81 research outputs found
Assessment of blood-brain barrier integrity by dynamic contrast enhanced MRI in transient middle cerebral artery occlusion model after localized brain cooling
Dept. of Medicine/๋ฐ์ฌIntroduction: Localized brain cooling before reperfusion reportedly helps to reduce the inflammatory response and recover the function of brain neurons in stroke therapy. Little is known about the effects of localized brain cooling on permeability changes associated with alterations to the blood-brain barrier (BBB).Purpose: The purpose of this study was to evaluate the effects of localized brain cooling on BBB permeability following transient middle cerebral artery occlusion (tMCAO) in rats, by using dynamic contrast enhanced- (DCE-) MRI.Materials and method: Thirty rats were divided into three groups (10 rats each): control group, localized cold-saline (20ยฐC) infusion group, and localized warm-saline (37ยฐC) infusion group. The left middle cerebral artery (MCA) was occluded for 1 h in anesthetized rats, followed by 3 h of reperfusion. In the localized saline infusion group, 6 mL of cold or warm saline was infused through the hollow filament for 10 min after MCA occlusion. DCE-MRI investigations were performed after 3 h and 24 h of reperfusion. Four pharmacokinetic parameters of the Tofts model (wash-in rate [Ktrans], wash-out rate [Kep], leakage-space volume [Ve], and plasma-space volume [Vp]) were calculated for each DCE-MRI. In addition, rotarod testing was performed before tMCAO, and on days 1โ9 after tMCAO. Myeloperoxidase (MPO) immunohistochemistry was performed to identify infiltrating neutrophils associated with the inflammatory response in the rat brain.Result: There was a statistically significant decrease in Ktrans and Kep at the infarction site in the cold-saline group compared with the control group (P < 0.05) and a decrease in Kep that approached significance in the cold-saline group compared with the warm-saline group (Kep: cortex, P = 0.0892 basal ganglia, P = 0.0925). The percentage of MPO-positive cells in the cold-saline group was significantly
lower than those in the control and warm-saline groups (P < 0.05). However, behavioral testing did not reveal a statistically significant difference among the three groups.Conclusion: Localized brain cooling can inhibit the increase in BBB permeability that follows transient cerebral ischemia and reperfusion in an animal model.ope
Relationships between thickening of reticular basement membrane and the clinical features in children with asthma
Dept. of Medicine/์์ฌ[ํ๊ธ]๋ชฉ์ : ์ฒ์์ ๊ธฐ๋ ์ผ์ฆ๊ณผ ๊ณผ๋ฏผ์ฑ, ๊ธฐ๋ ํ์๋ฅผ ํน์ง์ผ๋ก ํ๋ ๋ง์ฑ ์ผ์ฆ์ฑ ์งํ์ด๋ค. ์ฒ์์ด ๋ถ๋ถ์ ์ผ๋ก๋ ๊ฐ์ญ์ ์ธ ๊ธฐ๋ ํ์๋ฅผ ์ผ์ผํค์ง๋ง, ๊ถ๊ทน์ ์ผ๋ก ๋น๊ฐ์ญ์ ์ธ ํ์๋ฅผ ์ผ์ผํค๋ ๊ธฐ๋ ๊ฐํ์ ๋ฐ์ ์ํค๊ฒ ๋๋ค. ๊ธฐ๋ ๊ฐํ์ด ์ผ์ด๋ ๊ธฐ๋๋ ์ฌ๋ฌ ๊ตฌ์กฐ์ ๋ณํ๋ฅผ ๋๋ฐํ๊ฒ ๋๋๋ฐ ์ํผ์ธํฌ ์ธต์ ํ๋ฝ, ๊ธฐ์ ๋ง์ ๋นํ, ๊ธฐ๋ ํํ๊ทผ์ ์ฆ์, ์ ์ ํ๊ด์ ์ฆ๊ฐ ๋ฑ์ ์๊ฒฌ์ ๋ณด์ธ๋ค. ๋ณธ ์ฐ๊ตฌ์์๋ ์์ ์ฒ์ํ์์ ๊ธฐ์ ๋ง์ ๋๊ป๋ฅผ ์ธก์ ํ์ฌ ๊ธฐ๋ ๊ธฐ์ ๋ง ๋นํ๊ฐ ์์ ์ฒ์์ ๋ฏธ์น๋ ์ํฅ์ ์์๋ณด๊ณ ์ ํ์๋ค.๋ฐฉ๋ฒ: ๊ธฐ๊ด์ง ๋ด์๊ฒฝ์ ํตํด ์กฐ์ง๊ฒ์ฌ๋ฅผ ์ํํ 18๋ช
์ ์ฒ์ ํ์์ 24๋ช
์ ๋์กฐ๊ตฐ์ ๋์์ผ๋ก ํ์๋ค. ๊ธฐ๋ ๊ธฐ์ ๋ง์ ๋๊ป๋ฅผ ์ธก์ ํ์๊ณ , ๊ธฐ์ ๋ง์ ๋๊ป์ ์ฐ๋ น, ์ฑ๋ณ, ์ฒ์ ๋ฐ๋ณ๊ธฐ๊ฐ, ์ฒ์์ ์ค๋ฑ๋, FEV1, FEV1/FVC, FEF25-75%, ๋ฉํ์ฝ๋ฆฐ PC20๋ฐ ํธ์ฐ๊ตฌ ์, ํ์ฒญ ์ด IgE, ์ง๋จผ์ง ์ง๋๊ธฐ (Dermatophagoides pteronyssinus) ์ ๋ํ ํน์ด IgE์์ ์๊ด๊ด๊ณ๋ฅผ ๋ถ์ํ์๋ค.๊ฒฐ๊ณผ: ์ฒ์ ํ์์์์ ๊ธฐ์ ๋ง์ ๋๊ป๋ 8.3ยฑ1.4 ใ๋ก 6.8ยฑ1.3 ใ์ธ ๋์กฐ๊ตฐ์ ๋นํด ๊ธฐ๋ ๊ธฐ์ ๋ง์ด ์๋ฏธ์๊ฒ ๋นํ๋์ด ์์๋ค (p=0.0008). ๋ค์ค ํ๊ท ๋ถ์์ ์ํํด ๋ณด์์ ๋ ์ฑ๋ณ, FEV1/FVC, ํ์ฒญ ์ด IgE, ์ง๋จผ์ง ์ง๋๊ธฐ์ ๋ํ ํน์ด IgE๊ฐ ๊ธฐ๋ ๊ธฐ์ ๋ง ๋นํ๋ฅผ ์๊ฒฌํ ์ ์๋ ์ธ์๋ก ๋ํ๋ฌ๋ค. ๊ธฐ๋ ๊ธฐ์ ๋ง ๋นํ์ ์ฐ๋ น, ์ฒ์ ๋ฐ๋ณ๊ธฐ๊ฐ, FEV1, FEF25-75%, ๋ฉํ์ฝ๋ฆฐ PC20๋ฐ ํธ์ฐ๊ตฌ ์, ์ฒ์์ ์ค๋ฑ๋ ๊ฐ์๋ ์ ์ํ ์๊ด๊ด๊ณ๋ฅผ ๋ณด์ด์ง ์์๋ค.๊ฒฐ๋ก : ์์ ์ฒ์ ํ์๋ค์ ๋์กฐ๊ตฐ์ ๋นํด ์์์๊ฒ ๊ธฐ๋ ๊ธฐ์ ๋ง์ ๋นํ๊ฐ ๊ด์ฐฐ๋์์ผ๋ฉฐ, ์ฑ๋ณ, FEV1/FVC, ํ์ฒญ ์ด IgE, ์ง๋จผ์ง ์ง๋๊ธฐ์ ๋ํ ํน์ด IgE์ ๊ด๋ จ์ ๋ณด์๋ค.
