No abstract available.
Infant ; Infant, Newborn ; Lissencephaly* ; Spasms, Infantile*

BACKGROUND: The therapeutic effects of surfactant on acute lung injury derive not only from its recruiting action on collapsed alveoli but also from its anti-inflammatory effects. Pro-apoptotic action on alveolar neutrophils represents one of the important anti-inflammatory mechanisms of surfactant. In the present study, we evaluated the effects of surfactant on the apoptosis of human peripheral and rat alveolar neutrophils. METHODS: In the (Ed- the article is not definitely needed but it helps to separate the two prepositions 'in') in vitro study, human neutrophils were collected from healthy volunteers. An equal number of neutrophils (1X10(6)) (Ed-confirm) was treated with LPS (10, 100, 1000ng/ml), surfactant (10, 100, 1000micro gram/ml), or a combination of LPS (1000ng/ml) and surfactant (10, 100, 1000micro gram/ml). After incubation for 24 hours, the apoptosis of neutrophils was evaluated by Annexin V method. In the in vivo study, induction of acute lung injury in SD rats by intra-tracheal instillation of LPS (5mg/kg) was followed by intra-tracheal administration of either surfactant (30mg/kg) or normal saline (5ml/kg). Twenty-four hours after LPS instillation, alveolar neutrophils were collected and the apoptotic rate was evaluated by Annexin V method. In addition, changes of the respiratory mechanics of rats (respiratory rate, tidal volume, and airway resistance) were evaluated with one chamber body plethysmography before, and 23 hours after, LPS instillation. RESULTS: In the in vitro study, LPS treatment decreased the apoptosis of human peripheral blood neutrophils (control; 47.4+/-5.0%, LPS 10ng/ml; 30.6+/-10.8%, LPS 100ng/ml; 27.5+/-9.5%, LPS 1000ng/ml; 24.4+/-7.7%). The combination of low to moderate doses of surfactant with LPS promoted apoptosis (LPS 1000ng/ml + Surf 10micro gram/ml; 36.6+/-11.3%, LPS 1000ng/ml + Surf 100micro gram/ml; 41.3+/-11.2%). The high dose of surfactant (1000micro gram/ml) decreased apoptosis (24.4+/-7.7%) and augmented the anti-apoptotic effect of LPS (LPS 1000ng/ml + Surf 1000micro gram/ml; 19.8+/-5.4%). In the in vivo study, the apoptotic rate of alveolar neutrophils of surfactant-treated rats was higher than that of normal saline-treated rats (6.03+/-3.36% vs. 2.95+/-0.58%). The airway resistance (represented by Penh) of surfactant-treated rats was lower than that of normal saline-treated rats at 23 hours after LPS injury (2.64+/-0.69 vs. 4.51+/-2.24, p<0.05). CONCLUSIONS: Surfactant promotes the apoptosis of human peripheral blood and rat alveolar neutrophils. Pro-apoptotic action on neutrophils represents one of the important anti-inflammatory mechanisms of surfactant.
Acute Lung Injury* ; Airway Resistance ; Animals ; Annexin A5 ; Apoptosis* ; Healthy Volunteers ; Humans ; Neutrophils* ; Plethysmography ; Rats* ; Respiratory Mechanics ; Tidal Volume

To evaluate the effect of allergic parameters, such as serum IgE, eosinophil, and skin test on the bronchial hyperresponsiveness (BHR) in patients with chronic airflow obstruction, we performed methacholine bronchial provocation test, pulmonary function test, skin prick test, and measured blood eosinophil counts and serum IgE level from seventy-nine patients who showed persistent fixed airflow obstruction, less than 75% of predicted value in FEV~ and FEV1/FVC, despite of conventional treatment without steroid therapy for more than 3 months. The results were as follows 1) There were 53 patients with BHR and 26 patients without BHR. There were no statistically significant differences in sex, age, and smoking duration between positive BHR group and negative BHR group (p>0.05). 2) There was no statistically significant difference in absolute and predicted value of FVC(p>0.05). But there were significantly lower absolute, predicted value of FEV1 and FEV1/FVC% in positive group compared with negative group (p<0.05). 3) There was somewhat higher trend of serum IgE level in positive group. Skin test was not significantly different between two groups (p > 0.05 ). 4) Blood eosinophil count was significantly higher in positive group than in negative group(p<0.05). Conclusion of this study is that increased bronchial responsiveness in patients with chronic airflow obstruction is inversely related to the level of pulmonary function and significantly associated with blood eosinophilia.
Bronchial Provocation Tests ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Skin ; Skin Tests ; Smoke ; Smoking

