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Serum Vascular Endothelial Growth Factor as a Predictive Risk Factor for the Occurrence of Coronary Artery Lesions in Kawasaki Disease (가와사끼병에서 관상동맥류 발생에 관한 혈청 Vascular Endothelial Growth Factor의 임상적 의의)

  • Park, Min Hyuk;Jung, Hye Lim;Yang, Ju Hee;Shim, Jung-Yeon;Kim, Deok Soo;Shim, Jae Won;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.811-816
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    • 2003
  • Purpose : Kawasaki disease is an acute systemic vasculitis of unknown etiology with a predilection for the coronary arteries. Vascular endothelial growth factor(VEGF) is a cytokine which promotes vascular permeability and angiogenesis. We investigated serum VEGF(sVEGF) levels in Kawasaki disease to determine whether sVEGF level can be used as a risk factor to predict the occurrence of coronary artery lesions(CAL) in Kawasaki disease. Methods : We measured sVEGF levels in 11 patients with Kawasaki disease in acute phase(patient group)and 11 normal children(control group) by enzyme-linked immunosorbent assay(ELISA) method. We investigated the relationship between sVEGF levels and the lumen diameters of coronary artery and other potential CAL risk factors; duration of fever, hemoglobin, WBC counts, platelet counts, ESR, CRP and LDH levels. Results : SVEGF levels of patients in the acute phase of Kawasaki disease(mean $847.9{\pm}495.7pg/mL$) were significantly higher than that of normal controls(mean $279.9{\pm}150.6pg/mL$; P<0.05). SVEGF levels showed significant positive correlation with the lumen diameters of the coronary artery(P<0.05, $r_s=0.75$) in the patient group. There was no significant correlation between sVEGF levels and duration of fever or other laboratory measurements. Conclusion : Our results support the notion that sVEGF level may be considered as a predictive indicator for the occurrence of coronary artery lesions in Kawasaki disease.

Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

Factors affecting hematologic recovery and infection in high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk solid tumor (소아 고형종양의 고용량 화학요법 후 자가 조혈모세포이식에서 혈액학적 회복과 감염에 영향을 주는 요인)

  • Lee, Jung Hyun;Lee, Bo Lyun;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Jung, Hye Lim;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1079-1085
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    • 2006
  • Purpose : The purpose of this study was to evaluate factors affecting hematologic recovery and infection in high-dose chemotherapy(HDCT) and autologous stem cell transplantation(ASCT) in patients with high-risk solid tumor. Methods : From January 2004 to December 2005, 72 HDCTs and ASCTs were applied to children with high-risk solid tumor at Samsung Medical Center. Medical records of these 72 HDCTs and ASCTs were retrospectively analyzed. Results : The single most powerful predictor of neutrophil and platelet recovery was the number of transplanted $CD34^+$ cells. The duration of high fever was significantly longer in young patients, in patients treated with total body irradiation and/or thiotepa, and in patients transplanted with lower $CD34^+$ cell dose(<$2{\times}10^6/kg$). However, the difference in the duration of high fever according to the number of $CD34^+$ cells was not clinically significant. Conclusion : Findings in this study suggest that HDCT and ASCT with low $CD34^+$ cell dose is clinically feasible despite delayed hematologic recovery, especially at a dose >$1{\times}10^6/kg$ per transplantation. Therefore, it is important not to defer the appropriate time for HDCT for an additional collection of hematopoietic stem cells if the number of collected $CD34^+$ cells is >$1{\times}10^6/kg$ per transplantation.

Effect of different feeding times using a diet containing betaine on production, blood profile and a short chain fatty acid in meat ducks exposed to a scorching heat wave (베타인 사료의 급여시기가 폭염에 노출된 오리의 짧은 사슬지방산, 혈액 프로파일 및 생산성에 미치는 효과)

