• Title/Summary/Keyword: Lymph Nodes

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Disseminated Mycobacterium intracellulare Infection in an Immunocompetent Host

  • Kim, Won-Young;Jang, Sun-Joo;Ok, Tae-Jin;Kim, Gwang-Un;Park, Han-Seung;Leem, Jae-Chan;Kang, Bo-Hyoung;Park, Se-Jeong;Oh, Dong-Kyu;Kang, Byung-Ju;Lee, Bo-Young;Ji, Won-Jun;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.452-456
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    • 2012
  • Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.

Clinical Presentation and Management of Five Dogs with Apocrine Gland Adenocarcinoma of Anal Sac (다섯 마리의 개에서 발생한 아포크린샘암종 증례)

  • Oh, Ye-In;Seo, Kyoung-Won;Kim, Jun-Young;Youn, Jung-Hee;Hwang, Cheol-Young;Lee, Sang-Koo;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.606-611
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    • 2009
  • Five dogs diagnosed as apocrine gland adenocarcinoma (AGAC) of the anal sac based on cytology and/or histology. Mean age of these dogs was 11 years old. One dog treated with supportive care without other medical interventions for hypercalcemia was died one month after diagnosis. Other four dogs were treated with chemotherapy and one of these dogs was intervened with complete surgical resection. Two months after the diagnosis, one of the dogs treated with chemotherapy died. The survival time of other survived three dogs from the time of diagnosis was 19, 9, and 13 months respectively and they are still alive at this time. After chemotherapy, three dogs were managed generally in good body condition and maintained as similar in size as time of diagnosis. The results are suggested that it is worthwhile to try chemotherapy for managing AGAC in dogs especially complicated or metastasized to regional lymph nodes.

Differential Effect of MyD88 Signal in Donor T Cells on Graft-versus-Leukemia Effect and Graft-versus-Host Disease after Experimental Allogeneic Stem Cell Transplantation

  • Lim, Ji-Young;Ryu, Da-Bin;Lee, Sung-Eun;Park, Gyeongsin;Choi, Eun Young;Min, Chang-Ki
    • Molecules and Cells
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    • v.38 no.11
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    • pp.966-974
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    • 2015
  • Despite the presence of toll like receptor (TLR) expression in conventional $TCR{\alpha}{\beta}$ T cells, the direct role of TLR signaling via myeloid differentiation factor 88 (MyD88) within T lymphocytes on graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect after allogeneic stem cell transplantation (allo-SCT) remains unknown. In the allo-SCT model of C57BL/6 ($H-2^b$) ${\rightarrow}$ B6D2F1 ($H-2^{b/d}$), recipients received transplants of wild type (WT) T-cell-depleted (TCD) bone marrow (BM) and splenic T cells from either WT or MyD88 deficient (MyD88KO) donors. Host-type ($H-2^d$) P815 mastocytoma or L1210 leukemia cells were injected either subcutaneously or intravenously to generate a GVHD/GVL model. Allogeneic recipients of MyD88KO T cells demonstrated a greater tumor growth without attenuation of GVHD severity. Moreover, GVHD-induced GVL effect, caused by increasing the conditioning intensity was also not observed in the recipients of MyD88KO T cells. In vitro, the absence of MyD88 in T cells resulted in defective cytolytic activity to tumor targets with reduced ability to produce IFN-${\gamma}$ or granzyme B, which are known to critical for the GVL effect. However, donor T cell expansion with effector and memory T-cell differentiation were more enhanced in GVHD hosts of MyD88KO T cells. Recipients of MyD88KO T cells experienced greater expansion of Foxp3- and IL4-expressing T cells with reduced INF-${\gamma}$ producing T cells in the spleen and tumor-draining lymph nodes early after transplantation. Taken together, these results highlight a differential role for MyD88 deficiency on donor T-cells, with decreased GVL effect without attenuation of the GVHD severity after experimental allo-SCT.

Deoxypodophyllotoxin Induces a Th1 Response and Enhances the Antitumor Efficacy of a Dendritic Cell-based Vaccine

