Systemic lupus erythematosus (SLE) is a disease affecting blood vessels and connective tissue, which are damaged by deposition of pathogenic autoantibodies and immune complexes. Although a complex disease, SLE provides a number of insights into autoimmune pathogenesis. Autoimmune disease, in general, is characterized by B cell hyperactivity which results in hypergammaglobulinemia and production of a variety of autoantibodies reactive to organ-nonspecific antigens such as DNA, RNA, and cell membrane structures. SLE patients usually show a marked increase in the number of activated and immunoglobulin-producing circulating B cells. Recently, cytokines with specific effects on immune regulation have been detected and extensively studied. One of them, Interleukin-6 (IL-6), is an activated monocyte derived factor which stimulates B cell growth and differentiation. We investigated the serum IL-6 levels of SLE patients in an attempt to demonstrate their relationship with the patients' clinical manifestation, and the serum levels of C-reactive protein (CRP), circulating immune complexes (CICs,) and soluble interleukin-2 receptor (sIL-2R). The study subjects consisted of 22 patients with SLE who had visited Severance Hospital from July 1986 to September 1987 and 10 normal controls. The patients' sera were stored at -70degrees C and later analyzed. The serum levels of IL-6 were measured by ELISA method with Inter Test-6X Human IL-6 ELISA kit; the serum CRP levels by fluorescence polarization immunoassay; the serum CIC levels by solid phase Clp binding assay; and the serum sIL-2R levels ELISA method. The results were as follows: The mean serum IL-6 level of SLE patients (1,366 pg/ml) was higher that of the controls (98pg/ml) (p<0.05). Among the SLE patients studied. the mean serum IL-6 level was higher in those with vasculitis than those without. ln the SLE patients studied. a linear correlation was present between the measured serum IL-6 and CIC levels; however no correlation was present either between IL-6 and CRP levels, or between IL-6 level and platelet count. The mean sIL-2R level of the SLE patients studied (1,864 U/ml) was higher than that of the controls (300 U/ml). However, in the SLE patients studied, no correlation was present between the serum IL-6 and sIL-2R levels measured. The high serum IL-6 level might play an important role in the pathogenesis of SLE.
Antigen-Antibody Complex ; Autoantibodies ; Autoimmune Diseases ; B-Lymphocytes ; Blood Vessels ; C-Reactive Protein ; Cell Membrane Structures ; Connective Tissue ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Fluorescence Polarization Immunoassay ; Humans ; Hypergammaglobulinemia ; Interleukin-2 ; Interleukin-6* ; Lupus Erythematosus, Systemic* ; Monocytes ; Platelet Count ; RNA ; Vasculitis

No abstract available.

Purpose: The goal of this study was to evaluate the efficacy of suction drains following total hip arthroplasties, by comparing the post-operative results between the group with suction drains and the group without suction drains. Materials and Methods: Eighty-six patients, who underwent primary total hip arthroplasties from June 2001 to June 2004, were divided into two groups: group 1 (48 patients), with suction drains; and group 2 (38 patients), without suction drains. We assessed the perioperative hemoglobin and platelet levels, the amount of total blood loss, the amount of post-operative blood transfusions, post-operative ranges of motion (ROMs, at 6 weeks), wound problems, and general conditions. Results: Although the postoperative hemoglobin level was greater in group 2 than in group 1, there was no statistically significant difference. The amount of total blood loss and blood transfusions in group 1 were statistically greater than in group 2 (p<0.05). There were no statistically significant differences in the post-operative ROMs and wound complications between groups 1 and 2. Conclusion: There were no limitations of hip motion and no wound complications in the patients without suction drains after total hip arthroplasties. However, they required fewer post-operative blood transfusions than did the patients with suction drains, due to less post-operative blood loss; and the absence of a suction drain might prevent retrograde tube infections. In addition, patients without suction drains after total hip arthroplasties seemed to recover better did than those with suction drains. Therefore, suction drains might provide no benefit in total hip arthroplasties.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Blood Platelets ; Blood Transfusion ; Hip ; Humans ; Suction* ; Wounds and Injuries

Renal calcifications are a recognized complication of furosemide therapy in premature infants. Particularly in infants with chronic lung disease, the use of this potent diuretic is associated with hypercalciuria, which may predispose the infant to medullary nephrocalcinosis and renal calculi, We experienced two cases of nephrocalcinosis in very low birth weight infants. One had bronchopulmonary dysplasia, pneumonia, patent ductus arteriosus, ventricular septal defect and congestive heart failure and the other had systemic cytomegalovirus infection with cytomegalovirus pneumonitis and ricket of prematurity. Both patients received a large amount of furosemide. We presented these cases with brief review of literatures.
Bronchopulmonary Dysplasia ; Cytomegalovirus ; Cytomegalovirus Infections ; Ductus Arteriosus, Patent ; Furosemide ; Heart Failure ; Heart Septal Defects, Ventricular ; Humans ; Hypercalciuria ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Kidney Calculi ; Lung Diseases ; Nephrocalcinosis* ; Pneumonia

