This study was undertaken to investigate some mechanical properties of the skin with special relatio to pH. The abdomenal skin of guinea pig was prepared and cut into appropriate skin strips(1.5mm*15mm). The pieces of skin strips were then suvject to measurement (stretching and vreaking load) using a rheometer after treatment in various pH vuffers and humectant solutions (lactic acid, PCA, citric acid). The result are summarized as follows ; 1. Treatment of the skin in the extreme acidic (pH3) solution showed significant deformity (swelling and shrinkage in length). 2. The overall measurements after treatment in the humectant solutions were not significantly different from those in standard vuffer solutions. 3. The stretching was maxiaml at pH7 and minimal in the extreme ranges of pH(pH 3 and pH11). 4. The measurement of vreaking load showed minimal value at acidic pH3 and revealed linear increments as pH increased.
Abdomen ; Animals ; Congenital Abnormalities ; Guinea Pigs* ; Guinea* ; Hydrogen-Ion Concentration* ; Passive Cutaneous Anaphylaxis ; Skin*

Nine athletes and ten nonathletes were selected randomly to study the changes of cardiac function during exercise by impedance cardiography. The speed of the treadmill was maintained at 3.4 mph, and its grade was increased by 1% (Balke protocol). The exercise was continued until the target heart rate (THR), 85% of maximum oxygen uptake (VO2max). The measured parameters for pre- and post-exercise were stroke volume (SV), heart rate (HR), and cardiac output (CO). Average stroke volume of athletes at pre-exercise, 71.1 ml, was higher than that of nonathletes, 64.6 ml, and stroke volume of the former at post-exercise, 97.0 ml, was also higher than that of the latter, 85.2 ml. Therefore, despite the lower heart rate, cardiac outputs of athletes at pre- and post-exercise, 4.98 and 16.3 L/min, were higher than those of nonathletes, 4.87 and 14.2 L/min. For the second phase of the study, cardiac outputs of three subjects were measured during the continuous treadmill exercise with newly developed electrodes and shoes for minimizing motion artifact. Though there were several studies measuring cardiac output during continuous bicycle exercise, this is thought to be the first study in the world measuring cardiac output during continuous treadmill exercise without aid of ensemble averaging.
Adult ; *Cardiac Output ; *Cardiography, Impedance ; *Exertion ; Heart Rate ; Human ; Sports Medicine ; Stroke Volume ; Support, Non-U.S. Gov't

BACKGROUND/AIMS: The immunoregulatory molecules programmed death 1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) are associated with the dysfunction of antiviral effector T-cells, which leads to T-cell exhaustion and persistent viral infection in patients with chronic hepatitis C and chronic hepatitis B. Little is known about the role of PD-1 and CTLA-4 in patients with symptomatic acute hepatitis A (AHA). METHODS: Peripheral blood mononuclear cells were isolated from seven patients with AHA and from six patients with nonviral acute toxic hepatitis (ATH) during the symptomatic and convalescent phases of the respective diseases; five healthy subjects acted as controls. The expression of PD-1 and CTLA-4 on T-cells was measured by flow cytometry. RESULTS: PD-1 and CTLA-4 expression during the symptomatic phase was significantly higher in the T-cells of AHA patients than in those of ATH patients or healthy controls (PD-1: 18.3% vs 3.7% vs 1.6%, respectively, p<0.05; CTLA-4: 23.5% vs 6.1% vs 5.9%, respectively, p<0.05). The levels of both molecules decreased dramatically during the convalescent phase of AHA, whereas a similar pattern was not seen in ATH. CONCLUSIONS: Our findings are consistent with a viral-protective effect of PD-1 and CTLA-4 as inhibitory molecules that suppress cytotoxic T-cells and thereby prevent the destruction of virus-infected hepatocytes in AHA.
Acute Disease ; Adult ; CTLA-4 Antigen/*genetics ; Case-Control Studies ; Female ; Flow Cytometry ; Hepatitis/genetics ; Hepatitis A/*genetics/virology ; Hepatitis A Virus, Human ; Humans ; Male ; *Phenotype ; Programmed Cell Death 1 Receptor/*genetics ; T-Lymphocytes/metabolism

