• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.30-36
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• 2012

Background: Patients with ventilator-associated pneumonia (VAP) in intensive care unit (ICU) have a high mortality rate. The routine surveillance cultures obtained previously or an ATS guideline for hospital-acquired pneumonia was used in selecting initial antimicrobials. The object of this study was to compare the respiratory samples before VAP and bronchoalveolar lavage (BAL) culture. Methods: 54 patients underwent fiberoptic bronchoscopy to obtain BAL samples. We reviewed microbiologic specimen results of prior respiratory specimens (pre-VAP) and BAL. Results: Among 51 patients with 54 VAP episodes, 52 microorganisms of pre-VAP and 56 BAL samples were isolated. Pre-VAP included 21.2% of MRSA, and 32.6% of multidrug resistant-Acinetobacter baumannii (MDR-AB). BAL samples comprised 25.0% of MRSA, 26.7% of MDR-AB, 14.3% of Stenotrophomonas maltophilia and 3.6% of Klebsiella pneumonia in order. In pre-VAP samples compared to BAL samples, only 35.2% were identical. In BAL samples compared to pre-VAP samples obtained in 5 days before the onset of VAP, only 43.6% were identical. However, among BAL samples compared to pre-VAP samples obtained after more than 5 days, 13.3% were identical (p=0.037). Conclusion: Based on these data, pre-VAP samples obtained prior to 5 day onset of VAP may help to predict the causative microorganisms and to select appropriate initial antimicrobials.

• Journal of Ginseng Research
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• 제43권4호
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• pp.635-644
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• 2019

Background: To increase the pharmacological effects of red ginseng (RG, the steamed root of Panax ginseng Meyer), RG products modified by heat process or fermentation have been developed. However, the antiallergic effects of RG and modified/fermented RG have not been simultaneously examined. Therefore, we examined the allergic rhinitis (AR)-inhibitory effects of water-extracted RG (wRG), 50% ethanol-extracted RG (eRG), and bifidobacteria-fermented eRG (fRG) in vivo. Methods: RBL-2H3 cells were stimulated with phorbol 12-myristate-13-acetate/A23187. Mice with AR were prepared by treatment with ovalbumin. Allergic markers IgE, tumor necrosis factor-${\alpha}$, interleukin (IL)-4, and IL-5 were assayed in the blood, bronchoalveolar lavage fluid, nasal mucosa, and colon using enzyme-linked immunosorbent assay. Mast cells, eosinophils, and Th2 cell populations were assayed using a flow cytometer. Results: RG products potently inhibited IL-4 expression in phorbol 12-myristate-13-acetate/A23187-stimulated RBL-2H3 cells. Of tested RG products, fRG most potently inhibited IL-4 expression. RG products also alleviated ovalbumin-induced AR in mice. Of these, fRG most potently reduced nasal allergy symptoms and blood IgE levels. fRG treatment also reduced IL-4 and IL-5 levels in bronchoalveolar lavage fluid, nasal mucosa, and reduced mast cells, eosinophils, and Th2 cell populations. Furthermore, treatment with fRG reduced IL-4, IL-5, and IL-13 levels in the colon and restored ovalbumin-suppressed Bacteroidetes and Actinobacteria populations and ovalbumin-induced Firmicutes population in gut microbiota. Treatment with ginsenoside Rd significantly alleviated ovalbumin-induced AR in mice. Conclusion: fRG and ginsenoside Rd may alleviate AR by suppressing IgE, IL-4, IL-5, and IL-13 expression and restoring the composition of gut microbiota.

• Parasites, Hosts and Diseases
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• 제61권2호
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• pp.202-209
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• 2023

Lophomonas blattarum is an anaerobic protozoan living in the intestine of cockroaches and house dust mites, with ultramicroscopic characteristics such as the presence of a parabasal body, axial filament, and absence of mitochondria. More than 200 cases of Lophomonas infection of the respiratory tract have been reported worldwide. However, the current diagnosis of such infection depends only on light microscopic morphological findings from respiratory secretions. In this study, we attempted to provide more robust evidence of protozoal infection in an immunocompromised patient with atypical pneumonia, positive for Lophomonas-like protozoal cell forms. A direct search of bronchoalveolar lavage fluid via polymerase chain reaction (PCR), transmission electron microscopy (TEM), and metagenomic next-generation sequencing did not prove the presence of protozoal infection. PCR results were not validated with sufficient rigor, while de novo assembly and taxonomic classification results did not confirm the presence of an unidentified pathogen. The TEM results implied that such protozoal forms in light microscopy are actually non-detached ciliated epithelial cells. After ruling out infectious causes, the patient's final diagnosis was drug-induced pneumonitis. These findings underscore the lack of validation in the previously utilized diagnostic methods, and more evidence in the presence of L. blattarum is required to further prove its pathogenicity.

