    • /
    • 1998
  • Purpose : The proliferative nuclear antigen Ki-67, present in all cell cycle phases except G0, is a useful marker for the detection of proliferative cells in vivo. MIB I has been found to recognize an antigen in formalin-fixed and wax-embedded material. The aim of this study was to assess the efficacy of MIB-1 expression as a marker of representing the status of mesangial cell proliferation in renal tissues. Methods : Immunohistochemical staining for Ki-67 Ag using monoclonal antibody MIB-1 (Immunotech,505) were performed in 41 renal tissuses which were obtained by percutaneous renal biopsy done between January 1994 and December 1996. Results : In both glomeruli and renal tubules, MIB-1 expression was observed only in 2 of 18 ($11.1\%$) cases of IgA nephropathy, in 2 of the 4 ($50\%$) cases of mebranoproliferative glomerulonephritis, in 4 of the 5 ($80\%$) cases of poststreptococcal glomerulonephritis. But MIB-1 expression was not detected in all cases of minimal lesion and membranous nephropathy. Renal tubules In another 7 cases of IgA nephropathy were MIB-1 positive. Conclusion : MIB-1 expression in renal tissues may relate to the cell proliferation in glomeruli and renal tubules. But the efficacy of MIB-1 expression as a marker of mesangial cell proliferation may reveal a limited value because of it's lower positive rate in IgA nephropathy.

  • PDF

Clinical Manifestations of Norovirus Infection in Korean Pediatric Cancer Patients (한국 소아 암환자에서 노로바이러스 감염증의 임상 양상)

  • Choi, Hyunshin;Choi, Young Bae;Hwang, Ji-Young;Cheon, Doo-Sung;Jeong, Hye Sook;Choe, Yon Ho;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
    • /
    • v.18 no.1
    • /
    • pp.40-47
    • /
    • 2011
  • Purpose : Norovirus infection, a common cause of community-acquired gastroenteritis, can also lead to severe illness in immunocompromised patients. We investigated clinical manifestations of norovirus infection in pediatric cancer patients. Methods : Stool specimens were collected from pediatric patients with gastrointestinal symptoms between November 2008 and September 2009 at Samsung Medical Center, Seoul, Korea. Norovirus infection was identified by reverse-transcription polymerase chain reaction (RT-PCR). A retrospective chart review was performed in pediatric cancer patients who were diagnosed with norovirus infection. Results : Ten patients were diagnosed with norovirus infection by RT-PCR in stool samples. The median age was 0.83 years (range 0.25-5.5 years) and the male to female ratio was 1.5:1 (6 males and 4 females). Underlying diseases were hematologic malignancies (4/10, 40%), neuroblastoma (4/10, 40%), and brain tumors (2/10, 20%). Three patients were infected before hematopoietic cell transplantation (HCT) and four patients after HCT. All patients had diarrhea (10/10, 100%), with a median frequency of diarrhea of 8.5 times/day (range 4-22 times/day). Median virus shedding duration was 72.5 days (range 19-299 days). Four patients with pneumatosis intestinalis were conservatively treated with bowel rest and total parenteral nutrition. One patient with severe diarrhea and bloody stool had concomitant chronic gut graft-versus-host disease (GVHD). Norovirus infection-related mortality was not observed. Conclusion : Norovirus infection can cause significant clinical manifestations with prolonged viral shedding in immunocompromised patients. Norovirus should be considered in pediatric cancer patients with severe gastrointestinal symptoms.