No abstract available.
Arthritis, Rheumatoid* ; Humans ; Scleroderma, Localized*

Sarcoidosis is a rare d:sease in Korea and its association with erythema nodosurn is even rarer. Recently we saw a patient of bihilar adenopathy, who had arthralgia and erythematous nodules of both lower legs. A skin biopsy obtained from the erythematous nodule of the lower leg showed septal panniculitis, consitent with erythema nodosum, and a biopsy from the mediastinal lymph node revealed a pathology consistent with sarcoidosis. This is the first case of Lofgrens syndrome confirmed by histology ir, Korea.
Arthralgia ; Biopsy ; Erythema ; Erythema Nodosum ; Humans ; Korea ; Leg ; Lymph Nodes ; Panniculitis ; Pathology ; Sarcoidosis ; Skin

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

OBJECTIVES: Chronic pain is one of the most common experiences of humans and a typical psychophysiological disorder. The aim of this study was to measure the psychophysiological responses in chronic pain patients using a biofeedback system, and to compare them with the results from normal healthy subjects. METHODS: Forty two patients with chronic pain (17 males and 25 females, average age 44.67+/-11.10 years) and 42 normal healthy controls (17 males and 25 females, average age 45.17+/-10.46 years) participated in this study. Electromyography (EMG), skin conductance (SC), and skin temperature (ST) were recorded using biofeedback system during the 3 phases (baseline, stress, and recovery) of stress reactivity test, and average values of them were calculated. Difference of values between two groups in each corresponding phase was analyzed with independent t-test, and change of values across phases of stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). RESULTS: Compared to normal controls, chronic pain patients had higher value of EMG (baseline : 8.10+/-5.97 micronV vs 4.72+/-1.52 micronV, t=-3.56, p<0.01 ; stress : 11.25+/-6.89 micronV vs 8.49+/-4.78 micronV, t=-2.13, p<0.05 ; recovery : 7.12+/-3.77 micronV vs 4.78+/-1.59 micronV, t= -3.70, p<0.01) and SC (baseline : 1.06+/-1.0 micronS vs 0.42+/-0.29 micronS, t=-4.0. p<0.01 ; stress : 1.87+/-2.05 micronS vs 1.03+/-0.86 micronS, t=-2.47, p<0.05 ; recovery : 1.74+/-1.77 micronS vs 0.64+/-0.59 micronS, t=-3.8, p<0.01) in all the 3 phases. But, skin temperature comparison did not reveal significant differences in all the 3 phases between two groups. CONCLUSION: Psychophysiological responses of chronic pain patients in stress reactivity test were different from those of normal healthy controls. These results suggest that sympathetic nervous system is more activated in chronic pain patients.
Biofeedback, Psychology ; Chronic Pain ; Electromyography ; Female ; Humans ; Male ; Psychophysiologic Disorders ; Psychophysiology ; Skin ; Skin Temperature ; Sympathetic Nervous System

With an aging population, osteoporotic vertebral collapse is an increasingly common condition. This compression fractures has been considered a benign entity, quite responsive to conservative treatment. In a rare patients, however, a major neurologic complication and painful kyphosis despite conservative treatment can develop. Therefore, the purpose of this present study is to analyze the surgical results of 14 patients with severe back pain, an increasing kyphosis and neurologic deficits caused hy osteoporotic vertebral collapse following minor trauma, who were treated surgically. Presenting signs and symptoms included severe back pain with progression of kyphosis in 6 patients and increasing neural deficit in 8 patients. Of 14 patients, eight patients had an intravertebral cleft sign (vacuum sign). Indications for surgery included increasing kyphotic deformity, intractable pain, or increasing neurologic deficit. There was no correlation between intravertebral cleft sign and neurologic deficit. However, patients who had intravertebral cleft sign had not well respond to conservative treatment. As treatments, combined anterior and posterior fusion in 8, anterior fusion in 4, posterior instrumentation, and wide decompressive laminectomry in one patient, respectively, were carried out. The final correction of the deformity averaged 0.3 degrees. Therefore. correction of kyphosis was not favorably maintained because of variable surgical methods, and sinking of graft bone or instrumentation into the osteoporotic vertebral bodies. However, pain was reduced significantly in all patients. In addition neurological symptoms improved in 7 patients. One patient underwent reoperation with nnterior inierbody tusion together with anterior instrument because of an increasing kyphosis, neurologic. iymptoms and scvcre hack pain following wide decompressive laminectomy. There was no complication relatecl to instruments. The authors strongly helieved that surgical intervention has highly satisfactory results in patients who have intravertehral cleft sign with persistent back pain despite conservative treatment, and proressive or persistent neurologic deficits following osteoporotic vertebral collapse.
Aging ; Back Pain ; Congenital Abnormalities ; Fractures, Compression ; Humans ; Kyphosis ; Laminectomy ; Neurologic Manifestations ; Osteoporosis ; Pain, Intractable ; Reoperation ; Transplants

