Two-Track Medical Treatment Strategy According to the Clinical Scoring System for Chronic Rhinosinusitis

Kim, Dong-Kyu,Kang, Seong Il,Kong, Il Gyu,Cho, Young Hoon,Song, Seul Ki,Hyun, Se Jin,Cho, Sung Dong,Han, Sang-Yoon,Cho, Seong-Ho,Kim, Dae Woo The Korean Academy of Asthma, Allergy and Clinical 2018 Allergy, Asthma & Immunology Research Vol.10 No.5

<P><B>Purpose</B></P><P>The previously reported Japanese clinical scoring study (JESREC) suggests that chronic rhinosinusitis (CRS) can be divided into 4 subtypes according to the degree of eosinophilic CRS (ECRS) and offers the information regarding the prognosis of CRS to clinicians. However, this scoring system has not yet been validated by an immunological study and needs to provide treatment guidelines based on underlying immunologic profiles. We investigated the immunologic profile of each CRS subgroup according to the JESREC classification and suggest its clinical application.</P><P><B>Methods</B></P><P>A total of 140 CRS patients and 20 control subjects were enrolled. All patients were classified into 4 groups according to the JESREC (non-, mild, moderate and severe ECRS). Nasal tissues were analyzed for mRNA expression of major cytokines (IL-5, IL-10, IL-13, IL-17A, IL-22, IL-23p19, IFN-γ, periostin, thymic stromal lymphopoietin [TSLP] and ST2), major chemokines (CCL11, CCL24, CXCL1 and CXCL2), transcription factors (T-bet, GATA3, RORC and FOXP3) and COL1A1 for type I collagen. Protein levels of 3 major cytokines (IL-5, IL-17A and IFN-γ) were also measured by multiplex immunoassay. Principal component analysis (PCA) was conducted to investigate the overall profile of multiple mediators.</P><P><B>Results</B></P><P>The moderate/severe ECRS showed up-regulation of type 2-related mediators (IL-5, IL-13, periostin, TSLP and ST-2), whereas INF-γ (type 1 cytokine) and CXCL1 (neutrophil chemokine) expressions were increased in non-/mild ECRS compared with moderate/severe ECRS. The JESREC classification reflected an immunological endotype. In PCA data, PCA1 indicates a relative type 2 profile, whereas PCA2 represents a type 1/type 17-related profile. In this analysis, mild ECRS was indistinguishable from non-ECRS, whereas moderate to severe ECRS showed a distinct distribution compared with non-ECRS. The JESREC classification could be divided into 2 categories, non-/mild vs. moderate/severe ECRS based on underlying immunological analyses.</P><P><B>Conclusions</B></P><P>The CRS clinical scoring system from the JESREC study reflects an inflammatory endotype. However, the immunologic profile of mild ECRS was similar to that of non-ECRS. Therefore, we propose type 2-targeted medical treatment for moderate to severe ECRS and type 1/type 17-targeted for non-ECRS and mild ECRS as the first treatment option.</P>

주조직적합항원이 불일치하는 마우스 동종 조혈모세포이식에서 IL-2로 유도된 CD4+CD25+ T세포를 이용한 이식편대숙주병의 억제

현재호,정대철,정낙균,박수정,민우성,김태규,최병옥,김원일,한치화,김학기,Hyun, Jae Ho,Jeong, Dae Chul,Chung, Nak Gyun,Park, Soo Jeong,Min, Woo Sung,Kim, Tai Gyu,Choi, Byung Ock,Kim, Won Il,Han, Chi Wha,Kim, Hack Ki 대한면역학회 2003 Immune Network Vol.3 No.4

