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*

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

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

A retrospective study of 100 cervical spinal cord injury patients admitted consequtively to the Department of Neurosurgery, Dongsan Medical Center, Keimyung University between March, 1985 and June, 1989 was conducted. The average age was 42 and 84(84%) were male. The majority sustained their spinal cord injury in a motor vehicle accident(50%) or in a diving accident(36%). Thirty-three percent(33/100) of these patients had surgical intervention by anterior approach(14/33), posterior approach(17/33) and total laminectomy(2/33). The others were only immobilized by traction or neck brace. Not only neurological recovery in operated and nonoperated patients but also complete and incomplete injury was compared. The degree of the neurological injury was classified by the Frankel classification. 12 cases turned out to be more aggravated than the condition at admission, among them 9 cases were middle and low cervical incomplete injuries. At final follow-up no appreciable differences in achievement in activities of daily living and mobility were noted between patients treated with surgical stabilization of the cervical spinal column and those treated nonsurgically.
Activities of Daily Living ; Braces ; Classification ; Diving ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Motor Vehicles ; Neck ; Neurosurgery ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Injuries* ; Spine ; Traction

In order to find out the accuracy of the quantification of the infarction area by using triphenyltetrazolium chloride(TTC) staining and to evaluate the change of the infarction size according to the duration after the ischemic insult, in a series of 33 adult rats, a surgical occlusion of the middle cerebral artery(MCA) was carried out through a small subtemporal craniotomy. 11 animals at 6 hour, 12 animals at 24 hour and 10 animals at 48 hour following the surgical occlusion of the MCA, rats were sacrificed and brain slices were obtained and stained with TTC, and hematoxyline and eosin(H & E). The size of the infraction area stained by each method was quantified by a computer image analysis system. The average percent of the infarction size(+/-standard error) was larger in the 24 and 48 hour groups than that of the 6 hour group(determined by TTC:9.94+/-0.97 vs. 9.98+/-1.08 vs. 6.83+/-0.82%, respectively:6 hour vs. 24 & 48 hour groups;one-way ANOVA test p<0.05 determined by H & E:10.02+/-0.94 vs. 10.02+/-1.06 vs. 7.73+/-0.85%, respectively). However, there was no significant difference in the size of the infarction between the 24 and 48 hour groups. The size of the infarction area determined by either method was not significantly different in any group(TTC vs. H & E:paired t-test p>0.05), and linear regression analysis showed a significant correlation existed between the two methods in all groups. However, the degree of correlation was more prominent in the 24 and the 48 hour groups than 6 hour group(6 hour group:r=0.76, slope=0.78, y intercept=0.55;24 hour group:r=0.97, slope=1.03, y intercept=-0.78;48 hour group:r=0.98, slope=0.94, y intercept=0.42). From this study it is concluded that: 1) the evolution of the infarction size continues up to 24 hours following the arterial occlusion, and thereafter, the change of the infarction size is minimal in the rat. This data suggests that it is sufficient to evaluate the change of the infarction size up to 24 hours following the ischemic insult in the experimental study of ischemia in the rat. 2) the detection and the quantification of the cerebral infarction by using TTC staining is a reliable method after 24 hours following the ischemic insult. However, in the earlier period than 24 hours following the ischemic insult, staining with TTC coupled with histopathological H & E staining will add to the accuracy in the obtainin the quantity of the cerebral infarction in the rat.
Adult ; Animals ; Brain ; Cerebral Infarction* ; Craniotomy ; Hematoxylin ; Humans ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Linear Models ; Middle Cerebral Artery* ; Rats