BACKGROUND: Pulmonary tuberculosis is one of the diseases characterized granuloma formation which was controlled by cellular immune reactions. In the process of granulomatous changes, activated alveolar macrophages and T lymphocytes secrete many cytokines including interleukin-1 (IL-1), tumor necrosis factor-alpha(TNF-alpha), interferon-gamma (INF-gamma) which mediate inflammatory reactions. Intercelluar adhesion molecule-1(ICAM-1) also known to major role player in inflammatory processes, and increased cellular expressions when endothelial cell was stimulated by IL-1, TNF and IFN. METHOD: To evaluate relationships among cellular immune reactions and clinical stages, pulmonary tuberculosis patients were classifed into three groups according to their clinical stages including minimal, moderate and far advance tuberculosis. TNF-alpha, INF-gamma, sICAM-1 (soluble form of ICAM-1) were measured at the time of diagnosis and after 6-months anti-tuberculosis medications by radioimmuno assay or enzyme linked immunosolvent assay. RESULTS: TNF-alpha, INF-gamma, sICAM-1 were singificantly increased in moderate and far advanced pulmonary tuberculosis patients but no meaningful changes in minimal staged patients. 6-months anti-tuberculosis medications reduced serum sICAM-1 levels significantly, related to clinical improvement but no significnat changes were found in the serum levels of TNF-alpha and INF-gamma. In the point of correlations, positive ones revealed between TNF-alpha and sICAM-1, also between IFN-gamma and sICAM-1 but no correlation between TNF-alpha and IFN-gamma. CONCLUSION: Measurement of serum sICAM-1 could be usuful parameter to evaluate the severity of pulmonary tuberculosis and to monitor disease activities durig anti-tubercoulsis medications.
Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient’s sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.
Takotsubo cardiomyopathy (TTC) is defined as a reversible, acute ventricular dysfunction without any evidence of coronary artery obstruction. There have been reports of TTC caused by emotional or physical stress, drug use, hormone imbalance, or medical conditions such as pulmonary disease, sepsis, and trauma, but a relationship between TTC and pulmonary tuberculosis has not previously been reported. From our knowledge, this is the first report of TTC caused by pulmonary tuberculosis. Keywords: Takotsubo Cardiomyopathy; Tuberculosis, Pulmonary; Catecholamines
Background: Obstructive sleep apnea (OSA) has been assumed to be condition associated primarily in men. The prevalence of OSA has not been well studied in women. We aimed to evaluate the frequency of sleep apnea among females in a Korean population and associated factors. Methods: We analyzed the data for 402 consecutive female = 18 years of age, who were admitted to our sleep clinic for evaluation of OSA between 1994 and 2014. All subjects performed overnight polysomnography. OSA was defined as apnea-hypopnea index (AHI) = 5. Excessive daytime sleepiness was considered at an Epworth Sleepiness Scale score of = 10. Results: Among 402 subjects (mean age 50.1±13.3, 18 to 83 yr), the mean obstructive AHI among females was 11.4±17.6 events/h, and OSA was found in 183 (45.5%) of females (mean age 54.7±10.8), 24.1% of females have moderate and 10.4% severe OSA. Age, hypertension, body mass index, witnessed apnea and snoring were related to OSA (P ＜ 0.001, respectively), while daytime sleepiness and smoking status were not. The prevalence of hypertension (21.1%) in patients with OSA was higher than non-OSA groups (14.2%, P ＜ 0.001). OSA was independently related to hypertension among females with an odds ratio of 1.9 (95% CI 1.2-3.1) after adjustments for age, BMI. Conclusions: OSA occurs in 45.5% of females across a wide age range (18 to 80 yr). OSA is related to age, BMI and hypertension. Our findings suggest that OSA is common and an independent risk factor for hypertension among females.
Although neutrophils provide a means of defense against bacterial and fungal infection, they can also be destructive to host tissue.In addition, peripheral neutrophils have been implicated in the pathogenesis of various respiratory disorders, including the adult respiratory distress syndrome, emphysema and bronchial asthma.Neutrophils appear to mediate the later phase of inflammatory respon똥 in allergic asthma and may accumulate as a result of the release of neutrophil chemoattractants by mast cells.For the evaluaton of the role of neutrophils in bronchial asthma, these data analyzed the superoxide production and myeloperoxidase activity of peripheral neutrophils in bronchial asthmatics.Superoxide production by neutrophils after stimulation with 1O-6 M TPA(tetradecanoyl phorbol acetate) was significantly increased after than before oxygen administration in the bronchial asthmatics(p < 0.05).Myeloperoxidase activity of neutrophils after stimulation with 1O-6 M fMLP (Nformyl-methionyl leucylphenylalanine) appear to increase after than before oxygen administration, but statistically not significant in the bronchial asthmatics.주로작용하나， 반대로중성구의 여러 대사산물에 의해 숙주의 조직 손상을 일으키기도 한다2 -4) 그 주된 대 사 산울로는 myeloperoxidase, superoxide, hydroxyl radical둥으로 알려져 있 다3. 4 } 최근 기관지 천식의 후기
Background Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. objectives The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusions The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.
BACKGROUND: Craniofacial anatomic abnormalities related to structural narrowing of the upper airway have been reported in patients with obstructive sleep apnea syndrome. In this study, we evaluated the craniofacial anatomic characteristics of Korean patients with obstructive sleep apnea syndrome, and the role of cephalometric analysis in the prediction of abnormal breathing during sleep. METHODS: Thirty-nine patients with obstructive sleep apnea syndrome(OSAS), 39 simple snorers(simple snorers) and 20 controls(control) had cephalometric analysis using the technique of Riley et al., and underwent standardized polysomnographic recordings. Different variables, including sex, body mass index, cephalometric and polysomnographic data, were statistically analyzed. RESULTS: Pm-UPW and V-LPW distances were significantly shorter in OSAS when compared with simple snorers or control. PAS in simple snorers was shorter than in control. ANS-Gn distance in OSAS was significantly longer than in control. PNS-P distance in OSAS or simple snorers was significantly longer than in control. MP-H distance in OSAS was significantly longer than in simple snorers or control, and MP-H distance in simple snorers was also longer than in control. NL/Pm-P angle in OSAS was lesser than in control. MP-H distance in OSAS or in the combined groups of OSAS and simple snorers was significantly correlated with apnea-hypopnea index(AHI). PNS-P distance in the combined groups of OSAS and simple snorers was correlated with AHI. In male of all subjects, body mass index was significantly correlated with PNS-P or MP-H distance. CONCLUSION: Cephalometric analysis can be useful tool in determining the craniofacial anatomic abnormalities in patients with obstructive sleep apnea syndrome. Cephalometric parameters, especially MP-H distance, can be useful for predicting frequency of narrowing or obstruction of upper airway during sleep.
The purpose of this study is to investigate the utility of the pleural fluid cholesterol level in separating the exudates from the transudates, and in differentiating tuberculous exudates from non-tuberculous exudates.52 patients with pleural effusion were involved in this prospective study.By predefined criteria , 40 of these effusions were classified as exudates (Group I) and 12 as tran- sudates (Group II).Group 1 was subdivided into tuberculous exudates (Group A) and non-tuberculous
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