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NT-pro BNP : A new diagnostic screening tool for Kawasaki disease (가와사끼병에서 진단적 지표로서의 NT-proBNP)

  • Lee, Hyunju;Kim, Heejung;Kim, Hae Soon;Sohn, Sejung
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.539-544
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    • 2006
  • Purpose : The purpose of this study was to determine whether N-terminal fragment of B-type natriuretic peptide(NT-proBNP) may be used to differentiate acute Kawasaki disease(KD) from other clinically similar diseases. Methods : Using electrochemiluminescence immunoassay, NT-proBNP concentrations were measured in the acute phase within 10 days after the onset of KD(n=58) and in the convalescent phase, 60 to 81 days after the onset(n=51), and also in patients with acute febrile disease as a control(n=34). Echocardiography was performed to detect pericardial effusion(PE) and coronary artery lesions(CAL), and to measure the left ventricular dimension at diastole(LVIDd) and ejection fraction(LVEF). The cutoff value of NT-proBNP for separating KD from other diseases was determined. Results : NT-proBNP concentration in the acute phases of KD was significantly higher than that in the control group($1,501.6{\pm}2,132.6$ vs. $139.0{\pm}88.8pg/mL$, P<0.0001). In KD patients, NT-proBNP was elevated in the acute phase and was lowered in the convalescent phase($1,466.0{\pm}2,173.2$ vs. $117.5{\pm}95.5pg/mL$, P<0.0001). The cutoff value of 260 pg/mL discriminated KD patients from other patients, with a sensitivity of 93 percent and a specificity of 88 percent. The NT-proBNP was higher in patients with PE(n=17) compared with those without PE(n=41)($1,784.2{\pm}1,903.1$ vs. $1,384.4{\pm}2,232.6pg/mL$, P=0.52). Comparison of NT-proBNP could not be done between patients with CAL and those without, owing to a small number of patients with CAL(n=3). There was no correlation between NT-proBNP and LVEF index(r=0.104, P=0.46) or LVIDd index(r=0.171, P=0.22). Conclusion : NT-proBNP increases in the acute phase of KD and decreases to within normal range in the convalescent phase. NT-proBNP >260 pg/mL may be highly suggestive of acute KD. NT-proBNP may be used as a diagnostic tool for KD.

Immunomodulatory effect of the water extract of Aster tataricus through mitogen-activated protein kinase signaling pathway (Aster tataricus 물 추출물의 mitogen-activated protein kinase 신호 전달 경로를 통한 면역 조절 효과)

  • Lee, Chea Yeon;Park, Hyo Sung;Kong, Deok-Hoon;Kim, Young Kwan;Cho, Whajung
    • Journal of Nutrition and Health
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    • v.53 no.5
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    • pp.452-463
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    • 2020
  • Purpose: Aster tataricus (AT) is one of the Asteraceae perennial herbs used in traditional Chinese medicine. The herb contains various bioactive substances, such as flavonoids, isoflavonoids, and phenolic compounds in the roots, and exhibits a range of effects including anti-bacterial, anti-oxidant, and anti-inflammatory activities. This study compared the immunomodulatory effects of ethanol and water extracts of whole AT, except the roots, and analyzed the molecular mechanisms for the regulatory effects on cytokine secretion from THP-1 cells. Methods: The effects of AT extract on the cell viability and proliferation of THP-1 cells were analyzed using the Cell Counting Kit-8 method. The concentrations of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the cell culture supernatant of the AT-treated THP-1 cells were measured using an enzyme-linked immunosorbent assay. The protein levels of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), inhibitor of nuclear factor kappa B (IκBα), and mitogen-activated protein kinase (MAPK) phosphorylation in the cell lysates were determined by western blotting. Results: The water extract and the ethanol extract of AT did not affect the cell viability, and increased the proliferation of THP-1 cells significantly compared to the vehicle. The water extract increased the secretion of IL-1β from THP-1 cells in a dose-dependent manner, but the ethanol extract had no effect. The expression of COX-2 and iNOS protein and the phosphorylation of MAPK and Akt were induced in AT-treated cells. In addition, IκBα was degraded by AT in a concentration-dependent manner. IL-1β secretion by AT was reduced by extracellular-signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) inhibitors, while TNF-α secretion was decreased by inhibitors of ERK, p38 MAPK, and JNK. Interestingly, the p38 MAPK inhibitor increased the production of IL-1β by AT further. Conclusion: The water extract of the above-ground parts of AT contains immunomodulatory bioactive substances that stimulate immune cells through the MAPK signaling pathway.

