• 제목/요약/키워드: chronic infection

검색결과 942건 처리시간 0.027초

폐 침윤을 동반한 급성 중증 환자의 기관지 폐포 세척액에서 측정한 Pre-B-Cell Colony-Enhancing Factor의 임상적 유용성 (Clinical Utility of Pre-B-Cell Colony-Enhancing Factor in Bronchoalveolar Lavage Fluid of Acute Critical Ill Patients with Lung Infiltrates)

  • 이광하;홍상범
    • Tuberculosis and Respiratory Diseases
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    • 제67권5호
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    • pp.402-408
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    • 2009
  • Background: Pre-B-cell colony enhancing factor (PBEF) has been suggested as a novel biomarker in sepsis and acute lung injury. We measured the PBEF in bronchoalveolar lavage (BAL) fluid of acute critically ill patients with lung infiltrates in order to evaluate the clinical utility of measuring PBEF in BAL fluid. Methods: BAL fluid was collected by bronchoscope from 185 adult patients with lung infiltrates. An enzyme-linked immunosorbent assay was then performed on the collected fluids to measure the PBEF. Results: Mean patient age was 59.9 ${\pm}$14.5 years and 63.8% of patients were males. The mean concentration of PBEF in BAL fluid was 17.5 ${\pm}$88.3 ng/mL, and patients with more than 9 ng/mL of PBEF concentration (n=26, 14.1%) had higher Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores on the BAL exam day. However, there were no significant differences in clinical characteristics between survivors and non-survivors. In patients with leukocytosis (n=93) seen on the BAL exam day, the linear regression analysis revealed a significant, positive relationship between PBEF and APACHE II ($r^2$=0.06), SOFA score ($r^2$=0.08), Clinical Pulmonary Infection Score ($r^2$=0.05), and plateau pressure in patients on ventilators ($r^2$=0.07) (p<0.05, respectively). In addition, multivariate regression analysis with PBEF as a dependent variable showed that the plateau pressure ($r^2$=0.177, p<0.05) was correlated positively with PBEF. Conclusion: The PBEF level in the BAL fluid may be a useful, new biomarker for predicting the severity of illness and ventilator-induced lung injury in critically ill patients with lung infiltates and leukocytosis.

Cordycepin Suppresses Expression of Diabetes Regulating Genes by Inhibition of Lipopolysaccharide-induced Inflammation in Macrophages

  • Shin, Seul-Mee;Lee, Sung-Won;Kwon, Jeong-Hak;Moon, Sun-Hee;Lee, Seung-Jeong;Lee, Chong-Kil;Cho, Kyung-Hae;Ha, Nam-Joo;Kim, Kyung-Jae
    • IMMUNE NETWORK
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    • 제9권3호
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    • pp.98-105
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    • 2009
  • Background: It has been recently noticed that type 2 diabetes (T2D), one of the most common metabolic diseases, causes a chronic low-grade inflammation and activation of the innate immune system that are closely involved in the pathogenesis of T2D. Cordyceps militaris, a traditional medicinal mushroom, produces a component compound, cordycepin (3'-deoxyadenosine). Cordycepin has been known to have many pharmacological activities including immunological stimulating, anti-cancer, and anti-infection activities. The molecular mechanisms of cordycepin in T2D are not clear. In the present study, we tested the role of cordycepin on the anti-diabetic effect and anti-inflammatory cascades in LPS-stimulated RAW 264.7 cells. Methods: We confirmed the levels of diabetes regulating genes mRNA and protein of cytokines through RT-PCR and western blot analysis and followed by FACS analysis for the surface molecules. Results: Cordycepin inhibited the production of NO and pro-inflammatory cytokines such as IL-$1{\beta}$, IL-6, and TNF-${\alpha}$ in LPS-activated macrophages via suppressing protein expression of pro-inflammatory mediators. T2D regulating genes such as $11{\beta}$-HSD1 and PPAR${\gamma}$ were decreased as well as expression of co-stimulatory molecules such as ICAM-1 and B7-1/-2 were also decreased with the increment of its concentration. In accordance with suppressed pro-inflammatory cytokine production lead to inhibition of diabetic regulating genes in activated macrophages. Cordycepin suppressed NF-${\kappa}B$ activation in LPS-activated macrophages. Conclusion: Based on these observations, cordycepin suppressed T2D regulating genes through the inactivation of NF-${\kappa}B$ dependent inflammatory responses and suggesting that cordycepin will provide potential use as an immunomodulatory agent for treating immunological diseases.

