In systemic rheumatic disease, marker antibodies such as anti-Sm, anti Scl-70 and anti Jo-1 are helpful in the diagnosis of disease, but in rheumatoid arthritis, the diagnosis is difficult due to the low sensitivity and specificity of the rheumatoid factor(RF). So, a new maker antibody with high sensitivity and specificity was needed. Recently, the antiperi- nuclear factor(APF) has gained particular attention. The results of the APF and RF test in 165 patients with rheumatoid arthritis, 77 patients with osteoarthritis, and 109 normal healthy persons, which were taken between January, 1994 through December 1994 were as follows; 1. The sensitivity, specificity, and predictive value of positivity of the RF test in patients with rheumatoid arthritis were 58.2%, 93.5%, and 95.0%, and that of the APF test were 72.1%, 94.6% and 92.2%, respectively. 2. The sensitivity, specificity and predictive value of positivity when combining the APF with the RF were 83.0%, 85.7%, and 92.6%, respectively. 3. The disease status of the patients correlated with intensity of the APF test, that is, the more severe the disease status, the higher intensity. In conclusion, the APF was useful in the diagnosis of rheumatoid arthritis, and may be used as an indicator of disease status. When combining test the APF with RF, the incidence of sero-negative rheumatoid arthritis decreased.
Antibodies ; Arthritis, Rheumatoid ; Diagnosis ; Humans ; Incidence ; Osteoarthritis ; Rheumatic Diseases ; Sensitivity and Specificity

To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Birth Weight ; Diuresis* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Oxygen ; Respiration, Artificial ; Respiratory Rate

Saponin has been known to be a major antioxidant component in panax ginseng. Recent experimental study suggests that some antioxidant materials prevent Parkinson's disease caused by 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) in an animal model. The present study was performed to demonstrate the effect of ginseng saponins in the Parkinson's disease model induced by MPTP. To verify the effect of ginseng saponin on dopaminergic neurons in the mice brain, the tyrosine hydroxylase-immunoreactive (TH-ir) neurons were observed by immunohistochemical stain and immunoelectron microscopy (preembedding method). Also, in order to estimate the immunoreactivity of dopaminergic neuropils, they were quantified by image analysis. The number of TH-ir neurons of substantia nigra was significantly increased in the high-dose (0.46 mg/kg) ginseng saponin group compared with the MPTP injected group. The immunoreactivity of TH-ir neuropils in striatum was significantly increased in both high and low-dose (0.1 mg/kg) ginseng saponin groups compared with the MPTP injected group. In immunoelectron microscopic observation, TH-ir neurons of the control and both ginseng saponin injected group showed normal nuclei and well preserved cytoplasmic organelles. In the MPTP injected group, dying dopaminergic neurons showed destroyed nuclei and cytoplasmic organelles. These results suggest that ginseng saponin has a protective effect on the Parkinson's disease model induced by MPTP.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Brain ; Cytoplasm ; Dopaminergic Neurons* ; Mice* ; Microscopy, Immunoelectron ; Models, Animal ; Neurons ; Neuropil ; Organelles ; Panax* ; Parkinson Disease* ; Saponins* ; Substantia Nigra ; Tyrosine ; Tyrosine 3-Monooxygenase

Nonspecific immune parameters such as natural killer(NK) activity, antibody-dependent cellular cytotoxicity(ADCC), production of leukocyte migration inhibitory factor(LlF) and levels of immune complex(IC) were assessed in 47 patients with rheumatoid arthritis (RA) 20 with degenerative arthritis (DA) and 40 healthy controls. Peripheral blood (PB) as well as synovial fluid (SF) were collected from both RA and DA patients before treatment. Mononuclear cell suspensions and sera were prepared and submitted for the in vitro tests; 4-hr chromium-release assays using human K562 and mouse L1210 cells as targets for NK and ADCC assays respectively, 2-step agarose assay for LIF and platelet aggregation test for IC. Results revealed that 1) LIF activity of PB lymphocytes (PBL) from both RA and DA patients showed a significant (P < 0.05) decrease as compared with that from healthy controls. 2) PB-NK activity from RA patients showed an insignificant decrease as compared with that from DA or healthy controls. However, mononuclear cells isolated from SF (SFL) of RA patients exhibited significantly(P < 0.02) lower NK activity than PBL from the same patients. 3) In ADCC assays with PBL no significant differencies were observed among the 3 groups. 4) Higher titers of IC were detected in both PB and SF from RA patients than DA, and a negative correlation was found between serum IC levels and PB-NK activity. These data are discussed in light of previous reports, and a hypothesis regarding a decreased nonspecific cell-mediated immunity in conjunction with an increased humoral immune response, particularly in local sites, is proposed as one of the mechanisms underlying the pathogenesis of RA.
Adult ; Antibody-Dependent Cell Cytotoxicity ; Antigen-Antibody Complex/immunology ; Arthritis, Rheumatoid/immunology* ; Female ; Human ; Killer Cells, Natural/immunology ; Leukocyte Migration-Inhibitory Factors/biosynthesis ; Male ; Middle Age ; Synovial Fluid/immunology

