BACKGROUND: Serum eosinophil cationic protein(ECP) level has been proposed as a indirect marker of eosinophilic inflammation of the airway in bronchial asthma. OBJECTIVE: To evaluate serum ECP against indirect clinical markers of disease, we compared bronchial obstruction, bronchial hyperresponsiveness and peripheral blood eosinophil counts, total IgE with serum ECP levels in patients with bronchial asthma and normal controls. METHOD: Fourty-two patients with bronchial asthma and twenty-six normal controls were enrolled. Measurement were made by spirometry, inhalation challenge with methacholine, peripheral blood eosinophil counts, total IgE and FEIA(fluoroenzymatic immunoassay) of serum ECP RESULT: Serum ECP levels were significantly higher in asthmatic patients than normal controls(p<0.0,5). Serum ECP levels were correlated with peripheral blood eosinophil counts(p<0.01, r=0.544) and bronchial hyperresponsiveness(PC,)(p<0.01, r=-0.456) in patients with bronchial asthma. Serum ECP levels were correlated with degree of bronchial obstruction(FEV, % to predicted value, FEV1/FVC%) in total subjects, but not in asthmatic patients. CONCLUSION: Serum ECP level may be used as indicator of disease activity in bronchial asthma and be helpful in differentiation between normal person and asthmatic patients on simple serological method. Further studies on the changes of serum ECP levels according to disease course and therapeutic responses are needed.
Asthma* ; Biomarkers ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation ; Inhalation ; Methacholine Chloride ; Spirometry

BACKGROUND: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. METHODS: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 microgram ovalbumin(OA). Antigen airway challenges were done 14 ~16 days after sensitization and the sensitized rats were sacrificed 1h(AE), 6 ~8h(AL) and 1day(AD) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6 ~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. RESULTS: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). CONCLUSION: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.
Airway Obstruction ; Animals ; Asthma* ; Bronchi ; Eosinophils ; Humans ; Inflammation* ; Injections, Subcutaneous ; Lung ; Ovalbumin* ; Rats ; Rats, Sprague-Dawley* ; Trachea

BACKGROUND: Bioprosthetic devices for treating cardiovascular diseases and defects may provide alternatives to autologous and homograft tissue. We evaluated the mechanical and physical conditions of a porcine pericardial bioprosthesis treated with Glutaraldehyde (GA), Ethanol, or Sodium dodecylsulfate (SDS) before implantation. MATERIAL AND METHOD: 1) Thirty square-shaped pieces of porcine pericardium were fixed in 0.625%, 1.5% or 3% GA solution. 2) The tensile strength and thickness of these and other bioprosthesis, including fresh porcine pericardium, fresh human pericardium, and commercially produced heterografts, were measured. 3) The tensile strength and thickness of the six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were measured. RESULT: 1) Porcine pericardium fixed in 0.625% GA the thinnest and had the lowest tensile strength, with thickness and tensile strength increasing with the concentration of GA solution. The relationship between tensile strength and thickness of porcine pericardium increased at thicknesses greater than 0.1 mm (correlation-coefficient 0.514, 0<0.001). 2) There were no differences in tensile strength or thickness between commercially-produced heterografts. 3) Treatment of GA, ethanol, or SDS minimally influenced thickness and tensile strength of porcine pericardium, except for SDS alone. CONCLUSION: Porcine pericardial bioprosthesis greater than 0.1 mm thick provide better handling and advantageous tensile strength. GA fixation did not cause physical or mechanical damage during anticalcification or decellularization treatment, but combining SDS-ethanol pre-treatment and GA fixation provided the best tensile strength and thickness.
Bioprosthesis ; Cardiovascular Diseases ; Ethanol ; Glutaral ; Handling (Psychology) ; Humans ; Pericardium ; Sodium ; Tensile Strength ; Transplantation, Heterologous ; Transplantation, Homologous

BACKGROUND/AIMS: Hepatitis A is increasing during the recent years in Korea, and sporadic cases of hepatitis E are not rare. We investigated the etiology of acute viral hepatitis, including 27 cases of coinfection with hepatitis A and E, during the last 3 years. METHODS: Retrospective analysis of one hundred eleven patients with acute viral hepatitis at Chung-Ang University Hospital was done from January 2005 to July 2007. The patients were positive for any one of the following tests: IgM anti-HAV, IgM anti-HBc, HCV RNA and IgM anti-HEV. RESULTS: The proportions of acute viral hepatitis A, B and C were 94.6% (105/111), 4.5% (5/111) and 0.9% (1/111), respectively. Among the patients with hepatitis A, 27 patients (24.3%) were positive for IgM anti-HEV. We analyzed 105 patients with either hepatitis A only or they had coinfection of hepatitis A and E. The mean age, the duration of the hospital stay, the mean levels of serum transaminase, bilirubin and albumin and the protrombin time were similar between the patients with hepatitis A only and those with coinfection of hepatitis A and E. All the patients were discharged without serious complication such as fulminant hepatic failure. The biochemical liver function tests were normalized in all patients within 8 weeks. CONCLUSIONS: The most common etiology of acute viral hepatitis in Koreans was the hepatitis A virus. Patients coinfected with hepatitis A and E were observed. The patients with coinfection of hepatitis A and E showed no significant difference in their clinical features and laboratory parameters, as compared to the patients with hepatitis A only.
Bilirubin ; Coinfection ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Hepatitis E ; Humans ; Immunoglobulin M ; Korea ; Length of Stay ; Liver Failure, Acute ; Liver Function Tests ; Retrospective Studies ; RNA