OBJECTIVE: To understand T cell role in the immunopathogenesis of rheumatoid arthritis(RA), authors investigated Vbeta usage of T cell receptor(TCR) in different onset RA lesion of the same patient using a reverse transcriptase-polymerase chain reaction. The current pathogenic model of RA plays a critical role in CD4+ T cells, which are thought to be able to recognize a disease-relevant antigen in the joint. In this model, activation of a certain, specific, antigen induced T cells plays a pivotal role in the development and maintenance of chronic inflammation. To search a common clone in different onset of inflammatory joints will furnish the most exact information about T cells which play a role at initiation and perpetuation of synovitis. Here, We first characterized the change in TCR Vbeta shape with elapsing time between the two joints that have the consecutive inflammation . METHODS: Synovial fluids and peripheral blood were obtained from a patient with active RA who had two successively developing inflammatory joints with 1 week interval(the right knee joint(RT) was involved first and the left knee joint(LT) later). RT-PCR technology was employed to examine synovial fluid and peripheral T cells. Oligonucleotide primers specific for individual TCR Vbeta gene families were used to amplify the TCR gene products in a semiquantitative assay of their relative utilization in fresh T cells subpopulations(CD4+, CD8+ T cells). RESULTS: The CD4+ T cells with TCR Vbeta 1(LT: 4.78%, RT: 2.17%), Vbeta 2(LT: 5.84%, RT: 0. 63%), Vbeta 5.1 (LT: 3.40%, RT: 1. 07%), Vbeta 5. 2 (LT: l. 91%, RT: 0. 31%), Vbeta 8(LT: 4. 20%,RT: 0. 19%), Vbeta 9(LT: 2. 61%, RT: 0. 12beta), Vbeta 10(LT: 4. 08%, RT: l. 27%), Vbeta 12(LT: 4. 53%, RT: 0. 99%), Vbeta 22 (LT: 3. 85%, RT: 0. 38%), Vbeta 23(LT: 3. 99%, RT: 0. 63%) were used more predominantly in the left knee joint than in the right knee joint while Vbeta 15 and 18 were used far more in the right knee joint. The CD8+ T cells were used less frequently in the left side than in the right side except the Vbeta 3, 4 and 7 families. CONCLUSIONS: Among the CD4+ T cells, TCR Vbeta 1, 2, 5. 1, 5. 2, 8, 9, 10, 12, 22, 23 families might play a key role in early symptomatic synovitis in RA. The role of TCR Vbeta 15 and 18 families increase in progressing synovitis with time. On the other hand, the late recruitment of CD8+ T cells in the inflamed site might be related to nonspecific inflammatory reaction.
Arthritis, Rheumatoid* ; Clone Cells ; DNA Primers ; Genes, T-Cell Receptor ; Hand ; Humans ; Inflammation* ; Joints ; Knee Joint* ; Knee* ; Synovial Fluid ; Synovitis ; T-Lymphocytes