  • Lee, Jun-Sik;Kim, Dae-Hyun;Lee, Chang-Min;Ha, Tae-Kwun;Noh, Kyung-Tae;Park, Jin-Wook;Heo, Deok-Rim;Son, Kwang-Hee;Jung, In-Duk;Lee, Eun-Kyung;Shin, Yong-Kyoo;Ahn, Soon-Cheol;Park, Yeong-Min
    • IMMUNE NETWORK
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    • v.11 no.1
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    • pp.79-94
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    • 2011
  • Background: Dendritic cell (DC)-based vaccines are currently being evaluated as a novel strategy for tumor vaccination and immunotherapy. However, inducing long-term regression in established tumor-implanted mice is difficult. Here, we show that deoxypohophyllotoxin (DPT) induces maturation and activation of bone marrow-derived DCs via Toll-like receptor (TLR) 4 activation of MAPK and NF-${\kappa}B$. Methods: The phenotypic and functional maturation of DPT-treated DCs was assessed by flow cytometric analysis and cytokine production, respectively. DPT-treated DCs was also used for mixed leukocyte reaction to evaluate T cell-priming capacity and for tumor regression against melanoma. Results: DPT promoted the activation of $CD8^+$ T cells and the Th1 immune response by inducing IL-12 production in DCs. In a B16F10 melanoma-implanted mouse model, we demonstrated that DPT-treated DCs (DPT-DCs) enhance immune priming and regression of an established tumor in vivo. Furthermore, migration of DPT-DCs to the draining lymph nodes was induced via CCR7 upregulation. Mice that received DPT-DCs displayed enhanced antitumor therapeutic efficacy, which was associated with increased IFN-${\gamma}$ production and induction of cytotoxic T lymphocyte activity. Conclusion: These findings strongly suggest that the adjuvant effect of DPT in DC vaccination is associated with the polarization of T effector cells toward a Th1 phenotype and provides a potential therapeutic antitumor immunity.

Extraction and verification of highly immunologenic antigen for diagnosis of bovine brucellosis (소 브루셀라병 진단용 고면역원성 항원의 추출과 검증)

  • Bae, Jae-Hyung;Jo, Sang-Rae;Jeong, Eun-Hui;Jang, Eun-Hui;Kim, Seong-Eun;Kwon, Hui-Nyeong;Park, Dong-Yeop;Lee, Kuk-Cheon
    • Korean Journal of Veterinary Service
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    • v.33 no.2
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    • pp.135-141
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    • 2010
  • Bovine brucellosis, an important zoonosis, is diagnosed with serological tests such as the RBT, TAT using inactivated whole bacterial cells or bacterial lipopolysaccharide (LPS) antigen in Korea. However, a strong cross-reaction between Brucella spp. and Yersinia enterocolitica O9 in these tests has seriously complicated the diagnosis of animal brucellosis because Brucella spp. shares common antigenic determinants with Y. enterocolitica O9 in the smooth LPS region. In this study, Brucella-field strains were isolated from Brucellapositive Hanwoo in Kimhae, Korea and outer membrane protein (omp) which has low cross-reaction with Y. enterocolitica O9 and high immunogenicity was extracted from the field strains Then we compared ELISA using the extract with RBT-TAT. Fifteen field strains were isolated from 47 supra-mammary-lymph nodes, which were collected from 18 farms. Isolation rate was 32%. Brucella-specific antigen was identified by performing SDS-PAGE or Western blotting on extracted omp with at 0.5% n-lauroylsarcosine One hundred and ninety-two serum-samples were used in the experiment: 142 negative and 50 positive samples verified by RBT-TAT. According to ELISA results, 127 samples were negative and 15 appeared positive among 142 negatives by RBT-TAT, while 42 samples were positive and 8 were negative among 50 positives by RBT-TAT. Therefore, it showed 89.4% of specificity and 84% of sensi-tivity. Through the current experiments, we could set up an ELISA based on the omp which has low cross-reaction and high immunogenicity and concluded that the omp could be a good material for accurate diagnosis of bovine brucellosis.

The Preservation of Left Gastric Artery in Laparoscopy-Assisted Subtotal Gastrectomy with Splenectomy of Stomach Cancer (위암에서 복강경보조 원위부 위아전절제술 및 비장합병절제술 좌위동맥의 보존 증례 보고)

  • Lee, Sang-Rim;Park, Jong-Min;Han, Sang-Uk;Cho, Young-Kwan
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.42-46
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    • 2007
  • Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

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A Case of Pneumothorax Caused by Cystic Lung Metastasis of Angiosarcoma (혈관육종의 낭성 폐전이에 의한 기흉 1예)

  • Lee, Chan Joo;Choi, Jun Jeong;Jeon, Han Ho;Jung, Kyung Soo;Park, Byung Hoon;Park, Seon Cheol;Shin, Sang Yun;Chung, Wou Young;Byun, Min Kwang;Moon, Ji Ae;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.374-378
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    • 2008
  • Angiosarcoma is a rare but highly malignant tumorthat usually arises in the scalp or face of elderly males. Distant metastases favor the lung, liver, lymph nodes and skin. Metastatic pulmonary angiosarcoma commonly takes the form of a nodule but can sometimes appear as a thin-walled cyst. We report a case of 65 years-old male with a spontaneous pneumothorax, who underwent excision and radiotherapy for an angiosarcoma of the scalp 2 years ago. A chest CT scan revealed multiple cysts in the lung. The video-assisted thoracoscopic lung biopsy demonstrated subpleural cysts without tumor cells. A skin biopsy of the scalp showed an angiosarcoma. This case was diagnosed as a recurrence of an angiosarcoma with a supposed lung metastasis. This case suggests that a spontaneous pneumothorax in elderly people may be secondary to a pulmonary metastasis from an angiosarcoma of the scalp.

