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만성폐쇄성폐질환의 급성악화와 회복기에서 유도객담 내 Nuclear Factor-κB (NF-κB)의 활성도와 IL-6, IL-8 및 TNF-α의 농도 변화
송소향 ( So Hyang Song ),김치홍 ( Chi Hong Kim ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ) 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.2
연구배경 : COPD의 급성악화는 세균에 의한 감염, 바이러스성 상기도 감염, 대기오염, 기후변화 등에 의하며, COPD의 급성악화 시에 객담 내 호중구의 증가, IL-6와 IL-8 농도의 증가, 그리고 산화질소의 증가는 NF-κB의 활성화와 관련된 것으로 알려져 있다. 그러므로 COPD의 병인 및 급성악화의 기전에 NF-κB 활성도와 IL-6, IL-8 및 TNF-α가 관련이 있는지 연구하고자 하였다. 방법 : 정상대조군 및 COPD로 입원하였던 환자 Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the NF-κB is known to be an indicator of cellular activation and of inflammatory mediator production. This stud
기관지천식 마우스에서 기저막하 섬유화와 관련된 인자들: TGF-β1및 IL-17에 대한 CpG-oligodeoxynucleotides의 영향
송소향 ( So Hyang Song ),김치홍 ( Chi Hong Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.2
Background: Important features of airway remodeling in asthma include the formation of subepithelial fibrosis and increased deposition of collagen. Profibrotic cytokines such as TGF-β1 and IL-17 are involved in the formation of subepithelial fibrosis and are increased in patients with asthma, particularly in these severe disease. Previous reports have represented that administration of CpG-oligodeoxynu-cleotides (CpG-ODN) before allergen sensitization or challenge inhibits chronic inflammation and remodeling of airway in mice with chronic asthma, but the effect of CpG-ODN on TGF-β1 and IL-17 have not been evaluated. Objective: To evaluate the effect of CpG-ODN on the expression of these profibrotic cytokines and on collagen deposition, this study was performed in mice with chronic asthma. Method: Mice were subjected to repetitive ovalbumin (OVA) challenge for 2 months. CpG-ODN was administered intraperitoneally for sensitization. After the final challenge, airway hyperresponsiveness, peribronchial fibrosis, and levels of lung hydroxyproline were assessed. Levels of TGF-β1 and IL-17 in bronchoaveolar lavage (BAL) were assessed by ELISA and the number of TGF-β1+cells and IL-17+cells in peribronchial area by immumohistochemistry. Result: CpG-ODN significantly reduced airway hyperresponsiveness, eosinophil infiltration, and peribronchial fibrosis. Levels of TGF-β1 in BAL fluid (353±94 vs 270±66 pg/mL, OVA vs OVA+CpG, P<0.05) and peribronchial TGF-β1+cells (46±10 vs 27±5 TGF-β1+ cells/bronchus, OVA vs OVA+CpG, P<0.01) were significantly reduced in mice treated with CpG-ODN. Levels of IL-17 in BAL fluid (62±30 vs 34±10 pg/mL, OVA vs OVA+CpG, P=0.074) were not significantly reduced, but peribronchial IL-17+cells (27±7 vs 7.5±5.3 IL-17+ cells/bronchus, OVA vs OVA+CpG, P<0.01) and levels of lung hydroxyproline (13.1±5.3 vs 9.1±2.71ug/mL, OVA vs OVA+CpG, P<0.01) were significantly reduced in mice treated with CpG-ODN. Conclusion: CpG-ODN significantly reduced the levels of allergen-induced peribronchial fibrosis and collagen deposition. The reduction in peribronchial fibrosis and collagen deposition mediated by CpG-ODN might be due to several mechanisms including inhibition of profibrotic cytokines of TGF-β1 and IL-17 and a reduction in the number of peribronchial inflammatory cells expressing TGF-β1. (Korean J Asthma Allergy Clin Immunol 2006;26:136-144)
진행된 비소세포 폐암 환자에서 Concurrent Chemoradiotherapy 와 Conventional Radiotherapy의 비교
