Kim, Kyung Won;Lee, Byung Chul;Lee, Kyung Eun;Kim, Eun Soo;Song, Tae Won;Park, Mi Yeoun;Sohn, Myung Hyun;Kim, Kyu-Earn
Clinical and Experimental Pediatrics
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v.49
no.9
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pp.977-982
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2006
Purpose : There has been an increasing amount of literature concerning the association between Mycoplasma pneumoniae and asthma pathogenesis. Interleukin(IL)-6 stimulates the differentiation of monocytes, and can promote Th2 differentiation and simultaneously inhibit Th1 polarization. IL-8 is a potent chemoattractant and, it has been suggested, has a role in asthma pathogenesis. Nitric oxide (NO) synthesized by airway epithelium may be important in the regulation of airway inflammation and reactivity. Vascular endothelial growth factor(VEGF) has been reported to be a mediator of airway remodeling in asthma. We investigated the effects of M. pneumoniae on IL-6, IL-8, NO and VEGF production in human respiratory epithelial cells. Methods : A549 cells were cultured and inoculated with M. pneumoniae at a dose of 20 cfu/cell. After infection, the presence of M. pneumoniae in epithelial cell cultures was monitored by immunofluorescence and confirmed by polymerase chain reaction(PCR) detection. IL-6, IL-8 and VEGF were determined by an enzyme-linked immunosorbent assay and reverse transcriptase-polymerase chain reaction. NO was measured using the standard Griess reaction. Results : In A549 cells, M. pneumoniaeinduced IL-6, IL-8, NO and VEGF release in time-dependent manners. It also induced mRNA expression of IL-6, IL-8 and VEGF in similar manners. Conclusion : These observations suggest that M. pneumoniae might have a role in the pathogenesis of the allergic inflammation of bronchial asthma.
Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.
The respiratory tract is an essential part of the respiratory system involved in the process of respiration. However, if stenosis occurs, it interferes with breathing and can even lead to death. Asthma is a typical example of a reversible cause of airway narrowing, and the number of patients suffering from acute exacerbation is steadily increasing. Therefore, it is important to detect airway narrowing early and prevent the patient's condition from worsening. Optical coherence tomography (OCT), which has high resolution, is suitable for observing the microstructure of tissues. In this study we developed an endoscopic OCT system. We combined a 1300-nm OCT system with a servo motor, which can rotate at a high speed. A catheter was pulled back using a linear stage while imaging with 360° rotation by the motor. The motor was selected considering various requirements, such as torque, rotational speed, and gear ratio of pulleys. An ex vivo rabbit tracheal model was used as a sample, and the sample and catheter were immobilized by acrylic structures. The OCT images provided information about the structures of the mucosa and submucosa. The difference between normal and stenosed parts in the trachea was confirmed by OCT. Furthermore, through a three-dimensional (3-D) reconstruction process, it was possible to identify and diagnose the stenosis in the 3-D image of the airway, as well as the cross-sectional image. This study would be useful not only for diagnosing airway stenosis, but also for realizing 3-D imaging.
Purpose : Human metapneumovirus (hMPV) was recently discovered in children with respiratory tract infection. The aim of this study was to determine the frequency and the clinical manifestation of hMPV infection in Korean children. Methods : From January to December, 2005, we collected throat swabs from 1,098 children who were hospitalized for acute respiratory illness at the Department of Pediatrics, Kwang-Ju Christian Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. Results : We detected hMPV in 25 (2.2%) of the 1,098 hospitalized children. The mean age of the hMPV infected children was 2.3 years, and 84% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (60%) and bronchiolitis (20 %). The clinical manifestations included cough, fever, coryza, rale, wheezing and injected throats. Peribronchial infiltration and consolidation were the common chest X-ray findings. Four (16%) of 25 patients with hMPV infection had exacerbation of asthma. Coinfection with other respiratory viruses was found in six children (24%). Conclusion : hMPV is the cause of an important proportion of acute respiratory tract infection in Korean children. Additional studies are required to define the epidemiology and the extent of disease caused by hMPV and to determine future development of this illness in Korean children.
