• Tuberculosis and Respiratory Diseases
• /
• v.49 no.1
• /
• pp.82-92
• /
• 2000

Background : In chronic airway disease, mucus secretion is increased, but extraction of mucin, which is the main component of mucus secretion, is a very complicated and limited in clinical use. Recently, monoclonal antibody for mucin was developed for possible clinical use. In this study, cellular analysis and quantification of respiratory mucin in sputum of patients with chronic airway diseases were performed. Method : Sputum was collected from patients with asthma(n=33), bronchiectasis(n=8) or chronic bronchitis (n=13) by spontaneous expectoration or by hypertonic saline induction. Collected sputums was treated by 0.1% dithiotreitol to dissociate the disulfide bond of the mucus and filtered through a nylon gauze. Total cell count, viability and differential count were measured. For detection of mucin, collected samples were treated with sodium dodecyl sulfate polyacrylamide gel electrophoresis and then with monoclonal antibody(HMO2), as the primary antibody, and PAS stain. The amount of mucin was measured with ELISA by HMO2. Correlation with clinical information, cellular analysis, and amount of measured mucin were analyzed. Results : Total cell counts of sputum were significantly increased in patients with bronchiectasis but viability remained the same. Eosinophils were significantly increased in patients with asthma, neutrophils in bronchiectasis chronic bronchitis, respectively (p<0.05). The results of Western blotting and PAS staining confirmed the presence of glycoproteins and matched? with mucin. The amounts of mucin measured by ELISA were not significantly different among the disease groups. Significant correlation was identified between the amount of mucin and viability(r=-0.482, p<0.05). Conclusion : Inflammatory cells in the sputum of those with chronic airway disease were different for each disease type. Measurement of mucin by ELISA via monoclonal antibodies may be a simple method for the evaluation of chronic airway disease.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.1
• /
• pp.54-60
• /
• 2010

Purpose: Nuclear medicine manufacturers provide various softwares which shorten imaging time using their own image processing techniques such as UlatraSPECT, ASTONISH, Flash3D, Evolution, and nSPEED. Seoul National University Hospital has introduced softwares from Siemens and Philips, but it was still hard to understand algorithm difference between those two softwares. Thus, the purpose of this study was to figure out the difference of two softwares in planar images and research the possibility of application to images produced with high energy isotopes. Materials and Methods: First, a phantom study was performed to understand the difference of softwares in static studies. Various amounts of count were acquired and the images were analyzed quantitatively after application of PIXON, Siemens and ASTONISH, Philips, respectively. Then, we applied them to some applicable static studies and searched for merits and demerits. And also, they have been applied to images produced with high energy isotopes. Finally, A blind test was conducted by nuclear medicine doctors except phantom images. Results: There was nearly no difference between pre and post processing image with PIXON for FWHM test using capillary source whereas ASTONISH was improved. But, both of standard deviation(SD) and variance were decreased for PIXON while ASTONISH was highly increased. And in background variability comparison test using IEC phantom, PIXON has been decreased over all while ASTONISH has shown to be somewhat increased. Contrast ratio in each spheres has also been increased for both methods. For image scale, window width has been increased for 4~5 times after processing with PIXON while ASTONISH showed nearly no difference. After phantom test analysis, ASTONISH seemed to be applicable for some studies which needs quantitative analysis or high contrast, and PIXON seemed to be applicable for insufficient counts studies or long time studies. Conclusion: Quantitative values used for usual analysis were generally improved after application of the two softwares, however it seems that it's hard to maintain the consistency for all of nuclear medicine studies because result images can not be the same due to the difference of algorithm characteristic rather than the difference of gamma cameras. And also, it's hard to expect high image quality with the time shortening method such as whole body scan. But it will be possible to apply to static studies considering the algorithm characteristic or we can expect a change of image quality through application to high energy isotope images.