PURPOSE: To analyze the radiographic and HRCT findings of Pneumocystic carinii pneumonia. MATERIALS AND METHODS: We reviewed the medical records and retrospectively analysed the chest radiographs(n=31) and HRCT scans(n=17) of 31 patients with Pneumocystis carinii pneumonia who had been followed up at our institute between, 1993 and March 1998. Pneumocystis carinii pneumonia was confirmed by cytologic evaluation of sputum stained with methenamine silver(n=25) or on the basis of clinical history(n=6). The study group included 17 men and 14 women aged 28 -78(average, 53.6) years. Twenty-eight patients had underlying conditions such as hematologic diseases(n=13), AIDS(n=8), malignancy(n=2), DM(n=2) and malnutrition(n=1), and three were free from underlying diseases. RESULTS: Twenty patients had pure Pneumocystis carinii pneumonia and 11 had combined lung diseases, namely pulmonary tuberculosis(n=4), pulmonary metastasis(n=2), bacterial pneumonia(n=2), atypical mycobacterial infection(n=1), pulmonary edema(n=1), and Kaposi's sarcoma(n=1). Chest radiographic findings of 20 cases of pure Pneumocystis carinii pneumonia included consolidation(n=12), l inear-reticular opacity(n=8), ill defined haziness(n=7), and nodules(n=6), with bilaterality in is cases and zonal predominance in ten [central(n=5), lower(n=5)]. Ancillary findings included pleural effusion(n=10), cysts(n=5), lymphadenopathy(n=4) and pneumothorax(n=1). In two patients, findings were entirely normal. HRCT findings in ten cases of pure Pneumocystis carinii pneumonia included ground-glass opacity(n=6), consolidation(n=6), linear-reticular opacity(n=8), and nodules(n=5), with bilaterallity in seven cases and zonal predominance in five [central(n=5), lower(n=2)]. Ancillary findings among these cases included pleural effusion(n=4), lym-phadenopathy(n=2), cysts(n=1), and pneumothorax(n=1). HRCT findings in seven cases of Pneumocystis carinii pneumonia combined with other lung diseases included nodules(n=6), ground-glass opacity(n=5), linear-reticular opacity(n=4), and consolidation(n=3). CONCLUSION: Although ground-glass opacity in both pure Pneumocystis carinii pneumonia and this same condition combined with other lung diseases is a common radiologic finding, the possibility of variable radiologic findings in cases of Pneumocystis carinii pneumonia and other lung diseases with which it frequently combines is essential for approximate diagnosis of Pneumocystis carinii pneumonia.
Diagnosis ; Female ; Fluconazole ; Humans ; Lung Diseases ; Male ; Medical Records ; Methenamine ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Radiography, Thoracic ; Retrospective Studies ; Sputum ; Thorax

Necrotizing enterocolitis (NEC) is an acute fulminating disease of neonate characterized by diffuse or patchy intestinal necrosis accompanied by sepsis and often followed by perforation, peritonitis and death. We had experienced 2 cases of NEC recently which were diagnosed by clinical, X-Ray survey, histologic finding of operation. Review of the references concerning NEC was made briefly.
Enterocolitis, Necrotizing* ; Humans ; Infant, Newborn ; Necrosis ; Peritonitis ; Sepsis

The current best treatment for HCV infection is combination therapy with PEG-interferon and ribavirin. This combination therapy has markedly increased the number of sustained virologic responders but is associated with various side effects, especially hematological abnormalities. We recently experienced a 45-year-old man who developed PEG-interferon induced autoimmune hemolytic anemia (AIHA) and retinal premacular hemorrhage. The worsening hemolysis after ribavirin withdrawal and exclusion of other causes implicated PEG-interferon as the cause of the AIHA. To the best of our knowledge, this is the first case reported from Korea. Treatment with PEG-interferon requires careful follow-up, as it can induce or exacerbate autoimmune diseases.
Anemia, Hemolytic, Autoimmune ; Autoimmune Diseases ; Follow-Up Studies ; Hemolysis ; Hemorrhage ; Hepatitis ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Korea ; Middle Aged ; Retinal Hemorrhage ; Retinaldehyde ; Ribavirin

BACKGROUND: The p16INK4a (p16) tumor suppressor gene is frequently inactivated in human non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon γ-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. METHODS: This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. RESULTS: Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57.8±10.5 years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I(1 IA,10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III(9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. CONCLUSION: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.
Adenocarcinoma ; Biomarkers ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Cell Death ; Death-Associated Protein Kinases ; Disease Progression ; DNA Methylation ; Female ; Genes, Tumor Suppressor* ; Humans ; Interferons ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Male ; Methylation* ; Models, Animal ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Protein Kinases* ; Smoke ; Smoking