[์๋ฌธ]RATIONALE: Asthma is chronic inflammatory disease characterized by airway inflammation, bronchial hyperresponsiveness, airway obstruction. Although asthma induces partially reversible airway obstruction, in some patients, airflow obstruction can become irreversible. Such obstruction might be a consequence of airway remodeling. Remodeling comprises a number of structural changes, including epithelial detatchment, reticular basement membrane thickening, smooth muscle hypertrophy, and new vessel formation. This study investigated whether reticular basement membrane thickening is already present in children with asthma.METHODS: 18 children with asthma and 24 control subjects underwent flexible bronchoscopy with endobronchial biopsy. We used light microscopy to measure reticular basement thickness in plastic-embedded biopsy sections. We examined the relationship between reticular basement membrane thickening and age, sex, duration of asthma, asthma severity, FEV1, FEV1/FVC, FEF25-75%, methacholine PC20, eosinophil count, or presence of atopy.RESULTS: Reticular basement membrane thickness was greater in subjects with asthma (8.3 ยฑ 1.4 ใ) than in control subjects (6.8 ยฑ 1.3 ใ, p=0.0008). Multiple regression analysis revealed that sex, FEV1/FVC, total IgE, or atopy (IgE for Dermatophagoides pteronyssinus > 0.34 kUA/L) were the significant predictive factors for reticular basement membrane thickness. There was no significant difference between reticular basement membrane thickness and age, duration of asthma, FEV1, FEF25-75%, methacholine PC20, eosinophil count, or asthma severity.CONCLUSIONS: Reticular basement membrane thickening is already present in children with asthma. In addition, we find association between reticular basement membrane thickness and sex, FEV1/FVC, total IgE, or presence of specific IgE to Dermatophagoides pteronyssinus.ope
Inflammatory bowel disease in Korea: epidemiological, genomic, clinical, and therapeutic characteristics
Inflammatory bowel disease (IBD) describes chronic inflammatory disease of the intestines and has a variable course; Crohn's disease and ulcerative colitis comprise the two main forms of the condition. Although IBD occurs worldwide, its epidemiologic and clinical characteristics vary depending upon the geographic location and the ethnicity of the population. Identifying the characteristic features of IBD in populations living in different geographical locations and with different ethnicities may provide significant clues about its etiology and pathophysiology, which in turn may be helpful in the development of more appropriate treatment strategies for IBD for these different populations. Therefore, it is important for each country and region to evaluate critically the epidemiology, genomics, and clinical characteristics of IBD among its own population. We have performed a critical review of the recent data in Korea, and describe herein the current epidemiologic and genotypic status, as well as the clinical manifestations and therapeutic responses of IBD that are unique to Korean patientsope
Increased Serum Thymus and Activation-regulated Chemokine (TARC) Levels in Children with Atopic Dermatitis
Purpose: Thymus and activation-regulated chemokine(TARC) is responsible for the trafficking of Th2 lymphocytes into sites of allergic inflammation. We tested whether TARC is a useful marker for childhood atopic dermatitis(AD) and we evaluated age-related differences in the level of TARC.