• Journal of Chest Surgery
• /
• v.35 no.5
• /
• pp.343-349
• /
• 2002

background: In an attempt to investigate the role of oxidants in the activation of phospholipase $A_2$(PLA$_2$) and endogenous oxidative stress in the lung. acute inflammatory lung injury was induced by the instillation of hydrogen peroxide into the trachea of Sprague-Dawley rats. Material and Method: To prove the hypothesis thats released oxidants from neutrophils activate the PLA$_2$ retrogradely, activities of PLA$_2$ and lysoplatelet activating factor acetyltransferase(lysoPAF AT) were assayed i hours after instillation of hydrogen peroxide. In addition, to confirm the impairing effects of the activation of PLA$_2$ associated with endogenous oxidative stress, lung weight/body weight ratio(L$\times$10$^{-3}$ B), protein contents(mg/two lungs) in bronchoalveolar lavage(BAL) were measured. As neutrophilic respiratory burst has been known to play a pivotal role in the genesis of endogenous oxidative stress associated with acute inflammatory lung injury, BAL neutrophils counts and level of lung myelperoxidase(MPO) were measured after hydorgen peroxide insult. Morphological and histochemical studies were also performed to identify the effect of the endogenous oxidative stress. Result: Five hours after hydrogen peroxide instillation, lungs showed marked infiltration of neutrophils and increased weight. Protein contents in BAL increased significantly compared to those of normal rats. PLA$_2$ activity was enhanced in the hydrogen peroxide instilled group. Interestingly, the accelerated production of platelet activating factor(PAF) was confirmed by the increased activity of lysoPAF AT in the $H_2O$$_2$ employed lung. Morphologically, light microscopic findings of lungs after instillation of hydrogen peroxide showed atelectasis and infiltration of inflammatory cells, which was thought to be caused by lipid mediators produced by PLA$_2$ activation. In cerium chloride cytochemical electron microscopy, dense deposits of cerrous perhydroxide were identified. In contrast, no deposit of cerrous perhydroxide was found in the normal lung.

• Journal of Chest Surgery
• /
• v.34 no.7
• /
• pp.524-533
• /
• 2001

Background: Hyperoxemic cardiopulmonary bypass (CPB) has been recognized as a safe technique and is widely used in cardiac surgery. However, hyperoxemic CPB may produce higher toxic oxygen species and cause more severe oxidative stress and ischemia/reperfusion injury than normoxemic CPB. This study was undertaken to compare inflammatory responses and myocardial injury between normoxemic and hyperoxemic CPB and to examine the beneficial effect of normoxemic CPB. Material and method: Thirty adult patients scheduled for elective cardiac surgery were randomly divided into normoxic group (n=15), who received normoxemic CPB (about Pa $O_{2}$ 120 mmHg), and hyperoxic group (n=15), who received hyperoxemic CPB (about Pa $O_{2}$ 400 mmHg). Myeloperoxidase (MPO), malondialdehyde (MDA), adenosine monophosphate (AMP), and troponin-T (TnT) concentrations in coronary sinus blood were determined at pre- and post-CPB. Total leukocyte and neutrophil counts in arterial blood were measured at the before, during, and after CPB. Lactate concentration in mixed venous blood was analyzed during CPB, and cardiac index (Cl) and pulmonary vascular

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.2
• /
• pp.159-168
• /
• 2004

Background : In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the results were compared with those of cytologic examinations. Methods : Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity. Results : There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy. Conclusion : MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.

• The Korean Journal of Nuclear Medicine
• /
• v.29 no.4
• /
• pp.533-540
• /
• 1995

Attenuation correction is important in producing quantitative positron emission tomography (PET) images. Conventionally, photon attenuation effects are corrected using transmission measurements performed before tracer administration. The pre-injection transmission measurement approach may require a time delay between transmission and emission scans for the tracer studies requiring a long uptake period, about 45 minutes for F-18 deoxyglucose study. The time delay will limit patient throughput and increase the likelihood of patient motion. A technique lot performing simultaneous transmission and emission scans (T+E method) after the tracer injection has been validated. The T+E method substracts the emission counts contaminating the transmission measurements to produce accurate attenuation correction coefficients. This method has been evaluated in experiments using a cylindrical phantom filled with background water (5750 cc) containing $0.4{\mu}Ci/cc$ of F-18 fluoride ion and one insert cylinder (276 cc) containing $4.3{\mu}Ci/cc$. GE $Advance^{TM}$ PET scanner and Ge-68 rotating pin sources for transmission scanning were used for this investigation. Post-injection transmission scan and emission scan were peformed alternatively over time. The error in emission images corrected using post-infection transmission scan to emission images corrected transmission scan was 2.6% at the concentration of $1.0{\mu}Ci/cc$. No obvious differences in image quality and noise were apparent between the two images. The attenuation correction can be accomplished with post-injection transmission measurement using rotating pin sources and this method can significantly shorten the time between transmission and omission scans and thereby reduce the likelihood of patient motion and increase scanning throughput in PET.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.6
• /
• pp.1214-1222
• /
• 1998

