BACKGROUND: The growing number of spinal cord injured individuals facing old age makes the understanding of age related limitations increasingly important. This study was to investigate the age-related differences in rehabilitation outcome according to the level of cervical spinal cord injury and each category of activity of daily living(ADL). METHODS: Subjects were 79 adults with tetraplegia all of whom were admitted in National Rehabilitation Hospital. The level of injury was classified into upper cervical(C4, C5), mid-cervical(C6), and lower cervical(C7, C8) spinal cord injury. Eight ADL categories including feeding, grooming, bathing, dressing, toileting, bed-transfer, toilet/tub transfer, and indoor mobility were assessed using the scale of Spinal Cord Independence Measure. Age related differences were examined by separating the sample into two age groups(> or =40 and <40 years) RESULTS: There was no age related difference in rehabilitation outcome in upper cervical cord injury patients. In mid-cervical cord injury level, ADL capacities differed only in the feeding and grooming activities. In lower cervical cord injury level, older patients showed lower rehabilitation outcome than younger counterparts in all ADL categories examined. CONCLUSION: Along with injury level, age should be considered when formulating rehabilitation plans and functional prognostic statements in tetraplegic patients.
Activities of Daily Living ; Adult ; Animals ; Bandages ; Baths ; Grooming ; Humans ; Quadriplegia ; Rehabilitation* ; Spinal Cord Injuries* ; Spinal Cord* ; Treatment Outcome*

OBJECTIVE: Strong genetic evidence has shown an association between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and autoimmune diseases. This study was set out to determine whether the polymorphisms of the CTLA-4 exon 1 and promoter are associated with susceptibility to systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and their clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using Bst E II and Tru9 I was used to determine genotypes of the CTLA-4 exon 1 and promoter in 80 SLE, 86 RA patients and 86 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype frequency of the CTLA-4 exon 1 differed between SLE patients and controls (chi-squared=.74, 2 degrees of freedom (df), p=.03). The CTLA-4 AG genotype occurred more frequently in patients with SLE (46.3% vs. 33.7% controls). On the other hand, the CTLA-4 AA genotype as well as the CTLA-4 GG genotype was less frequent among SLE patients than among control subjects (1.3% vs. 9.3% and 52.5% vs. 57.0% respectively). The genotype distribution of the CTLA-4 promoter differed between SLE patients and control subjects (CT, TT, CC genotypes 27.5%, 0%, 72.5% vs. 16.3%, 4.7%, 79.1% controls respectively, chi-squared=.36, 2 df, p=0.04). When the association was analyzed with respect to sex, the distribution of the CTLA-4 exon 1- promotor genotypes was significantly different between female SLE patients and females in the control group (chi-squared=8.16, 3 df, p=0.04). The frequencies of the CTLA-4 exon 1 and promoter genotypes, allele and phenotypes and exon 1-promotor genotypes were not significantly different between RA patients and control subjects. Clinically, there were no significant differences in patients with SLE and RA according to the CTLA-4 polymorphisms. CONCLUSION: The polymorphisms within the CTLA-4 exon 1 and promoter appear to play a role in susceptibility to SLE, but not to be associated with clinical features of SLE, susceptibility to RA and its clinical features.
Alleles ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Exons* ; Female ; Freedom ; Genotype ; Hand ; Humans ; Lupus Erythematosus, Systemic* ; Lymphocytes ; Phenotype ; Polymerase Chain Reaction

