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Differences in Clinical Characteristics of Invasive Tracheobronchial Aspergillosis according to the Presence of Invasive Pulmonary Aspergillosis

  • Pak, Chuiyong;Jo, Woori;Kim, Jin Hyoung;Im, Jae Uk;Jeong, Joseph;Cha, Hee Jeong;Choi, Eun-Young;Ra, Seung Won
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.326-332
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    • 2021
  • Background: The association of invasive tracheobronchial aspergillosis (ITBA) with invasive pulmonary aspergillosis (IPA) is not well established. We aimed to compare clinical characteristics between patients who exhibited ITBA with IPA and those who exhibited isolated ITBA (iITBA). Additionally, the usefulness of serum or bronchial galactomannan (GM) tests in diagnosing ITBA was evaluated. Methods: This retrospective single-center case-control study was conducted over a period of 4 years. Fifteen patients were enrolled after confirming the presence of ITBA using bronchoscopy-guided biopsy (iITBA, 7 vs. ITBA+IPA, 8). Clinical characteristics of patients and results obtained from serum or bronchial GM tests were compared between the two groups. Mortality was assessed using data collected from a 6-month follow-up period. Results: The ITBA+IPA group showed a higher prevalence of hematologic malignancy (75% vs. 14%, p=0.029), a greater number of patients with multiple bronchial ulcers (75% vs. 14%, p=0.029), lower platelet counts (63,000/μL vs. 229,000/μL, p<0.001), and a mortality rate which was significantly higher (63% vs. 0%, p=0.026) than the iITBA group. In the ITBA+IPA group, 57% of patients tested positive according to the serum GM assay, whereas in the iITBA group, all patients tested negative (p=0.070). The bronchial GM level was high in both groups, but there was no significant difference between them. Conclusion: Patients with ITBA+IPA had a greater number of hematologic malignancies with lower platelet counts and a poorer prognosis than patients diagnosed with iITBA. Findings obtained from bronchoscopy and bronchial GM tests were more useful in diagnosing ITBA than the serum GM test results.

Performance Evaluation of Reconstruction Algorithms for DMIDR (DMIDR 장치의 재구성 알고리즘 별 성능 평가)

  • Kwak, In-Suk;Lee, Hyuk;Moon, Seung-Cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.29-37
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    • 2019
  • Purpose DMIDR(Discovery Molecular Imaging Digital Ready, General Electric Healthcare, USA) is a PET/CT scanner designed to allow application of PSF(Point Spread Function), TOF(Time of Flight) and Q.Clear algorithm. Especially, Q.Clear is a reconstruction algorithm which can overcome the limitation of OSEM(Ordered Subset Expectation Maximization) and reduce the image noise based on voxel unit. The aim of this paper is to evaluate the performance of reconstruction algorithms and optimize the algorithm combination to improve the accurate SUV(Standardized Uptake Value) measurement and lesion detectability. Materials and Methods PET phantom was filled with $^{18}F-FDG$ radioactivity concentration ratio of hot to background was in a ratio of 2:1, 4:1 and 8:1. Scan was performed using the NEMA protocols. Scan data was reconstructed using combination of (1)VPFX(VUE point FX(TOF)), (2)VPHD-S(VUE Point HD+PSF), (3)VPFX-S (TOF+PSF), (4)QCHD-S-400((VUE Point HD+Q.Clear(${\beta}-strength$ 400)+PSF), (5)QCFX-S-400(TOF +Q.Clear(${\beta}-strength$ 400)+PSF), (6)QCHD-S-50(VUE Point HD+Q.Clear(${\beta}-strength$ 50)+PSF) and (7)QCFX-S-50(TOF+Q.Clear(${\beta}-strength$ 50)+PSF). CR(Contrast Recovery) and BV(Background Variability) were compared. Also, SNR(Signal to Noise Ratio) and RC(Recovery Coefficient) of counts and SUV were compared respectively. Results VPFX-S showed the highest CR value in sphere size of 10 and 13 mm, and QCFX-S-50 showed the highest value in spheres greater than 17 mm. In comparison of BV and SNR, QCFX-S-400 and QCHD-S-400 showed good results. The results of SUV measurement were proportional to the H/B ratio. RC for SUV is in inverse proportion to the H/B ratio and QCFX-S-50 showed highest value. In addition, reconstruction algorithm of Q.Clear using 400 of ${\beta}-strength$ showed lower value. Conclusion When higher ${\beta}-strength$ was applied Q.Clear showed better image quality by reducing the noise. On the contrary, lower ${\beta}-strength$ was applied Q.Clear showed that sharpness increase and PVE(Partial Volume Effect) decrease, so it is possible to measure SUV based on high RC comparing to conventional reconstruction conditions. An appropriate choice of these reconstruction algorithm can improve the accuracy and lesion detectability. In this reason, it is necessary to optimize the algorithm parameter according to the purpose.