• Tuberculosis and Respiratory Diseases
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• 제62권6호
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• pp.506-515
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• 2007

연구배경: 원내 폐렴의 적절한 항균제 치료를 위해서는 원발 병소에서의 원인균 규명과 항균제에 대한 내성 유무 확인이 필수적이다. 본 연구는 원내 폐렴이 의심되는 경우 기관지내시경을 통한 정량적 기관지폐포 세척술(bronchoalveolar lavage, BAL) 배양검사를 시행하여 빈번하게 분리되는 균주와 이들의 항균제 내성 현황을 알아보고자 하였다. 방 법: 2004년 1월부터 2006년 6월까지 한림의대 한강성심병원 화상 중환자실과 비화상 중환자실에서 폐 침윤의 원인규명 위해 BAL 검사를 시행하였다. 104 CFU/mL 이상의 균주가 분리되면 양성으로 판정하였다. 결 과: BAL 검사 결과 화상중환자실 27예(77.1%), 비화상중환자실 22예(59.4%)에서 배양 양성이었다. 분리되는 주요 균주는 S. aureus, Acinetobacter species 및 P. aeruginosa 였다. 화상중환자실에서 분리된 S. aureus의 경우 전부 MRSA(100%)였으며, 비화상중환자실에서는 71.4%가 MRSA로 보고되었다. P. aeruginosa의 경우 화상중환자실 및 비화상중환자실에서 amikacin 54.6% vs. 50.0%, ciprofloaxacin 100% vs. 50%, cefepime 90.9% vs. 50%, imipenem 72.7% vs. 50%, ceftazidime 45.5% vs. 25% 및 piperacillin/tazobactam 90.9% vs. 50%의 내성률을, Acinetobacter species의 경우는 amikacin 90.9% vs. 100%, ciprofloxacin 100% vs. 87.5%, cefepime 90.9% vs. 100%, imipenem 100% vs. 62.5%, ceftazidime 90.9% vs. 100% 및 piperacillin/tazobactam 81.8% vs. 62.5%의 내성률을 보여주었다. 결 론: 화상중환자실과 비화상중환자실에서 원내 폐렴이 의심되는 환자의 원인균 분포와 약제 내성 현황을 알 수 있었으며 향후 항균제 치료 전략에 도움을 줄 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제67권6호
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• pp.569-573
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• 2009

Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by surfactant component accumulation in the alveolar space. Idiopathic PAP has recently been recognized as a autoimmune disease of impaired alveolar macrophage function caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). While whole lung lavage has been the standard treatment, not every patient shows a complete response. Subcutaneous injection or inhalation of GM-CSF is another promising treatment option for PAP. A 45-year-old patient visited our hospital for dyspnea, he was diagnosed as PAP and underwent whole lung lavage. Eighteen months later, the patient had not achieved complete remission in despite of initial response. After then he was administered with GM-CSF (5 ${mu}g/kg/day$, subcutaneous injection) for fivetimes a week during 2 months. Nine months later, the abnormal shadows in high-resolution computed tomography (HRCT) decreased and the patient fully recovered in forced vital capacity. After 60 months, the HRCT scan showed complete remission of PAP.

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.437-443
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• 1998

노작성 호흡곤란과 흉부 X-선 사진상의 이상소견으로 입원한 환자에서 직업력상의 규사폭로력과 조직검사에서의 폐포단백증의 소견으로 이차성 폐포단백증을 진단하고 전폐세척술의 시행으로 증상의 호전을 보인 1 예를 경험하였기에 문헌고찰과 함께 보고하였다.

• Tuberculosis and Respiratory Diseases
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• 제41권2호
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• pp.158-164
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• 1994

호흡곤란 및 청색증을 주소로 입원한 44세의 남자환자에서 경기관지 폐생검상 폐포내 PAS염색 양성인 인지질 축적과, 전자현미경상 적층체가 관찰되어 폐포단백증으로 진단한 환자에서 치료목적으로 전폐세척술을 시행하였으나 부작용으로 뇌부종이 발생하여 사망한 1예를 경험하였기에 문헌고찰과 함께 보고하였다.

