BACKGROUND: Mycobacterium tuberculosis is a facultative intracellular pathogen which persists and multiplies within macrophage. Competent cell mediated immunity by cooperation of both T lymphocyte and macrophage of the host is required to kill the Mycobacterium tuberculosis. But a precise understanding of the pathogenesis of tuberculosis infection in pulmonary alveolar macrophage has not been achived. Research on the macrophage's basic microbicidal mechanism has elucidated the importance of oxygen-dependent or oxygen-independent components. Oxygen dependent processing begins with the reduction of oxygen by NADPH oxidase and generation of superoxide. In this study, the oxidative metabolic status of blood monocyte and pulmonary alveolar macrophage in patients with active pulmonary tuberculosis was accessed and compared with that of healthy control subjects to know whether there was a basic difference in superoxide generation by mononuclear cells between two groups. METHODS: Pulmonary alveolar macrophage was purified after performing BAL(bronchoalveolar lavage) through the bronchi of infected lesion by Plastic adhesion method. Blood monocyte was purified by Ficoll-Hypaque method. Superoxide generation by blood monocyte and pulmonary alveolar macrophage was measured by ferricytochrome-C reduction method after either stimulated with PMA(phorbol myristate acerate) or non-stimulated states. We also measured the effect of pulmonary tuberculosis patent's serum on superoxide generation by monocyte. RESULTS: 1) Generation of superoxide by alveolar macrophage obtained from patients with pulmonary tuberculosis was little higher than those of controls, and PMA enhanced the generation of 2) Generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis was little higher than those of control(P>0.05), and PMA more enhanced the generation of superoxide in patientswith pulmonary tuberculosis than those in controls(p<0.02). 3) Patient's serum enhanced the generation of superoxide by blood monocyte obtained from patients with pulmonary tuberculosis and controls, but not in the case of PMA stimulated blood monocyte. CONCLUSION: The present study suggest that the phenomenon of M. tuberculosis escape the microbicidal action of macrophage was not result of suppressed superoxide generation by blood monocyte and pulmonary alveolar macrophage, rather there might be a factor to stimulate the generation of superoxide by blood monocyte in pulmonary tuberculosis patient serum, but the comparision with effect of control's serum on superoxide generation needs further elucidation.
Bronchi ; Humans ; Immunity, Cellular ; Lymphocytes ; Macrophages ; Macrophages, Alveolar* ; Monocytes* ; Mycobacterium tuberculosis ; Myristic Acid ; NADPH Oxidase ; Oxygen ; Plastics ; Superoxides* ; Tuberculosis ; Tuberculosis, Pulmonary* ; United Nations

BACKGROUNDS/AIMS: High intraluminal pressure has been reported to cause left colonic diverticula. However, the pathophysiology of right colonic diverticula is still unclear. Methane gas has been reported to delay small intestinal transit and to increase intraluminal pressure. The aim of this study was to evaluate the relationship between right colonic diverticula and intestinal gas produced by enteric bacteria. METHODS: Lactulose breath tests were performed in 30 patients who were diagnosed with right colonic diverticula via colonoscopy. The control group consisted of 30 healthy adults with no specific symptoms or medical histories. A hydrogen or methane producer was defined in 2 ways: either one that exhibited a breath hydrogen level > or = 20 ppm (methane > or = 10 ppm) baseline or one that exhibited an increase in breath hydrogen > or = 20 ppm (methane > or = 10 ppm) above baseline within the first 90 minutes of the test. RESULTS: The lactulose breath test (LBT) positivity in the diverticular group and the control group were 40.0% and 33.3%, respectively, without a statistically significant difference. The concentrations of methane and hydrogen gas measured by LBT increased over time, but there was no significant difference between the control and the diverticular groups. CONCLUSIONS: There was no significant relationship between right colonic diverticula and intestinal gases produced by enteric bacteria. However, time-dependent formation of diverticula should be taken into consideration, therefore long-term, large-scale follow-up studies may reveal further pathogenesis of right colonic diverticulosis.
Adult ; Breath Tests ; Colon ; Colonoscopy ; Diverticulosis, Colonic ; Diverticulum ; Diverticulum, Colon ; Enterobacteriaceae ; Gases ; Humans ; Hydrogen ; Lactulose ; Methane