Effects of sleep-inducing juice on sleep quality and heart rate variability in adults with disturbed sleep

  • Kim, Choun-sub;Kim, Maengkyu;Kim, Min-ju;Jung, Hyeyoung
    • Nutrition Research and Practice
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    • v.14 no.6
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    • pp.606-620
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    • 2020
  • BACKGROUND/OBJECTIVES: Although some juices affect subjective sleep quality, there is a lack of information on the effect of a specific juice on objective sleep quality and heart rate variability (HRV) during sleep; thus the present study investigated whether a blended juice made from natural extracts influenced sleep quality and HRV during sleep in adults with disturbed sleep. SUBJECTS/METHODS: A randomized, crossover study was conducted on twenty-five adults (15/10, female/male) complaining of difficulty initiating or maintaining nighttime sleep (Pittsburgh sleep quality index [PSQI] ≥ 5). During feeding sessions (FS), subjects received sleep-inducing juice made of natural ingredients (250 mL/trial) twice a day for 8 weeks or non-FS (N-FS) for 8 weeks while maintaining normal activities. Sleep quality and parameters were recorded via wearable actigraph for 7 consecutive days, and PSQI scores were assessed before and after the intervention. HRV was also monitored at rest and during sleep. RESULTS: After receiving the sleep-inducing juice intervention (FS), PSQI scores were significantly decreased (P < 0.001) and correlated with a significant decline in fatigue severity scale and visual analogue scale levels (P < 0.05; both). HRV indices of vagal activity were significantly improved during FS (P < 0.05), and no significant differences in N-FS were observed. Sleep efficiency and total sleep time increased significantly (P < 0.05) and sleep latency, total counts, sleep fragmentation index, and movement index, decreased significantly (P < 0.05, all 4) during FS, with no significant differences-observed during N-FS. CONCLUSIONS: This study results demonstrated that an 8-week course of sleep-inducing juice has led to improve sleep quality, suggesting an enhanced cardiac vagal tone during sleep. Thus, it could be a well-tolerated option for adults with disturbed sleep.

Value of the Platelet to Lymphocyte Ratio in the Diagnosis of Ovarian Neoplasms in Adolescents

  • Ozaksit, Gulnur;Tokmak, Aytekin;Kalkan, Hatice;Yesilyurt, Huseyin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2037-2041
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    • 2015
  • Background: Relationships between poor prognosis of ovarian malignancies and changes in complete blood count parameters have been proposed previously. In this work, we aimed to evaluate clinicopathologic features in adolescents with adnexal masses and sought to establish any predictive value of the platelet to lymphocyte ratio (PLR) in diagnosis. Materials and Methods: This retrospective study was conducted on 196 adolescent females with adnexal masses. Three groups were constituted with respect to clinical or histopathology results: group 1, non-neoplastic patients (n:65); group 2, neoplastic patients (n:68); and group 3 expectantly managed patients (n:63). The main parameters recorded from the hospital database and patient files were age, body mass index (BMI), chief symptoms, diameter of the mass (DOM), tumor marker levels, complete blood count values including absolute neutrophil, lymphocyte, and platelet counts, mean platelet volume, platelet distribution width, and platecrit, surgical features, and postoperative histopathology results. Results: The expectantly managed patients were younger than the other groups (p=0.007). The mean body mass index (BMI) was higher in the neoplastic group (p=0.016). Preoperative DOM, CA125, mean platelet volume and PLR were statistically significantly different between the groups (p<0.05). ROC curve analysis demonstrated that increased PLR (AUC, 0.609; p=0.011) and BMI (AUC, 0.611; p=0.011) may be discriminative factors in predicting ovarian neoplasms in adolescents preoperatively. When the cut-off point for the PLR level was set to 140, the sensitivity and specificity levels were found to be 65.7% and 57.6%, respectively. Conclusions: We suggest that beside a careful preoperative evaluation including clinical characteristics, ultrasonographic features and tumor markers, PLR may predict ovarian neoplasms in adolescents.