BACKGROUND: The metabolic syndrome is a cluster of related cardiovascular risk factors and it is the cause of morbidity and mortality in cardiovascular diseases. Recently, new diagnostic criteria of glucose metabolism impairment has been recommended. The purpose of this study was to estimate the difference of cardiovascular risk by investigating the prevalence of metabolic syndrome according to the degree of glucose metabolism impairment. METHODS: A population of 757 subjects was selected from a database of individuals who visited a health promotion center. We classified these subjects into 5 groups [Normal, Isolated impaired glucose tolerance (I-IGT), Isolated impaired fasting glucose (I-IFG), combined IGT with IFG (IGT/IFG) and Diabetes]. We compared the general characteristics, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the prevalence of metabolic syndrome in these groups. RESULTS: HOMA-IR and the prevalence of metabolic syndrome in the IGT/IFG and the Diabetes group were significantly greater than the Normal group. HOMA-IR and the prevalence of metabolic syndrome of the I-IGT and the I-IFG group were not significantly different with the Normal group. CONCLUSION: The insulin resistance and the prevalence of metabolic syndrome in the IGT/IFG group was significantly greater than the Normal group, and its presence may increase the risk of cardiovascular diseases. Therefore, it is important to control other combined metabolic disorders to prevent cardiovascular events after effective selection for IGT/ IFG.
Cardiovascular Diseases ; Fasting ; Glucose* ; Health Promotion ; Homeostasis ; Insulin Resistance ; Metabolism* ; Mortality ; Prevalence* ; Risk Factors

Small cell carcinoma of the cervix has been traditionally considered a rare subtype ofsquamous cell carcinoma characterized by a highly malignant behavior. However, it has becomeobvious that the majority of small cell carcinomas of the cervix expresses neuroendocrine,not squamous, differentiation. One case of intermediate cell neuroendocrine carinoma andthree cases of small cell undifferentiated carcinoma were reported. Patients ranged in age from37 to 50 (median, 44years) and presental as stages Ib(two patients), IIa(one patient), andIIb(one patient). One cases of intermediate cell neuroendocrine carinoma was combined with-endocervical adenocarcinoma and one case of small cell undifferentiated carcinoma was combinedwith adenocarcinoma in situ. All 4 tumors expressed one or more epithelial markers andneuroendocrine markers. Electron microscopically, neuroendocrine granules were observed inall 4 cases but large amount in intermediate cell neuroendocrine carinoma. A variety of treatmentregimens was employed. One patient with intermediate cell neuroendocrine carinoma isalive now for 60 months after starting of treatment. But two of three patients with small cellundifferentiated carcinoma died of disease (34, 45 months) and one of them is alive now for20 months. One patient had spinal metastasis and paraplegia which were treated twice withsurgery and irradiation on tumor bed and the other patient was comatose with multiple livermetastasis. Small cell undifferentiated carcinoma of the cervix was more aggressive thanintermediate cell neuroendocrine carcinoma of the cervix. We can differentiate small cellundifferentiated carcinoma of the cervix from intermediate cell neuroendocrine carcinoma of thecervix, pathologically, ultrastructurally and immunocytochemically.
Adenocarcinoma ; Carcinoma ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Cervix Uteri* ; Coma ; Female ; Humans ; Neoplasm Metastasis ; Paraplegia

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics and neurocognitive functions in schizophrenia patients with treatment-resistant auditory hallucination. METHODS: The 30 patients with treatment-resistant hallucination (hallucinating patients) were compared with 31 patients without hallucination (non-hallucinating patients) and 30 normal controls. The hallucinating patients included the schizophrenic patients who reported not-remitting hallucinations for 2 years in spite of appropriate treatments. The non-hallucinating patients included schizophrenic patients who had chronic illness course, and not reporting hallucination within 2 years. The hallucination characteristics and neurocognitive were measured by self report questionnaires on hallucination: functions Wisconsin card sorting test (WCST), Continuous performance test (CPT) and Sentence repetition test (SRT) among three groups. Psychopathology, depressive symptomps and extrapyramidal symtomps were measured by Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Beck depression Inventory (BDI) and Extrapyramidal Symptom Rating Scale (ESRS), separately. RESULTS: The auditory hallucinations 1 or 2 times a day (33%), with the contents of criticising and cursing (26%) were most frequent. Hallucinating patients did not feel uncomfortable with their hallucinations. WCST performances were significantly decreased in hallucinating patients than non-hallucinating patients, especially on total error (35.2+/-7.6 vs 25.3+/-10.0), perseverative error (54.8+/-14.9 vs 38.5+/-13.0). In CPT, hallucinating patients showed more error response (11.9+/-8.1 vs 8.9+/-7.5) and more prolonged reaction time to incorrect answers (552.4+/-433.2 ms vs 492.7+/-358.5 ms). CONCLUSION: Integrating these observations, it can be said that schizophrenic patients with treatment-resistant auditory hallucination have more neurocogntive functional deficits implying frontal lobe dysfunction than non-hallucinating schizophrenic patients.
Chronic Disease ; Depression ; Frontal Lobe ; Hallucinations* ; Humans ; Psychopathology ; Surveys and Questionnaires ; Reaction Time ; Schizophrenia* ; Self Report ; Wisconsin