  • Bang, Han-Tae;Hwangbo, Jong;Kang, Hwan-Ku;Park, Byung-Sung
    • Journal of the Korean Applied Science and Technology
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    • v.32 no.3
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    • pp.427-438
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    • 2015
  • The effects of different feeding times, using a diet containing 800 ppm betaine, on production, blood profile, and the short-chain fatty acid (SCFA), was investigated using 240 Cherry Valley (Anas platyrhynchos) meat ducks exposed to a scorching heat wave. The animals were randomly assigned to four groups, each of which was replicated three times with twenty ducks per replicate. The experimental period was 42 days for each group. Four groups were assigned into C (heat wave control group without betaine), T1 (ad libitum group fed a diet containing 800 ppm betaine), T2 (diet-restricted group fed twice daily between 05:00-10:00 and 17:00-20:00, using a diet containing 800 ppm betaine), and T3 (night-restricted group, fed from 17:00-10:00, with a diet containing 800 ppm betaine). At 42 days, body weight increased in order of T2, T1, T3 compared to the heat wave control group although. However, these differences were not found between the groups of T1 and T3. The heat wave control group, provided an ad libitum diet without betaine (C), showed an elevated feed conversion ratio compared to the groups fed a diet containing betaine. However, these differences were not found between the groups of T1, T2 and T3. RBC and platelet profiles except for PLT and MPV showed statistically significant differences between study groups fed a diet containing betaine. T2 presented significantly higher blood electrolytes $Na^+$ and $Cl^-$ than the other groups. T2 also showed a blood gas level that was generally higher than the other groups. Total SCFA, acetic acid and propionic acid concentration has been the increasing trend in T2, but butyric acid, isobutyric acid and valeric acid concentration has been the decreasing trend in T2 compared to the other groups. It is concluded that the feeding-restricted group, fed two times daily between 05:00-10:00 and 17:00-20:00, with a diet containing 800 ppm betaine may improve growth performance in meat ducks exposed to a scorching heat wave.

Survey on Korean-native Calves Diseases and Mortality (한우 송아지의 질병발생과 폐사율 조사)

  • 강문일;한동운;정용운;정도영;이채용;이정길;위성환;조재진
    • Korean Journal of Veterinary Service
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    • v.24 no.3
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    • pp.223-241
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    • 2001
  • From September 1996 to September 1999, 419 Korean-native calves with diseases under 6-month old collected from Kyonggi, Chungcheong, Chonlla and Kyongsang were examined by clinical, microbiological, parasitic, hematologic and histopathological mean. Among them, 124 cases were tested about the neutralization antibodies against infectious bovine rhinotracheitis virus(IBRV), Parainfluenza-3 virus(PI-3V), bovine uiral diarrhea virus(BVDV), bovine ephemeral fever virus(BEFV). In calf diseases in the survey, enteric diseases(72.8%) were most frequently involved and the following orders were taken by respiratory(17.4%) and reproductive (5.0%) disorders. In the causative pathogens associated with calf diseases and motality, 48.4% was induced by bacteria origin and also 35.6% by viral agents. Calf mortality was up to 76.3% in the cae of bacterial diseases and 55.7% in viral diseases. In bacterial diseases, frequent disorders were composed of colibacillosis(52.7%), salmonellosis(13.8%), pasteurellosis(12.8%) and campylobacteriosis(3.9%) and their mortalities showed 73.8% in colibacillosis, 73.0% in pasteurellosis, 67.9% in salmonellosis and 50.0% in campylobacteriosis (50.0%). Among the outbreaks of viral diseases, there were BVD(22.8%), bovine rotavirus infection(20.8%), bovine coronavirus infection(16.8%), bovine respiratory syncytial virus infection(15.4%), IBR(15.4%). Akabane disease(4.7%) and Chuzan diseases(3.4%). Interesting results through this studies were obtained the first isolate to Chuzan virus and Ainovirus in Korea which could be promised the development for diagnostic method and vaccines soon. Calf mortality to Akabane and Chuzan diseases was 100%. Main parasitic diseases were occupied by coccidiosis and babesiosis and their mortality of babesiosis was 20.0%. Other diseases were abomasal impaction(6.7%) and toxicosis(4.5%). The mortality of abomasal impaction was 89.3%. In some causes with malformations(1.9%) were confirmed as anasarca, derodidymus, polymelia, humerus hypoplasia, and tracheal collapse. Calf diseases had mostly been occurred in one month old grout (52.5%) and its prevalence was 25.1% in two to three month old group and 22.4% in four to six month old group. In calf mortality by age, there were 37.9% in one month old group, 18.1% in two and three month old group, and 13.8% in four to six month old group, respectively. The older the age of calf, the less the prevalence of calf enteric diseases. Respiratory diseases in calves to be tested frequently occurred in one to two month old group (41.4%). In one month old calves, the prevalence of enteric disease was 80.0%(p<0.05) and that of reproductive and respiratory disease was 9.5% and 8.2%, respectively. In two month old and four to six month old, enteric disease was 65.7% and 63.8% and respiratory disease was 28.6% and 26.6%. Seasonal prevalence and mortality of Korean-native calf diseases were not a significant difference. Prevalence of calf diseases in summer(31.5%) frequently occurred to compare that in winter(20.3%). Abortion and malformation in calves frequently occurred in spring. Hematological values in 84 calves with clinical signs showed mild to marked leukocytosis. Also, there was slight increase in hematocrit, platelet, mean corpuscular volume and mean plasma volume, but all of those were included the higher level to normal ranges. Calves with respiratory signs showed slightly erythrocytosis. One hundred seventy three calves without clinical signs were not significant different to ill cases in hematological values, but number of platelets was in higher normal range. In 125 calves, 84.8% was taken the antibody to IBRV, but 72% with the antibody had recorded the titer level lower than log$_2$5. The neutralizing antibody levels of higher than $log_{2}5$ to PI-3V and BVD virus were 60.8% and 67.2% cases, respectively. There were the cases of 57.6% had the neutralizing antibody level lower than log$_2$5 to BEFV.