김휘정 ( Hui Jung Kim ),이동수 ( Dong Soo Lee ),송소향 ( So Hyang Song ),정수미 ( Su Mi Jung ),김영균 ( Young Kyoon Kim ),윤세철 ( Se Chul Yoon ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ) 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.3
비결핵성 기관지탄분섬유증의 임상적 특징과 방사선학적 특징
장시진 ( See Jin Jang ),이숙영 ( Sook Young Lee ),김석찬 ( Suk Chan Kim ),이소영 ( So Young Lee ),조현선 ( Hyun Sun Cho ),박기훈 ( Ki Hoon Park ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ),김영균 ( 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.2
연구배경: 기관지내시경 시행 시 기관지점막에 탄분침착을 보이는 경우가 종종 있다. 이러한 기관지탄분섬유증은 결핵과 연관이 있다고 여겨지는데 최근 논문들에 의하면 결핵 이외의 만성폐쇄성 폐질환이나 폐렴 등의 다양한 폐질환과 관련이 있음이 보고되어 진다. 방법: 2003년 1월부터 2006년 7월까지 강남성모병원에서 기관지내시경 검사를 시행 받은 환자들 중 기관지 탄분침착이 있는 환자들을 대상으로 진료기록지를 통해 후향적 분석을 하였다. 기저질환, 임상소견, 폐기능 검사 및 조직소견, 방사선소견을 분석하였고 비결핵성 기관지탄분섬유증 환자에서 기관지협착이 동반된 경우 스테로이드 투여 시 그 치료성적을 분석하였다. 결과: 총 74명 중 비결핵성 기관지탄분섬유증 환자가 54명(73%)이었다. 이 중 41명(76%)에서 협착이 동반되었고 13명(24%)은 탄분침착만 보였다. 비결핵성 기관지탄분섬유증 환자 중 협착이 동반된 경우 14명에서 고식적 치료로 스테로이드를 투여하였는데 이 중 9명(64%)에서 임상적인 호전을, 6명(43%)에서 방사선학적인 호전을 보였다. 결론: 기관지 탄분섬유증은 결핵뿐만 아니라 만성폐쇄성 폐질환, 폐렴등의 다양한 호흡기 질환과 관련이 있다. 비결핵성 기관지 탄분섬유증 환자에서 고식적인 치료에 잘 반응하지 않을 경우 스테로이드를 고려해 볼 수 있다. Background: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. Methods: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary`s hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. Results: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. Conclusion: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc. (Tuberc Respir Dis 2007; 63: 139-144)
이달의 X-선 : 양측 폐문 림프절 종대를 동반한 간질성 결절성 폐침윤
윤재호 ( Jae Ho Yoon ),여창동 ( Chang Dong Yeo ),신은중 ( Eun Joong Shin ),송소향 ( So Hyang Song ),김치홍 ( Chi Hong Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
단순 흉부 X-선에서 양측성 폐문 림프절 비후를 보이는 대표적인 질환으로 유육종증, 림프종, 결핵, 폐암, 아밀로이드증, 브루셀라증, 콕시디오이데스진균증(Coccidioidomycosis) 등이 있다. LIP의 방사선학적 소견은 보통 비특징적이고, 초기 병변에서 양측 폐하에 망상, 망상결절성 침윤을 보이며 병이 진행됨에 따라 낭성 변화를 동반하고, 봉소상을 보이는 경우가 있으나, 본 증례의 환자와 같이 종격동과 양측 폐문에 림프절 종대를 동반하는 경우에 대한 보고는 흔치 않다. 저자들은 흉부 X-선 및 CT상 종격동과 양측 폐문 부의 림프절 종대를 동반한 간질성 결절성 폐침윤 소견을 나타낸 환자에서 흉강경하 폐 생검을 통해 진단된 LIP를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Lymphocytic interstitial pneumonia(LIP) is an uncommon condition in which the alveolar septa and extra-alveolar interstitial space are markedly expanded by small lymphocytes, plasma cells and histiocytes. Chest radiographs generally show nonspecific patterns with the most common pattern showing bibasilar reticular or reticulonodular infiltrates. Hilar or mediastinal lymphadenopathy and pleural effusions are usually absent. We encountered a 42-year-old female patient who was admitted to hospital because of exertional dyspnea and palpitation. The chest X-ray showed an enlarged bilateral hilar shadow and diffusely increased bronchovascular markings in both lung fields. The chest CT showed diffuse nodular infiltrations with mild septal thickening and combined patchy ground glass opacity in both lungs, and conglomerated mediastinal and bilateral hilar lymphadenopathy. A diagnosis of LIP was made from the tissue pathology taken by a thoracoscopic lung biopsy. The patient showed clinical and radiographic improvement after 3 months of treatment with prednisolone. We report a case of LIP presenting as diffuse nodular interstitial infiltrations with multiple mediastinal and bilateral hilar lymphadenopathy. (Tuberc Respir Dis 2006; 61: 294-298)