OBJECTIVE: CD40 and the TNFR belong to the NGF/TNFR supergene family. Ligation of CD40 on B cells induces activation ignals leading to proliferation, Ig isotype class switching, germinal center formation but also induces Fas antigen expression.In addition,CD40 ligation induces pro-inflammatory cytokines including TNF-alpha and LT-alpha gene transcription by human B cell.TNF-alpha is a pleiotropic cytokine and also induces Fas antigen expression on various cells. Lately it has been known that TNF-alpha plays an important role in the pathogenesis of chronic inflammatory diseases,including rheumatoid arthritis,or chronic inflammatory bowel diseases.However there have been occurrence of autoantibodies,or autoimmune disease such as lupus after use of anti TNF-alpha blocking agents. In this report,we tested the relationship and biological significance of CD40 ligation and TNFR signaling with respect to Fas antigen expression on human B cells. METHODS: Ramos Burkitt's lymphoma B cell was used as a prototype of ger-minal center B lymphocyte,and R2G6 cell was utilized as a model of activated germinal center B cell.CD40 lgation was performed by the coculture with CD40 ligand bearing L-293 cells,or anti-CD40 monoclonal antibody,whereas control was obtained with CD-8-L-293 cells or control antibody.Expression of Fas antigen was determined with flow cytometer.Apoptosis assay was conducted by two ways.Alamar blue reduction assay after sIgM cross linking or anti-Fas anti-body,in the presence or absence of CD40 ligation or TNF-alpha .In addition,DNA content assay was utilized to make sure the proportion of apoptotic Ramos B cells by various treatments. RESULTS: 1)CD40 and TNF-alpha induced Fas antigen expression on Ramos B cell line cells and rendered them susceptible to Fas-mediated apoptosis.2)CD40 and TNFR signaling upregulate Fas antigen independently.3)Both TNFR and CD40 signaling rescue sIgM crosslink induced apoptosis of Ramos B cell line cells,only CD40,but not TNFR,signaling rescues Ramos cells from Fas-mediated apoptosis. CONCLUSION: Taken together,these results demonstrate that B cell signaling via two distinct members of the NGF/TNFR superfamily,CD40 and TNFR, independently engage the Fas pathway and provide mechanisms for eliminating B cells.Acting alone,both signals will ready B cells for Fas-mediated apoptosis. In concert with sIg signaling,the rescue effect provided uniquely by CD40 ligation assures the selective survival of only those B cells which have bound antigen and presented it to antigen-specific T(h) cells .
Antigens, CD95* ; Apoptosis ; Autoimmune Diseases ; B-Lymphocytes ; Burkitt Lymphoma ; CD40 Ligand ; Cell Line ; Coculture Techniques ; Cytokines ; Germinal Center ; Humans* ; Immunoglobulin Class Switching ; Ligation ; Receptors, Tumor Necrosis Factor* ; Tumor Necrosis Factor-alpha*

Cardiac myxoma is a rare but potentially treatable cause of stroke. The diagnosis is rarely made on typical triad of constitutional, embolic, and obstructive symptoms, and it is difficult because there is no specific history, physical examination, chest X-ray, or electrocardiographic findings, but with the development of echocardiography the correct diagosis is now usualy made. Neurologic manifestation is frequent(25-45%) and presented with embolic infarction, aneurysm formation, intracranial hemorrhage, and distant metastasis. We experienced five patients with cardiac myxoma who presented with these neurologic manifestations. Also we should be considered in the differential diagnosis of cerebral infarction, particularly when multiple cerebral infarction and constitutional or obstructive symptoms are conjoined in young age stroke. We describe five patients who presented with embolic infarction, cerebral metastasis and aneurysm formation.
Aneurysm ; Cerebral Infarction ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Infarction ; Intracranial Hemorrhages ; Myxoma* ; Neoplasm Metastasis ; Neurologic Manifestations* ; Physical Examination ; Stroke ; Thorax

PURPOSE: Is there any relationship between penile size and physical stature? This study was performed to answer this question and provide guidelines of penile size to assist in counseling patients for penile augmentation. MATERIALS AND METHOD: Penile size, body weight and height were measured in 150 young healthy men, and the body mass index(BMI) was calculated in weight(kg)/height(m)2. The penile length and circumference were measured with tape in flaccid and erect states. The 'lengthening ratio' was calculated by 'erect length/flaccid length', and 'tumescent ratio' was calculated by 'erect circumference/flaccid circumference'. All the data was statistically evaluated and the following results were obtained. Result : The average length and circumference were 8.26+/-1.07cm and 8.34+/-1.03cm respectively in the flaccid state, and 13.42+/-1.38cm and 11.17+/-1.05cm in the erect state. The average lengthening and tumescent ratios were 1.64+/-0.22 and 1.35+/-0.08, and were negatively correlated to the flaccid penile length and circumference. Height was positively correlated to erect penile length and lengthening ratio. There was a relationship between body weight and erect penile length in a positive direction, but with other penile parameters there were none. There was no relationship between BMI and any parameters of penile size. However, the erect penile length of the normal BMI group was longer than that of the lower BMI group. CONCLUSIONS: The results show that the flaccid penile size is related to the erect penile size and there is some relation between penile size and physical stature. We believe these results will be applicable to the penile augmentation.
Body Size ; Body Weight* ; Counseling ; Humans ; Male