Background: In kidney transplantation, donor specific transfusion may induce tolerance as a result of some immune regulatory cells against the graft. In organ transplantation, the immune state arises from a relationship between the immunocompromised graft and the immunocompetent host. However, a reverse immunological situation exists between the graft and the host in hematopoietic stem cell transplantation (HSCT). In addition, early IL-2 injections after an allogeneic murine HSCT have been shown to prevent lethal graft versus host disease (GVHD) due to CD4+ cells. We investigated the induction of the regulatory CD4+CD25+ cells after a transfusion of irradiated recipient cells with IL-2 into a donor. Methods: The splenocytes (SP) were obtained from 6 week-old BALB/c mice ($H-2^d$) and irradiated as a single cell suspension. The donor mice (C3H/He, $H-2^k$) received $5{\times}10^6$ irradiated SP, and 5,000 IU IL-2 injected intraperitoneally on the day prior to HSCT. The CD4+CD25+ cell populations in SP treated C3H/He were analyzed. In order to determine the in vivo effect of CD4+CD25+ cells, the lethally irradiated BALB/c were transplanted with $1{\times}10^7$ donor BM and $5{\times}10^6$ CD4+CD25+ cells. The other recipient mice received either $1{\times}10^7$ donor BM with $5{\times}10^6$ CD4+ CD25- cells or the untreated SP. The survival and GVHD was assessed daily by a clinical scoring system. Results: In the MLR assay, BALB/c SP was used as a stimulator with C3H/He SP, as a responder, with or without treatment. The inhibition of proliferation was $30.0{\pm}13%$ compared to the control. In addition, the MLR with either the CD4+CD25+ or CD4+CD25- cells, which were isolated by MidiMacs, from the C3H/He SP treated with the recipient SP and IL-2 was evaluated. The donor SP treated with the recipient cells and IL-2 contained more CD4+CD25+ cells ($5.4{\pm}1.5%$) than the untreated mice SP ($1.4{\pm}0.3%$)(P<0.01). There was a profound inhibition in the CD4+CD25+ cells ($61.1{\pm}6.1%$), but a marked proliferation in the CD4+CD25- cells ($129.8{\pm}65.2%$). Mice in the CD4+CD25+ group showed low GVHD scores and a slow progression from the post-HSCT day 4 to day 9, but those in the control and CD4+CD25- groups had a high score and rapid progression (P<0.001). The probability of survival was 83.3% in the CD4+CD25+ group until post-HSC day 35 and all mice in the control and CD4+CD25- groups died on post-HSCT day 8 or 9 (P=0.0105). Conclusion: Donor graft engineering with irradiated recipient SP and IL-2 (recipient specific transfusion) can induce abundant regulatory CD4+CD25+ cells to prevent GVHD.

이종재료 접합부 선단의 크랙 전파 거동

국정한,성호현,송일규 한국기술교육대학교 1997 論文集 Vol.4 No.1

In this study, the crack behavior around the bonded dissimilar materials is analyzed by using by Finite Element Method(FEM) in case that it approaches or passes through the bonded line perpendicularly. The analysis criterion is based on the energy(△U) when the crack progresses or passes through the bonded line. The variables are the width of dissimilar material and distance from the crack tip to the bonded line. Values of E(Young's modulus), V(Poisson's ratio) and △U(Energy) for base material are different from those(E', V', △U') for dissimilar material. The outcome of this study is obtained by comparing △U with △U'

SS400강 용접부의 파괴인성치에 관한 연구

국정한,송일규,김봉중,오세용,성호현 한국기술교육대학교 1999 論文集 Vol.6 No.1

In this work, we studied the mechanical properties, structure and the stress intensity factor of the welded areas which were annealed from 500。C to 900。C with an interval of 100。C. The main results are as follow. 1. The as-welded specimen showed the highest tensile strength and yield point. The tensile strength and the yield point decrease as the annealing temperature increased from 500。C to 900。C, and they became smaller in the order of deposited metal, heat affected zone and base metal. 2. The hardness was maximum at about 9 mm from the welding center line, and it decreased drastically in the heat affected zone located between 9∼15mm from the center line. 3. The elongation decreased in the order of base metal, the fusion zone and heat affected zone while it increased as annealing temperature increased. 4. The stress intensity factor(S. I. F.) declined as the length of notch increased and it became smaller in the order of fusion zone, base metal and heat affected zone. This is because fracture toughness is affected by brittlization at heat affected zone as well as the initiation and propagation of cracks.

소성변형 부위에서의 피로크랙전파

성호현,송일규,국정한 한국기술교육대학교 1998 論文集 Vol.5 No.1

In this study, the behavior of a fatigue crack propagation near the expanded hole was investigated in terms of the plastic deformation and position of hole with respect to the propagating crack tip. The results of this study are summarized as follows. 1. The crack propagation rate is high when the crack tip approaches the hole but the retardation effect becomes prolonged when the crack tip is at the very vicinity of the hole. 2. The proper expansion of the hole seemed to play an important role for the retardation of the fatigue crack propagation rate. It is found that 5% of plastic deformation in mild steel show the best effect of the fatigue crack retardation.