OBJECTIVES: To compare the mortality rate of children under ages five from different countries by their causes and to explore the cause of death that is relatively higher in South Korea and came up with measures for resolution. METHODS: The statistics were based from section ICD(International Classification of Diseases)-10 of WHO(World Health Organization) Mortality Database. Among the OECD(Organization for Economic Cooperation and Development) countries, 15 countries with higher GDP(Gross Domestic Product) than South Korea were studied by the mortality rate from 2005 to 2010 sorted into two groups: 0 year group and 1-4 years group. Then the cause of death investigated in detail. RESULTS: Among the 15 countries, average mortality of 0 year group in Korea ranked 8th and the average mortality of 1-4 years group ranked 4th out of 15. There were no significance in the mortality of 0 year group caused by any specific disease, but unnatural death was ranked 2nd after the United States. The natural death of 1-4 years group was ranked 6th, and the unnatural death was ranked 2nd after the Unites States. Among the natural deaths of 1-4 years group, the cause of death significantly higher was found to be disease G(nervous system disease). Among the subgroups of disease G, the orders went epilepsy, cerebral palsy, paralysis, and inflammatory disease. CONCLUSIONS: We have identified major causes of death of children under age 5. The highest proportion of cause of death in 1-4 years group was nervous system disease and we have proposed resolution. Henceforth, this data will be used as a foundational data for formulating policies relation to the Mother-Child Health.
Cause of Death ; Cerebral Palsy ; Child ; Child Mortality ; Classification ; Epilepsy ; Humans ; Korea ; Mortality ; Nervous System Diseases* ; Paralysis ; United States ; World Health Organization

We present a case of a 64-year-old woman with acute myeloid leukemia who developed a hepatic abscess during the neutropenic period after induction chemotherapy. To treat the abscess, meropenem and ciprofloxacin were administered to target Klebsiella pneumoniae and percutaneous drainage performed. As a result, the patient's fever and c-reactive protein (CRP) subsequently improved. After six weeks of antibiotic therapy, an abdominal computed tomography scan revealed remains of the liver abscess as well as an ileus in the small bowel. Molds from the Mucor genus were cultured from repeated liver abscess drainage and an abscess wall biopsy confirmed hepatic mucormycosis. Along with administration of amphotericin-B deoxycholate for four weeks, we performed lobectomy for hepatic mucormycosis and small bowel resection for a suspected small bowel mucormycosis. After these operations, the patient received liposomal amphotericin B for three weeks and was then maintained with oral posaconazole for more than four weeks. Our case report suggests that hepatic mucormycosis should be considered when a hepatic abscess exhibits a retarded response to antibacterial agents, especially for patients with risk factors. In addition, because an isolated hepatic mucormycosis is infrequent, a thorough search for the extent of the disease is necessary before surgical resection.
Abscess ; Amphotericin B ; Anti-Bacterial Agents ; Biopsy ; C-Reactive Protein ; Ciprofloxacin ; Deoxycholic Acid ; Drainage ; Female ; Fever ; Fungi ; Humans ; Ileus ; Induction Chemotherapy ; Klebsiella pneumoniae ; Leukemia, Myeloid, Acute ; Liver Abscess ; Mucor ; Mucormycosis ; Risk Factors ; Thienamycins ; Triazoles

Background: Riehl’s melanosis of the face and neck has been reported in middle-aged women who have darker skin types. Recently, cases of Riehl’s melanosis have been on the rise in Korea, which might reflect the increased use of various cosmetic products and procedures. Objective: This study was designed to analyze the clinicopathological characteristics and treatment outcomes of Riehl’s melanosis in Korean patients. Methods: We closely observed 80 patients with Riehl’s melanosis diagnosed in Asan Medical Center and Hanyang University Medical Center between 2005 and 2015. A skin biopsy was analyzed in 51 patients, and a patch test was carried out in 16 patients. Results: Patients with chronic Riehl’s melanosis (＞12 months) had an increased frequency of previous laser treatments. Patients with acute Riehl’s melanosis (＜3 months) reported a previous history of dry skin, itching, or irritation as a result of the use of hair dye. Patients older than 50 years, with darker skin type, and with a longer disease duration (＞12 months) had poor response rates. Chronic Riehl’s melanosis may be preceded by repeated irritation of barrier-compromised skin, and acute Riehl’s melanosis seems to be an allergic form of Riehl’s melanosis. Conclusion Riehl’s melanosis has different clinical manifestations according to disease duration and different treatment responses based on disease duration.