Purpose : This study was performed to investigate the epidemiologic and clinical features of 13 respiratory viruses in children with acute lower respiratory tract infections (ALRIs). Methods : Nasopharyngeal aspirates were prospectively obtained from 325 children aged 15 years or less from May 2008 to April 2009 and were tested for the presence of 13 respiratory viruses by multiplex real-time-polymerase chain reaction (RT-PCR). Results : Viruses were identified in 270 children (83.1%). Co-infections with ${\geq}2$ viruses were observed in 71 patients (26.3 %). Respiratory syncytial virus (RSV) was the most common virus detected (33.2%), followed by human rhinovirus (hRV) (19.1%), influenza virus (Flu A) (16.9%), human metapneumovirus (hMPV) (15.4%), parainfluenza viruses (PIVs) (8.3%), human bocavirus (hBoV) (8.0%), adenovirus (ADV) (5.8%), and human coronavirus (hCoV) (2.2%). Clinical diagnoses of viral ALRIs were bronchiolitis (37.5%), pneumonia (34.5%), asthma exacerbation (20.9%), and croup (7.1%). Clinical diagnoses of viral bronchiolitis and pneumonia were frequently demonstrated in patients who tested positive for RSV, hRV, hMPV, or Flu A. Flu A and hRV were most commonly identified in children older than 3 years and were the 2 leading causes of asthma exacerbation. hRV C was detected in 14 (4.3%) children, who were significantly older than those infected with hRV A ($mean{\pm}SD$, $4.1{\pm}3.5$ years vs. $1.7{\pm}2.3$ years; P =0.009). hBoV was usually detected in young children ($2.3{\pm}3.4$ years) with bronchiolitis and pneumonia. Conclusion : This study described the features of ALRI associated with 13 respiratory viruses in Korean children. Additional investigations are required to define the roles of newly identified viruses in children with ALRIs.
Background: Inhaled corticosteroids (ICSs) are the most essential medication for asthma control. Many reports suggest that the usage of ICSs improves not only the control of asthma symptoms but also prevents exacerbation. We investigated whether increases in ICS prescriptions are associated with decreases in asthma exacerbation in the clinical practice setting. Methods: We retrospectively analyzed the database of adult asthma patients who had visited a tertiary referral hospital, the Asan Medical Center between January 2000 and December 2009. The number of emergency department (ED) visits, admissions, intensive care unit (ICU) care, deaths, and ICS prescriptions were analyzed to evaluate the time trend of asthma exacerbation as a function of the ICS prescription rate during the ten years. Results: The numbers of ED visits, admissions, and episodes of ICU care decreased during the ten years (p<0.001, p=0.033, p=0.001, respectively) while the number of ICS prescriptions increased (p<0.001). We found a correlation between the number of ICS prescriptions and the number of ED visits, admissions, or ICU care. For these outcomes, the correlation coefficients were r=-0.952, p<0.001; r=-0.673, p=0.033; r=-0.948, p<0.001, respectively. Conclusion: The number of ICS prescriptions increased during the past ten years while the number of asthma exacerbations decreased. Our results also showed a negative correlation between the ICS prescription rate and asthma exacerbation in the clinical practice setting. In other words, an increase in ICS prescription may be a major cause of a decrease in asthma exacerbations.
Exercise is the strongest stress to which the body is ever exposed. The body responds to this stress through a set of physiological changes in its metabolic, hormonal, and immunological systems. In this study, responses of the immune system to the long-term aerobic and anaerobic exercises have been investigated. Regular moderate exercise is associated with a reduced incidence of infection compared with a sedentary groups. Aerobic training increases the heart rate and enhances the body's intake of oxygen long enough to benefit the condition of the body. In recent years, the importance of exercise in everyday life has been rapidly increasing. Moderate exercise appears to stimulate the immune system. And also, Exercise elicits an increase in the numbers of circulating lymphocytes and lymphocyte subsets (including NK cells) which is followed by a decrease in the numbers of cells during recovery from exercise. However, prolonged bouts of strenuous exercise cause a temporary depression of various aspects of immune functions (e.g. lymphocyte proliferation, monocyte antigen presentation, open window periods, exercise induced asthma, exercise induced anaphylaxis) that usually lasts 2-24 hr after exercise depending on the intensity and duration of the exercise bout. Exercise-induced bronchoconstriction (EIB) was defined as a decrease of at least 15% in pre exercise forced expiratory volume in one second at any time point after exercise. This includes elevation of cortisol and cathecholamines in plasma. On the other hand, highly trained athletes exhibit a chronic mild hypercortisolism at baseline that maybe an adaptive change to chronic exercise. And, Consuming carbohydrate during prolonged strenuous exercise attenuates rises in stress hormones and appears to limit the degree of exercise-induced immune depression. Recent evidence suggests that antioxidant vitamin supplementation may also reduce exercise stress and impairment of leukocyte functions.