글쓰기 교육과 한문 교육의 앞으로의 방향

손병국,오정란,조규일,최기용,한지현 광운대학교 인문사회과학연구소 2000 인문사회과학논문집 Vol.29 No.-

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

FK506과 cyclosporin A가 기관지상피세포, 단핵구, 림프구 및 폐포대식세포에서 $I{\kappa}B{\alpha}$ 분해 및 $IKK{\alpha}$ 활성에 미치는 효과

윤호일,이창훈,이희석,이춘택,김영환,한성구,심영수,유철규,Yoon, Ho Il,Lee, Chang-Hoon,Lee, Hee-Seok,Lee, Choon-Taek,Kim, Young Whan,Han, Sung Koo,Shim, Young-Soo,Yoo, Chul-Gyu 대한결핵및호흡기학회 2003 Tuberculosis and Respiratory Diseases Vol.54 No.4

연구배경 : Cyclosporin A(CsA)와 tacrolimus(FK506)은 현재 임상에서 널리 쓰이는 면역억제제이다. CsA와 FK506이 $I{\kappa}B/NF-{\kappa}B$ 경로에 미치는 영향에는 세포에 따라 다양한 효과가 알려져 있다. 그러나 CsA와 FK506이 기관지 상피세포에서 $I{\kappa}B/NF-{\kappa}B$ 경로에 미치는 효과에 관해서는 알려져 있지 않고, 각종 염증 세포에서의 차이에 관해서도 보고가 미미한 실정이다. 본 연구에서는 비염증세포인 기관지상피세포와, 폐의 염증에 중요한 역할을 하는 염증 세포(폐포대식세포, 단핵구, 림프구)에서 CsA와 FK506이 $I{\kappa}B{\alpha}$의 분해에 미치는 영향과 그 기전을 평가하였다. 방 법 : 비염증세포로는 BEAS-2B와 A549 세포주를 이용하였다. FK506 또는 CsA 전처치 후 TNF-${\alpha}$로 자극하고 anti-$I{\kappa}B{\alpha}$ 항체를 이용한 Western blot으로 $I{\kappa}B{\alpha}$의 분해 여부를 관찰하였다. 염증세포로는 폐포대식세포, 말초혈액 단핵구 및 림프구를 이용하였고, 역시 FK506 또는 CsA 전처치 후 TNF-${\alpha}$, IL-$1{\beta}$, LPS로 자극하고 anti-$I{\kappa}B{\alpha}$ 항체를 이용한 Western blot으로 $I{\kappa}B{\alpha}$의 분해 여부를 관찰하였다. IKK의 활성도는 GST-$I{\kappa}B{\alpha}$를 기질로 이용한 in vitro immune complex kinase assay로 평가하였다. 결 과 : 사용된 모든 세포에서 CsA와 FK506은 $I{\kappa}B{\alpha}$의 발현에 영향을 미치지 않았다. 기관지 상피세포에서 TNF-${\alpha}$ 자극에 의한 $I{\kappa}B{\alpha}$의 분해는 CsA의 전처치로 억제되었으나, FK506의 전처치로는 억제되지 않았다. 단핵구, 림프구 및 폐포대식세포에서 외부자극에 의한 $I{\kappa}B{\alpha}$의 분해는 CsA 또는 FK506의 전처치로 억제되었으나 IKK활성은 억제되지 않았다. 결 론 : CsA와 FK506은 각각 기관지 상피세포와 단핵구, 림프구, 폐포대식세포에서 외부 자극에 의한 $I{\kappa}B{\alpha}$의 분해를 억제하는데, 이는 IKK 활성화의 억제가 아닌 다른 경로를 통하는 것으로 생각된다. Background : Cyclosporin A(CsA) and tacrolimus(FK506) have been widely used as immunosuppressants. The effects of CsA, or FK506, on the $I{\kappa}B/NF-{\kappa}B$ pathway have been shown to vary according to the cell type. However, their effects on the $I{\kappa}B/NF-{\kappa}B$ pathway have not been reported in bronchial epithelial cells. In this study, the effects of CsA and FK506 on the $I{\kappa}B/NF-{\kappa}B$ pathway in bronchial epithelial cells, monocytes, lymphocytes and alveolar macrophages were evaluated. The relationship between their effects on the $I{\kappa}B/NF-{\kappa}B$ pathway and $I{\kappa}B$ kinase(IKK) activity was also investigated. Methods : BEAS-2B and A549 cells, pulmonary alveolar macrophages, peripheral blood monocytes and lymphocytes were used. The cells were pre-treated with CsA, or FK506, for various time periods, followed by stimulation with TNF-${\alpha}$, LPS or IL-$1{\beta}$. The $I{\kappa}B{\alpha}$ expressions were assayed by Western blot analyses. The IKK activity was evaluated by an in vitro immune complex kinase assay, using GST-$I{\kappa}B{\alpha}$ as the substrate. Results : Neither CsA nor FK506 affected the level of $I{\kappa}B{\alpha}$ expression in any of the cell types used in this study. CsA pre-treatment inhibited the TNF ${\alpha}$-induced $I{\kappa}B{\alpha}$ degradation in bronchial epithelial cells. In contrast, the TNF ${\alpha}$-induced $I{\kappa}B{\alpha}$ degradation was not affected by FK506 pre-treatment. However, FK506 suppressed the cytokine-induced $I{\kappa}B{\alpha}$ degradation in the pulmonary alveolar macrophages, peripheral blood monocytes and lymphocytes. The inhibitory effect of CsA, or FK506, on $I{\kappa}B{\alpha}$ degradation was not related to IKK. Conclusions : CsA and FK506 suppressed the $I{\kappa}B{\alpha}$ degradation in bronchial epithelial cells, monocytes, lymphocytes and alveolar macrophages, so this may not be mediated through IKK.

