PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Vaccination is the most successful immunological practice that improves the quality of human life and health. Vaccine materials include antigens of pathogens and adjuvants potentiating the effectiveness of vaccination. Vaccines are categorized using various criteria, including the vaccination material used and the method of administration. Traditionally, vaccines have been injected via needles. However, given that most pathogens first infect mucosal surfaces, there is increasing interest in the establishment of protective mucosal immunity, achieved by vaccination via mucosal routes. This review summarizes recent developments in mucosal vaccines and their associated adjuvants.
Humans ; Immunity, Mucosal ; Methods ; Needles ; Vaccination ; Vaccines*

Vaccination is one of the most successful applications of immunology and for a long time has depended on parenteral administration protocols. However, recent studies have pointed to the promise of mucosal vaccination because of its ease, economy and efficiency in inducing an immune response not only systemically, but also in the mucosal compartment where many pathogenic infections are initiated. However, successful mucosal vaccination requires the help of an adjuvant for the efficient delivery of vaccine material into the mucosa and the breaking of the tolerogenic environment, especially in oral mucosal immunization. Given that M cells are the main gateway to take up luminal antigens and initiate antigen-specific immune responses, understanding the role and characteristics of M cells is crucial for the development of successful mucosal vaccines. Especially, particular interest has been focused on the regulation of the tolerogenic mucosal microenvironment and the introduction of the luminal antigen into the lymphoid organ by exploiting the molecules of M cells. Here, we review the characteristics of M cells and the immune regulatory factors in mucosa that can be exploited for mucosal vaccine delivery and mucosal immune regulation.
Administration, Oral ; Animals ; Antigens, Bacterial/*immunology ; Antigens, Viral/*immunology ; Bacterial Vaccines/administration & dosage/*immunology ; Humans ; Immunity, Mucosal ; Intestinal Mucosa/cytology/*immunology ; Peyer's Patches/cytology/*immunology ; Viral Vaccines/administration & dosage/*immunology

The human body is continuously threatened by pathogens, and the immune system must maintain a balance between fighting infection and becoming over-activated. Mucosal surfaces cover several anatomically diverse organs throughout the body, such as the respiratory and gastrointestinal tracts, and are directly exposed to the external environment.Various pathogens invade the body through mucosal surfaces, making the mucosa the frontline of immune defense. The immune systems of various mucosal tissues display distinctive features that reflect the tissues' anatomical and functional characteristics. This review discusses the cellular components that constitute the respiratory and gastrointestinal tracts; in particular, it highlights the complex interactions between epithelial and immune cells to induce Ag-specific immune responses in the lung and gut. This information on mucosal immunity may facilitate understanding of the defense mechanisms against infectious agents that invade mucosal surfaces, such as severe acute respiratory syndrome coronavirus 2, and provide insight into effective vaccine development.

BACKGROUND: Urinary bladder cancer has been diagnosed by urine cytology and cystoscopy with biopsy. Recently, in vitro noninvasive diagnostic tests, measuring urinary nuclear matrix protein22(NMP22) and bladder tumor antigen(BTA), were introduced. We analyzed the usefulness of the NMP22 and BTA tests for diagnosing bladder cancer and compared those with voided urine cytology. MATERIALS AND METHODS: Single voided urine specimens were obtained from 27 patients with bladder cancer and 23 healthy volunteers. The urine specimens were assayed by enzyme immunoassay(NMP22, Matrietech(R), Newton, MA.) and latex immunoassay(BTA, Bard, USA). Urine cytology was performed in patients with bladder cancer. RESULTS: Mean urinary NMP22 level of patients with bladder cancer(144.6 U/mL) was significantly higher than those of normal controls(2.9 U/mL, P<0.01). The sensitivities were 89% and 74% for NMP22 and BTA tests, respectively, compared with 41% for voided urine cytology. The sensitivities of NMP22 and BTA tests were 88%, 63% at grade 1(G1), 82%, 73% at G2, and 100%, 88% at G3, respectively(P<0.01; NMP22, P=0.580; BTA). According to tumor stage, the sensitivities of NMP22 and BTA tests were both 79% at superficial, and 100% and 69% at invasive cancer, respectively(P=0.110; NMP22, P=0.678; BTA). The sensitivities of urine NMP22 and BTA tests combined with urine cytology were both 96%. In following of transitional cell carcinoma patients, agreement between urine cytology and BTA test was 75%(24/32). Among the various urologic disease, false positive rate for BTA test was 17%(8/47). CONCLUSION: Urinary NMP22 and BTA tests were more sensitive than voided urine cytology regardless of tumor grade and stage, so these noninvasive and simple tests can be used as screening tests for urinary bladder transitional cell carcinoma.
Biopsy ; Carcinoma, Transitional Cell* ; Cystoscopy ; Diagnostic Tests, Routine ; Healthy Volunteers ; Humans ; Latex ; Mass Screening* ; Nuclear Matrix ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urologic Diseases

Interactions between microbes and epithelial cells in the gastrointestinal tract are closely associated with regulation of intestinal mucosal immune responses. Recent studies have highlighted the modulation of mucosal immunity by microbe-derived molecules such as ATP and short-chain fatty acids. In this study, we undertook to characterize the expression of the ATP-gated P2X7 receptor (P2X7R) on M cells and its role in gastrointestinal mucosal immune regulation because it was poorly characterized in Peyer's patches, although purinergic signaling via P2X7R and luminal ATP have been considered to play an important role in the gastrointestinal tract. Here, we present the first report on the expression of P2X7R on M cells and characterize the role of P2X7R in immune enhancement by ATP or LL-37.
Adenosine Triphosphate ; Epithelial Cells ; Fatty Acids, Volatile ; Gastrointestinal Tract ; Immunity, Mucosal ; Peyer's Patches ; Phenobarbital ; Receptors, Purinergic P2X7*