Methods: Serum TARC level, serum total IgE level, total eosinophil count and specific IgE level were measured in 401 children. They were characterized as having IgE-mediated atopic dermatitis(n=157), non-IgE mediated atopic dermatitis(n=107), or as healthy control subjects(n=137).
Results: TARC levels in AD significantly were higher than those in healthy control subjects.(152.9+/-11.6 vs 56.7+/-5.2 pg/mL, P<0.05) Serum TARC levels significantly correlated with disease severity(SCORAD index) both in children with IgE mediated AD(r=0.670, P<0.05) and children with non-IgE mediated AD.(r=0.605, P<0.05) Serum TARC levels in control subjects decreased in accordance with age.(r=-0.201, P<0.05)
Conclusion: Serum TARC might be a useful marker for disease severity both in children with IgE mediated AD and children with non-IgE mediated AD. Serum TARC levels in control subjects decreased in accordance with ages.ope
A Good Outcome for a Case of Chronic Pneumonitis of Infancy
Chronic pneumonitis of infancy (CPI) is a very rare interstitial lung disease. Its pathological features differ from other types of interstitial pneumonia that occur in adults and children. The mortality rate of CPI is high, even with treatment. We report a case of a 3 month old girl diagnosed with CPI after an open lung biopsy who improved after proper treatment.ope
Changes in integrity of normal-appearing white matter in patients with moyamoya disease: a diffusion tensor imaging study
BACKGROUND AND PURPOSE: DTI is widely used for the evaluation of white matter integrity in various neurologic diseases. The purpose of this study was to investigate changes in white matter integrity by using DTI in NAWM of patients with MMD and to evaluate the correlation between diffusion and perfusion characteristics through an interhemispheric comparison.
MATERIALS AND METHODS: We retrospectively reviewed 20 primary MMD patients with asymmetric disease stage and 20 age-matched healthy controls. FA(CS) and ADC(CS) values of bilateral centrum semiovale were measured by using region of interest analysis. Mean FA(CS) and ADC(CS) were compared between patient and control groups by unpaired t test. Interhemispheric differences in FA(CS) and ADC(CS) were assessed and compared between the H-TTP(delayed) and the H-TTP(shorter) by using paired t test. AIs also were assessed to verify interhemispheric differences.
RESULTS: The patient group showed a significantly lower mean FA(CS) and a higher mean ADC(CS) value than the control group. In the patient group, the H-TTP(delayed) had a significantly lower FA(CS) and higher ADC(CS) value than the H-TTP(shorter). Both AI(FA) and AI(ADC) were significantly higher in the patient compared with the control group.
CONCLUSIONS: DTI can describe subtle changes in white matter integrity in NAWM of patients with primary MMD that are not detected by conventional MR imaging. In addition, diffusion characteristics are well correlated with perfusion characteristics. We believe that DTI is a useful ancillary tool to evaluate patients with MMD.ope
Diagnostic yield of double-dose gadobutrol in the detection of brain metastasis: intraindividual comparison with double-dose gadopentetate dimeglumine
BACKGROUND AND PURPOSE: Accurate assessment of the number and lesion characteristics of brain metastasis is very important in GKS. The purpose of this study was to compare the diagnostic efficacy of DD gadobutrol in the detection of brain metastases compared with a DD 0.5-mol/L gadolinium contrast, gadopentetate dimeglumine.