BACKGROUND: The extrauterine fetal incubation system must meet stable blood gas exchange and sufficient oxygen supply to provide the physiologic oxygen consumption of the fetus. In the fetus, blood gas exchange is totally sustained by the placental circulation. The placenta can be regarded as an extracorporeal organ, and the basic structure of placental circulation comprises arteriovenous (AV) bypass. To mimic this mode of circulation, we used AV ECMO (extracorporeal membrane oxygenation) in the goat fetus, and attempted to achieve stable blood gas exchange and oxygen supply to the fetus. METHODS: Pregnant goats, weighting 30 - 35 kg, were anesthetized with N2O-O2-enflurane. We performed a cesarean section with a midline incision, and cannulated via the umbilical vessels after a hysterotomy, and connected the fetuses to an ECMO circuit. The fetus was transferred to an incubator containing normal saline mixed with antibiotics. Blood samples were obtained every 4 to 6 hours from the circuit for electrolytes, hemoglobin and blood gas analysis and arterial blood pressure and heart rate were monitored through the umbilical artery. Oxygen delivery and consumption were calculated from the measured parameters. Microscopic examinations of the liver, kidney and lung were performed 24 hours after ECMO to know the effect of AV ECMO on the circulation of the organ. RESULTS: AV ECMO was done for 24 hours in the six goat fetuses and the main cause of death was circulatory failure. Heart rates and blood pressure were stable during ECMO. Sodium bicarbonate was injected when mild acidosis occurred and blood gas exchange was maintained stable. Mean pump flow rate was 156 +/- 62 ml/min/kg and oxygen extraction ratio was 30.4%. The liver function tests were sustained within normal limits both before and 24 hours after ECMO, but BUN and creatininincreased beyond upper normal limits 24 hours after ECMO. Microscopic features of the liver and kidney showed congestion 24 hours after ECMO. The fetal lung after 24 hours of ECMO especially showed an increase of mature capillaries in the septum and wall of alveoli compared with the twin fetal lung. CONCLUSIONS: These results indicate that the extrauterine fetal incubation model used for this study was suitable to blood gas exchange and utility of oxygen for goat fetuses.
Acidosis ; Anti-Bacterial Agents ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Capillaries ; Cause of Death ; Cesarean Section ; Electrolytes ; Estrogens, Conjugated (USP) ; Extracorporeal Membrane Oxygenation ; Female ; Fetus* ; Goats* ; Heart Rate ; Hemodynamics ; Humans ; Hysterotomy ; Incubators ; Kidney ; Liver ; Liver Function Tests ; Lung ; Membranes ; Oxygen ; Oxygen Consumption ; Placenta ; Placental Circulation ; Pregnancy ; Shock ; Sodium Bicarbonate ; Twins ; Umbilical Arteries

The principal objective of this study was to acquire basic data regarding the mycelial growth characteristics for the artificial cultivation of Coprinus comatus. 12 URP primers were employed to evaluate the genetic relationships of C. comatus, and the results were divided into three groups. Among six kinds of mushroom media, MYP medium was selected as the most favorable culture medium for C. comatus. The optimal temperature and pH ranges for the mycelial growth of C. comatus were 23~26degrees C and pH 6~8, respectively. The carbon and nitrogen sources for optimal mycelial growth were sucrose and tryptone, respectively.
Agaricales ; Carbon ; Coprinus ; Cultural Characteristics ; Hydrogen-Ion Concentration ; Nitrogen ; Sucrose