It is well known that the main source of upper gastrointestinal(UGI) bleeding in patients with liver cirrhosis is the variceal rupture of esophagus. But, peptic ulcer disease, congestive gastrophathy, and gastric varices are frequently found by endoscopic examination in patients with liver cirrhosis. These lesions are related to UGI bleeding. It is necessary to verify the causes of bleeding in liver cirrhosis, and evaluate the influencing factors related with UGI bleeding, and define the endoscopic findings of bleeding in liver cirrhosis. We reviewed the records of 145 episodes of UGI bleeding in cirrhosis, with endoscopy performed within 24 hours of entry, and report here the bleeding sites, influencing factors related with UGI bleeding, and endoscopic findings. The most common bleeding site was the esophageal varices(66.9%). Other bleeding lesions included gastric ulcer(8.3%), congestive gastrophathy(6.9%), undetermined origin(6.9%), duodenal ulcer(6.2%), gastric varices(2.1%), esophageal varices+gastric ulcer(1.4%), and esophageal varices+duodenal ulcer(1.4%). Endoscopic features of bleeding esophageal varices were identified as Spurting(2.1%), Oozing(11.3%), Red plugh(10,3 %), White plugh(14.4%), and Red-color sign(61.9%). In bleeding esophageal varices, gradeIV varices(41.2%) had a significantly higher association with bleeding than gradeI varices(2.1%), gradeII varices(22.7%), and gradeIII varices(34.0%). Endoscopic features of bleeding gastric ulcer were identified as Spurting(8.3%), Oozing(25.0%), Blood clots(58.3%), and Exposed blood vessels on ulcer base(41.7%). Endoscopic features of bleeding duodenal ulcer were identified as Oozing(44.4%), Blood clots(55.6 %), and Exposed blood vessels on ulcer base(55.6%). We found no difference in the bleeding sources according to etiology of cirrhosis(P>0.05). Bleedings due to the variceal rupture of esophagus were more frequently found in Child class B(71.2%) and C(75.0%) than A(34.8%)(P<0.05).
Blood Vessels ; Child ; Duodenal Ulcer ; Endoscopy ; Esophageal and Gastric Varices ; Esophagus ; Estrogens, Conjugated (USP) ; Fibrosis ; Hemorrhage* ; Humans ; Liver Cirrhosis* ; Liver* ; Peptic Ulcer ; Rupture ; Stomach Ulcer ; Ulcer

A 57-yr-old woman previously diagnosed with chronic hepatitis B was admitted via the emergency room because she suddenly developed epigastric pain with abdominal distension. On computed tomography (CT), a round enhancing mass was found on the left hepatic lobe with ascites in the peritoneal space. Bloody ascites were found upon tapping the ascites, and this led to the diagnosis of ruptured hepatocellular carcinoma (HCC). The patient was immediately treated with transcatheter arterial chemoembolization (TACE) including 50 mg of adriamycin and 10 mL of lipiodol, and then we performed left lateral segmentectomy 20 days later. To prevent recurrence of HCC by any micrometastasis, the patient subsequently received 8 cycles of adjuvant systemic chemotherapy (a regimen of epirubicin (50 mg/m2), cisplatin (60 mg/m2) and 5-fluorouracil (200 mg/m2)) at monthly intervals. After this, the patient has been regularly followed up and she shows no signs of tumor recurrence 7 years later. This case suggests that surgical resection and subsequent adjuvant systemic chemotherapy with using an ECF regimen may provide long-term survival for patients ruptured HCC.
Biopsy ; Carcinoma, Hepatocellular/*diagnosis/therapy ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hepatectomy/methods ; Humans ; Liver Neoplasms/*diagnosis/therapy ; Middle Aged ; Rupture, Spontaneous ; Time Factors ; Tomography, X-Ray Computed