• Title/Summary/Keyword: 2003

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The Comparision of Right Anterolateral Thoracotomy and Median Sternotomy in the Atrial Septal Defect Repair. (심방중격결손증 수술에서 우전측부개흉술과 정중흉골절개술의 비교)

  • Kim, Hyuck;Kim, Sang-Heon;Kim, Young-Hak;Chung, Won-Sang;Kang, Jung-Ho;Lee, Chul-Beom;Jee, Heng-Ok;Kim, Nam-Soo;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.1-6
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    • 2003
  • Currently, atrial septal defect repair has been considered low risk operation duo to the development of open heart surgery Not only the operation itself, but also the cosmetic aspect is now focused. Though many methods exist as minimally invasive cardiac surgery in atrial septal defect repair, some surgeons advocate that right anterolateral thoracotomy is better than the others in the cosmetic aspect and we compared right anterolateral thoracotomy with median sternotomy. Material and Method: From January 1999 to August 2002, 43 patient underwent atrial septal defect repair by one operator, including 15 patients through right anterolateral thoracotomy(group A) and 15 patients through median sternotomy(group B) in Hanyang university Hospital. The data were randomized and operation outcomes were analyzed between these two groups. Result: The mean weight of group A was 38.77$\pm$15.57kg and 38.21$\pm$21.82kg in group B. In group A, mean operation (OP) time was 197.6$\pm$61.40min, mean cardiopulmonary bypass(CPB) time was 48.66$\pm$13.02min and mean fibrillation time or aortic cross clamp(ACC) time was 30$\pm$11.64min. In group B, mean OP time was 212.33$\pm$31.95min, mean CPB time was 55$\pm$12.10min, and mean fibrillation or ACC time was 29.33$\pm$9.04min. There was no significant differences in these two groups. In group A, mean mechanical ventilation time was 3.78$\pm$0.78 hours, mean postoperative ICU stay was 1.2$\pm$0.47 days and mean postoperative hospital stay was 10.20 41.08 days. In group B, mean mechanical ventilation time was 5.95$\pm$3.73 hours, mean post operative ICU stay was 1.41$\pm$0.61 days, and mean postoperative hospital stay was 12.20$\pm$3.55 days. There was no any significant difference in two groups. Group A had significantly lower mean thoracic and pleuropericardial drainage than group B (175.33$\pm$90.54cc vs 352.33$\pm$239.43cc, p<0.05). Complication was seen in one case in group B, transient 2nd degree A-V block. Conclusion: Right anterolateral thoracotomy was better than median sternotomy not only in cosmetic aspect but also in postoperative thoracic and pleuropericardial drainage, using the same instrument(p.0.05). But, right anterolateral thoracotomy was more technically difficult due to narrow operative field and we should be careful of aortic cannulation.

The Evaluation of Factors Which Influence Binding Efficiency of Modified in Vivo Erythrocyte Labeling Technique (변형 체내 표지법에 의한 적혈구 표지시 결합효율에 영향을 미치는 인자 평가)