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*

Transesophageal echocardiogram (TEE) was performed in the 86 normal persons using a UM9 of ATL with a 3.5 MHZ transducer in the Heart Center of Dong-A University Hospital during March-September 1990. 1) The transesophageal basal short axis views in the normal were seen in the Fig. 2~6. The Fig. 2 showed 3 aortic valve cusps, Fig. 3 the left coronary artery, Fig. 4 the right pulmonary artery bifurcated from the main pulmonary artery, Fig. 5 3 major vessels of superior vena cava, aorta and pulmonary artery and Fig. 6 the Left atrial appendage. 2) The transesophageal 4-chamber views in the normal were seen in Fig. 7~10. The Fig. 7 showed the left ventricular outflow tract, Fig. 8 right and left atrium and ventricle, Fig. 9 the atrial septum containing the membrane of fossa ovalis and Fig. 10 right atrium and ventricle. 3) The transesophageal transgastric short axis view in the normal was seen in Fig. 11. Fig. 11 showed the transverse image of LV and RV. 4) The transesophageal ascending aorta image was observed in Fig. 3. descending aorta image in Fig. 12 and the transesophageal aortic arch image in Fig. 14. 5) From the transesophageal 4 chamber view the septum-lateral wall dimension of the left ventricle was 5.0cm and the dimension between the apex and the closed mitral valve 6.3cm. The medial-lateral dimension of the left atrial appendage was 3.0cm and the superior-inferior dimension 4.1cm. The dimension of the descending aorta was 2.7cm and the ascending aorta 3.0cm.
Aorta ; Aorta, Thoracic ; Aortic Valve ; Atrial Appendage ; Atrial Septum ; Axis, Cervical Vertebra ; Coronary Vessels ; Echocardiography, Transesophageal ; Heart ; Heart Atria ; Heart Ventricles ; Humans ; Membranes ; Mitral Valve ; Pulmonary Artery ; Transducers ; Vena Cava, Superior

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

BACKGROUND: The effect of Video Display Terminals(VDT) Syndrome is well documented. The purpose of this study is to examine the difference in systemic subjective symptoms between long term users of computers with that of the general population and to help plan to avoid the risk of developing Video Display Terminal Syndrome. METHOD: Data was collected for this study between August 1996 and February 1997. Two groups consisting of seventy(70) long term computer users(Exposed Subjects) and fifty nine(59) non users (Non Exposed Subjects), were selected for the survey. Data was gathered from the exposed subjects through their response to the survey questionnaire posted on the internet requiring detailed responses concerning ten systemic subjective symptoms that were experienced as a result of the long term exposure to VDT. Data was gathered from the non exposed subjects through written responses to the questionnaire. RESULTS: Among the more significant difference was the experience of ocular symptoms among the exposed group. The exposed group experienced in descending order eleven items of ocular symptoms. Congestion, strain, decreased visual acuity, ocular pain, and dryness. Among seven items of lifestyle, the exposed group characteristically exercised less(P<0.05) and did more home activity (P<0.05), characteristically lead healthier life than the non exposed group. Participation in exercise differed most among the groups. The exposed group participating in moderate exercise scored 517+/-551.6 compared to the non exposed group which exercised very vigorously(p<0.05). In comparison of subjective symptom and life styles per daily exposure time(over 8,10,16 hours daily) there was significant difference between 8 and 10hour exposers only in the stress item(P<0.05). In the exposure group there were less cardiovascular symptoms(P<0.05) due to more art activity(P<0.05), more cardiovascular symptoms and less sleep activity(P<0.001) and more ocular symptoms(P<0.05) due to higher levels of stress. CONCLUSIONS: By exercising, exposers can decrease the respiratory symptoms, and by seeking methods that enable efficient management of work time, the subjects can benefit from the reduced work time, and by seeking methods so that one receive less stress and can resolve them they can reduce their ocular symptoms, sleep problems, cardiovascular symptoms. And in their spare time, the subjects can be recommended to involve in art activity for each person, through PC indirectly. Designing the development of cyber gallery, museum, literature room, concert can reduce the oecur-rence rate of cardiovascular symptoms.
Computer Terminals ; Estrogens, Conjugated (USP) ; Humans ; Internet ; Life Style* ; Museums ; Visual Acuity ; Surveys and Questionnaires