A CASE OF TYPE II7 MIRIZZI SYNDROME (Type II Mirizzi 증후군 1례)

  • Kim, Hong-Jin;Lee, Joo-Hyeong;Shin, Myeong-Jun;Kwun, Koing-Bo;Chang, Jae-Chun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.197-202
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    • 1990
  • Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

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Sudden Death Caused by Clostridium perfringens Type D Enterotoxemia in Feedlot Cattle (비육 우의 Clostridium perfringens D 형 장독 혈증에 의한 폐사)

  • Jang, Seong-Jun;Do, Sun-Hee;Ki, Mi-Ran;Hong, Il-Hwa;Park, Jin-Kyu;Cho, Yu-Jeong;Ji, Ae-Ri;Park, Se-Il;Park, Sang-Joon;Kim, Tae-Hwan;Kwak, Dong-Mi;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.20 no.5
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    • pp.639-643
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    • 2010
  • Sudden deaths have occurred in feedlot cattle with marked necro-hemorrhagic enteritis of the jejunum, ileum and colon. Suckling beef calves are the most frequently affected. Over-consumption of large amounts of milk, inadequate colostrum intake, chilling and stress are conducive to the development of enterotoxemia. Enterotoxemia caused by Clostridium perfringens type D mostly occurs following a sudden change of diet, particularly to feeds made richer in order to grow the cattle to market weight in feedlots. During July 2006, sudden deaths of cattle occurred in the Youngcheon regional area of Gyeongbuk province. There were no significant clinical signs except anorexia, depression, intermittent diarrhea and mild respiratory failure. Histological findings revealed a prominent intranuclear inclusion as well as infiltration of the globular leukocytes in various organs including the heart, kidneys, liver, spleen and lymph nodes. Spleen and lymphatic tissues showed lymphatic necrosis and a starry sky appearance. In the submucosa of the small intestines, basophilic aggregation was detected with massive infiltration of the globular leukocytes and eosinophils. Gram staining for the tissue sections containing inclusions of the small intestines revealed a positive histochemical reaction. Taken together, we suggest that Clostridium perfringens type D-induced enterotoxemia is determined to be the cause of sudden death of feedlot cattle.

Prognostic value of nodal SUVmax of 18F-FDG PET/CT in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy

  • Lee, So Jung;Kay, Chul-Seoung;Kim, Yeon-Sil;Son, Seok Hyun;Kim, Myungsoo;Lee, Sea-Won;Kang, Hye Jin
    • Radiation Oncology Journal
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    • v.35 no.4
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    • pp.306-316
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    • 2017
  • Purpose: To investigate the predictive role of maximum standardized uptake value ($SUV_{max}$) of 2-[$^{18}F$]fluoro-2-deoxy-D-glucose($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) in nasopharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT). Materials and Methods: Between October 2006 and April 2016, 53 patients were treated with IMRT in two institutions and their PET/CT at the time of diagnosis was reviewed. The $SUV_{max}$ of their nasopharyngeal lesions and metastatic lymph nodes (LN) was recorded. IMRT was delivered using helical tomotherapy. All patients except for one were treated with concurrent chemoradiation therapy (CCRT). Correlations between $SUV_{max}$ and patients' survival and recurrence were analyzed. Results: At a median follow-up time of 31.5 months (range, 3.4 to 98.7 months), the 3-year overall survival (OS) and disease-free survival (DFS) rates were 83.2% and 77.5%, respectively. In univariate analysis, patients with a higher nodal pre-treatment $SUV_{max}$ (${\geq}13.4$) demonstrated significantly lower 3-year OS (93.1% vs. 55.5%; p = 0.003), DFS (92.7% vs. 38.5%; p < 0.001), locoregional recurrence-free survival (100% vs. 50.5%; p < 0.001), and distant metastasis-free survival (100% vs. 69.2%; p = 0.004), respectively. In multivariate analysis, high pre-treatment nodal $SUV_{max}$ (${\geq}13.4$) was a negative prognostic factor for OS (hazard ratio [HR], 7.799; 95% confidence interval [CI], 1.506-40.397; p = 0.014) and DFS (HR, 9.392; 95% CI, 1.989-44.339; p = 0.005). Conclusions: High pre-treatment nodal $SUV_{max}$ was an independent prognosticator of survival and disease progression in nasopharyngeal carcinoma patients treated with IMRT in our cohort. Therefore, nodal $SUV_{max}$ may provide important information for identifying patients who require more aggressive treatment.