Kartagener's syndrome is an autosomal recessively inherited condition characterized by triad of situs inversus, bronchiectasis, and chronic sinusitis. And recently it was classified as a subclass of dyskinetic cilia syndrome, which has a defect in mucociliary transport resulting from immotile or dyskinetic beating of cilia. Electron microscopic examination of the cilia from sperm tails, nasal and bronchial epithelium of patients reveals the partial or the complete absence of dynein arms or radial spoke, or microtubule disposition. This patient had all the triad of Kartagener's syndrome and showed two extracentral microtubules on the electron microscopic examination of the nasal mucosa. Most patients have dynein arms defect, but it is rare to have extracentral microtubules. So we report one case of Kartagener's syndrome with extracentral microtubules confirmed by electron microscopy.
Ammonia ; Apoptosis ; Arm ; Bronchiectasis ; Cilia* ; Dyneins ; Epithelium ; Helicobacter pylori ; Humans ; Kartagener Syndrome* ; Microscopy, Electron ; Microtubules* ; Mucociliary Clearance ; Nasal Mucosa ; Sinusitis ; Situs Inversus ; Sperm Tail

Bronchial asthma is a chronic airway inflammation disorder involving lymphocyte activation and various cytokines secretion by lymphocyte. The inflammatory response results from a complex network of interactions between inflammatory cells (mast cells, eosinophils, macrophages) and resident cells belonging to the lung structure itself like EC, fibroblasts, or bronchial epithelial cells. IL-6 which is known to up-regulate the endothelial cell expression of adhesion molecules participating in the development of the inflammatory reaction in bronchial asthma is produced by alveolar macrophage. ICAM-1 is produced by bronchial epithelial cell and expression by endothelial cell, which is known to enhance of the influx of various cells. RANTES which is known to a potent chemoattractant for eosinophils, lymphocytes, and monocytes, a member of the CC chemokine family, is expressed by bronchial epithelial cell. To evaluate whether markers of lymphocyte activation are useful markers of disease activity in bronchial asthma, we measured sIL-6, sICAM-1, sRANTES in 42 patients with mild to moderate bronchial asthma and in 26 normal controls and compared the result with other disease activity markers in asthma (pulmonary function, blood eosinophil counts). The mean level of sIL-6 was higher than that of normal control and correlated significantly with sICAM-1, FEV1% to predicted value. The mean level of sICAM-1 was higher than that of normal control and correlated significantly with FEV1%, FEV1% to predicted value. The mean level of sRANTES showed the tendency to be higher than that of normal control, but not significant statistically, and did not correlated with sIL-6, sICAM-1, FEV1%, FEV1% to predicted value, blood eosinophil counts. It appeared that sIL-6 and sICAM-1 could be a disease marker in bronchial asthma. But, clinical application of the measurement of these markers needs to be studied further.
Asthma* ; Chemokine CCL5 ; Cytokines ; Endothelial Cells ; Eosinophils ; Epithelial Cells ; Fibroblasts ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Lung ; Lymphocyte Activation ; Lymphocytes ; Macrophages, Alveolar ; Monocytes

BACKGROUND: The routine application of the combined regimen of corticosteroid-antituberculosis therapy to the tuberculous pleurisy remains controversial. Steroid therapy to tuberculous pleurisy could be effective on the acceleration of absorption of pleural effusion and symptom improvement, but there has been debate about the effect of prednisolone on the prevention of pleural adhesion. So we studied the efficacy of combined regimen of prednisolone-antituberculosis therapy on the absorption of pleural effusion and prevention of pleural adhesion. METHODS: A prospective, randomized study was performed in 82 patients, 50 patients(non-steroid group) were treated with only antituberculosis regimen for 6 months and in 32 patients(steroid group) prednisolone(30mg/day) were administered in addition to antituberculosis regimen for one months and tapered for another month. The amount of pleural effusion was compared at the beginning of treatment, 2nd month, 6th month and final visit with chest X-ray findings which were graded from grade 0(complete absorption) to grade 6(near total haziness). RESULTS: The amount of pleural effusion of steroid group at 2nd month, 6th month and final visit was lesser than that of non-steroid group (P<0.05). The incidence of the complete absorption of the pleural effusion was 3/32(9.4%) in steroid group, 1/50(2%) in non-steroid group at 2nd month after treatment; and 12/32(37.5%) in steroid group, 6/50(12%) in non-steroid group at 6th month after treatment (P<0.05). At final observation, the incidence of residual pleural thickening was 15/32(47%) in steroid group and 37/50(74%) in non-steroid group (P<0.05). No serious side effects were noted during the treatment with prednis olone. CONCLUSION: The administration of prednisolone in conjunction with antituberculosis chemotherapy improved the absorption of pleural effusion and decreased the residual pleural thickening.
Absorption ; Acceleration ; Drug Therapy ; Humans ; Incidence ; Pleural Effusion ; Prednisolone* ; Prospective Studies* ; Thorax ; Tuberculosis, Pleural*

