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기관지천식 환자에서 유도객담을 이용한 기도 염증의 평가
남언정,이종명,김건우,김신우,김능수 경북대학교 병원 2003 경북대학교병원의학연구소논문집 Vol.7 No.1
Objectives : This study was performed to investigate the relationship between cell counts, supernatant and lysate ECP levels in sputum, and physiologic markers in adult asthmatic. Methods : Twenty-two patients with mild to moderate persistent asthma, ten patients with acute exacerbated asthma and nine healthy subjects were enrolled. Sputum was induced by inhalation of hypertonic saline, and homogenized with 0.1% dithiothreitol. A total and differential cell was measured in supernatant fluid. Cell pellet was centrifuged, and ECP(supernatant ECP) was measured in supernatant fluid. Cell pellet was reacted with a cellular lysis buffer to release cell-associated ECP, and ECP(lysate ECP) was measured again in supernatant fluid. The ratio of supernatant to lysate ECP was calculated as an index of eosinophil degranulation. Spirometry and methacholine bronchial challenge tests were also performed as physiological markers of asthma. Results : The patients with acute exacerbated asthma showed significantly higher percentage of sputum neutrophil, eosinophil count, concentration of sputum supernatant ECP and ratio of supernatant to lysate ECP than those of normal controls and stable asthmatic patients(p<0.05, respectively). The level of sputum supernatant ECP, supernatant/lysate ECP ratio, and percentage of neutrophil showed negative correlations with pulmonary functions, but no correlations with a degree of bronchial hyperresponsiveness. There was no significant correlations between of serum ECP level and physiological parameters. Conclusion : These results suggest that both neutrophils and eosinophils play roles in the exacerbation of asthma. The sputum supernatant/lysate ECP ratio might be valuable in assessment of activation status of eosinophils in various hypereosinophilic conditions or diseases.
기관지천식 환자에서 Furosemide, Disodium cromoglycate 및 Heparin 흡입이 고장액 식염수 기관지유발검사에 미치는 영향
강천일,현상훈,남언정,김건우,윤종수,서영익,이종명,김능수 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3
목적 : 기관지천식 환자에서 고장액 식염수의 흡입은 기도수축을 유발할 수 있으며 이는 운동유발성 천식반응과 밀접한 관계가 있는 것으로 알려져 있다. 저자들은 알레르겐 흡입이나 운동에 의해 유발되는 천식에 예방효과가 있는 것으로 알려진 disodium cromoglycate(DSCG), furosemide 및 heparin 흡입이 4.5% NaCl 기관지유발검사(BPT)에 미치는 영향을 조사하였다. 대상 및 방법 : 4.5% NaCl BPT에서 양성반응을 보이는 기관지천식 환자 13명을 대상으로 하였으며 사용된 약물은 furosemide 40㎎, DSCG 40㎎ 및 heparin 1,000μ/㎏이었다. 먼저baseline 4.5% NaCl BPT를 시행한 다음 이들 약물로 전처치후 다시 4.5% NaCl BPT를 시행하여 약물의 효과를 관찰하였다. 결과 : Furosemide 40㎎, DSCG 40㎎및 heparin 1,000μ/㎏의 흡입 전처치는 고장액 식염수에 의한 기도수축 반응에 뚜렷한 예방효과를 보였다. Furosemide와 DSCG로 전처치한 군(n=6)에서 이들의 기도수축 방어율은 각각 100.6±6.6%, 91.1±17.2%였으며 furosemide와 heparin으로 전처치한 군(n=7)에서는 각각 58.7±29.2%, 59.0±51.1%로서 각 군에서 이들 약제간의 방어율에는 유의한 차이가 없었다. 결론 : Furosemide(40㎎), DSCG(40㎎) 및 heparin(1000μ/㎏)의 흡입 전처치는 고장액 식염수에 의한 기도수축 반응에 뚜렷한 예방효과를 보였으며, 적어도 이 용량에서 기도수축 예방 정도에는 유의한 차이가 없음을 알 수 있었다. Background: Hypertonic saline (4.5% NaCl) inhalation is known to induce broncho-constriction by affecting mast cell, epithelial cell and vagal afferent pathway in some asthmatics. Disodium cromoglycate (DSCG) is known to have a preventive effect on allergic asthma and exercise induced asthma, and recently it was reported that furosemide and heparin had similar effect. The purpose of this study was to evaluate the effects of furosemide, DSCG and heparin on hypertonic saline provocation test in asthmatics. Methods: Thirteen asthmatics with a positive response to hypertonic saline challenge were enrolled. Hypertonic saline and test drugs were generated by ultrasonic nebulizer. After taking baseline 4.5% NaCl challenge, subjects were rechallenged with 4.5% NaCl after inhalation of furosemide 40㎎, DSCG 40㎎ or heparin 1,000μ/㎏. Results: 1. There was a significant positive relationship between PC_20-methacholine and PTM-4.5% NaCl(r=0.5575, p = 0.024). 2. Furosemide, DSCG and heparin had no direct bronchodilating effects. 3. Premedication of furosemide and DSCG(n=6) showed significant protective effects on 4.5% NaCl induced broncho-constriction. The average protection rate were 100.6±6.6% and 91.1±17.2%, respectively. 4. Premedication of furosemide and heparin(n=7) showed significant protective effects on 4.5% NaCl induced broncho-constriction. The average protection rate were 58.7±29.2% and 59.0±51.1%. respectively. Conclusions: Furosemide(40㎎), DSCG(40㎎) and heparin(1.000μ/㎏) had significant protective effects on hypertonic saline induced broncho-constriction in asthmatics, and there were no significant differences in their potency of protection rate.