NT-proBNP as a useful tool in diagnosing incomplete Kawasaki disease (불완전 가와사끼병에서 NT-proBNP의 진단적 역할)

  • Lee, Dong-Won;Kim, Yeo-Hyang;Hyun, Myung-Chul;Kwon, Tae-Chan;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.519-524
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    • 2010
  • Purpose : To determine the efficacy of the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) as a useful diagnostic method in children with incomplete Kawasaki disease (KD). Methods : Ninety-six patients who were diagnosed as having KD between January 2008 and June 2009 were enrolled in the study. American Heart Association recommendations for diagnosis were used, and patients were divided into the complete KD and incomplete KD groups. Blood tests including NT-proBNP were performed on admission day. Nineteen patients who had other febrile diseases other than KD were enrolled as control. Results : Thirty-three patients (34%) had incomplete KD. Change in the lips and oral cavity and conjunctivitis were the most common clinical features, but their frequency was lower than complete KD (76% vs 98%, 76% vs 90%). Patients with incomplete KD exhibited significantly higher NT-proBNP level than that of control ($1,407.7{\pm}1633.5pg/mL$ vs $126.2{\pm}135.5pg/mL$, $P$<0.001). An NT-proBNP cutoff value of 158 pg/mL provided a sensitivity of 81% and a specificity of 74% for diagnosis of incomplete KD. Conclusion : NT-proBNP assay can be clinically useful for the diagnosis of incomplete KD, if the patient has persistent fever, change in the lips and oral cavity, and conjunctivitis, and if the patient with those symptoms is suspected to have incomplete KD.

Retrospective Cohort Study on the Administration of Sedative for Delirium in Terminally Ill Cancer Patients and Survival Time (말기암환자의 섬망으로 인한 진정제 투약과 생존기간에 관한 후향적 코호트 연구)

  • Park, Hyoung Sook;Kim, Dae Sook;Bae, Eun Hee;Kim, Jung Rim;Seo, Jung Hwa;Yun, Jung Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.119-126
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    • 2016
  • Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

Occupational Demands and Educational Needs in Korean Librarianship (한국적 도서관학교육과정 연구)

