抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma

The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Infectious Diseases Society of America.

https://www.medpagetoday.com/upload/2008/3/6/CRC.pdf

Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

We elucidated the effects of various components of ischemic medium on the outcome of simulated ischemia-reperfusion injury. Hypoxia for up to 12 hours induced neither apoptotic bodies nor LDH release. However, reoxygenation after 6 or 12 hours of hypoxia resulted in a marked LDH release along with morphological changes compatible with oncotic cell death. H9c2 cells were then subjected to 6 hours of simulated ischemia by exposing them to modified hypoxic glucose-free Krebs-Henseleit buffer. Lowered pH (pH 6.4) of simulated-ischemic buffer resulted in the generation of apoptotic bodies during ischemia, with no concomitant LDH release. The degree of reperfusion-induced LDH release was not affected by the pH of ischemic buffer. Removal of sodium bicarbonate from the simulated ischemic buffer markedly increased cellular damages during both the simulated ischemia and reperfusion. Addition of lactate to the simulated ischemic buffer increased apoptotic cell death during the simulated ischemia. Most importantly, concomitant acidosis and high lactate concentration in ischemic buffer augmented the reperfusion-induced oncotic cell death. These results confirmed the influences of acidosis, bicarbonate deprivation and lactate on the progression and outcome of the simulated ischemia-reperfusion, and also demonstrated that concomitant acidosis and high lactate concentration in simulated ischemic buffer contribute to the development of reperfusion injury.

Effects of pH, Buffer System and Lactate on the Simulated Ischemia-reperfusion Injury of H9c2 Cardiac Myocytes

Background：Thrombotic and fibrinolytic factors which change in women following menopause, may be of pathogenetic importance in atherogenetic and thrombotic cardiovascular diseases by altering fibrinolysis on vascular surfaces. We investigated whether parameters of thrombosis and fibrinolysis were different before and after menopause. Methods：Thrombotic factors such as plasma plasminogen activator inhibitor type 1(PAI-1, fibrinogen, α 2-antiplasmin, lipoprotein(a were measured. In addition, fibrinolytic factors such as plasma tissue-type plasminogen activator(t-PA, plasminogen, antithrombin-III were also assessed in 41 premenopausal women, 174 menopausal women and 201 men. Results：PAI-1 and fibrinogen and t-PA were significantly higher in menopausal women than in premenopausal women(13.1±6.6 vs 16.9±9.5ng/ml, p=0.046, 293.6±83.3 vs 347.5±256.9mg/dl, p=0.001, 10.1±4.4 vs 12.5±5.6ng/ml, p=0.003. A positive significant correlation was found between PAI-1 and t-PA levels(r=0.444, p=0.003, but there were no significant relationship between PAI-1 and any other thrombogenic and fibrinolytic factors. Conclusion：PAI-1, fibrinogen, t-PA were higher in menopausaal women than in premeno-pausal women. The findings suggest that increase of athersclerotic and thrombotic cardiovascular diseases after menopause may be influenced by these changes.

https://e-kcj.org/Synapse/Data/PDFData/1054KCJ/kcj-27-1074.pdf

The Difference of Thrombogenic and Fibrinolytic Factors inPremenopausal and Menopausal Women

Study design Retrospective cohort study. Objective To find out the predictive factors for the failure to follow-up in patients who underwent spinal surgery. Summary of background data Causes for loss to follow-up range from geographical accessibility to dissatisfaction with surgeons. There were few reports that investigated loss to follow-up after spinal surgery. Methods A total of 649 patients who underwent laminectomy and 193 patients who underwent L4-L5 fusion from August 2006 to August 2013 were enrolled in this retrospective study. In each surgical group, demographic data and comorbidities as assessed by the Charlson index were investigated and analyzed for correlation with follow-up. The between-group difference of failure to follow-up was also evaluated. Results The fusion group (n=193) was more likely to follow-up and the between-group difference was statistically significant (P=0.047). In the laminectomy group (n=649), 271 patients (41.8%) made regular hospital visits. Those who were male, had a spouse, or had fewer comorbidities were less prone to loss to follow-up (P 0.05). In contrast, 51.8% (n=100) of patients who underwent fusion had regular follow-ups. The fusion group showed a statistical difference in follow-up rate based only on sex (P=0.002). Conclusions Our study shows that patients who underwent decompression alone were less likely to attend follow-up than were patients who underwent fusion surgery. Whereas the factors correlated with loss to follow-up after laminectomy alone were sex, marital status, and number of comorbidities, the only predictor after fusion was male sex. Sex was the only shared risk factor for loss to follow-up. Level of evidence Level III.