OBJECTIVE: To investigate whether the polymorphism of Fas promoter gene is associated with susceptibility to systemic lupus erythematosus (SLE) and its clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using MvaI was used to determine genotypes of the Fas promoter in 87 SLE patients and 87 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype distribution of the Fas promoter did not differ between SLE patients and control subjects (AA, GA, GG genotypes 31.0%, 54.0%, 14.9% in SLE patients vs. 29.9%, 55.2%, 14.9% in controls respectively, chi2=0.03, 2 degrees of freedom, p=0.99). No significant differences were also found in allele frequencies between the groups. Clinically in the lupus patients according to the Fas promoter polymorphism, there were no significant differences in age at onset, anti-ds DNA titer, C3, C4 level, renal involvement, number of ACR (American College of Rheumatology) criteria presented, SLE Disease Activity Index, SLICC/ACR (The Systemic Lupus international Collaborating Clinics/American College of Rheumatology) damage index, and autoantibody profiles except for anti-RNP antibody. The frequency of anti-RNP antibody in the lupus patients was increased in AA group (71.4%) compared to GA and GG groups (26.2% and 30.0%, p=0.007). CONCLUSION: The Fas promoter polymorphism does not seem to confer susceptibility to SLE, but seems to have some influence on the development of certain autoantibody like anti-RNP antibody, suggesting that the Fas promoter polymorphism is functional.
DNA ; Freedom ; Gene Frequency ; Genotype ; Humans ; Lupus Erythematosus, Systemic* ; Polymerase Chain Reaction

OBJECTIVE: To investigate whether the polymorphism of Fas promoter gene is associated with susceptibility to systemic lupus erythematosus (SLE) and its clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using MvaI was used to determine genotypes of the Fas promoter in 87 SLE patients and 87 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype distribution of the Fas promoter did not differ between SLE patients and control subjects (AA, GA, GG genotypes 31.0%, 54.0%, 14.9% in SLE patients vs. 29.9%, 55.2%, 14.9% in controls respectively, chi2=0.03, 2 degrees of freedom, p=0.99). No significant differences were also found in allele frequencies between the groups. Clinically in the lupus patients according to the Fas promoter polymorphism, there were no significant differences in age at onset, anti-ds DNA titer, C3, C4 level, renal involvement, number of ACR (American College of Rheumatology) criteria presented, SLE Disease Activity Index, SLICC/ACR (The Systemic Lupus international Collaborating Clinics/American College of Rheumatology) damage index, and autoantibody profiles except for anti-RNP antibody. The frequency of anti-RNP antibody in the lupus patients was increased in AA group (71.4%) compared to GA and GG groups (26.2% and 30.0%, p=0.007). CONCLUSION: The Fas promoter polymorphism does not seem to confer susceptibility to SLE, but seems to have some influence on the development of certain autoantibody like anti-RNP antibody, suggesting that the Fas promoter polymorphism is functional.
DNA ; Freedom ; Gene Frequency ; Genotype ; Humans ; Lupus Erythematosus, Systemic* ; Polymerase Chain Reaction

Behcet's disease is characterized by recurrent orogenital ulcers and ocular and cutaneous inflammatory lesions. It is a multisystem disorder affecting the skin, mucous membrane, eyes, joints, CNS and blood vessels. The vascular involvements consist of thrombophlebitis, arterial occlusion and arterial aneurysm. Rupture of large artery aneurysm is the leading cause of death in patients with Behcet's disease and surgical treatment is necessary. But, surgical treatment is often difficult and may lead to formation of further false aneurysms at the site of vascular anastomosis. Endovascular stent-graft placement emerged as an alternative treatment that is less invasive with a lower risk. We report a case of the aneurysm of right common iliac artery associated with Behcet's disease. Percutaneous stent-graft placement was attempted and successfully controlled aneurysmal manifestations.
Aneurysm* ; Aneurysm, False ; Arteries ; Behcet Syndrome* ; Blood Vessels ; Cause of Death ; Humans ; Iliac Artery* ; Joints ; Mucous Membrane ; Rupture ; Skin ; Thrombophlebitis ; Ulcer