Background: Inverted follicular keratosis (IFK) is a benign tumor that occurs mainly as a single lesion in the head and neck. Histologically, the tumor lobules show endophytic or exophytic growth and are characterized by squamous eddies. IFK should be differentiated from seborrheic keratosis, verruca vulgaris, and squamous cell carcinoma (SCC).In particular, differentiating from well-differentiated SCC can be difficult when downward growth is observed along with some mitotic figures and inflammatory cell infiltration. Objective: To evaluate and compare the clinical and histopathological characteristics of IFK and well-differentiated SCC. Methods: We retrospectively reviewed the clinicopathological records of 21 patients diagnosed with IFK and 21 randomly assigned patients diagnosed with well-differentiated SCC between 2000 and 2022 at the Dermatology Department of the Yeungnam University Medical Center. Results: IFK occurs frequently on the head and neck of middle aged and older adults, and its average size is less than 1 cm. Acantholysis was observed in varying degrees in IFK; however, well-differentiated SCC was mostly absent (17 cases) or mild (three cases) showing a statistically significant difference. Squamous eddies were observed in 21 cases of IFK and eight of well-differentiated SCC. The average number of dyskeratotic cells and mitotic counts did not differ significantly between IFK and well-differentiated SCC. Conclusion We suggested some evidence for the irritant origin of IFK. We also compared the clinicohistological findings of IFK with those of well-differentiated SCC and concluded that excluding atypical cells, abnormal mitotic figures, and irregular invasive borders is important for differential diagnosis.

Allergic response to common environmental agents has been regarded as a main pathogenetic mechanism of bronchial asthma. However, allergic sensitization (atopy) can not be detected in a siginificant number of adult asthmatic patients. The etiology of nonatopic asthma has not yet been defined. To evaluate the possible involvement of autoimmune response against bronchial mucosa in the pathogenesis of nonatopic asthma, we performed indirect immunofluorescence staining of fresh frozen human bronchial mucosa tissue using serum samples from patients with atopic and nonatopic asthma, healthy controls, and patients with systemic lupus erythematosus. On immunostaining, circulating IgG autoantibodies against bronchial mucosa were detected in 2 (9.1%) of 22 patients with nonatopic asthma and in none of 22 patients with atopic asthma and of 22 healthy controls. IgG autoantibodies from the two patients with nonatopic asthma predominantly stained the cytoplasmic membrane of basal cells in bronchial epithelium. Serum samples from 10 patients with systemic lupus erythematosus immunostained the nucleus of epithelial cells in whole layer of bronchial epithelium. This study showed the presence of circulating IgG autoantibodies against the bronchial epithelial cell in a small portion of patients with nonatopic asthma. Further studies may be necessary to evaluate the possible involvement of autoimmune mechanism in the pathogenesis of nonatopic asthma.
Asthma/immunology* ; Autoantibodies/immunology* ; Autoantibodies/blood ; Bronchi/immunology* ; Epithelial Cells/immunology ; Human ; Immunity, Mucosal/immunology ; Respiratory Mucosa/immunology*

Onychomycosis is usually caused by dermatophytes, but some nondermatophytic molds and yeasts are also associated with invasion of nails. The genus Chaetomium is a dematiaceous nondermatophytic mold found in soil and plant debris as a saprophytic fungus. We report the first Korean case of onychomycosis caused by Chaetomium globosum in a 35-year-old male. The patient showed brownish-yellow discoloration and subungual hyperkeratosis on the right toenails (1st and 5th) and left toenails (1st and 4th). Direct microscopic examination of scraping on the potassium hydroxide preparation revealed septate hyphae and repeated cultures on Sabouraud's dextrose agar (SDA) without cycloheximide slants showed the same fast-growing colonies, which were initially velvety white then turned to dark gray to brown. However, there was no growth of colony on SDA with cycloheximide slants. Brown-colored septated hyphae, perithecia and ascospores were shown in the slide culture. The DNA sequence of internal transcribed spacer region of the clinical sample was a 100% match to that of C. globosum strain ATCC 6205 (GenBank accession number EF524036.1). We confirmed C. globosum by KOH mount, colony, and light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical amorolfine 5% nail lacquer for 3 months.
Agar ; Arthrodermataceae ; Base Sequence ; Chaetomium ; Cycloheximide ; Fungi ; Glucose ; Humans ; Hydroxides ; Hyphae ; Lacquer ; Light ; Male ; Morpholines ; Nails ; Naphthalenes ; Onychomycosis ; Plants ; Potassium ; Potassium Compounds ; Sequence Analysis, DNA ; Soil ; Sprains and Strains ; Yeasts