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Report for Development of Korean Portable Cardiopulmonary Bypass II. Experimental Study of Portable Cardiopulmonary Bypass for Emergency Cardiopulmonary Resuscitation after Cardiac Arrest in Normal Dogs (한국형 이동식 심폐소생기 개발 보고 II. 응급소생술을 위한 이동식 심폐소생기의 동물 실험 연구)

  • Kim, Hyoung-Mook;Lee, In-Sung;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Lee, Hye-Won;Lee, Kyu-Back;Chang, Jun-Kuen;Kim, Chong-Won;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1147-1158
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    • 1998
  • Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

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Protective effects of quality certified traditional Doenjang in Korea on TNF-α-induced vascular inflammation in human umbilical vein endothelial cells (혈관내피세포에서 TNF-α 자극에 의해 유도되는 혈관염증에 대한 전통식품 품질인증 된장의 효능 평가)

  • Kim, Eun-Ju;Jang, Yeon-Jeong;Kim, So-Young;Choi, Hye-Sun;Park, Shin-Young
    • Food Science and Preservation
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    • v.23 no.3
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    • pp.378-386
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    • 2016
  • Anti-atherogenic effects in tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$)-stimulated human umbilical vein endothelial cells (HUVEC) are involved in the suppression of oxidative stress, cell adhesion molecules, and pro-inflammatory factors. This study investigated the vascular inflammation inhibitory activity of traditional Doenjang plays a key role in the pathogenesis and progression of atherosclerosis. The protective effects of Korean Deonjang was investigated on the expression of cell adhesion molecules (CAMs) in tumor necrosis factor (TNF)-${\alpha}$-induced human umbilical vascular endothelial cells (HUVECs). Deonjang extracts (20, 50, $100{\mu}g/mL$) decreased the expression of 20 ng/mL TNF-${\alpha}$-induced vascular cell adhesion molecule (VCAM)-1 intracellular adhesion molecule (ICAM)-1 proteins, and their corresponding mRNA levels. Nitric oxides (NO) produced by endothlial nitric oxides synthase (eNOS) dilated blood vessels, which had protective effects against platelet and leukocyte adhesion. While TNF-${\alpha}$-induced suppressed the production of nitric oxide in HUVECs, Doenjang restored NO production in HUVECs. In addition, Deonjang reduced the TNF-${\alpha}$-induced expression of inducible NO synthase (iNOS) and cyclooxygenase (COX)-2 mRNA levels. These results suggested that Doenjang can inhibited the production of cell adhesion molecules and inflammatory mediators, which could be a potential candidate for preventing atherosclerosis.

Clinical Significance of Serum PDGF-BB and IGF-1 in Coal Workers' Pneumoconiosis (석탄광부 진폐증 환자에서 PDGF-BB, IGF-1의 의의)