Kim, Ye-Jin;Kang, Se-Chan;NamKoong, Seung;Choung, Myoung-Gun;Sohn, Eun-Hwa
Korean Journal of Plant Resources
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v.25
no.1
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pp.1-6
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2012
Atopic dermatitis is a chronic, allergic inflammatory skin disease that is accompanied by pruritic chronic eczema and markedly increased levels of inflammatory cells in endothelial cells. Arctium lappa L. is a popular edible vegetable cultivated in Asia. This study examined the effect of butanol extracts of A. lappa (ALBE) on the expression of adhesion molecule, ICAM-1 and the production of NO-iNOS induced by TNF-alpha in A549 endothelial cells. We also studied the effects of ALBE on the proliferation of keratinocyte. We observed significant inhibition of NO-iNOS production in dose-dependant manners and ALBE at $100\;{\mu}g$/mL suppressed the expression of ICAM-1 in TNF-${\alpha}$-induced A549 cells. In addition, the treatment of ALBE for 48 hrs increased the proliferation of HaCaT keratinocytes. These results support that ALBE has an anti-inflammatory effects for the treatment of atopic dermatitis.
Background: We present a case of asthma-chronic obstructive pulmonary disease syndrome (ACOS), which has features of both asthma and chronic obstructive pulmonary disease, in a 63-year-old man treated with Korean medicine. Methods: For four weeks of hospitalization, the patient received acupuncture, Guarujisil-tang decoction, and herbal steam therapy. The main symptoms of ACOS, which are dyspnea, chest discomfort, and throat discomfort, were treated with acupuncture. Guarujisil-tang decoction and herbal steam therapy were administered to relieve cough and smooth the expectoration of mucus. Results: By the end of hospitalization, no significant change was observed in lung function. However, the patient's subjective symptoms, including dyspnea, chest discomfort, sore throat, and sweating, were improved. The patient's objective sign of opaque yellow mucus changed to clear mucus after the treatment. His scores for the quality of life questionnaire for adult Korean asthmatics and the modified Borg scale also showed improvement from 42 to 62 and from 3 to 1, respectively. Conclusions: Although we reported only one ACOS case, this study is significant in that case reports of ACOS treated with Korean medicine are rare. Further study is needed to confirm the effectiveness of Korean medicine in patients with ACOS.
Kim, Jung Ho;Jeon, Hyo Keun;Kim, Mi Kyeong;Kyung, Sun Yong;An, Chang Hyeok;Lee, Sang Pyo;Park, Jung Woong;Jeong, Sung Hwan
Tuberculosis and Respiratory Diseases
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v.60
no.6
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pp.663-672
/
2006
Background: $PM_{10}$(Particulate matter with a diameter ($<10{\mu}m$), which is characterized by different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also produce unique particulate matter in affected areas. This study investigated the cytokine produced by A549 epithelial cells exposed to particles collected during both the Asian dust pfenomenon and ambient air particles in a non-dusty period. Method: Air samples were collected using a high volume air sampler(Sibata Model HV500F) with an air flow at $500{\ell}/min$ for at least 6 hours. The cytokine messenger RNA(mRNA) was measured using a reverse transcriptase polymerase chain reaction(RT-PCR). The A549 cells were exposed to 10 to $500{\mu}g/m{\ell}$ of a suspension containing $PM_{10}$ for 24 hours. Each was compared with those in the non-exposed control cells. Result: The mRNA levels of interleukin(IL)-$1{\alpha}$, $IL-I{\beta}$, IL-8, and the granulocyte macrophage colony stimulating factor(GM-CSF) increased after veing exposed to $PM_{10}$ in the ambient air particles, compared with those in the non-exposed control cells. The increase in $IL-1{\alpha}$ and IL-8 were dose dependent at a $PM_{10}$ concentration between $100{\mu}g/m{\ell}$ and $500{\mu}g/m{\ell}$. The mRNA level of IL-8 in the A549 epithelial cells was higher during the in the Asian dust period($500{\mu}g/m{\ell}$) than during the non dust period. Conclusion: A549 cells exposed to the $PM_{10}$ collected during the Asian dust period produce more proinflammatory cytokine than during non-dusty period. This cytokine enhances the local inflammatory response in the airways and can also contribute to the systemic component of this inflammatory process.
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