  • Choi Sung Jin;Yoon Byong Tae;Koo Bon Young
    • Journal of the Korean Society for Library and Information Science
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    • v.12
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    • pp.269-327
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    • 1985
  • This study was undertaken to meet more fully the demands for improved training of library personnel, occasioned by the rapidly changing roles and functions of libraries as they try to adapt to the vast social, economic and technological changes currently in progress in the Korean society. The specific purpose of this research is to develop a standard curriculum at the batchelor's level that will properly equip the professional personnel in Korean libraries for the changes confronting them. This study started with the premise that to establish a sound base for curriculum development, it was necessary first to determine what concepts, knowledge, and techniques are required for professional library personnel to perform it at an optimal level of efficiency. Explicitly, it was felt that for the development of useful curricula and courses at the batchelor's level, a prime source of knowledge should be functional behaviours that are necessary in the job situation. To determine specifically what these terminal performance behaviours should be so that learning experience provided could be rooted in reality, the decision was reached to use a systems approach to curriculum development, which is an attempt to break the mold of traditional concepts and to approach interaction from an open, innovative, and product-oriented perspective. This study was designed to: (1) identify what knowledge and techniques are required for professional library personnel to perform the job activities in which they are actually engaged, (2) to evaluate the educational needs of the knowledge and techniques that the professional librarian respondents indicate, and (3) to categorise the knowledge and techniques into teaching subjects to present the teaching subjects by their educational importance. The main data-gathering instrument for the study, a questionnaire containing 254 items, was sent to a randomly selected sample of library school graduates working in libraries and related institutions in Korea. Eighty-three librarians completed and returned the questionnaire. After analysing the returned questionnaire, the following conclusions have been reached: (A) To develop a rational curriculum rooted in the real situation of the Korean libraries, compulsory subjects should be properly chosen from those which were ranked highest in importance by the respondents. Characters and educational policies of, and other teaching subjects offered by, the individual educational institution to which a given library school belongs should also be taken into account in determining compulsory subjects. (B) It is traditionally assumed that education in librarianship should be more concerned with theoretical foundations on which any solution can be developed than with professional needs with particulars and techniques as they are used in existing library environments. However, the respondents gave the former a surprisingly lower rating. The traditional assumption must be reviewed. (C) It is universally accepted in developing library school curricula that compulsory subjects are concerned with the area of knowledge students generally need to learn and optional subjects are concerned with the area to be needed to only those who need it. Now that there is no such clear demarcation line provided in librarianship, it may be a realistic approach to designate subjects in the area rated high by the respondents as compulsory and to designate those in the area rated low as optional. (D) Optional subjects that were ranked considerably higher in importance by the respondents should be given more credits than others, and those ranked lower might be given less credits or offered infrequently or combined. (E) A standard list of compulsory and optional subjects with weekly teaching hours for a Korean library school is presented in the fourth chapter of this report.

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Role of PKR and EGR-1 in Induction of Interleukin-S by Type B Trichothecene Mycotoxin Deoxynivalenol in the Human Intestinal Epithelial Cells (B형 트리코테센 곰팡이 독소 데옥시니발레놀에 의한 인체 장관 상피세포 염증성 인터루킨 8유도에서의 PKR과 EGR-1의 상호 역할 규명)

  • Park, Seong-Hwan;Yang, Hyun;Choi, Hye-Jin;Park, Yeong-Min;Ahn, Soon-Cheol;Kim, Kwan-Hoi;Lee, Soo-Hyung;Ahn, Jung-Hoon;Chung, Duk-Hwa;Moon, Yu-Seok
    • Journal of Life Science
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    • v.19 no.7
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    • pp.949-955
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    • 2009
  • Mucosal epithelia sense external stress signals and transmit them to the intracellular cascade responses. Ribotoxic stress-producing chemicals such as deoxynivalenol (DON) or other trichothecene mycotoxins have been linked with gastrointestinal inflammatory diseases by Fusarium-contamination. The purpose of this study was to test the hypothesis that DON evokes the epithelial sentinel signals of RNA-dependent protein kinase (PKR) and early growth response gene 1 (EGR-1), which together contribute to the pro-inflammatory cytokine interleukin 8 (IL-8) in human intestinal epithelial cells. PKR suppression by the dominant negative PKR expression attenuated DON-stimulated interleukin-8 production. Moreover, 1L-8 transcriptional activation by DON was also reduced by PKR inhibition in the human intestinal epithelial cells. Treatment with the PKR inhibitor also suppressed EGR-1 promoter activity, mRNA and protein induction, although mitogen-activated protein (MAP) kinases such as extracellular signal-regulated protein kinases (ERK) 1/2, p38, c-Jun N-terminal Kinase (INK) were little affected or even enhanced in presence of a PKR inhibitor. These patterns were also compared in the EGR-1-suppressed cells, which showed much more suppressed production of 1L-8. All things taken into consideration, DON-activated sentinel signals of EGR-1 via PKR mediated interleukin-8 production in human intestinal epithelial cells, which provide insight into the possible general mechanism associated with mucosal inflammation as an intestinal toxic insult by ribotoxic trichothecene mycotoxins.