• 대한한의학회지
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• 제23권3호
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• pp.104-118
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• 2002

Objectives : To study the effects of Kumsooyukkun-jeon on asthma. Methods : Asthma was induced to Balb/c mice with ovalbumin using the method of Hatfield et al. We measured the histological profiles of lung and trachea, numbers of cellular compartments in the bronchoalveolar lavage fluid (BALF), numbers and morphology of the mast cells in the trachea, numbers of mucous-secretory cells in the bronchus, morphology of the bronchus, ultramicroscopical appearance of surface of trachea and number of cilia and mucous-secretory cells by scanning electron microscope. Results : 1. Hypertrophy of mucous membrane of trachea and bronchus and bronchioles in the lung, peritracheal, peribronchus and peribronchiolar inflammatory cell infiltration, and mucoid exudate deposition the lumen were observed in control groups but these phenomena were recovered in the Kumsooyukkun-jeon groups. 2. Cellular compartments including neutrophil and eosinophil were increased in the BALF of control groups but these phenomena were recovered in the Kumsooyukkun-jeon groups. 3. Degranulation and decrease of the numbers of mast cells were detected in the trachea of control groups. However, these phenomena were recovered in the Kumsooyukkun-jeon groups. 4. Shedding, decrease of cilia cell and increase of mucous-secretory cells in the surface of the trachea were measured in control groups but these phenomena were recovered in the Kumsooyukkun-jeon groups. Conclusions : It is considered that Kumsooyukkun-jeon has somewhat favorable effects on asthma.

• Clinical and Experimental Pediatrics
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• 제56권1호
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• pp.8-12
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• 2013

Asthma is associated with increased levels of eosinophils in tissues, body fluids, and bone marrow. Elevated levels of eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) have been noted in asthma patients. Higher levels of EDN and ECP are also associated with exacerbated asthmatic conditions. Thus, EDN, along with ECP, may aid the diagnosis and monitoring of asthma. Several groups have suggested that EDN is more useful than ECP in evaluating disease severity. This may partially be because of the recoverability of EDN (not sticky, 100% recovery rate), as ECP is a sticky and more highly charged protein. In terms of clinical utility, EDN level is a more accurate biomarker than ECP when analyzing the underlying pathophysiology of asthma. As a monitoring tool, EDN has shown good results in children with asthma as well as other allergic diseases. In children too young to fully participate in lung function tests, EDN levels may be useful as an alter native measurement of eosinophilic inflammation. EDN can also be used in adult patients and in multiple specimen types (e.g., serum, sputum, bronchoalveolar lavage fluid, and nasal lavage fluid). These results are repeatable and reproducible. In conclusion, EDN may be a novel biomarker for the diagnosis, treatment, and monitoring of asthma/allergic disease.

• 대한예방한의학회지
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• 제27권3호
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• pp.35-46
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• 2023

Objectives : Gumiganghwal-tang and its main components have been used for treatment of cough, headache, joint pain and fever. Using a respiratory inflammatory model, we intend to demonstrate the its anti-inflammatory effect and immune mechanism of Gumiganghwal-tang. Methods : We induced the respiratory inflammation mouse model by papain treatment. Female BALB/C mice (8 weeks old) were divided into three groups as follows: saline control group, papain treatment group (vehicle), papain and Gumiganghwal-tang (200 mg/kg) treatment group (n=4). To verify the anti-inflammatory effect of Gumiganghwal-tang extracts, we measured the infiltration of inflammatory cells in bronchoalveolar lavage fluid (BALF) and nasal lavage fluid (NALF). Additionally, the efficacy of Gumiganghwal-tang extracts on Th2 cell population and alveolar macrophage in lung were analyzed by using flow cytometry. Results : Gumiganghwal-tang extracts administration decreased inflammatory cell infiltration in BALF and NALF, especially of eosinophils. Furthermore, interleukin-5 level was reduced in lung by drug administration. Interestingly, Gumiganghwal-tang extracts treatment also decreased the Th2 cell (CD4⁺GATA3⁺) population and increased the alveolar macrophage (CD11b⁺CD11c⁺) population in lung. Conclusions : Our findings indicate that Gumiganghwal-tang extracts have anti-inflammatory effects by mediating Th2 cell and alveolar macrophage cell activation.