  • Seo, Han-Kyung;Kim, Min-Woo;Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.300-305
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    • 2004
  • Purpose: We underwent this study to evaluate the factors which influence labeling efficiency when modified in vivo erythrocyte labeling technique was used. Materials and methods: Thirty healthy volunteers (M:F=19:11, age:$25{\pm}2$ yrs) were enrolled in this study. Totally, two hundred ten samples were obtained from them. The 1 mg of stannous pyrophosphate was injected intravenously at the beginning of labeling. After suitable tinning time (5 min, 20 min, 35 min) passed by, blood (5 mL, 3 mL or 1 mL) was withdrawn into 10 mL syringe previously containing Tc-99m (740 MBq) and anticoagulant (heparin, ACD or CPDA) through 19-gauged scalp needle. The generator ingrowth time of Tc-99m was within 24 hrs in each case. The blood samples were placed on rotating invertor during incubation (10 min, 25 min, 40 min) but some of them were not. Immediately after the conclusion of incubation, the labeled blood specimens to analyze were centrifuged. and then %Unbound Tc-99m was calculated. Statical analysis was used paired T-test and one way ANOVA with SPSS 10.0. Results: The binding efficiency at 1 mL of blood volume was $73{\pm}32%,\;91{\pm}10%$ at 3 mL and $96{\pm}7%$ at 5 mL (p<0.01). The binding efficiency at 5 min of tinning time was $45{\pm}23%,\;98{\pm}6%$, at 20 min and $97{\pm}8%$ at 35 min (p<0.001). The binding efficiency at 10 min of incubation time was $96{\pm}7%,\;95{\pm}12%$ at 25 min and $98{\pm}3%$ at 40 min (p>0.05). The binding efficiency in case of using rotating invertor was $96{\pm}7%$ and the binding efficiency in case of not using it was $87{\pm}18%$ (p>0.05). There was no significant difference between them. In binding efficiency according to kinds of anticoagulants, ACD was $98{\pm}4%$, CPDA was $97{\pm}6%$ and heparin was $89{\pm}20%$ (p<0.001). Conclusion: When modified in vivo erythrocyte labeling technique is used with Tc-99m, the methods to obtain the highest labeling efficiency are as follow. The withdrawing blood volume should be over 3 mL, tinning time should be kept between 20 min and 35 min, and incubation time should be kept between 10 min and 40 min. ACD or CPDA have to be used as a anticoagulant except heparin and the blood samples should be placed on rotating invertor during incubation.

Quality Properties of Chonggak Kimchi Fermented at different Combination of Temperature and Time (발효 온도와 시간 조합을 달리한 총각김치의 품질 특성)

  • Kang, Jeong-Hwa;Kang, Sun-Hee;Ahn, Eun-Sook;Chung, Hee-Jong
    • Journal of the Korean Society of Food Culture
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    • v.18 no.6
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    • pp.551-561
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    • 2003
  • To determine the conditions of the fermentation and storage for Chonggak kimchi in kimchi refrigerator, prepared Chonggak kimchi took into kimchi refrigerators which were controlled at four different modes of the fermented temperature and time, and fermented and kept for 16 weeks. The pH in Chonggak kimchi fermented at $20^{\circ}C$ for 24 hours/stored at $-1^{\circ}C$ dropped greater than all of kimchi fermented at other combinations, and the changes of pH at any combinations were not greater than those in Baechu kimchi, because pH in Chonggak kimchi did not dropped below 4.5. Acidities in Chonggak kimchi were greatly increased at higher temperature. The acidity in Chonggak kimchi during the first week of fermentation was lower than that in Baechu kimchi and then it was rather higher because of the addition of waxy rice paste. In texture, puncture force of Chonggak kimchi was decreased slowly until 8 weeks of fermentation and then did not changed much and the highest values showed in Chonggak kimchi stored directly at $-1^{\circ}C$ without any fermentation. In sensory evaluation, the scores for the carbonated flavor and the sourness were the highest in Chonggak kimchi fermented at $20^{\circ}C$ for 24 hours/stored at $-1^{\circ}C$, but the lowest in Chonggak kimchi stored directly at $-1^{\circ}C$ without any fermentation because of some undesirable flavors. The lowest hardness showed in Chonggak kimchi fermented at highest temperature and the best hardness was in Chonggak kimchi fermented at $5^{\circ}C$ for 3 days or 6 days/stored at $-1^{\circ}C$. The appearance was the best in Chonggak kimchi fermented at $20^{\circ}C$ for 24 hours/stored at $-1^{\circ}C$ and the worst was in Chonggak kimchi stored directly at $-1^{\circ}C$ without any fermentation. The overall acceptability of Chonggak kimchi fermented at $20^{\circ}C$ for 24 hours/stored at $-1^{\circ}C$ was good after 4 weeks of fermentation, but in Chonggak kimchi fermented at $5^{\circ}C$ for 3 days or 6 days/stored at $-1^{\circ}C$ it was good after 6 weeks. Total microbial counts in most of Chonggak kimchi were reached to a maximum number within 7 days, and then decreased similarly at all modes. Leuconostoc spp. and Lactobacillus spp. increased to maximum number of $1.48{\times}10^9\;and\;5.62{\times}10^9$, respectively, in Chonggak kimchi fermented for 7 days. Yeast counts showed a increasing trend not depends on fermenting temperature and they were lower counts than those in Baechu kimchi. Waxy rice paste which added to Chonggak kimchi resulted in increasement of glucose as a carbon source and stimulated to reproduce the microbes in Chonggak kimchi.

