• Childhood Kidney Diseases
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• 제21권2호
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• pp.165-168
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• 2017

Focal segmental glomerulosclerosis (FSGS) in children, which is a kind of nephrotic syndrome showing steroid resistance, usually progresses to a substantial number of end stage renal disease (ESRD). Although the pathogenesis of primary FSGS is unclear, several recent studies have reported that FSGS is associated with circulating immune factors such as soluble urokinase-type plasminogen activator receptor (suPAR) or anti-CD40 autoantibody. We report a successfully treated case of a 19-year-old female patient who experienced a recurrence of primary FSGS. After the diagnosis of FSGS, the patient progressed to ESRD and received a kidney transplantation (KT). Three days later, recurrence was suspected through proteinuria and hypoalbuminemia. She has been performed plasmapheresis and high dose methylprednisolone pulse therapy and shown remission status without increasing proteinuria for four years after KT. In conclusion, strong immunosuppressive therapy may be helpful for a good prognosis of recurrent FSGS, suppressing several immunologic circulating factors related disease pathogenesis.

• 대한핵의학회지
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• 제38권2호
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• pp.111-114
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• 2004

Molecular imaging provides a visualization of normal as well as abnormal cellular processes at a molecular or genetic level rather than at a anatomical level. Conventional medical imaging methods utilize the imaging signals produced by nonspecific physico-chemical interaction. However, molecular imaging methods utilize the imaging signals derived from specific cellular or molecular events. Because molecular and genetic changes precede anatomical change in the course of disease development, molecular imaging can detect early events in disease progression. in the near future, through molecular imaging we can understand basic mechanisms of disease, and diagnose earlier and, subsequently, treat earlier intractable diseases such as cancer, neuro-degenerative diseases, and immunologic disorders. In beginning period, nuclear medicine started as a molecular imaging, and has had a leading role in the field of molecular imaging. But recently molecular imaging has been rapidly developed. Besides nuclear imaging, molecular imaging methods such as optical imaging, magnetic resonance imaging are emerging. Each imaging modalities have their advantages and weaknesses. The opportunities from molecular imaging look bright. We should try nuclear medicine continues to have a leading role in molecular imaging.

• Parasites, Hosts and Diseases
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• 제51권1호
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• pp.69-74
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• 2013

Leishmania tropica is one of the causative agents of leishmaniasis in humans. Routes of infection have been reported to be an important variable for some species of Leishmania parasites. The role of this variable is not clear for L. tropica infection. The aim of this study was to explore the effects of route of L. tropica infection on the disease outcome and immunologic parameters in BALB/c mice. Two routes were used; subcutaneous in the footpad and intradermal in the ear. Mice were challenged by Leishmani major, after establishment of the L. tropica infection, to evaluate the level of protective immunity. Immune responses were assayed at week 1 and week 4 after challenge. The subcutaneous route in the footpad in comparison to the intradermal route in the ear induced significantly more protective immunity against L. major challenge, including higher delayed-type hypersensitivity responses, more rapid lesion resolution, lower parasite loads, and lower levels of IL-10. Our data showed that the route of infection in BALB/c model of L. tropica infection is an important variable and should be considered in developing an appropriate experimental model for L. tropica infections.

• Journal of Korean Dental Science
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• 제15권2호
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• pp.101-111
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• 2022

The purpose of laboratory tests in the field of oral medicine can be divided into two categories: (1) medical evaluation of patients with systemic diseases that are planning to receive dental care and (2) diagnosis of patients with certain oral diseases. First, laboratory tests are commonly used to evaluate patients with systemic diseases who need dental management. A combination of multiple tests is usually prescribed as a test panel to diagnose and assess a specific disease. Test panels closely related to oral medicine include those for rheumatoid arthritis, connective tissue disease/lupus, liver function, thyroid screening, anemia, and bleeding disorders. Second, laboratory tests are used as auxiliary diagnostic methods for certain oral diseases. They often provide crucial diagnostic information for infectious diseases caused by bacteria, fungi, and viruses that are associated with pathology in the oral and maxillofacial regions. Laboratory tests for infectious diseases are composed of growth-dependent methods, immunologic assays, and molecular biology. As the field develops, further application of laboratory tests, including synovial fluid analysis in temporomandibular joint disorders, salivary diagnostics, and hematologic biomarkers associated with temporomandibular disorders and orofacial pain conditions, is currently under scrutiny for their reliability as diagnostic tools.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권1호
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• pp.3-11
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• 2020

Immunoglobulin G4 (IgG4)-related dacryoadenitis and sialoadenitis (IgG4-DS) are part of a multiorgan fibroinflammatory condition of unknown etiology termed IgG4-related disease (IgG4-RD), which has been recognized as a single diagnostic entity for less than 15 years. Histopathologic examination is critical for diagnosis of IgG4-RD. CD4+ T and B cells, including IgG4-expressing plasma cells, constitute the major inflammatory cell populations in IgG4-RD and are thought to cause organ damage and tissue fibrosis. Patients with IgG4-RD who have active, untreated disease exhibit significant increase of IgG4-secreting plasmablasts in the blood. Considerable insight into the immunologic mechanisms of IgG4-RD has been achieved in the last decade using novel molecular biology approaches, including next-generation and single-cell RNA sequencing. Exploring the interactions between CD4+ T cells and B lineage cells is critical for understanding the pathophysiology of IgG4-RD. Establishment of pathogenic T cell clones and identification of antigens specific to these clones constitutes the first steps in determining the pathogenesis of the disease. Herein, the clinical features and mechanistic insights regarding pathogenesis of IgG4-RD were reviewed.