Effect of Magnesium on the Contractility of the Isolated Guinea-Pig Aortic and Rat Smooth Muscles (마그네슘이온이 적출한 기니피그 대동맥평활근과 흰쥐 자궁평활근의 수축성에 미치는 효과에 관한 연구)

  • Ahn, Hyuk;Hwang, Sang-Ik
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.452-464
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    • 1990
  • It is well known that extracellular Calcium plays a very important role in several steps of smooth muscle excitability and contractility, and there have been many concerns about factors influencing the distribution of extracellular Ca++ and the Ca++ flux through the cell membrane of the smooth muscle. Based on the assumption that Mg++ may also play an important role in the excitation and contraction processes of the smooth muscle by taking part in affecting Ca++ distribution and flux, many researches are being performed about the exact role of Mg++, especially in the vascular smooth muscle. But yet the effect of Mg++ in the smooth muscle activity is not clarified, and moreover the mechanism of Mg++ action is almost completely unknown. Present study attempted to clarify the effect of Mg++ on the excitability and contractility in the multiunit and unitary smooth muscle, and the mechanism concerned in it. The preparations used were the guinea-pig aortic strip as the experimental material of the multiunit smooth muscle and the rat uterine strip as the one of the unitary smooth muscle. The tissues were isolated from the sacrificed animal and were prepared for recording the isometric contraction. The effects of Mg++ and Ca++ were examined on the electrically driven or spontaneous contraction of the preparations. And the effects of these ions were also studied on the K+ or norepinephrine contracture. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% 02 and kept at 35oC. The results obtained were as follows: 1] Mg++ suppressed the phasic contraction induced by electrical field stimulation dose-dependently in the guinea-pig aortic strip, while the high concentration of Ca++ never recovered the decreased tension. These phenomena were not changed by the a - or b - adrenergic blocker. 2]Mg++ played the suppressing effect on the low concentration [20 and 40 mM] of K+-contracture in the aortic muscle, but the effect was not shown in the case of 100mM K+-contracture. 3] Mg++ also suppressed the contracture induced by norepinephrine in the aortic preparation. And the effect of Mg++ was most prominent in the contracture by the lowest [10 mM] concentration of norepinephrine. 4] In both the spontaneous and electrically driven contractions of the uterine strip, Mg++ decreased the amplitude of peak tension, and by the high concentration of Ca++ the amplitude of tension was recovered unlike the aortic muscle. 5] The frequency of the uterine spontaneous contraction increased as the [Ca++] / [Mg++] ratio increased up to 2, but the frequency decreased above this level. 6] Mg++ decreased the tension of the low[20 and 40mM] K+-contracture in the uterine smooth muscle, but the effect did not appear in the 100mM K+-contracture. From the above results, the following conclusion could be made. 1] Mg++ seems to suppress the contractility directly by acting on the smooth muscle itself, besides through the indirect action on the nerve terminal, in both the aortic and uterine smooth muscles. 2] The fact that the depressant effect of Mg++ on the K+-contracture is in inverse proportion to an increase of K+ concentration appears resulted from the extent of the opening state of the Ca++ channel. 3] Mg++ may play a depressant role on both the potential dependent and the receptor-operated Ca++ channels. 4] The relationship between the actions of Mg++ and Ca++ seems to be competitive in uterine muscle and non-competitive in aortic strip.

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Correlations between the Capacity of In Vitro Fertilization and the Assays of Sperm Function and Characteristics in Frozen-thawed Bovine Spermatozoa (소 동결-융해 정자에 있어서 체외수정능력과 정자 기능 및 성상 분석법간의 상관관계)