Purpose: The purpose of this study was to determine the usefulness of two-dimensional shear wave elastography (2D SWE) in the assessment of liver stiffness (LS) and dispersion slope (DS) to evaluate hepatic fibrosis and the treatment response in patients with autoimmune hepatitis (AIH). Methods: Patients diagnosed with AIH who underwent 2D SWE between June 2014 and June 2021 were enrolled in this retrospective study. The patients were classified into four groups according to the histologic stage of fibrosis (F1-F4). The baseline characteristics, laboratory test results, histologic results, and 2D SWE results were analyzed. The diagnostic performance of LS measurements in hepatic fibrosis staging was investigated, and variables were compared before and after steroid treatment for AIH. Results: In total, 69 patients were analyzed. The LS values differed according to the stage of liver fibrosis (P<0.001). The area under the curve for LS was 0.903, 0.815, and 0.854 for ≥F2, ≥F3, and F4, respectively. The diagnostic performance of LS measurements was significantly greater than that of serum biomarkers, except for fibrosis index-4 for F4 (P<0.05). Significant differences were observed in follow-up examinations in both the LS value and DS in patients who received steroid therapy (P=0.012 and P=0.011, respectively). Conclusion In conclusion, 2D SWE is a useful method for the assessment of hepatic fibrosis in patients with AIH. In follow-up examinations, LS and DS can be used as reliable parameters to evaluate the treatment response of AIH.

BACKGROUND: HIV-specific immunity, such as strong CD4+ helper and CD8+ cytotoxic T lymphocytes (CTL) responses, develops soon after HIV infection, but usually it can not control HIV replication which ultimately results in severe immune deficiency. HIV-specific CTLs, which are induced by HIV-specific CD4+ helper responses, are the key to cellular immune control of HIV. Measurement of HIV-1-specific CTLs using recombinant Gag protein may be very useful, because it is not restricted by HLA haplotype of the infected individual. MATERIALS AND METHODS: Enzyme-linked immunospot (ELISPOT) assays by using recombinant Gag protein were performed to evaluate HIV-1-specific gamma-interferon cellular responses of 25 HIV-1 infected Korean patients, who had been treated at least for the prior 12 months with highly active antiretroviral therapy at Catholic University Kangnam St. Mary's Hospital. RESULTS: The study group consisted of 25 chronically HIV-infected individuals with a median age of 51 years. The median CD4 counts were 556/mm3 (range:369-994/mm3) and HIV RNA titers were < 25 copies/mL (range: <25-180copies/mL). HIV-1-specific ELISPOT assay results range from 0 to 49 SFCs/2 x 10(5) PBMCs (median, 23.5 SFCs/2 x 10(5) PBMCs). CMV pp65-specific ELISPOT assay results range from 5 to 591 SFCs/2 x 10(5) PBMCs (median, 34 SFCs/2 x 10(5) PBMCs). There was no correlation between CD4 counts and HIV-1-specific SFCs measured by ELISPOT using recombinant protein. CONCLUSION: ELISPOT assays by using recombinant Gag protein may be considerable value in the assessment of cell-mediated immunity of HIV-1 infected patients.
Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Enzyme-Linked Immunospot Assay ; Gene Products, gag* ; Haplotypes ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immunity, Cellular ; Interferon-gamma ; RNA ; T-Lymphocytes, Cytotoxic

BACKGROUND: HIV-specific immunity, such as strong CD4+ helper and CD8+ cytotoxic T lymphocytes (CTL) responses, develops soon after HIV infection, but usually it can not control HIV replication which ultimately results in severe immune deficiency. HIV-specific CTLs, which are induced by HIV-specific CD4+ helper responses, are the key to cellular immune control of HIV. Measurement of HIV-1-specific CTLs using recombinant Gag protein may be very useful, because it is not restricted by HLA haplotype of the infected individual. MATERIALS AND METHODS: Enzyme-linked immunospot (ELISPOT) assays by using recombinant Gag protein were performed to evaluate HIV-1-specific gamma-interferon cellular responses of 25 HIV-1 infected Korean patients, who had been treated at least for the prior 12 months with highly active antiretroviral therapy at Catholic University Kangnam St. Mary's Hospital. RESULTS: The study group consisted of 25 chronically HIV-infected individuals with a median age of 51 years. The median CD4 counts were 556/mm3 (range:369-994/mm3) and HIV RNA titers were < 25 copies/mL (range: <25-180copies/mL). HIV-1-specific ELISPOT assay results range from 0 to 49 SFCs/2 x 10(5) PBMCs (median, 23.5 SFCs/2 x 10(5) PBMCs). CMV pp65-specific ELISPOT assay results range from 5 to 591 SFCs/2 x 10(5) PBMCs (median, 34 SFCs/2 x 10(5) PBMCs). There was no correlation between CD4 counts and HIV-1-specific SFCs measured by ELISPOT using recombinant protein. CONCLUSION: ELISPOT assays by using recombinant Gag protein may be considerable value in the assessment of cell-mediated immunity of HIV-1 infected patients.
Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Enzyme-Linked Immunospot Assay ; Gene Products, gag* ; Haplotypes ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immunity, Cellular ; Interferon-gamma ; RNA ; T-Lymphocytes, Cytotoxic