천골욕창에 발생한 우췌양 암종 1례 (Case Report of Verrucous Carcinoma Arising in Sacral Pressure Sore)

  • 정재훈;허찬영;권순성;백롱민;민경원
    • Archives of Plastic Surgery
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    • 제34권4호
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    • pp.520-523
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    • 2007
  • Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

외과적 자연기흉의 임상적 고찰 (Clinical Investigation of Surgical Spontaneous Pneumothorax)

  • 윤윤호
    • Journal of Chest Surgery
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    • 제1권1호
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    • pp.19-24
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    • 1968
  • A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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대전광역시 양봉농가의 꿀벌질병 감염률 조사 (Prevalence of honeybee (Apis mellifera) disease in Daejeon)

  • 김영주;김종호;오윤희;이상준;송선경;정은영;이상준;이석주;문병천
    • 한국동물위생학회지
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    • 제39권4호
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    • pp.253-258
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    • 2016
  • This study was conducted to investigate the prevalence of honey bee (Apis mellifera) disease in Daejeon. From May to September in 2014, 63 samples were collected from 63 apiculture farms in the regions and reverse transcriptase-polymerase chain reaction (RT-PCR) and polymerase chain reaction (PCR) was conducted. A total of 11 infectious pathogens, including 6 virus, 2 bacteria, 2 fungi, and 1 parasite, were investigated in honeybee colonies suffering from symptom of sudden collapse, depopulation or paralysis. The infectious pathogens and infection rates among 63 honeybee colonies detected were as follows: sacbrood virus (12.7%), chronic bee paralysis virus (1.6%), stonebrood (11.1%), American foulbrood (19.0%), European foulbrood (6.3%), respectively. The result indicate that foul-brood was most prevalent disease in apiculture farms in Daejeon area.

Helicobacter pylori의 병원성 비교를 위한 gerbil의 수침구속스트레스 모델 (Water-Immersion-Restraint Stress model in Mongolian gerbil forcomparison of pathoaenicity of Helicobacter pylori strains)

  • 이진욱;김옥진
    • 대한수의학회지
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    • 제44권4호
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    • pp.607-613
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    • 2004
  • Helicobacter pylori (H. pylori)-infection is an important pathogen of stomach cancer after chronic gastritis and ulceration in the stomach and duodenum. However, the virulences of H. pylori strains have not been well-defined between clinical isolates. This study was designed to establish water-immersion-restraint stress (WIRS) model in mongolian gerbil for comparison of pathogenicity of H. pylori strains. To determine an optimal duration time for WIRS model in gerbil, 5-week-old Mongolian gerbils were divided into different groups by WIRS duration time. After graded duration of WIRS, the macroscopic ulcer index (UI) was measured with the stomach and duodenum of sacrificed animal. There were no significant differences between male and female in same duration group. However, the UI increased significantly in a time-dependent fashion. The group of 6 hours-WIRS animals showed severe hemorrhage and ulceration in their stomach and duodenum. On the other hand, the very mild lesions induced in 2 hours-treated animals. Therefore, we determined an optimal duration time for WIRS model in gerbil as 4 hours. Thereafter, we evaluated whether this WIRS model in gerbil could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains by enhancement of pathological severity in H. pylori-infected gerbils. Mongolian gerbils were divided into H. pyloriinfected and PBS-inoculated groups. Thereafter, they were divided again into 4 hours-WIRS and no WIRS subgroups. After treatment, the severity of pathological changes was evaluated in a same manner with previous duration-determining experiment. When the animals were exposed to WIRS, the UI was significantly higher in the infected group than in the uninfected group. These results suggested that the established gerbil-WIRS model in this study enhanced effectively the severity of pathogenic changes in the H. pylori-infected Mongolian gerbils and could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains.