Effect of $PGF_2a+PGF_2a+CIDR$ Program on Estrous Response in Holstein with Varying BCS in Early Postpartum (분만후 젖소에 있어서 $PGF_2a+PGF_2a+CIDR$ Program 적용에 의한 발정유기시 BCS의 영향)

  • Baek K. S.;Park S. J.;Park S. B.;Kim H. S.;Lee H. J.;Lee W. S.;Jeon B. S.;Ahn B. S.;Kim J. G.;Jeong G. Y.;Son J. K.
    • Journal of Embryo Transfer
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    • v.20 no.3
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    • pp.279-287
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    • 2005
  • This study was carried out to investigate resumption of ovarian cyclicity and effect of BCS on estrous response by treatment of $PGF_2a+PGF_2a+CIDR$ program on day 40 postpartum in lactating dairy cow. First $PGF_2a$ was given on day 40 postpartum, second $PGF_2a$ was given 14 days apart to cows not-responded to 1st $PGF_2a$ and then CIDR was inserted for 7 days after 5 days in cows not-responded to 2nd $PGF_2a$. The $42.9\%$ of the cows showed more than 1 ng/mL milk progesterone concentration within 10 to 30 days postpartum. About $19\%$ of the cows exhibited more than 1 ng/mL milk pro-gesterone concentration between 31 to 50 days postpartum. However $38.1\%$ of the cows have not shown more than 1 ng/mL milk progesterone up to 50 days postpartum. Estrous response to the treatment of 1 st $PGF_2a$ and 2nd $PGF_2a$ was $47.5\%$ and $52.4\%$, respectively. Combination of 1 st $PGF_2a$ and 2nd $PGF_2a$ was $75\%$ and combination of 1st $PGF_2a$+2nd $PGF_2a$+CIDR was $87.5\%$. Estrous response to the treatment of $PGF_2a+PGF_2a$ program was $61.5\%$ in cows with less than 2.50 BCS and $81.5\%$ in cows with 2.75${\~}$3.50 BCS. Estrous response to the treatment of CIDR was $40\%$ in cows with less than 2.50 BCS and $80\%$ in cows with 2.75${\~}$3.50 BCS. Estrous response to the treatment of PPC on day 40 postpartum was $76.9\%$ in cows with less than 2.50 BCS and $96.3\%$ in cows with 2.75${\~}$3.50 BCS.

Effects of Strains and Enviromental Factors on Economic Traits in Korean Native Chicken (한국재래닭의 경제 형질에 미치는 계통 및 환경의 효과)