BACKGROUND: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. METHODS: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 microgram ovalbumin(OA). Antigen airway challenges were done 14 ~16 days after sensitization and the sensitized rats were sacrificed 1h(AE), 6 ~8h(AL) and 1day(AD) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6 ~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. RESULTS: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). CONCLUSION: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.
Airway Obstruction ; Animals ; Asthma* ; Bronchi ; Eosinophils ; Humans ; Inflammation* ; Injections, Subcutaneous ; Lung ; Ovalbumin* ; Rats ; Rats, Sprague-Dawley* ; Trachea

No abstract available.
Nitric Oxide* ; Paclitaxel* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To report the long-term follow-up results after cyclocryotherapy, applied to the 3-o'clock and 9-o'clock positions in blind refractory glaucoma patients. METHODS: We retrospectively reviewed the charts of 19 blind patients, and a total of 20 eyes with refractory glaucoma who were treated with cyclocryotherapy. Cyclocryotherapy treatments were performed using a retinal cryoprobe. The temperature of each cyclocryotherapy spot was -80degrees C and each spot was maintained in place for 60 seconds. Six cyclocryotherapy spots were placed in each quadrant, including the 3-o'clock and 9-o'clock positions. RESULTS: The mean baseline pretreatment intraocular pressure (IOP) in all eyes was 50.9 ± 12.5 mmHg, which significantly decreased to a mean IOP at last follow-up of 14.1 ± 7.1 mmHg (p < 0.001). The mean number of antiglaucoma medications that patients were still taking at last follow-up was 0.3 ± 0.6. Devastating post-procedure phthisis occurred in only one eye. CONCLUSIONS: Cyclocryotherapy, performed at each quadrant and at the 3-o'clock and 9-o'clock position, is an effective way to lower IOP and, thus, is a reasonable treatment option for refractory glaucoma patients who experience with ocular pain and headaches.
Adult ; Aged ; Aged, 80 and over ; Blindness/etiology/*surgery ; Cryosurgery/*methods ; Female ; Follow-Up Studies ; Glaucoma/complications/physiopathology/*surgery ; Humans ; Intraocular Pressure/*physiology ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Treatment Outcome ; *Visual Acuity

BACKGROUND: Cardiac tamponade is associated with the expiratory increase and the expira-tory decrease in left ventricular filling flow. With Doppler echocardiography, we analyzed the respiratory variations of mitral and tricuspid inflows, and pulmonary and hepatic venous flows in patients with cardiac tamponade. METHODS: Respiratory hemodynamic changes in mitral and tricuspid inflows and pulmonary and hepatic venous flows were evaluated using Doppler echocardiography in 13 patients (6 men and 7 women; mean age 51+/-13 years) with large pericardial effusion and clinical cardiac tamponade, and compared the results with those of 11 control subjects (3 men and 8 women, mean age 53+/-13 years). Doppler examination was repeated after pericardiocentesis in 6 patients. RESULTS: Peak velocity of early diastolic mitral inflow (E velocity) decreased during inspiration compared with expiratory increase; the mean percentage change was 40%. Peak velocity of late diastolic mitral inflow (A velocity) decreased 13% during inspiration. E/A ratio decreased 31% during inspiration. Deceleration time (DT) and isovolumic relaxation time (IVRT) increased by 26% and 44%, respectively, during inspiration. But respiratory variations of tricuspid inflow were opposite to those of mitral inflow. Tricuspid E velocity increased during inspiration and decre-ased during expiration. The mean percentage change was 123%, which was larger than thte 40% of mitral inflow. The most characteristic findings of pulmonary venous flow during respiration were the expiratory increases of peak diastolic velocity (DV) and diastolic time-velocity integral (D-TVI). The mean percentage changes of peak systolic velocity (SV), DV and D-TVI during respiration were 27%, 45% and 53% respectively. In contrast, the SV and DV of hepatic venous flow increased during inspiration and decreased during expiration. The respiratory variations of peak systolic reverse flow velocity (SR) and peak diastolic reverse flow velocity (DR) were opposite to those of SV and DV. DR notably increased during expiration, and the mean percentage change was 61%. The ratio of RFI (Inspiratory reverse flow integral) to FFI (forward flow integral) of the tamponade group was 270%. The mean percentage changes of each parameters decreased after pericardiocentesis. CONCLUSION: Patients with cardiac tamponade showed inspiratory increases of diastolic tri-cuspid filling flow and hepatic forward flow. Expiratory increases included diastolic mitral filling flow, pulmonary venous systolic and diastolic flow, and hepatic venous reverse flow. Such res-piratory variations decreased after pericardiocentesis.
Cardiac Tamponade* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Relaxation ; Respiration