만성 복통과 발진을 주소로 내원한 6세 여아에서 진단된 폐흡충증 1예 (A Case of Pulmonary Paragonimiasis with Chronic Abdominal Pain and Erythematous Rash in a 6-year-old Girl)

  • 김주영;박민규;이용주;허선;조기영
    • Pediatric Infection and Vaccine
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    • 제25권1호
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    • pp.54-59
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    • 2018
  • 기생충 감염은 소아 인구에게서 드물기 때문에 진단이 어려울 수 있다. 환아는 6개월 동안 간헐적인 상복부 통증과 양손과 양측 팔 모두에 발생한 홍반성 발진을 동반한 늑막 삼출을 주소로 내원하였다. 환아는 검사상 혈청 호산구증가와 현저한 삼출성, 호산구성 흉막삼출액이 확인되었다. 동시에 폐렴 미코플라스마에 대한 높은 항체가 때문에 항생제 치료를 받았으나 흉막삼출은 호전되지 않았다. 환아의 분변에서 시행한 기생충 알의 검사상 음성이었으나 혈청 및 흉막삼출액의 기생충 특이 항원에 대한 면역효소측정법에서 폐흡충 특이 IgG에 대해 양성을 보였다. Praziquantel의 치료 후 호흡기 증상, 흉수 및 피부 증상이 호전되었다. 이에 만성 복통과 홍반성 발진을 주소로 내원한 소아 환자에서 폐흡충에 의한 흉막삼출액을 진단 및 치료하였기에 보고하는 바이다.

The Early Induction of Suppressor of Cytokine Signaling 1 and the Downregulation of Toll-like Receptors 7 and 9 Induce Tolerance in Costimulated Macrophages

  • Lee, Hyo-Ji;Kim, Keun-Cheol;Han, Jeong A;Choi, Sun Shim;Jung, Yu-Jin
    • Molecules and Cells
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    • 제38권1호
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    • pp.26-32
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    • 2015
  • Toll-like receptors (TLR) 7 and 9 transduce a cellular signal through the MyD88-dependent pathway and induce the production of inflammatory mediators against microbial nucleotide components. The repeated stimulation of TLR4 leads to endotoxin tolerance, but the molecular mechanisms of tolerance induced through the costimulation of individual TLR has not yet been established, although endosomal TLRs share signaling pathways with TLR4. In the present study, mouse macrophages were simultaneously stimulated with the TLR7 agonist, gardiquimod (GDQ), and the TLR9 agonist, CpG ODN 1826, to examine the mechanism and effector functions of macrophage tolerance. Compared with individual stimulation, the costimulation of both TLRs reduced the secretion of TNF-${\alpha}$ and IL-6 through the delayed activation of the NF-${\kappa}B$ pathway; notably, IL-10 remained unchanged in costimulated macrophages. This tolerance reflected the early induction of suppressor of cytokine signaling-1 (SOCS-1), according to the detection of elevated TNF-${\alpha}$ secretion and restored NF-${\kappa}B$ signaling in response to the siRNA-mediated abrogation of SOCS-1 signaling. In addition, the restimulation of each TLRs using the same ligand significantly reduced the expression of both TLRs in endosomes. These findings revealed that the costimulation of TLR7 and TLR9 induced macrophage tolerance via SOCS-1, and the restimulation of each receptor or both TLR7 and TLR9 downregulated TLR expression through a negative feedback mechanisms that protects the host from excessive inflammatory responses. Moreover, the insufficient and impaired immune response in chronic viral infection might also reflect the repeated and simultaneous stimulation of those endosomal TLRs.