OBJECTIVE: We tried to determine the relevance of thrombocytosis as a possible prognostic factor in patient with epithelial ovarian cancer. METHODS: One hundred and eighty-three (183) patients with epithelial ovarian cancer had been surgically treated in our hospital between January 1984 and December 2001. Uni- and multivariate analyses were performed of 9 clinical variables including age, FIGO stage, histologic subtype, grade, volume of residual tumor, presence of ascites, pretreatment levels of hemoglobin, platelet, and tumor marker (CA 125). The Kaplan-Meier method and log-rank test were used for univariate analysis and a multiple regression analysis based on the Cox proportional hazards model was done to find the independent prognostic variables. RESULTS: Prevalence of thrombocytosis was 20.8% and significantly correlated with FIGO stage (p=0.015), tumor grade (p=0.029), presence of ascites (p=0.001) and volume of residual tumor (p=0.032). Significant difference in survival between patients with or without thrombocytosis was found (p=0.006). Multivariate analysis model was used and only volume of residual tumor (p=0.004) was significant independent prognostic variable. Thrombocytosis (p=0.041) was significant independent prognostic variable in patients with early FIGO stage of disease. CONCLUSION: Thrombocytosis is a useful prognostic factor in epithelial ovarian cancer and significantly independent prognostic factor in patients with early FIGO stage of disease.
Ascites ; Blood Platelets ; Humans ; Multivariate Analysis ; Neoplasm, Residual ; Ovarian Neoplasms* ; Prevalence ; Proportional Hazards Models ; Thrombocytosis*

We describe a patient with rheumatoid arthritis(RA) who developed bronchiolitis obliterans organizing pneumonia(BOOP) during the treatment of bucillamine. A 51 year-old man was admitted to the hospital for an abnormal shadow on his chest radiogragh. He had been diagnosed as having RA 3 years previously and had been receiving 200 mg of bucillamine for 21 months. Two months prior to admission, he presented with a cough and his chest X-ray showed opacities in both lower lungs. He was treated with antibiotics for 2 months after the development of cough and lesions on the chest X-ray, but the symptoms and lung lesions became more aggravated. On admission, an HRCT revealed airspace consolidations in the subpleural space of both basal lungs and a CT-guided fine needle aspiration biopsy showed Masson's body filling air space, interstitial infiltration of acute and chronic inflammatory cells and type II cell hyperplasia, consistent with BOOP. Bucillamine was stopped and 50 mg of prednisolone was administered. His symptoms and infiltrations on the chest X-ray resolved. We suggest that bucillamine should be considered as a drug possibly associated with BOOP.
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects* ; Arthritis, Rheumatoid/drug therapy* ; Biopsy, Needle ; Bronchiolitis Obliterans Organizing Pneumonia/diagnosis* ; Bronchiolitis Obliterans Organizing Pneumonia/chemically induced* ; Case Report ; Cysteine/therapeutic use ; Cysteine/analogs & derivatives ; Cysteine/adverse effects* ; Follow-Up Studies ; Human ; Male ; Middle Age ; Radiography, Thoracic ; Risk Assessment ; Tomography, X-Ray Computed