BACKGROUND: The endothelial expresson and upregulation of ICAM-1 and epidermal keratinocyte expression of ICAM-1 are well documented in psoriasis. ICAM-1 mediates the adhesion and trafficking of circulating activated skin-seeking CD45RO+ memory CD4+ T lymphocytes from the vessel into the dermis and epidermis of psoriatic skin by binding to its ligand LFA-1(lymphocyte function-associated antigen-1) expressed on lymphocyte membranes. OBJECTIVE: The purpose of this study was to investigate the expression of ICAM-1 in vascular endothelium and keratinocyte of psoriatic skin and the difference of ICAM-1 expression between early and fully developed psoriatic lesions. METHODS: We have studied the expression of ICAM-1 in twelve psoriatic patients who had not been treated for psoriatic lesions for 1 month and three normal human skin samples by immunohistochemical staining using monoclonal antibody against ICAM-1. RESULTS: Immunohistochemical staining revealed anti-ICAM-1 antibody positively stained only in the subpapillary endothelial cells of normal skin. But in all psoriatic lesions studied, anti- ICAM-1 antibody was stained positively in the endothelium of papillary and subpapillary plexus, and in fully developed psoriatic lesions, anti-ICAM-1 antibody was stained focally in epidermal keratinocytes. CONCLUSION: The results suggest that ICAM-1 expression on papillary microvessels and keratinocytes may play an important role in the transendothelial and transepidermal migration of lymphocytes from the vessel into the dermis and epidermis of psoriatic skin.
Dermis ; Endothelial Cells ; Endothelium ; Endothelium, Vascular* ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Lymphocytes ; Membranes ; Memory ; Microvessels ; Psoriasis ; Skin* ; T-Lymphocytes ; Up-Regulation

Bullous pemphigoid(BP) is a bullous disease in elderly people characterized by subepidermal bullae on erythematous and normal skin. Peripheral blood easinophilia have been reported in the patients with BP, and blood eosinophilia may be related to disease activity and severity in BP. We report a 70-year old man BP. He showed peripheral blood eosinophilia, and was treated successfully with a combination of low dose steroids & tetracycline-niacinamide(T-N) therapy. The eosinophil counts fell to normal levels as the skin lesion cleared.
Aged ; Eosinophilia ; Eosinophils ; Humans ; Pemphigoid, Bullous* ; Skin ; Steroids

Many patients with Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome(TTP-HUS) satisfactorily respond to plasma exchange. Some patients, however, respond either not at all or only transiently and incompletely. In the refractory case, endothelial cell-derived unusually large von Willebrand factor multimers(ULvWFM) have an important role in the formation of microthrombi. As the ULvWFM may be removed in the cryoprecipitate, we reason the plasma depleted of cryoprecipitate(the plasma cryosupernatant) should be considered for effectiveness in the treatment of refractory TTP- HUS. We experienced a 48 year old woman presented with diarrhea, jaundice and oliguria. She had microangiopathic hemolytic anemia, renal impairment, platelets of 21,000/mm3 and LDH 3,258U/L. She had not improved after plasma exchange with fresh frozen plasma(FFP)(1.5 plasma volumeX7 days). On hospital day 8, her HUS had not responded, platelets of 37,000/mm3 and LDH 1,588U/L. Substitution of cryosupernatant for FFP was associated with prompt increased in the platelet count to normal and complete resolution of HUS. Therefore. the cryosupernatant fraction of plasma should be considered as an alternative to whole FFP for plasma exchange if there is continuing platelet consumption and microvascular thrombosis in spite of intensive conventional plasma therapy.
Anemia, Hemolytic ; Blood Platelets ; Diarrhea ; Female ; Hemolytic-Uremic Syndrome* ; Humans ; Jaundice ; Middle Aged ; Oliguria ; Plasma Exchange* ; Plasma* ; Platelet Count ; Thrombosis ; von Willebrand Factor

We performed this study to understand the health status and food intake of North Koreans. Information was collected by individual closed in-depth interviews of 11 escapers from North Korea as well as books, newspapers and North Korean movies. Interviews were done from October, 1996 to May, 1997, covering their heights and weights, their appearance and disease, food system and intake of various main/side foods, concern about health and hygiene. North Korean's height and BMI were lower than those of South Koreans. Difference of BMIs between North and South Koreans was profound in middle aged women than in other age groups. Childrem showed many malnutrition appearances of moon face, large abdomem, arrow-like legs, flaky skin, decolored hair, etc.. Main foods in North Korea were rice-shaped corn, corn flour, wheat flour and wet noodle, and side foods were kimchi and/or soups and steamed soy paste. Food supply system there seemed not to work normally for many years, so foods, especially in cities, has been extremely short in government-operating shops, but some in private market. Many housewives were eager to make and sell simple snack food products, We noticed that North korea schools didn't check students' health even though their medical policy was based on preventive medicine. Their living environmental hygiene was shown to be oyt of control.
Democratic People's Republic of Korea ; Eating* ; Female ; Flour ; Food Supply ; Hair ; Humans ; Hygiene ; Leg ; Malnutrition ; Middle Aged ; Periodicals ; Preventive Medicine ; Skin ; Snacks ; Steam ; Triticum ; United Nations ; Weights and Measures ; Zea mays