측두골 골절 : 임상적 및 방사선학적 분석 Clinical and Radiological Analysis

조성원,최순관,조성진,김범태,신원한,윤일규,변박장 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

The objective of this study is to review of the incidence of temporal bone fractures and complications resulting from temporal bone fractures and to analyze the correlation between clinical and radiological findings. A series of 49 patients who were diagnosed temporal bone fracture with rhinorrhea, bloody otorrhea, admitted to Soonchunhyang University Chon-an Hospital from January 1997 to September 1999, were studied retrospectively. Clinical analyses were focused on age, sex, type of accident, external wound site, CSF leakage, hearing loss and facial nerve palsy. The high resolution CT scan consisted of a series of 3-mm thick sections through the temporal bone using the GE CT scanner (General Electric Inc.). In radiologic analyses, fracture types of temporal bone were divided into longtudinal fracture(LF), transverse fracture(TF) and mixed fracture(MF) respectively. The CT scans were examined for mastoid antral haziness(MH), middle ear cavity haziness(MeH), ossicular chain disruption(OD), otic capsule fracture(OF), pneumocephalus(Pn). The type of facial canal fracture was classified as fracture of internal auditory canal portion(FIAC), fracture of perigeniculate portion(FPG), fracture of tympanic portion(FT), fracture of mastoid portion(FM). The correlation between clinical and radiological findings was analysed. A total of 49 fractured temporal bones resulted in 9 CSF fistula, 23 hearing loss( 13 conductive type, 7 sensorineural type), 17 facial nerve injuries ranging from mild paresis to complete paralysis. The mose common etiology of the injury was from a motor vehicle accident(28%). The type of fracture observed on high resolution CT scanning was a LF in 39(78%) patients, a TF in 7(14%) patients and a MF in 3(6%) patients. The majority of fractures terminate in the floor of the middle cranial fossa in LF and passed lateral to the otic capsule in TF. Average time of onset of delayed facial palsy was 3.5 days. No patient developed prolonged otorrhea or meningitis during hospitalization and there was no requirement of surgical management. Hearing loss was the most common complication of temporal bone fracture(48%). Conductive hearing loss was associated with middle ear cavity haziness and ossiclular chain disruption. in temporal bone CT. A total of 29 cases facial canal fracture in temporal bone CT resulted in 14 perigeniculate portion(FPG), 12 tympanic portion(FT), 3 mastoid portion(FM). There was no correlation between radiological facial canal fracture and clinical facial nerve palsy. Four of 17 patients with facial nerve injury required facial nerve exploration under general anesthesia. We thought that prognosis and therapeutic planning in patients with temporal bone fractures were based on the clinical and radiological findings.

The study of simplified technique compared with analytical solution method for calculating the energy consumption Loads of four houses having various wall construction

( Gyu Il Han ) 한국어업기술학회 2011 수산해양기술연구 Vol.47 No.1