  • Shin, Pyo Jin;Yong, Suk Joong;Shin, Kye Chul;Lee, Won Yeon;Kim, Shin Tae;Cha, Bong Suk;Jeon, Geun Jae
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.338-345
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    • 2002
  • Background : Coal workers' pneumoconiosis(CWP) is a fibrotic lung disease resulting from the chronic inhalation of coal dust. Various cytokines and growth factors secreted from macrophages and monocytes play a key role in the pathogenesis of pneumoconiosis. The platelet-derived growth factor (PDGF)-BB and the insulin-like growth factor(IGF)-1 secreated from the macrophages and monocytes are believed to stimulate the accumulation of mesenchymal cells and fibrosis of the lower respiratory tract that is observed in fibrotic lung disease. The serum concentraion of PDGF-BB and IGF-1 in 30 CWP patients and 10 healthy controls were measured in order to determine if PDGF-BB and IGF-1 can be used as sensitive biomarkers in CWP. Method : Serum was collected from 30 patients with CWP(13 with simple CWP and 17 with complicated CWP) and 10 healthy controls. The serum concentrations of PDGF-BB and IGF-1 were measured using ELISA (R&D system, Minneapolis, MN). Results : The serum PDGF-BB concentration in patients with complicated CWP($10083.76{\pm}639.07pg/mL$) was significantly higher than in the patients with simple CWP ($8493.88{\pm}848.51pg/mL$) and the healthy controls ($3726.17{\pm}292.20pg/mL$) (p<0.05). Compared to the healthy controls ($413.40{\pm}1.94ng/mL$), there was no significant difference in the serum IGF-1 concentration in patients with simple ($366.77{\pm}183.67ng/mL$) and complicated CWP ($403.18{\pm}15.39ng/mL$) (p>0.05). Conclusion : These results show the important role of the PDGF-BB mediated pathways in the pathogenesis of CWP. These data suggests that the PDGF-BB serum concentration is a useful biomarkers of the fibrotic extent in CWP patients.

Limitation of Prediction on Intravenous Immunoglobulin Responsiveness in Kawasaki Disease (가와사끼병에서 정맥용 면역글로불린 치료 반응 예측의 한계)

  • Kim, Seong-Koo;Han, Ji-Yoon;Rhim, Jung Woo;Oh, Jin Hee;Han, Ji-Whan;Lee, Kyung Yil;Kang, Jin-Han;Lee, Joon-Sung
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.169-176
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    • 2010
  • Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

Ototoxic Evaluation of Cis-platinum (Cis-Platinum의 이중독증에 관한 임상적 고찰)

  • 홍원표;정명현;오혜경;이경재
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.17.1-17
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    • 1982
  • In 1965, Rosenberg reported that platinum compounds not only inhibit growth and cell division of E. coli but also has anti-tumor activity. Since then, through animal and clinical experiments by Welsch(1971), Speer(1972), Rossof(1972), Hill(1974), and Wittes(1975), it was proved that Cis-platinum has excellent supressive effects on malignant tumor, especially on head and neck cancer. Accordingly, Cis-platinum is now widely used, sometimes without any other durg, or sometimes with Bleomycin and Methotrexate etc. Inspite of the strong anticancer effect, the use of Cis-platinum is quite often discouraged because of the reports that Cis-platinum causes auditory impairment at high frequencies above the speech range due to inner ear damage and irreversible change in the renal tubules. Since Kohonen et al(1965), Standnicki et al(1974) reported that Cisplatinum has toxic effects at the basal turn of the cochlea using guinea pig, many studies on ototoxicity after infusion of Cis-platinum have been carried out using animals. But the studies on ototoxicity in human beings can hardly be found except in reports by Piel et al(1974) and Hong et al (1979). So the authors did a study which tried to clarify the ototoxic effect by comparing the hearing level after infusion of Cis-plastinum with the hearing level before infusion of Cis-plastinum in 30 patients who was treated with Cis-platinum and admitted to the dept. of otolaryngology of Yonsei University Hospital during 2 years and a half from July. 1979 to March. 1982 and the following results were obtained. 1) The results of auditory evaluation, using the pure tone average, hearing loss of 4kHz and 8kHz, Speech Reception Threshold, PB score, SISI showed that the difference of dosage does not change the hearing level after infusion of Cis-platinum and before infusion of Cis-platinum. 2) Cis-platinum had no effect on the hearing level of patients with conductive hearing loss, or with sensorineural hearing loss, as well as with normal hearing level. 3) The infusion of Cis-platinum did not cause any change in creatinine clearance, creatinine, uric acid, but only one case showed that Cis-platinum caused severe nephrotoxicity. 4) The infusion of Cis-plastinum did not cause any change in hemoglobin, leukocyte count, platelet count and there was no correlation with the amount of infusion. 5) To see the side effect of hydration practiced with the infusion of Cis-platinum, the electrolytes, particularly the K level in the serum was measured. But the results did not show any change. 6) Judging from the results of this study mentioned above, ototoxicity caused by infusion of Cis-platinum can be prevented by sufficient hydration. Also the results might say that the appropriate method of infusion of Cis-platinum might be effective in the patients with head and neck cancer who had sensorineural hearing loss for whom the infusion of Cis-platinum has been absolutely cotraindicated.

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