BACKGROUND: The routine application of the combined regimen of corticosteroid-antituberculosis therapy to the tuberculous pleurisy remains controversial. Steroid therapy to tuberculous pleurisy could be effective on the acceleration of absorption of pleural effusion and symptom improvement, but there has been debate about the effect of prednisolone on the prevention of pleural adhesion. So we studied the efficacy of combined regimen of prednisolone-antituberculosis therapy on the absorption of pleural effusion and prevention of pleural adhesion. METHODS: A prospective, randomized study was performed in 82 patients, 50 patients(non-steroid group) were treated with only antituberculosis regimen for 6 months and in 32 patients(steroid group) prednisolone(30mg/day) were administered in addition to antituberculosis regimen for one months and tapered for another month. The amount of pleural effusion was compared at the beginning of treatment, 2nd month, 6th month and final visit with chest X-ray findings which were graded from grade 0(complete absorption) to grade 6(near total haziness). RESULTS: The amount of pleural effusion of steroid group at 2nd month, 6th month and final visit was lesser than that of non-steroid group (P<0.05). The incidence of the complete absorption of the pleural effusion was 3/32(9.4%) in steroid group, 1/50(2%) in non-steroid group at 2nd month after treatment; and 12/32(37.5%) in steroid group, 6/50(12%) in non-steroid group at 6th month after treatment (P<0.05). At final observation, the incidence of residual pleural thickening was 15/32(47%) in steroid group and 37/50(74%) in non-steroid group (P<0.05). No serious side effects were noted during the treatment with prednis olone. CONCLUSION: The administration of prednisolone in conjunction with antituberculosis chemotherapy improved the absorption of pleural effusion and decreased the residual pleural thickening.
Absorption ; Acceleration ; Drug Therapy ; Humans ; Incidence ; Pleural Effusion ; Prednisolone* ; Prospective Studies* ; Thorax ; Tuberculosis, Pleural*

To evaluate the effect of allergic parameters, such as serum IgE, eosinophil, and skin test on the bronchial hyperresponsiveness (BHR) in patients with chronic airflow obstruction, we performed methacholine bronchial provocation test, pulmonary function test, skin prick test, and measured blood eosinophil counts and serum IgE level from seventy-nine patients who showed persistent fixed airflow obstruction, less than 75% of predicted value in FEV~ and FEV1/FVC, despite of conventional treatment without steroid therapy for more than 3 months. The results were as follows 1) There were 53 patients with BHR and 26 patients without BHR. There were no statistically significant differences in sex, age, and smoking duration between positive BHR group and negative BHR group (p>0.05). 2) There was no statistically significant difference in absolute and predicted value of FVC(p>0.05). But there were significantly lower absolute, predicted value of FEV1 and FEV1/FVC% in positive group compared with negative group (p<0.05). 3) There was somewhat higher trend of serum IgE level in positive group. Skin test was not significantly different between two groups (p > 0.05 ). 4) Blood eosinophil count was significantly higher in positive group than in negative group(p<0.05). Conclusion of this study is that increased bronchial responsiveness in patients with chronic airflow obstruction is inversely related to the level of pulmonary function and significantly associated with blood eosinophilia.
Bronchial Provocation Tests ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Skin ; Skin Tests ; Smoke ; Smoking

BACKGROUND: Postoperative pulmonary complications are amongst the greatest causes of morbidity and mortality during liver transplantation. Postoperative mechanical ventilation and tracheal extubation are important parts of postoperative critical care. However, there are no comparative studies on postoperative mechanical ventilation, duration of intensive care units admission between cadaveric whole liver transplantation and living related liver transplantation groups, which are different from anesthetic and surgical procedures. In our present study, we have compared mechanical ventilation, duration of ICU admission and its influencing factors between the two groups. METHODS: We have retrospectively studied 67 cases and depending on the surgical procedures, we divided them into two groups; control group undergoing cadaveric whole liver transplantation and experimental group undergoing living related liver transplantation. Each group was evaluated based on operation time, time of mechanical ventilation, duration of ICU admission, amounts of infused fluid and transfusion during operation, preoperative and extubation O2 index, serum creatinine levels, and preoperative and intraoperative risk score. RESULTS: The mechanical ventilation time in experimental group was observed to be shorter than in control group, and serum creatinine level during the 3rd postoperative day in experimental group was lower than in control group (P<0.05). However, there was no difference in duration of ICU admission, O2 index, fluid amount and transfusion, and risk score between the two groups. CONCLUSIONS: We conclude that living related liver transplantation reduces mechanical ventilation time with no effect on ICU admission periods. Higher risk score is correlated with prolongation of postoperative mechanical ventilation.
Airway Extubation ; Cadaver* ; Creatinine ; Critical Care ; Intensive Care Units ; Liver Transplantation* ; Liver* ; Mortality ; Respiration, Artificial* ; Retrospective Studies