  • Sang, Byeong-Don;Choi, Cheol-Hwan;Kim, Hak-Gyu;Kim, Si-Dong;Jang, Byeong-Gwi;Na, Jae-Cheon;Yu, Dong-Jo;Lee, Sang-Jin;;Lee, Jun-Heon
    • Korean Journal of Poultry Science
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    • v.30 no.4
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    • pp.235-244
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    • 2003
  • This study was carried out to estimate the effects of strain and generation on the major production performances of Korean native chicken. The data were collected from 11,583 birds of the 7 generations over the year 1995 through 2001 at National Livestock Research Institute, Korea. Results obtained were summarized as follows: The body weights at 150 and 270 days of age were 1,557.7 and 1880.7, 1,471.7 and 1,738.2, 1,393.5 and 1,694.9, 1,591.2 and 1,910.0, 1,545.6 and 1,763.6g in Red Brown, Yellow Brown, Gray Brown, Black, and White strains, respectively. The Coefficient of Variations (CVs) of the body weights at 150 and 270 days of age were 9.65~13.79% and 13.29~15.16%. The ages at first egg were 150.0, 148.3, 149.5, 152,8 and 147.7 days in Red Brown, Yellow Brown, Gray Brown, Black and White strains, respectively and the CVs were between 9.33 and 10.11%. The egg weights at the first egg and 270 days of age were 33.2 and 50.8, 32.2 and 49.2, 32.2 and 49.1, 33.0 and 50.0, 30.7 and 47.8g respectively. The CVs of the egg weights of the first egg and at 270 days of age were 13.54~15.27% and 6.93~7.36%. The numbers of eggs produced by 270 days of age were 77.0, 79.3, 77.3, 73,7, 75.4, respectively, and observed CVs were between 29.98~36.99%. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The highest least square (LS) means of the body weights at 150 and 270 days of age were observed in Black strain as 1,594.38 and 1,911.57g. The earliest LS mean of the ages at first egg was 146.88days in White strain. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in Red Brown strain as 32.20 and 50.74g. The LS mean of the largest number of egg production was 79.50 eggs in Yellow Brown strain. Also, The significant generation effects were investigated in all the major economic traits. The highest LS means of the body weights at 150 and 270 days of age were observed in the generation 3 as 1,599.74 and 1,905.01g. The earliest LS mean of the age at first egg was 143.31 days in 4th generation. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in 7th and 5th generation as 35.68 and 50.42g. The LS means of the largest number of egg production was 78.53 eggs in generation 6. In general, light body weight, short time for the age at first egg, heavy egg weight, and large number of egg production were observed as the generation proceeded.

Preoperative Concurrent Radio-chemotherapy for Rectal Cancer: Report of Early Results (직장암에 대한 수술 전 동시병용 방사선-항암 화학요법: 초기 치료결과 보고)

  • Shin, Seong-Soo;Ahn, Yong-Chan;Chun, Ho-Kyung;Lee, Woo-Yong;Kang, Won-Ki;Park, Young-Suk;Park, Joon-Oh;Song, Sang-Yong;Lim-Do-Hoon;Park, Won;Lee, Jung, Eun;Kang, Min-Kyu;Park, Yung-Je
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.125-134
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    • 2003
  • Purpose: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. Materials and Methods: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4$\~$6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. Results: The compliance to the current preoperative CRCT protocol was excellent, where 92.5$\%$ (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9$\%$), while resection was abandoned during laparotomy in two patients (5.7$\%$). Gross complete resection was peformed in 30 patients, gross incomplete resection was peformed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5$\%$ (15/33), and the complete resection rate with the negative resection margin 78.8$\%$ (26/33). During the CRCT course, grade 3 $\~$4 neutropenia developed in four patients (10.8$\%$). Local recurrence after surgical resection developed in 12.1$\%$ (4/33), and distant metastases after the preoperative CRCT start developed in 21.6$\%$ (8/37). The overall 3-years survival rate was 87$\%$. Conclusion: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.

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.