Predictive Factors for Postoperative Follow-up: Which Patients are Prone to Loss to Follow-up After Spinal Surgery?

혈구 탐식성 조직구 증식증은 발열, 범혈구 감소증, 간비장 종 대와 골수, 간, 림프절의 식혈증을 특징으로 하는 임상 증후군으 로 1) 1939년 최초로 조직구 골수성 망상적혈구 증가증으로 보고 되었다 2) . 이 질환은 크게 상염색체열성으로 유전되는 원발성 혹 은 가족성 혈구 탐식성 조직구 증식증과 속발성 혈구 탐식성 조 직구 증식증으로 분류되며 속발성의 원인으로는 Epstein-Barr 바이러스, 세균감염, 악성종양, 결체조직질환, 면역억제치료, 장기 간의 지질을 함유한 정맥영양요법 등이 거론되고 있다 3) . 저자들은 전신성 홍반성 루푸스와 미만성 증식성 사구체신염 으로 진단 후 치료 중이던 남아의 말초혈액검사에서 범혈구 감 소증 소견이 지속되어 시행한 골수 검사에서 혈구 탐식성 조직 구 증식증으로 진단된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

A Case of Hemophagocytic Lymphohistiocytosis in aChild with Systemic Lupus Erythematosus

Cathepsin S (CatS), a cysteine protease belonging to the papain family, has been proposed as an attractive therapeutic target for asthma and autoimmune diseases due to the fact that CatS is closely implicated in the process of antigen presentation. Indeed, it has been reported that inhibition of CatS decreases chronic inflammatory pain in a collageninduced arthritis (CIA) model of rheumatoid arthritis. Thus, there is a growing interest among medicinal chemists to identify CatS inhibitors. Morpholineurea-leucine homophenylalanine vinyl sulfone 1 (LHVS, Figure 1) has been previously identified as a potent CatS inhibitor but limited selectivity for members of the cathepsin family. A number of selective CatS inhibitors have been reported as potential therapeutic agents, including cyanopeptide-, pyrrolopyrimidine-, aminopyrimidine-, cyanopyrazolidine-based inhibitors. Although some CatS inhibitors are currently being evaluated in clinical trials, potent and selective CatS inhibitors are still required. With respect to development of selective CatS inhibitors, we recently reported novel selective cathepsin S inhibitors based on a proline scaffold. Following up on this work, we herein report the synthesis of a series of proline analogues with vinyl sulfone group, which is a key functional group of LHVS. We evaluated these novel compounds for their in vitro CatS inhibitory activity to investigate a structure-activity relationship (SAR). The general synthetic procedure for preparing 4-sulfonyl substituted proline-derived analogues is summarized in Scheme 1. Mesylation of the commercially available proline analogue 2 was performed under Mitsunobu condition and subsequent nucleophilic substitution by a thiol afforded the thioether 4, which was converted to sulfone 5 by mCPBA oxidation. After deprotection of tert-Boc, acid chloride or

http://koreascience.or.kr:80/article/JAKO201408439034396.pdf

Young Hoon Kim

Papers

Effects of pH, Buffer System and Lactate on the Simulated Ischemia-reperfusion Injury of H9c2 Cardiac Myocytes

The Difference of Thrombogenic and Fibrinolytic Factors inPremenopausal and Menopausal Women

Predictive Factors for Postoperative Follow-up: Which Patients are Prone to Loss to Follow-up After Spinal Surgery?

A Case of Hemophagocytic Lymphohistiocytosis in aChild with Systemic Lupus Erythematosus

Synthesis of Vinyl Sulfone-tethered Proline Derivatives as Highly Selective Cathepsin S Inhibitors