Nam, Eon Jeong,Sa, Keum Hee,You, Dong Wan,Cho, Jang Hee,Seo, Jae Seok,Han, Seung Woo,Park, Jae Yong,Kim, Sung Il,Kyung, Hee Soo,Kim, In San,Kang, Young Mo Wiley Subscription Services, Inc., A Wiley Company 2006 Vol.54 No.9
<B>Objective</B><P>To delineate the expression of transforming growth factor β–inducible gene h3 (βIG-H3) in rheumatoid synovitis and to determine the regulatory role of βIG-H3 in the adhesion and migration of fibroblast-like synoviocytes (FLS).</P><B>Methods</B><P>Synovial tissue was obtained from patients with rheumatoid arthritis (RA) during joint replacement surgery, and FLS were isolated using enzymatic treatment. Immunohistochemical staining was performed to show the expression of βIG-H3 within rheumatoid synovium. Synthesis of βIG-H3 from FLS was determined by semiquantitative reverse transcription–polymerase chain reaction, Western blot analysis, and enzyme-linked immunosorbent assay. Cell adhesion and migration assays were performed using the YH18 peptide in the fourth fas-1 domain of βIG-H3 and function-blocking antibodies to integrins.</P><B>Results</B><P>Expression of βIG-H3 was up-regulated in RA synovial tissue compared with synovial tissue from patients with osteoarthritis. FLS isolated from RA synovial tissue constitutively produced βIG-H3, which was up-regulated by transforming growth factor β1, interleukin-1β, and tumor necrosis factor α. Although FLS expressed a variety of integrins, βIG-H3 mediated adhesion and migration of FLS through interaction with αvβ3 integrin. Cytokines failed to affect the βIG-H3–mediated adhesion. However, migration of FLS guided by βIG-H3 was enhanced by interferon-γ and platelet-derived growth factor type BB. The YH18 peptide in the fourth fas-1 domain of βIG-H3 inhibited adhesion and migration in a dose-dependent manner.</P><B>Conclusion</B><P>The results suggest that βIG-H3, which is abundantly expressed in RA synovial tissue, plays a regulatory role in chronic destructive inflammation through the modulation of the adhesion and migration of FLS. This finding indicates the relevance of βIG-H3 and αvβ3 integrin–interacting motifs as potential therapeutic targets in this disease.</P>
( Eon Jeong Nam ),( Yong Min Chang ),( Jang Woo Park ),( Shi Jin Sung ),( Jung Wan Hong ),( Hasan Al Faruque ),( Jong Min Lee ),( Young Mo Kang ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Rheumatoid arthritis (RA) is a chronic infi ammatory disease in which adequate diagnosis of disease activity is particularly important for optimizing treatment outcomes. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is used to detect infi ammatory changes in synovial joints, and to discriminate active and inactive stages of disease. However, DCE-MRI has not been previously used to evaluate quantitative kinetic parameters, such as vascular permeability. The aim of this study was to investigate the quantitative changes in vascular permeability associated with chronic infi ammatory arthritis. Methods: Arthritis was induced in DBA/1J mice by immunization with bovine type- II collagen emulsifi ed in complete and incomplete Freund`s adjuvants. The severity of arthritis was monitored using the clinical arthritis index (CAI). R images of mice were obtained at different stages of arthritis progression, and 3 weeks after methotrexate (MTX) treatment. Immunohistochemical staining with an anti-CD31 antibody was used to assess vessel density. Results: Permeability maps on the knee joint revealed less heterogeneity during the active stage, compared to early and late stages of arthritis. Vascular permeability increased progressively until the active stage of arthritis was reached, and thereafter declined gradually. The pattern of permeability changes quantified using DCE-MRI was consistent with the vascular densities and disease activity. Furthermore, vascular permeability and densities decreased signifi cantly in a dose-dependent manner after treatment with MTX. Conclusions: Vascular permeability assessed by DCE-MRI can be used as an imaging biomarker for tracking disease progression, and for monitoring therapeutic effi cacy in infi ammatory arthritis.