Dendritic cells (DCs) are the most potent antigen presenting cells that can activate naive T cells. Mature DCs exress high levels of MHC and costimulatory molecules on their surface and have capacity to produce IL-12, a 75 kDa heterodimeric cytokine composed of p35 and p40 subunit. IL-12 is currently thought to be one of most critical determinants for skewing the immune response towards Th1. Expression of IL-12 in dendritic cells seems to be regulated by various stimuli including CD40L. In the present study we investigated expression of IL-12 in mature DCs, which were cultured from bone marrow cells in the presence of GM-CSF. Maturity of the DCs was confirmed by morphologic characteristics, immunophenotypes, and allostimulatory activities. Exprssion levels of IL-12 p40 in the DCs were measured by semi-quantitative RT-PCR. Increases in IL-12 p40 expression were observed after treatment with lipopolysaccharide (LPS), an anti-MHC class II monoclonal antibody, or an anti-CD40 monoclonal antibody. The most remarkable increases, however, were observed in the DCs treated with an anti-CD40 monoclonal antibody. These results support a previous notion that signals through CD40/CD40L interaction may be important for the production of IL-12 by DCs. Moreover, results of this study show a possibility of using monoclonal antibodies against CD40 molecules for preparing DCs producing high amount of IL-12, which can be used for anti-tumor or anti-viral immunotherapy.
Animals ; Antibodies, Monoclonal ; Antigen-Presenting Cells ; Bone Marrow Cells ; CD40 Ligand ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunotherapy ; Interleukin-12* ; Mice* ; T-Lymphocytes

Tuberculosis of the middle ear is a disease rarely encountered in recent years. Because what used to be the typical clinical signs of this disease have been changed in recent years and the index of suspicion being low, there is frequently a considerable delay prior to diagnosis. This can lead to irreversible complications. A case of tuberculous otitis media complicated with lateral sinus thrombosis and subperiosteal abscess is reported with review of the literature, emphasizing the fact that this entity must be considered in the differential diagnosis of persistent suppurative otitis media.
Abscess* ; Diagnosis ; Diagnosis, Differential ; Ear, Middle ; Lateral Sinus Thrombosis ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Tuberculosis

Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Aedes ; Arboviruses ; Arm ; Arthralgia ; Chikungunya virus* ; Culicidae ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Islands ; Skin ; South America* ; Suriname* ; Volunteers ; Young Adult

Diverticula are frequently seen in the sigmoid, descending, ascending and transverse colons whereas rectal diverticula are extremely rare. The stapled rectal mucosectomy for the treatment of a prolapsed hemorrhoid is less painful and has lower morbidity; therefore, it has been commonly used despite possible complications. This paper reports a case of a rectal diverticulum that developed after a procedure for prolapsed hemorrhoids (PPH). A 42-year-old man with a history of hemorrhoidectomies came to the hospital because of constipation. On sigmoidoscopy, a 2-cm-sized, feces-filled pocket was located just above the anorectal junction. After removal of the fecal material, a huge rectal diverticulum (-4 cm in diameter) was seen. Pelvic magnetic resonance imaging (MRI) confirmed the diagnosis of rectal diverticulum outpouching through the muscular layer of the intestine in a left posterolateral direction. The patient was discharged without complication after a transanal diverticulectomy had been performed, and the direct rectal wall had been repaired.
Adult ; Colon, Sigmoid ; Colon, Transverse ; Constipation ; Diagnosis ; Diverticulum* ; Hemorrhoidectomy ; Hemorrhoids* ; Humans ; Intestines ; Magnetic Resonance Imaging ; Sigmoidoscopy

Migration of inflammatory cells into damaged tissue is essential to host defense mechanisms and immune responses. Monocyte chemoattractant protein-1(MCP-1), a member of the CC or beta-chemokine family is a powerful leukocyte recruitment factor that is relatively specific for monocyte/macrophage. The purpose of present study was to evaluate temporal change of expression of mRNA for MCP-1 in the sciatic nerve and hindlimb muscle of Sprague-Dawley rat. The mid-portion of the sciatic nerve was exposed, cut under aseptic condition and then animals were sacrificed 1, 2, 3, 7, 14 days after denervation of the sciatic nerve. Semiquantitative RT-PCR method and image analysis system were used to analyze change in expression of mRNA for MCP-1. Expression of mRNA for MCP-1 in the distal stump of the denervated sciatic nerve was up-regulated within 1 day and peaked on the second day following transection of the sciatic nerve. Thereafter high expression of mRNA for MCP-1 lasted for 7 days after transection of the nerve. However the expression of mRNA for MCP-1 was rapidly decreased on the 14th day after denervation. Temporal change of expression of mRNA for MCP-1 in the proximal portion of the denervated sciatic nerve was very similar with that of distal one. The gastrocnemius muscle also showed significant increase in expression of mRNA for MCP-1 on the 1st day with maximal expression on the 7th day after denervation of the sciatic nerve. In contrast, the expression of mRNA for MCP-1 in the soleus muscle was lower than the gastrocnemius muscle in the course of the denervation-induced atrophy. Additionally alpha-lipoic acid, a potent antioxidant that is used in treatment for diabetic neuropathy, suppressed significantly expression of mRNA for MCP-1 in the denervated sciatic nerve but not in atrophied hindlimb muscles.
Animals ; Atrophy ; Chemokine CCL2* ; Defense Mechanisms ; Denervation* ; Diabetic Neuropathies ; Hindlimb* ; Humans ; Leukocytes ; Monocytes* ; Muscle, Skeletal ; Muscles ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger* ; Sciatic Nerve* ; Thioctic Acid