Composition of Vitamin A, E, $B_l$ and $B_2$ Contents in Korean Cow's Raw Milk in Korea (국내산 원유 중 비타민 A, E, $B_l$$B_2$ 함량에 관한 연구)

  • Kwak Byung-Man;Kim Sung-Han;Kim Kang-Seob;Lee Ki-Woong;Ahn Jang-Hyuk;Jang Chi-Hoon
    • Food Science of Animal Resources
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    • v.26 no.2
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    • pp.245-251
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    • 2006
  • This study was performed to investigate the changes of vitamin A, vitamin E, vitamin $B_l$ and vitamin $B_2$ contents in cow's raw milk collected from dairy farms in Chungcheong-do and Jeolla-do for a year. The contents of fat soluble vitamin A and E were changed as seasonal effect, but water soluble vitamin $B_l$ and $B_2$ contents were not changed as seasonal effect. Vitamin A content in cow's raw milk was as follows [minimum ${\sim}$maximum (mean), ug/100 mL]; $35.1{\sim}59.0$ (44.4) in spring, $36.7{\sim}65.6$ (50.0) in summer, $28.7{\sim}61.2$ (46.8) in autumn and $29.9{\sim}57.8$ (43.1) in winter. In case of vitamin E was as follows [minimum${\sim}$maximum (mean), ug/100 mL]; $28.3{\sim}59.2$ (45.8) in spring, $39.6{\sim}69.9$ (58.8) in summer, $35.0{\sim}62.8$ (46.2) in autumn and $26.0{\sim}55.4$ (41.5) in winter. In case of vitamin $B_l$ was as follow [minimum${\sim}$maximum (mean), ug/100 mL]; $27.7{\sim}57.9$ (42.84) in spring, $32.4{\sim}66.1$ (49.39) in summer, $34.1{\sim}63.7$ (46.69) in autumn and $20.6{\sim}61.4$ (43.20 in winter. The amounts of vitamin $B_2$ in cow's raw milk was as follows [minimum${\sim}$maximum (mean), ug/100 mL]; $150{\sim}182$ (160 in spring, $145{\sim}185$ (163) in summer, $149{\sim}180$ (166) in autumn and $148{\sim}190$ (167) in winter.

EFFECT OF INDUCTION CHEMOTHERAPY ON FLAP SURVIVAL RATE IN MICROSURGERY (종양수술전 화학요법이 미세수술시 피판생존율에 미치는 영향)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.6
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    • pp.421-429
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    • 2003
  • Purpose : Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. Materials and Methods: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. Results: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. Conclusion: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.

Lymphocyte Proportion and Cytokines from the Bone Marrow of Patients with Far-Advanced Pulmonary Tuberculosis with Peripheral Lymphocytopenia (말초혈액의 림프구감소증을 동반한 중증폐결핵 환자들에서 골수 내의 림프구 분획과 사이토카인 소견)

  • An, Chang Hyeok;Kyung, Sun Yong;Lim, Young Hee;Park, Gye Young;Park, Jung Woong;Jeong, Sung Hwan;Ahn, Jeong Yeal
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.449-458
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    • 2003
  • Background : The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)(< $1,000/mm^3$) and $T_4$-cell count ${\leq}500/mm^3$. However, the cause of PB lymphocytopenia in FAPTB is unclear. The aim of this study was to analyze the lymphocyte proportion and cytokines of the bone marrow(BM) in FAPTB patients with peripheral lymphocytopenia in order to clarify whether the limiting step of the lymphocytopenia occurs in production, differentiation, or circulation. Methods : This study included patients with FAPTB between August 1999 and August 2002 who visited Gachon Medical School Gil Medical Center. The exclusion criteria were old age(${\geq}65years$), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-${\alpha}$, Interferon-${\gamma}$, and TGF-${\beta}$ levels in the BM were measured by ELISA. Result : Thirteen patients(male : female=9:4) were included and the mean age was $42{\pm}12$years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group ($7.4{\pm}3.0%$, $694{\pm}255/mm^3$ vs. $17.5{\pm}5.8%$, $1,377{\pm}436/mm^3$, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group($9{\pm}4%$ vs. $12{\pm}3%$, p=0.138). The IL-2($26.0{\pm}29.1$ vs. $112.2{\pm}42.4pg/mL$, p=0.001) and IL-10($3.4{\pm}4.7$ vs. $12.0{\pm}8.0pg/mL$, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. Conclusion : These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.