Innate immunity and carbohydrate metabolism alterations precede occurrence of subclinical mastitis in transition dairy cows

  • Dervishi, Elda;Zhang, Guanshi;Hailemariam, Dagnachew;Dunn, Suzana M.;Ametaj, Burim N.
    • Journal of Animal Science and Technology
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    • v.57 no.12
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    • pp.46.1-46.19
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    • 2015
  • Background: This study examined whether activation of innate immunity and alterations of carbohydrate and lipid metabolism precede development of subclinical mastitis (SCM). Methods: Blood samples were collected from the coccygeal vein from 100 Holstein dairy cows at -8, -4, disease diagnosis week, and +4 weeks postpartum. Six healthy cows (controls - CON) and six cows that showed clinical signs of SCM were selected for serum analyses. All serum samples were analyzed for acute phase proteins (APP) haptoglobin (Hp) and serum amyloid A (SAA); proinflammatory cytokines including interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF) and serum lactate, BHBA, and NEFA concentration. Data of DMI, milk production, and milk composition were recorded and analyzed. Results: The results showed that cows with SCM had greater concentrations of SAA, TNF (P < 0.01), and lactate before expected day of parturition (P < 0.05) compared to CON cows. Cows with SCM showed greater concentrations of lactate starting at -8 weeks (P < 0.05) and TNF starting at -4 weeks prior to the expected day of parturition (P < 0.01). Interestingly, at -4 weeks, concentrations of IL-1 and Hp were lower in cows with SCM compared to healthy cows (P < 0.01) followed by an increase during the week of disease diagnosis (P < 0.05). Subclinical mastitis was associated with lower DMI, at -4 weeks before calving, milk production (P < 0.05) and increased somatic cell counts (SCC) (P < 0.01). Conclusions: Results of this study suggest that SCM is preceded by activated innate immunity and altered carbohydrate metabolism in transition dairy cows. Moreover the results support the idea that Hp, lactate, and SAA, at -8 weeks, and TNF and IL-1 at -4 weeks can be used as early indicators to screen cows during dry off for disease state.

The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

  • Choi, Hyun Nam;Han, Yea Sik;Kim, Sin Rak;Kim, Han Kyeol;Kim, Hyun;Park, Jin Hyung
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.647-653
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    • 2014
  • Background Administration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP) contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection. Methods A total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively. Results The median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ${\times}200$ HPF) in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group. Conclusions This study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

Investigation of Pathogenic Microbial Contamination in Medicinal Herb Products on the Market (유통 한약재에 대한 병원성미생물 분포)

  • Ham, Hee Jin;Yu, In Sil;Lee, Jib Ho;Kim, Su Jin;Yu, Young Ah;Lee, En Sun;Kim, Hee Sun
    • Korean Journal of Medicinal Crop Science
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    • v.25 no.2
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    • pp.108-114
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    • 2017
  • Background: The study was conducted to investigate the distributions of faecal bacteria in commercial oriental medicine herb products. Methods and Results: A survey was conducted on the microbial contamination levels and antimicrobial specificity of Bacillus cereus and other microbes using 106 oriental medicine herb products on sale in Seoul. Pouring and isolation methods such as standard plate counts were used to identify the bacteria. The isolated bacterias included coliforms, Bacillus spp., Enterococcus spp., Staphylococcus spp., Listeria spp.were identified by using gram staining and an API (analytical profile index) kit. Antimicrobial drugs discs were determined by CLSI (clinical and laboratory standards institute). Conclusions: The bacterial isolates present in the herbal medicines included 98 coliforms, 45 Bacillus spp., 29 Enterococcus spp., and 2 Listeria spp. Among these, there were nine Bacillus cereus strains, one Enterococcus faecium strain, and one Enterococcus faecalis strain present. The 9 Bacillus cereus strains were tested for susceptibility to 36 types of antibiotics products by the disc diffusion method. The strains showed resistance to 13 of these antibiotic products and semi-resistance to 5 antibiotic products. On the basis of these results, any oriental medicine herb product can be assumed to be contain resistant or semi-resistant bacterial strains. Therefore, we suggest prescribing guidelines and special management for the use of antibiotics in farms producing oriental medicine herb products.