Sweet's syndrome is acute febrile neutrophilic dermatosis. It frequently involves upper and lower limbs, head and neck. The dermatologic symptom of Sweet's syndrome is elevated plaque, pain, and skin erythema. We have experienced a case of Sweet's syndrome which involved auricle and have needed to differentiate it from perichondritis. For the cases of assumed perichondritis that do not improve symptoms with treatment compatible for perichondiritis, Sweet's syndrome could be the etiology.
Ear, External ; Erythema ; Head ; Lower Extremity ; Neck ; Paraneoplastic Syndromes ; Skin ; Sweet Syndrome*

Psoriasis is a dermatological disease which has various clinical presentation. Thick red plaques with clear margin and silvery scale characterize psoriasis. Recurrent tonsillitis infected by streptococcus has been reported to be related with Guttate psoriasis. Psoriasis is treated dermatologically by phototherapy, photochemical therapy, retinoid therapy, local steroid therapy and antibiotics. The authors report a case of the 33-year-old female with Guttate psoriasis treated by tonsillectomy. She has experienced that her psoriatic skin lesions got worse every time she suffered from tonsillitis, but Guttate psoriatic skin lesions have disappeared after tonsillectomy.
Adult ; Anti-Bacterial Agents ; Female ; Humans ; Palatine Tonsil ; Phototherapy ; Psoriasis* ; Skin ; Streptococcus ; Tonsillectomy* ; Tonsillitis

BACKGROUND AND OBJECTIVES: Psychological distress may develop from tinnitus, or that recognition of tinnitus may even be greater during exposure to environmental stress. So, patients with tinnitus need to consider the psychologic aspect in their diagnosis and treatment. The aim of this study is to evaluate the degree and characteristics of the psychologic factors associated in patients undergoing tinnitus retraining therapy. MATERIALS AND METHOD: 119 patients with tinnitus who received the Symptom Check List-90-Revision (SCL-90-R) and a control group without tinnitus were compared first; and then 92 out of 119 patients performed the follow up study after three months of tinnitus retraining therapy. RESULTS: The results were as follows. 1. The tinnitus group scored higher than the control group in somatization, anxiety, phobic anxiety (p<0.05). 2. The gender difference, age, duration, position, hearing, and Feldmann masking curve of tinnitus were not related to the psychologic status of patients with tinnitus (p>0.05). 3. The psychologic aspect of patients with tinnitus were related to loudness, pitch, annoyance (p<0.05). 4. The follow-up study of 3 months on patients who underwent tinnitus retraining therapy showed diminished score in all components of SCL-90-R, except phobic anxiety, and paranoid (p<0.05). CONCLUSION: This study indicated that the compliant behaviour of tinnitus is related closely with intrinsic psychodynamic mechanism.
Anxiety ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Masks ; Psychology ; Surveys and Questionnaires ; Tinnitus*