  • Ryu, B.Y.;Chung, Y.C.;Kim, C.K.;Shin, H.A.;Han, J.H.;Kim, S.H.;Moon, S.Y.;Kim, H.R.;Choi, H.
    • Korean Journal of Animal Reproduction
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    • v.26 no.3
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    • pp.275-289
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    • 2002
  • The objective of this study was to develop an in vitro assessment of sperm fertilizing capacity of bulls and investigate the factors influencing sperm function and characteristics of frozen-thawed bovine spermatozoa. in vitro fertilization (IVF), the evaluation of motility and normal morphology, HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, luminol and lucigenin-dependent chemiluminescence for the measurement of reactive oxygen species (ROS), the measurement of malondialdehyde formation for the analysis of lipid peroxidation (LPO), and the evaluation of DNA fragmentation using the method of 747-mediated nick end labelling (TUNEL) by flow cytometry were performed in frozen-thawed bovine spermatozoa. Correlations between the rates of fertilization, blastocyst formation after IVF and the values of respective assays were investigated. 1. IVF rate and blastocyst formation rate averaged 64.4% and 34.3% for spermatozoa from high -fertility bull group and averaged 18.5% and 6.2% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. Sperm motility and percentage acrosome reaction averaged 79.0% and 66.2% for spermatozoa from high-fertility bull group and averaged 40.7% and 22.9% for spermatozoa from low-fertility bull group, respectivitely. There were not different between two bull groups. 2. Luminol depenent chemiluminescence, LPO and DNA fragementation averaged 6.4, 2.0 nmol and 2.6% from spermatozoa from high-fertility bull group and averaged 6.5, 3.1 nmol and 7.4% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. There was no significant difference in lucigenin dependent chemiluminescence between two bull groups. 3. Fertilization rate was positively correlated with motility and the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between fertilization rate and the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. 4. Blastocyst formation rate was positively correlated with the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between blastocyst formation rate and motility, the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. In conclusion, these data suggest that ROS significantly impact semen quality. The assays of this study may provide a basis fur improving in vitro assessment of sperm fertilizing capacity.

Soil amendment for turfgrass vegetation of the Incheon International Airport runway side on the Yeongjong reclaimed land (인천국제공항 착륙대 잔디 식재 지반 조성을 위한 영종도 매립 토양 개량)

  • Yoo, Sun-Ho;Jeong, Yeong-Sang;Joo, Young-Kyu;Choi, Byung-Kwon;Wu, Heun-Young;Lee, Tae-Young
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.2
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    • pp.93-104
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    • 2002
  • A field survey and experiment was conducted from 1996 to 1998 to develop rational technology for turfgrass vegetation of runway side of Incheon International Airport on the reclaimed tidal land in Young-Jong Island. Backfill of the experimental site was finished on August 1995. The experimental site was 8 ha located in the middle of the construction place for the main parking lot in front of the terminal building construction. The experimental field was drained by main open ditch, and divided three main plots, no subsurface tile drain, subsurface tile drain spacing with 22.5m, and with 45 m, respectively. The 17 sub plots were designed to test the effect of soil covering with red earth loam by 5 cm and 20 cm depth, application of chemical compound fertilizers and livestock manures, dressing of artifical soils and hydrophylic soil conditioners. The tested turfgrasses were three transplanting indigenous turfgrasses, Zoysia koreana, Zoysia sinica and Zoysia japonica, and two hydroseeding mixed exotic turgrasses, cool type I(tall fescue 30%, kentucky blue grass 40%, perenial ryegrass 30%), and cool type II(tall fescue 40%, perenial ryegrass 20%, fine fescue 20%, alkaligrass 20%). The soil backfilled with dredged seasand was sand textured with high salt concentration and low fertility. The soil showed high pH, low organic matter and low available phophate contents. The percolation rate was fast with high hydraulic conductivity. Desalinization was fast after installation of the main open drainage system. No subsurface tile drainage effect was found showing little difference in turfgrass growth. The covering and visual growth of turfgrasses were the best in the 20-cm soil covering with compound fertilizer treatment. The covering and visual growth of turfgrasses were satisfactory in the 5 cm soil covering with compound fertilizer treatment and with livestock manure treatments. The hydrophillic soil conditioner treatments were effective but expensive at present. The coverage and visual quality of turfgrasses were good for Zoysia koreana and Zoysia japonica. The coverages of turfgrasses by the hydroseeding with the mixed exotic turfgrasses were less than transplanting of native turfgrasses. In conclusion, for the runway side vegetation purposes, the subsurface tile drainage might not necessary as main open ditch drainage be sufficient due to fast percolation rate of the backfilled dredged seasand. The 5 cm soil covering with red earth might be sufficient for the runway side, but the 20 cm soil covering might be necessary for the runway side where high density of turfgrass coverage was necessary to protect from the airplance air blow.