OBJECTIVES: The authors attempted to estimate the incidence of posttraumatic stress disorder (PTSD) and the differences of sociodemographical features, injury severity, depression and anxiety between PTSD and non-PTSD groups artier motor vehicle accident. METHODS: The subjects were 104 patients who had undergone motor vehicle accidents, and been hospitalized to orthopedic surgery hospitals. We administered them clinician-administered PTSD scale(CAPS) for diagnosing PTSD, injury severity scale(ISS) for identifying their physical injury, self-reported questionnaire made to identify socioepidmogrphic data, Beck Depression Inventory(BDI) for measuring depression, and State Trait Anxiety Inventory I, II(STAI- I, II)for measuring anxiety. RESULTS: The incidence of PTSD in subjects was 61.5%. Most of sociodemogrphic factors were not different between PTSD and non-PTSD groups. Only there were signigicant differences between PTSD group and non-PTSD group on the cases that observed the dead or the wounded at the scene of motor vehicle accident( chi2=8.478, p<0.05) and BDI(t=5.03, p<0.05). CONCLUSION: These results indicate that prevalence of PTSD is higher after motor vehicle accident and both of the two groups report much higher depression and anxiety than normal population. In addition, the results of this study show that the observation of dead or wounded at accident situation can be of risk factors to precipitatae PTSD.
Accidents, Traffic ; Anxiety ; Depression ; Humans ; Incidence ; Motor Vehicles* ; Orthopedics ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic* ; Wounds and Injuries

BACKGROUND: Recently, identification of fungi have been supplemented by molecular tools, such as ribosomal internal transcribed spacer (ITS) sequence analysis. According to these tools, morphological Exophiala species was newly introduced or redefined. OBJECTIVE: This study was designed to investigate the phylogenetics based on ribosomal ITS sequence analysis from clinical Exophiala species isolated in Korea. METHODS: The strains of Exophiala species were 4 clinical isolates of phaeohyphomycosis agents kept in the department of dermatology, Dongguk University Medical Center(DUMC), Gyeongju, Korea. The DNAs of total 5 strains of Exophiala species were extracted by bead-beating method. Polymerase chain reaction of ITS region using the primer pairs ITS1-ITS4, was done and phylogenetic tree contributed from sequences of ITS region from 5 Korean isolates including E. dermatitidis CBS 109154 and comparative related strains deposited in GenBank. RESULTS: The strains of Exophiala species were 3 strains of E. dermatitidis, 1 strain of E. jeanselmei and 1 strain of Exophiala new species. Among the 3 subtypes (type A, B, C) of E. jeanselmei, E. jeanselmei DUMC 9901 belonged to type B. Of the 2 main types of E. dermatitidis (type A, B) and 3 subtypes of E. dermatitidis type A (A0, A1 and A2), two strains (E. dermatitidis CBS 709.95, E. dermatitidis CBS 109154) belonged to A0 subtypes, 1 strain (E. dermatitidis DUMC 9902) A1 subtype, respectively. CONCLUSION: Phylogenetic analysis of ITS region sequence provided useful information not only for new species identification but for the subtyping and origin of Exophiala species.
Dermatology ; DNA ; Exophiala ; Fungi ; Korea ; Phaeohyphomycosis ; Phylogeny ; Polymerase Chain Reaction ; Sequence Analysis ; Sprains and Strains

PURPOSE: This study was designed to identify current status of the subspecialist training programs and related factors affecting subspecialists' job selection. METHODS: The study subjects were 5,569 subspecialist trainees in 61 hospitals between 1989 and 1999. Among them, 1,260 subjects were selected to identify employment status after training. Also we analysed factors affecting career selection for 863 subspecialists on which basic information was available. RESULTS: About 26.6% of all subspecialist trainees trained in 1999 was for subspecialties in internal medicine, the largest majority, and 89.3% was in metropolitan areas. Also 91.1% were trained in teaching hospitals. Among subspecialists completed training, 79.5% selected career to work at general or teaching hospitals as of 1999, but 13.5% practised at clinics. The factors affecting career selection after training were gender, ownership of medical school, and specialty. CONCLUSION: The fact that not a few subspecialists work at primary care clinics means there are unreasonable human resource allocation and planning, with probable poor quality of primary care. Therefore, it is necessary to have a human resource plan at the national level for appropriate number of subspecialists, based on each specialty, in particular. Any structural factors affecting destination of subspecialist trainees, such as gender and graduated medical school, etc, should be dealt with in the long run.
Education* ; Employment ; Hospitals, Teaching ; Humans ; Internal Medicine ; Ownership ; Primary Health Care ; Resource Allocation ; Schools, Medical