Leukocyte Sequestration and Free Radical-Mediated Lung Injury in Ovine Cardiopulmonary bypass Using Membrane Oxygenator (양에서 막형 산화기를 사용하여 심폐바이패스할 경우 백혈구격리 및 자유라디칼로 중재되는 폐손상)

  • 김원곤;신윤철;서정욱
    • Journal of Chest Surgery
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    • v.32 no.11
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    • pp.978-983
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    • 1999
  • Background: Complement activation with transpulmonary leukocyte sequestration is considered a main mediator leading to ischemia-reperfusion lung(I-R) injury. We studied the role of leukocytes in the formation of I-R injury in ovine cardiopulmonary bypass(CPB) model with a membrane oxygenator. Material and Method: Five sheep were used. CPB circuitry consisted of a roller pump(American Optical Corp., Greenwich, CT, USA) and a membrane oxygenator(UNIVOX-IC, Bentley, Baxter Health Corp, Irvine, CA, USA). The CPB time was fixed at 120 min. Ten minutes after the start of CPB, total CPB was established. Thereafter a total CPB of 100 min was performed, followed by another 10 min of partial CPB. The CPB was discontinued and the animals were fully recovered. For measuring left and right atrial leukocyte counts, blood samples were taken before thoracotomy, 5 min and 109 in after the start of CPB, and 30 min and 120 min after weaning. C3a was measured before thoracotomy, 109 min after the start of CPB, and 30 min and 120 min after weaning. Plasma malondialdehyde(MDA) was checked before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. One to two grams of lung tissue were taken for water content measurement before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. Lung biopsy specimens were examined by light and electron microscopy. Result: Of 5 animals, 4 survived the experimental procedures. Of these, 3 animals survived on a long-term basis. No significant differences in transpulmonary gradients of leukocyte were found and no significant complement activation was expressed by C3a levels. MDA level did not show significant changes related to lung reperfusion despite an increase after the start of CPB. On both light and electron microscopic examinations, mild to moderate acute lung change was observed. Interstitial edema, leakage of erythrocytes into the alveolar space and endothelial cell swelling were the main findings. Water content of the lung showed a slight increase after the start of CPB, but there was no statistical significance. Conclusion: These findings indicate that ischemia-repersusion lung injury may not be from complement activation-leukocyte sequestration but from another source of oxygen free radicals related to CPB.

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The Effect of Changiga on Immune Cell & Serum OA-specific IgE in BALF in Rat Asthma Model (창이자(蒼耳子)가 제 I 형 알레르기 천식(喘息)모델 흰쥐의 BALF내(內) 면역세포(免疫細胞) 및 혈청(血淸) IgE에 미치는 영향(影響))

  • Lee Byoung-Hee;Lee Sang-Jae;Kim Kwang-Ho
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.2
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    • pp.93-105
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    • 2001
  • BACKGROUND : Changiga is a hetnal medicine which has been used of the traditional therapeutic agent of asthma. So I examine the effect of Changija on immune Cell&serum OA-specific IgE in BALF in rat asthma model. MATERIAL and METHODS : Rats were sensitized with OA; at day 1 sensitized group and Changiga(CIG) groups were systemically immunized by subcutaneous ingection of 1mg OA and 300mg of Al(OH)3 in a total volume of 2ml. At the same time, 1ml of 0.9% saline containing $6{\times}109$ B. pertussis bacilli was injected by i.p. 14 days, after the systemic immunization, rats received local immunization by inhaling 0.9% saline aerocol containing 2%(wt/vol) OA, A day after local immunization, BAL fluid was collected from the rats. A day after local immunization, rats were orally administered with Changiga extract 14 days, Lymphocyte, CD4+ T-cell CD8+ T-cell counts, CD4+/CD8+ ratio in BALF, change of serum OA-specific IgE level in the peripheral blood were measured and evaluated. RESULT : Changiga showed a suppressive effect on a rat asthme model. Changiga decreased lymphocyte, CD4+ T-cell, CD4+/CD8+ ratio in BALF, serum OA-specific IgE level as compared with the control group, whereas Changiga decreased CD8+ T-cell in BALF with statistical nonsignificance as compared with the control group. CONCLUSION: This study shows that Changiga have a suppressive effect on rat allergic athma model. Changiga would be useful allergic asthma treatment agent.

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Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years

  • Yun, Jeong Hee;Byun, Joung Hun;Kim, Sung Hwan;Moon, Sung Ho;Park, Hyun Oh;Hwang, Sang Won;Kim, Yong Hwan
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.435-442
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    • 2016
  • Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p=0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.