MATERIALS AND METHODS: Records of 27 patients (male to female ratio, 15:12; mean age, 57.1 years) diagnosed with brain metastasis and having undergone GKS were retrospectively analyzed. All patients underwent the first 3D-T1-GRE MR imaging with a DD of gadopentetate dimeglumine. The second MR imaging with a DD of gadobutrol was performed during GKS by using the same parameters used for the first scan. Two neuroradiologists counted the number of enhancing lesions on 2 consecutive MR imaging examinations and reached consensus. Lesion-brain CNR was measured from 45 lesions, and paired t test analysis was performed between DD gadopentetate dimeglumine and gadobutrol MR imaging.
RESULTS: On DD gadopentetate dimeglumine-enhanced images, a total of 130 lesions were detected visually. With DD gadobutrol, 25 additional lesions were detected on GKS MR imaging. There was no missing lesion on DD gadobutrol MR imaging. The mean lesion-brain CNR was higher on DD gadobutrol MR imaging than on DD gadopentetate dimeglumine imaging (2.17 +/- 0.19 versus 1.90 +/- 0.26; P = .00011, paired t test, 2-tailed). Only 2 cases showed lower CNR on DD gadobutrol images: 1 with hemorrhagic metastasis from renal cell carcinoma and the other with steroid treatment after the first MR imaging.
CONCLUSIONS: DD 1.0-mol/L gadobutrol provides higher lesion conspicuity and enhances lesion detection in brain metastasis compared with DD 0.5-mol/L gadolinium contrast agentsope
Effect of Obesity on Atopy and Bronchial Hyperresponsiveness in Children
Purpose : The prevalence of asthma and allergic diseases is on the increase and that of obesity is on the continuous increase all over the world. There are recent studies on the association between asthma and obesity, which are still controversial. This study aimed at identifying the effect of obesity on atopy and bronchial hyperresponsiveness in children.
Methods : This study was conducted with 443 subjects ranging from six to 15 years of age, and consisted of 283 boys and 160 girls. They went through pulmonary function tests and methacholine challenge tests with their eosinophil counts within blood, total serum IgE levels, serum eosinophil cationic protein(ECP) levels, heights, and weights measured. After determining body mass index(BMI), BMI percentiles were determined by using a BMI percentile curve based on gender and age. After the classification on the basis of the 85th, 90th, and 95th BMI percentiles, a comparison was made in frequencies of atopy, total serum IgE, eosiniphil counts within blood, and serum ECPs as well as in frequencies of bronchial hyperresponsiveness for the total group, the boys, and the girls, respectively.
Results : Among the groups classified by BMI percentiles, there was no significant differences in total serum IgE, eosinophil counts within blood, and serum ECPs. There also was no significant differences in bronchial hyperresponsiveness or pulmonary functions among them. Effect of atopy and pulmonary function test variables on BMI did not show any statistical significance in boys, girls or the total group.
Conclusion : There was domestically no association between obesity and atopy and bronchial hyperresponsiveness among children.ope
Polymorphisms of the CTLA-4 promoter(-318) and exon 1(๏ผ49) genes with atopic dermatitis in Korean children
Purpose: The gene-encoding cytotoxic T lymphocyte-associated antigen-4(CTLA-4) is one of the candidate genes for conferring susceptibility to atopic dermatitis(AD). The aim of the study was to investigate the association between Korean children with AD and the polymorphisms of CTLA-4 gene promoter(-318) and exon 1(+49).
Methods: The CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) polymorphisms were genotyped via restriction fragment length polymorphism methods in 145 children with atopic eczema, 69 children with non-atopic eczema, and 96 healthy controls.
Results: There was no significant difference in genotype and allele frequencies of the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms when the atopic eczema, non-atopic eczema, and control groups were compared. Additionally the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms were not shown to be associated with severity, IgE level, or eosinophil counts.
Conclusion: Our data show that the polymorphisms within the CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) genes are not associated with susceptibility to AD in Korean children.ope
Two Cases of Urticaria Developed by Antianemics which Contain Cow's Milk Protein(casein) or Egg White Protein(ovalbumin)
Hemo-Q and AlbumaxV solution are widely used antianemics. Hemo-Q8 contains cowยดs milk protein(casein) and Albumaxe contains egg white protein(ovalbumin). Cowยดs milk protein and egg protein can cause common allergic diseases in infants and young children. We reported two cases of young children with milk and egg allergy who presented skin symptoms after ingestion or cutaneous contact with Hemo-Q8 or Albumaxe solution. When Hemo--Q or Albumax@ solution was taken or rubbed on, erythematous papules and wheals were developed in 10-20 minutes, but other antianemics which donยดt contain milk or egg protein contents didnยดt show skin manifestations.ope
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