목과(木瓜)의 항염(抗炎) 및 면역반응(免疫反應)에 대한 실험적(實驗的) 연구(硏究) (Anti-inflammatory Effect of Fructus Chaenomelis(FC))

  • 이수정;김송백;최창인;이기상;조한백
    • 대한한방부인과학회지
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    • 제21권4호
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    • pp.36-48
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    • 2008
  • Purpose: The purpose of this study is to investigate anti-inflammatory effect and immune responses of aqueous extract from Fructus Chaenomelis (FC). Methods: We studied anti-inflammatory effect by means of examining the production of NO(nitric oxide) and expressions of pro-inflammatory cytokine (TNF-$\alpha$(tumor necrosis factor-alpha), IL(Interleukin)-6, IL-12) in the LPS-induced peritoneal macrophages of mice. Also, The western blot analysis has been done to look into the mechanism of anti-inflammatory effect. Results: 1. The FC extract did not have any cytotoxicity in the peritoneal macrophages. 2. The FC extract inhibits the productions of NO, IL-6. IL-12 in the LPS-stimulated peritoneal macrophages of mice, but not of TNF-$\alpha$. 3. The FC extract inhibits the activation of NF-${\kappa}B$(nuclear factor-kappa B) by keeping $I{\kappa}B-\alpha$(inhibitory kappa B-alpha) from degradating, but not of MAPKs(mitogen-activated protein kinases) such as ERK(extracelluar signa 1-regulated kinase), JNK(c-Jun N-terminal kinase), p38. Conclusion: These results show that FC extract inhibits the production of pro-inflammatory cytokines such as IL-6. IL-12. NO by inhibiting NF-${\kappa}B$ activation in the peritoneal macrophages of mice. In conclusion, this experiment suggests that FC extract may be effective for the treatment of acute and chronic inflammation including genitourinary infection.

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한방병원에 내원한 노장층 피부과 환자에 관한 임상적 고찰 (A Clinical Study of Elderly Patients with Skin Diseases)

  • 최인화
    • 한방안이비인후피부과학회지
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    • 제15권2호
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    • pp.289-301
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    • 2002
  • Background: It is axiomatic that average life span is prolonged in proportion to the advance of socio-economic improvements and medical science. Consequently, the number of elderly patients with skin diseases is increasing. Objective: This study was performed to examine the patterns of skin diseases in elderly patients that had visited Dongguk Oriental Medical hospital, Dept. of Dermatology. We also compared these patients to the young generational groups. Methods: We studied 67 elderly patients with complaints of skin diseases who had visited our hospital from March 2000 to February 2002. We analysed their skin diseases and compared them with the younger group's. Results: The results were as follows; 1. The common disease groups were eczema(32.8$\%$); pruritus(23.9$\%$); viral infections (13.4$\%$); psoriasis(9.0$\%$); fungal infections and urticaria(6.0$\%$). 2. The disorders prevalent in men were eczema(30.0$\%$); herpes zoster & pruritus(23.3$\%$); fungal infection(13.3$\%$); psoriasis (3.3$\%$); melasma(6.7$\%$). 3. The common diseases of women's group were observed in the following order; eczema(35.l$\%$); pruritus(24.3$\%$); psoriasis(13.5$\%$); urticaria(10.8$\%$); other dermatoses(8.1$\%$); herpes zoster(5.4$\%$). 4. The most frequent skin disease for those in their 50's was eczema(32.3$\%$); 60's, pruritus(36.8$\%$); 70's, eczema(50.0); and over eighties., eczema and pruritus(40.0$\%$). Conclusion: This study suggests that dermatologic problems in the elderly are very common, especially eczema, pruritus. It is a very different pattern from the younger group's. And we have to better consider more effective management and treatment for them; especially further dermatologic studies including substantial medical care. Usually Oriental medicine is good at treating chronic diseases and less harmful. So we expect it to be generally better for elderly patients than western medicine.

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