No abstract available.
Eosinophilia* ; Respiratory Insufficiency*

BACKGROUND/AIMS: SCN5A encodes the cardiac-specific NaV1.5 sodium channel, and Brugada syndrome is a cardiac conduction disorder associated with sodium channel alpha-subunit (SCN5A) mutation. The SCN5A-encoded NaV1.5 channel is also found on gastrointestinal smooth muscle and interstitial cells of Cajal. We investigated the relationship between functional dyspepsia (FD) and SCN5A mutation to evaluate sodium channelopathy in FD. METHODS: Patients with Brugada syndrome or FD were examined using upper endoscopy, electrogastrography (EGG), FD symptom questionnaire based on Rome III criteria and genetic testing for SCN5A mutation. Symptom scores of FD and EGG findings were analyzed according to SCN5A mutation. RESULTS: A total of 17 patients (4 Brugada syndrome and 13 FD) participated in the study. An SCN5A mutation was noted in 75.0% of the patients with Brugada syndrome and in 1 (7.7%) of the patients with FD. Of 4 patients with SCN5A mutation, 2 (50%) had FD. Postprandial tachygastria and bradygastria were noted in 2 (50%) and 1 (25%) of the patients with SCN5A mutation, respectively. The EGG findings were not significantly different between positive and negative mutation in 17 patients. CONCLUSIONS: Although we did not find statistically significant results, we suggest that it is meaningful to attempt to identify differences in symptoms and gastric myoelectric activity according to the presence of an SCN5A mutation by EGG analysis. The relationship between FD and sodium channelopathy should be elucidated in the future by a large-scale study.
Brugada Syndrome ; Channelopathies ; Dyspepsia ; Endoscopy ; Gastrointestinal Diseases ; Genetic Testing ; Humans ; Interstitial Cells of Cajal ; Muscle, Smooth ; Ovum ; Pilot Projects ; Surveys and Questionnaires ; Rome ; Sodium ; Sodium Channels

PURPOSE: This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. MATERIAL AND METHODS: Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200cGy) radiation therapy alone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. RESULTS: Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group (25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting (22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. CONCLUSION: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Bone Marrow ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Follow-Up Studies ; Humans ; Incidence ; Nausea ; Neoplasm Metastasis ; Pulmonary Fibrosis ; Survival Rate ; Survivors ; Vomiting

OBJECTIVE: Estrogen related receptor beta (Esrrb) is a member of the orphan nuclear receptors and may regulate the expression of pluripotency-related genes, such as Oct4 and Nanog. Therefore, in the present study, we have developed a method for delivering exogenous ESRRB recombinant protein into embryos by using cell-penetrating peptide (CPP) conjugation and have analyzed their effect on embryonic development. METHODS: Mouse oocytes and embryos were obtained from superovulated mice. The expression of Oct4 mRNA and the cell number of inner cell mass (ICM) in the in vitro-derived and in vivo-derived blastocysts were first analyzed by real time-reverse transcription-polymerase chain reaction and differential staining. Then 8-cell embryos were cultured in KSOM media with or without 2 microg/mL CPP-ESRRB protein for 24 to 48 hours, followed by checking their integration into embryos during in vitro culture by Western blot and immunocytochemistry. RESULTS: Expression of Oct4 and the cell number of ICM were lower in the in vitro-derived blastocysts than in the in vivo-derived ones (p<0.05). In the blastocysts derived from the CPP-ESRRB-treated group, expression of Oct4 was greater than in the non-treated groups (p<0.05). Although no difference in embryonic development was observed between the treated and non-treated groups, the cell number of ICM was greater in the CPP-ESRRB-treated group. CONCLUSION: Treatment of CPP-ESRRB during cultivation could increase embryos' expression of Oct4 and the formation rate of the ICM in the blastocyst. Additionally, an exogenous delivery system of CPP-conjugated protein would be a useful tool for improving embryo culture systems.
Animals ; Blastocyst ; Blotting, Western ; Cell Count ; Embryonic Development ; Embryonic Structures* ; Estrogens ; Female ; Immunohistochemistry ; Mice* ; Oocytes ; Orphan Nuclear Receptors ; Pregnancy ; RNA, Messenger

St. Francisco General Hospital, Seoul, Korea. Although the incidence of pulmonary tuberculosis is declining, the number of extrapulmonary tuberculosis has remained constant. Tuberculous Lymphadenitis accounts for over 50% of total inflammatory lymphadenitis and the most common site is cervical lymph node. We report a case of single cervical tuberculous cold abscess associated with multiloculated and septated tuberculous pleurisy. Intracavitary urokinase instillation via percutaneous catheter is indicated in loculated and septated pleural effusion. And our result was satisfactory without complication.
Abscess* ; Catheters ; Hospitals, General ; Incidence ; Korea ; Lymph Nodes ; Lymphadenitis ; Pleural Effusion ; Seoul ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pleural* ; Tuberculosis, Pulmonary ; Urokinase-Type Plasminogen Activator

No abstract available.
Actinomycosis*