No abstract available.
Lupus Erythematosus, Systemic* ; Polyarteritis Nodosa*

Quantitative serial measurements of Alpha-fetoprotein (a-FP) and Beta-human chorionic gonadotropin (B-HCG) using radioimmunoassay were performed in a patient with recurrent non-germinomatous germ cell tumor (NGGCT) into CNS during radiotherapy and chemotherapy. When the pineal tumor was initially presented, elevated levels of serum a-FP and B-HCG fell dramatically to normal rage after the completion of cranial irradiation (5,060cGy). Three months later, the patient had a rise in serum and CSF tumor markers coincident with recurrence of tumor into lumbal spinal canal. Serum levels were not changed despite of 15 days of whole spine irradiation (2,000cGy) although decreased remarkably 1 month after the completion of radiotherapy (4,230cGy). At the time of relapse in the suprasella area and the cerebellopontine angle, serum and CSF levels rised again. As a result of two courses of chemotherapy the tumor markers fell markedly, but the tumor was spread to other sites into CNS. We conclude serial measurements of a-FP and B-HCG are useful for the diagnosis of the non-germinomatous germ cell tumor into CNS and for monitoring disease activity.
alpha-Fetoproteins ; Cerebellopontine Angle ; Chorionic Gonadotropin ; Cranial Irradiation ; Diagnosis ; Drug Therapy ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Pinealoma ; Radioimmunoassay ; Radiotherapy ; Rage ; Recurrence ; Spinal Canal ; Spine ; Biomarkers, Tumor*

In the article, Methods of Hematoxylin and Erosin Image Information Acquisition and Optimization in Confocal Microscopy, there was a typographical error in the title.

No abstract available.
Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Pilot Projects* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND & PURPOSE: Of thalamic stroke syndrome, according to previous reports, the syndrome of hemiataxia and hemisensory loss (thalamic ataxia syndrome) is known to have localizing value confined to the lesion of posterolateral thalamus. And ataxia in thalamic ataxia syndrome is due to interruption of cerebellar outflow pathways. We observed the clinical characteristics of cerebellar manifestations in patients with thalamic ataxia syndrome to clarify intrathalamic cerebellar pathways because it is known that parts of cerebellar efferent fibers do not pass through the thalamus. METHODS: Ten patients with ataxia (5 men, 5 women ; mean age 64), out of 47 thalamic stroke patients admitted to Kyung Hee University Hospital from Jan. 1994 to May. 1995, were selected. The localization of the lesion was based on CT or MR imaging and ataxia was characterized in view of cerebellar functions - coordination of movement, regulation of equilibrium and muscle tone. RESULTS: Out of 10 patients, 4 patients were thalamic hematoma, 4 patients thalamic hematoma with intraventricular hemorrhage, 2 patients thalamic infarction. Four patients were hemiataxia-hemiparesis-hemisensory loss, 4 patients hemiataxia-hemisensory loss, 2 patients hemiataxia-hemiparesis. Posterolateral thalamus was involved in 4 patients, dorsal thalamus in 3 patients, posterolateral and dorsal thalamus in 3 patients. All patients had dysmetria, dysdiadochokinesia, kinetic tremor. Two patient has gait ataxia. Speech and ocular motility disturbances were not noted. CONCLUSION: Thalamic ataxia syndrome appeared in the lesion of posterolateral and dorsal thalamus. Common cerebellar manifestations symptoms of incoordination.
Ataxia* ; Cerebellar Ataxia ; Female ; Gait Ataxia ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Stroke* ; Thalamus ; Tremor

OBJECT: Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder. METHODS: Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between with subcortical hyperintensities and patients without them. RESULTS: Seven Patients(21.8%) had subcortical hyperintensities, but among 8 patients who were or older, 5 patients(625) had them, Age and age of onset of patients with subcotical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintesities had more familial loading. CONCLUSION: Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.
Age of Onset ; Aging ; Bipolar Disorder* ; Brain ; Humans ; Magnetic Resonance Imaging*

PURPOSE: To obtain reliable clinical data arthroscopic discectomy, the authors compared the treatment results of the arthroscopic discectomy (AS) with microscopic discectomy (MS) only in the protruded type of lumbar disc herniations. MATERIAL AND METHODS: Each arthroscopic and microscopic discectomy groups consisted of 39 patients who were operated between May 1993 and October 1997. Minimum follow-up period was 12 months. Method of operation was selected at random and was performed under local infiltration anesthesia in all cases. Clinical and radiological results were evaluated by same protocol before and at one, three, six and 12 months after operation. The herniations of the AS group affected L4-5 in 35 patients and L5-S1 in 4 patients, and of MS group affected L4-5 in 31 patients and L5-S1 in 8 patients. Age, sex and level showed no statistical differences in both groups. RESULTS: Average admission periods were 2.8 days in AS and 4.8 days in MS group. The overall objective clinical result was satisfactory in 92% and 90% respectively. At L4-5 level, it was 97% and 87%, while 50% and 100% at L5-S1. In accordance with the direction of protrusion, midline type showed 100% and 83%, while posterolateral type showed 91% in both group respectively. Disc space height was changed in AS group from 12.2mm preoperatively to 11.2mm (8.3%) postoperatively, and in MS group, from 12.4mm to 10.9mm (16.9%) (p<0.05) . CONCLUSION: From the clinical and radiological results, it was concluded that although overall objective and subjective clinical results were similarly satisfactory in both methods, the clinical result of AS was better in L4-5 level, while that of MS were much better in L5-S1. Radiologically, narrowing of disc space height after AS were significantly less than in MS. So, arthroscopic discectomy is more recommended in the protruded type of lumbar disc herniation at L4-5 level than microscopic discectomy.
Anesthesia, Local ; Diskectomy* ; Follow-Up Studies ; Humans ; Prospective Studies*