Background : The intrapleural hypofibrinolysis is caused by mainly excessive concentration of pleural plasminogen activator inhibitor-1 antigen(PAI-1 Ag), which binds tissue type plasminogen activator. In pleural inflammation induced by sclerosing agents for pleurodesis, levels of pleural PAI-1 antigen increase in relation to decreasing D-dimer levels. It has been known that the pleural mesothelial cells have the capability of secreting PAI-1 Ag in response to inflammation in vivo. Therefore, we estimated whether pleural inflammation changes the balance between fibrinolytic and coagulative properties in exudative pleural effusions. Method : The thirty cases was included in our study. We determined the pleural levels of glucose, lactic dehydrogenase(LDH), pH and the counts of white blood cell(WBC), polymorpho leukocyte(PMN), lymphocyte as the parameters of pleural inflammation and cellular components of pleural fluid. The plasma level of fibrinogen in fluid and the neutrophil count in blood were determined. The levels of D-dimer, PAI-1 Ag and thrombinantithrombin III complex(TAT) were determined by ELISA(Behring, Marburg, Germany). Result : The causes of pleural effusion were as following : tuberculous in 14 cases, malignant in 10 cases and parapneumonic in 6 cases. The levels of pleural D-dimer, PAI-1 Ag and TAT was significantly higher than that of plasma(p<0..001). The severity of pleural inflammation did not correlated with pleural D-dimer, PAI-1 Ag, TAT and their plasma levels. But the level of pleural TAT correlated with pleural WBC and lymphocyte count. Conclusion : We found that the severity of pleural inflammations did not correlated with pleural D-dimer, PAI-1 Ag, TAT and the possibility of local production of PAI-1 antigen is present.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.5
• /
• pp.557-567
• /
• 2001

Background : Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. Method : Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post operative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet endothelial cell adhesion molecule, PECAM). Results : Microvessel counts(MVCs) in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage I and II or N0 stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). Conclusion : In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status(limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.5
• /
• pp.456-462
• /
• 2006

Background: Differential diagnosis is very important in patients with pleural effusions. A few studies on the etiologies of massive pleural effusions have been reported, but these were conducted in different decades and locations. In the present study, the etiologic spectrum of massive pleural effusions in Korea, were evaluated through an investigation at one university hospital. Methods: Retrospective chart reviews were performed in patients having undergone thoracentesis between July 2002 and July 2005. Pleural effusions were deemed to be massive if they occurred in two thirds or more of one hemithorax. The etiologies of massive pleural effusions, pleural fluid findings, serum laboratory findings, and sputum and pleural fluid cytologies were compared. Results: Of 298 pleural effusions cases, 41 (13.8%) had massive pleural effusions. The most frequent causes of massive pleural effusions were malignancy (19; 46.3%) followed by tuberculosis (15; 36.6%), parapneumonic effusion (4; 9.8%) and transudate (3; 7.3%). Compared with massive benign effusions, patients with massive malignant pleural effusions were more likely to have lower adenosine deaminase (ADA) activity, a higher amylase level and higher RBC count in their pleural fluids. Also, compared with non-tuberculosis effusions, patients with massive tuberculous pleural effusions were more likely to have lower RBC and neutrophil counts, but a higher lymphocyte count, adenosine deaminase (ADA) activity and protein level. Conclusion: The most common etiologies of massive pleural effusions in Korea are malignancy and tuberculosis. A high ADA content favors a tuberculous condition, while bloody effusions with a relatively lower ADA content. favors malignancy. The proportion of tuberculosis in massive pleural effusions was higher than in previous reports.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.6
• /
• pp.554-561
• /
• 2006

Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.