To investigate the awareness of medical students about an implementation of peer mentoring program between senior and junior, this research survey was carried out on 341 students of a medical school including 62 students of 1(st) premedical graders, 72 of 2(nd) premdical grade, 74 of 3(rd) medical grade, 73 of 4(th) medical grade, and 60 of 5(th) medical grade. The questionnaire for the survey was composed of items, freely responding styled, about such as ‘conflicts experiencing during school living’, i‘nstances requesting senior's assistance’, ‘needs for a senior-junior mentoring’, ‘intention participating as mentor or mentee in prospective mentoring program’, ‘contents willing to get mentoring’, ‘formality of mentoring program’. As a result, there is strong needs to introduce the peer mentoring programs for graduating the doctors fitting to the outcomes based on institutional framework, and to cultivate the seniors as mentors through proper educations because the senior's advice or assistance may exert considerable reflections and influences on junior's lives.
Humans ; Mentors* ; Prospective Studies ; Schools, Medical* ; Students, Medical

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory*

BACKGOUND: Interferon-alpha2b has already proven to be effective in the clinical treatment of virus-originated diseases such as hairy cell leukemia, condyloma acuminatum, and AIDS-related Kaposi's sarcoma. The use of recombinant interferon-alpha2b may allow various types of wart to be treated relatively atraumatically and with less incidence of recurrence. OBJECTIVE: We tried to compare the effectiveness and safety of intralesional injections of recombinant interferon-alpha2b with natural interferon-alpha2b in the treatment of patients with various types of wart. METHOD: Patients with more than two warts were treated by injecting the different warts with 0.5 to 1.0X105 IU/1mm3 of recombinant and natural interferon-alpha2b, twice per week for 4 to 20 weeks. The response to treatment was followed up at 36 weeks. RESULTS: At the end of treatment, clearing of the treated warts had occurred in 83.3% of the recombinant interferon-alpha2b group and 91.6% of the natural interferon-alpha2b group. A more rapid cure rate was observed in the natural interferon-alpha2b group than in the recombinant interferon-alpha2b group. The rest showed partial improvement. With evaluation for relapse up to 16 weeks after treatment, warts were found to relapse in 11.1% of both the recombinant and natural interferon groups. CONCLUSION: Intralesional natural interferon-alpha2b has a better therapeutic effect than recombinant interferon-alpha2b, and may be considered as a therapeutic modality of recalcitrant verruca or when it can be anticipated that destructive techniques or blistering agents will not be tolerated.
Blister ; Humans ; Incidence ; Injections, Intralesional ; Interferons ; Leukemia, Hairy Cell ; Recurrence ; Sarcoma, Kaposi ; Warts*

Pulmonary embolism is a not uncommon perioperative complication that results in substantial morbidity and mortality. However prompt diagnosis is difficult because clinical symptoms and signs of pulmonary embolism are not completely obvious. We report a case of severe pulmonary embolism on the first postoperative day of total abdominal hysterectomy in a patient transfused preoperatively for iron deficiency anemia caused by menorrhagia. We diagnosed pulmonary embolism by echocardiogram and chest spiral computerized tomography and the patient was moved to the intensive care unit. Tissue plasminogen activator was given and followed by continuous heparin infusion but the patient did not improve. He developed multiple organ dysfunction syndrome and died on the seventh postoperative day.
Anemia ; Anemia, Iron-Deficiency ; Female ; Heparin ; Humans ; Hysterectomy ; Intensive Care Units ; Menorrhagia ; Multiple Organ Failure ; Postoperative Complications ; Pulmonary Embolism ; Thorax ; Tissue Plasminogen Activator ; Tomography, Spiral Computed

BACKGROUND AND OBJECTIVES: The pathological findings of Non-Q wave myocardial infarction(NQMI) on ECG did not always correspond to subendocardial infarction(SEMI). The purpose of this study was to evaluate the diagnostic validity of ECG for SEMI by myocardial contrast echocardiography (MCE) in the patients with acute myocardial infarction(AMI). MATERIALS AND METHODS: The study population was 84 patients who underwent MCE under the diagnosis of AMI. MCE was performed by intracoronary injection of sonicated Hexabrix into the infarct related artery and SEMI was diagnosed by inspecting endocardial defect with epicardial enhancement on MCE. RESULTS: (1) Among 19 NQMI cases, 7 cases showed SEMI with MCE score 0.5, 11 cases with score 1, and 1 case with score 0. Among 65 Q-wave MI(QMI) cases, only 5 cases showed SEMI. (2) 7 cases who had NQMI with SEMI showed LV wall motion recovery at follow-up echocardiography except 1 case. Whereas, of 5 QMI cases who had SEMI, only 1 case improve LV wall motion. CONCLUSION: NQMI on ECG does not always imply SEMI on MCE, but the absence of pathologic Q wave in the patients with SEMI is thought to be a predictive factor of the recovery of LV wall motion.
Arteries ; Diagnosis ; Echocardiography* ; Electrocardiography* ; Follow-Up Studies ; Humans ; Infarction* ; Ioxaglic Acid