• 대한핵의학회지
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• 제16권2호
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• pp.1-24
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• 1982

Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other endocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunopathologic studies indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide techniques as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disase including TRH stimulation test, $T_3$ suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique in thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

• 혜화의학회지
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• 제9권2호
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• pp.251-268
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• 2001

We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

• IMMUNE NETWORK
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• 제20권5호
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• pp.40.1-40.15
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• 2020

The protein encoded by the Gene Associated with Retinoid-Interferon-Induced Mortality-19 (GRIM-19) is located in the mitochondrial inner membrane and is homologous to the NADH dehydrogenase 1-alpha subcomplex subunit 13 of the electron transport chain. Multiple sclerosis (MS) is a demyelinating disease that damages the brain and spinal cord. Although both the cause and mechanism of MS progression remain unclear, it is accepted that an immune disorder is involved. We explored whether GRIM-19 ameliorated MS by increasing the levels of inflammatory cytokines and immune cells; we used a mouse model of experimental autoimmune encephalomyelitis (EAE) to this end. Six-to-eight-week-old male C57BL/6, IFNγ-knockout (KO), and GRIM-19 transgenic mice were used; EAE was induced in all strains. A GRIM-19 overexpression vector (GRIM19 OVN) was electrophoretically injected intravenously. The levels of Th1 and Th17 cells were measured via flow cytometry, immunofluorescence, and immunohistochemical analysis. IL-17A and IFNγ expression levels were assessed via ELISA and quantitative PCR. IL-17A expression decreased and IFNγ expression increased in EAE mice that received injections of the GRIM-19 OVN. GRIM19 transgenic mice expressed more IFNγ than did wild-type mice; this inhibited EAE development. However, the effect of GRIM-19 overexpression on the EAE of IFNγ-KO mice did not differ from that of the empty vector. GRIM-19 expression was therapeutic for EAE mice, elevating the IFNγ level. GRIM-19 regulated the Th17/Treg cell balance.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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• pp.34-42
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• 2018

Purpose: Monogenic inflammatory bowel disease (IBD) patients do not respond to conventional therapy and are associated with a higher morbidity. We summarized the clinical characteristics of monogenic IBD patients and compared their clinical outcomes to that of non-monogenic IBD patients. Methods: We performed a retrospective cohort study of all children <18 years old who were diagnosed with IBD between 2005 and 2016. A total of 230 children were enrolled. Monogenic IBD was defined as a presentation age less than 6 years old with confirmation of a genetic disorder. We subdivided the groups into monogenic IBD (n=18), non-monogenic very early-onset IBD (defined as patients with a presentation age <6 years old without a confirmed genetic disorder, n=12), non-monogenic IBD (defined as all patients under 18 years old excluding monogenic IBD, n=212), and severe IBD (defined as patients treated with an anti-tumor necrosis factor excluding monogenic IBD, n=92). We compared demographic data, initial pediatric Crohn disease activity index/pediatric ulcerative colitis activity index (PCDAI/PUCAI) score, frequency of hospitalizations, surgical experiences, and height and weight under 3rd percentile among the patients enrolled. Results: The initial PCDAI/PUCAI score (p<0.05), incidence of surgery per year (p<0.05), and hospitalization per year (p<0.05) were higher in the monogenic IBD group than in the other IBD groups. Additionally, the proportion of children whose weight and height were less than the 3rd percentile (p<0.05 and p<0.05, respectively) was also higher in the monogenic IBD group. Conclusion: Monogenic IBD showed more severe clinical manifestations than the other groups.

• Toxicological Research
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• 제21권2호
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• pp.121-128
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• 2005

Economic animal husbandry workers exposed to organic dust can be suffered from immunologic disorders. Our study was to determine immunological parameters related with occurrence of respiratory allergic diseases to animal husbandry workers in Korea for the first time. Peripheral blood were obtained from twenty-five pig barn workers, forty-nine chicken farming workers and fifty-one non-agricultural control workers. Significantly upregulated plasma IgE level was observed with pig-barn workers than that of chicken farming workers or healthy community control subjects. Furthermore, level of histamine, a hallmark of allergy induction, was upregulated in the pig and chicken farming workers in comparison with that of the control subjects. Downregulation of $IFN_\gamma$ and $TNF_{\alpha}$ production from T cells was apparent in the animal husbandry workers compared with the control subjects. Meanwhile, T cells collected from the pig barn workers demonstrated significantly higher production of IL-4 and IL-10 than the other groups. There were also alterations in IgG subclass distribution. In conclusion, immunological modulation probably leading to occupational allergic diseases can be occurred in the economic animal husbandry workers and the pig barn workers could be the most risky group to the work-related allergic disease.