Dural arteriovenous fistula (DAVF) is an uncommon condition. However, it is important for otologists because it is the most common cause of pulsatile tinnitus and may also present with intracranial hemorrhage and neurological disturbance. Many therapeutic approaches, such as surgery and endovascular techniques, have been proposed to obliterate the lesions. Surgery may be accompanied by massive blood loss. Transarterial embolization seldom obliterates transverse-sigmoid sinus DAVFs completely and permanently. In recent years, several authors have reported the effect of transvenous embolization of transverse-sigmoid sinus DAVFs in English literature. We recently experienced a case of sigmoid DAVF treated by transvenous embolization and report it with a review of the literature.
Arteriovenous Fistula ; Central Nervous System Vascular Malformations* ; Colon, Sigmoid ; Endovascular Procedures ; Intracranial Hemorrhages ; Tinnitus

The clinical manifestations of leukemic patients who have temporal bone infiltration are acute mastoiditis, hearing impairment, tinnitus, dizziness, otorrhea, retro-auricular mass and facial nerve palsy. Otologic manifestations of leukemic patients have also been reported several times. However, reports about temporal bone infiltration by leukemic cells after complete remission have been rare, and there have not yet been any reports about both temporal bone infiltration that has been confirmed by mastoid biopsy after remission. We recently experienced a case of recurring acute myelogenous leukemia in both temporal bones after a complete remission and report it with a review of the literature.
Biopsy ; Dizziness ; Facial Nerve ; Hearing Loss ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Mastoid ; Mastoiditis ; Paralysis ; Temporal Bone* ; Tinnitus

BACKGROUND AND OBJECTIVES: Recently, incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection has been increasing. There are problems with children with MRSA otorrhea in visiting otolaryngology clinics, since systemic vancomycin or teicoplanin injection can cause systemic side effects in children and admission and medical costs are higher. In this study, we used the conventional antibiotics orally and topically for the treatment of otorrhea by MRSA infection to compare the therapeutic effects of conventional antibiotics with the systemic vancomycin or teicoplanin. The author also tried to determine the timing of systemic vancomycin injection for the control of MRSA otorrhea. MATERIALS AND METHOD: Twenty-eight pediatric patients with MRSA otorrhea were treated with either conventional antibiotics (20 patients) topically and orally or systemic vancomycin or teicoplanin injection (8 patients). The use of vancomycin or teicoplanin injection was indicated when otorrhea didn't stop despite of 3-4 weeks of conventional treatment and when referred from local clinics, and in case of cholesteatoma, when it came as a result of complication of middle ear disease. RESULTS: The average therapeutic period for the conventionally treated group was 24.7 days. On the other hand, the average period was 12.3 days and 9.8 days for the systemic vancomycin and teicoplanin injection group, respectively. CONCLUSION: The conventional antibiotics treatment, topically or orally applied for the treatment of MRSA otorrhea in children, has advantages in relation to time and economy, although the average therapeutic period was longer than the treatment with systemic vancomycin or teicoplanin injection. The author suggests the usage of conventional antibiotics for 3 weeks prior to the use of systemic vancomycin injection.
Anti-Bacterial Agents ; Child ; Cholesteatoma ; Community-Acquired Infections ; Ear, Middle ; Hand ; Humans ; Incidence ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Otolaryngology ; Staphylococcus aureus ; Staphylococcus* ; Teicoplanin ; Vancomycin

Eosinophilic gastroenteritis is an uncommon disease characterized by the presence of abnormal gastrointestinal symptoms, eosinophilic infiltration in one or more areas of the gastrointestinal tract, an absence of the indentifiable cause of eosinophilia and the exclusion of eosinophilic involvement in organs other than gut. The etiology is unknown, and the pathogenesis is poorly understood. Clinical presentations depend on the region of gastrointestinal tract involved and the depth of bowel involvement. We experienced a case of eosinophilic gastroenteritis involving entire GI tract with eosinophilic ascites in a 72-year-old female with abdominal distention and pain. The patient was treated with corticosteroid successfully. We report this case with a brief review of the literatures.
Aged ; Ascites* ; Eosinophilia ; Eosinophils* ; Female ; Gastroenteritis* ; Gastrointestinal Tract ; Humans

The most common pancreatic cancer is adenocarcinoma. Primary adenosquamous cell carcinoma of the pancreas is very rare and aggressive. A 46-year-old man presented with a 3-month history of dyspepsia and a 7-kg weight loss. The physical examination showed tenderness of the right upper quadrant of the abdomen. There was no jaundice. Amylase and lipase were elevated. CA 19-9 was elevated to 566.7 U/mL. Gastroduodenoscopy showed a hard ulceroinfiltrative mass with a yellowish exudate that bled readily on touch in the second portion of the duodenum. Abdominal computed tomography showed a 7.1 x 6.3-cm heterogeneously enhancing mass in the pancreatic head. The pancreatic mass had invaded the duodenum wall, gastric antrum, and gastroduodenal artery sheath. Fine-needle aspiration biopsy of the pancreatic mass revealed adenosquamous cell carcinoma, anaplastic type. We concluded that an adenosquamous cell carcinoma of pancreas had invaded the duodenal mucosa causing ulceration.
Amylases/blood ; Biopsy, Fine-Needle ; CA-19-9 Antigen/blood ; Carcinoma, Adenosquamous/blood/complications/*diagnosis/pathology ; Duodenoscopy ; Duodenum/pathology ; Humans ; Intestinal Mucosa/pathology ; Lipase/blood ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms/blood/complications/*diagnosis/pathology ; Tomography, X-Ray Computed