Vaccination is one of the most effective methods available to prevent infectious diseases. Mucosa, which are exposed to heavy loads of commensal and pathogenic microorganisms, are one of the first areas where infections are established, and therefore have frontline status in immunity, making mucosa ideal sites for vaccine application. Moreover, vaccination through the mucosal immune system could induce effective systemic immune responses together with mucosal immunity in contrast to parenteral vaccination, which is a poor inducer of effective immunity at mucosal surfaces. Among mucosal vaccines, oral mucosal vaccines have the advantages of ease and low cost of vaccine administration. The oral mucosal immune system, however, is generally recognized as poorly immunogenic due to the frequent induction of tolerance against orally-introduced antigens. Consequently, a prerequisite for successful mucosal vaccination is that the orally introduced antigen should be transported across the mucosal surface into the mucosa-associated lymphoid tissue (MALT). In particular, M cells are responsible for antigen uptake into MALT, and the rapid and effective transcytotic activity of M cells makes them an attractive target for mucosal vaccine delivery, although simple transport of the antigen into M cells does not guarantee the induction of specific immune responses. Consequently, development of mucosal vaccine adjuvants based on an understanding of the biology of M cells has attracted much research interest. Here, we review the characteristics of the oral mucosal immune system and delineate strategies to design effective oral mucosal vaccines with an emphasis on mucosal vaccine adjuvants.
Biology ; Communicable Diseases ; Immune System ; Immunity, Mucosal ; Lymphoid Tissue ; Mucous Membrane ; Receptor, Anaphylatoxin C5a ; Vaccination ; Vaccines

PURPOSE: The characteristics of allergic rhinitis can be different among countries and areas because causative allergens and aggravating factors depend on the living environment. However, there have been few studies on the clinical feature of Korean children with allergic rhinitis, as well as on clinical characteristics in different age groups. The aim of this study was to investigate the clinical characteristics of Korean children with allergic rhinitis. METHODS: The medical records of children under 12 years of age who had rhinitis symptoms were analyzed in terms of clinical symptoms and positive allergens. Subjects were classified into 2 groups: those with allergic rhinitis (AR group) and nonallergic rhinitis (NAR group). Both groups were subdivided into 3 categories: the 1-4 years, 5-8 years, and 9-12 age groups. RESULTS: Among 516 children, 397 (76.94%) belonged to the AR group and 119 (23.06%) belonged to the NAR group. The male to female ratios were 2:1 in both groups. There were significant differences in sneezing and itching between the AR and NAR groups across different age subgroups. There were significant differences in nasal obstruction between the AR and NAR groups in the 9-12 age group. The incidence of AR was 77.8 % in chronic sinusitis patients. Sensitized allergens were house dust mites, animal hair, pollen, and mold in decreasing order in the AR group. Children who were sensitized to animal hair more frequently had sneezing than those who were not. CONCLUSION: Sneezing and itching strongly suggest allergic rhinitis in Korean children. Clinical characteristics of allergic rhinitis in Korean children would helpful in early diagnosis and adequate treatment of disease.
Allergens ; Animals ; Child* ; Early Diagnosis ; Female ; Fungi ; Hair ; Humans ; Incidence ; Male ; Medical Records ; Nasal Obstruction ; Pollen ; Pruritus ; Pyroglyphidae ; Rhinitis* ; Sinusitis ; Sneezing

BACKGROUND: The spinal administration of neostigmine has been shown to produce analgesia, but this analgesia is limited by adverse effects. This study was designed to determine whether intra-articular neostigmine results in an analgesic effect in a rat inflamed knee joint model, and to investigate the possible involvement of nitric oxide in neostigmine-induced analgesia. METHODS: Male Sprague Dawley rats were divided into three groups; control group, neostigmine group (1, 3, 10micro gram), and L-NAME group (neostigmine 1, 3, 10micro gram + L-NAME 500micro gram). Inflammation was induced by injecting 2% carageenan into the right knee joint. Intraarticular drugs were injected at an hour after the injection of carageenan. Effects of these drugs were assessed before and at 4, 8, 12, 24, 60, and 120 hours after inflammation using a Dynamic plantar aesthesiometer. RESULTS: There were significant differences between the neostigmine 3, and 10micro gram group and the control group. There were no significant differences between the neostigmine group and the L-NAME group except for in the neostigmine 10micro gram L-NAME group at 24 hours. There were no significant differences between the neostigmine 3micro gram L-NAME group and the control group. This result shows that injection of L-NAME partially reverses the anlgesic effects of the neostigmine. CONCLUSIONS: Intra-articular neostigmine results in an analgesic effect at the site of inflammation. Although this study could not prove the involvement of nitric oxide in the peripheral analgesic effect of neostigmine, it demonstrates the possible involvement of nitric oxide in neostigmine-induced analgesia.
Analgesia ; Animals ; Arthritis* ; Humans ; Inflammation ; Knee Joint ; Male ; Neostigmine* ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide ; Rats* ; Rats, Sprague-Dawley

In the Visible Korean project, 642 three-dimensional (3D) surface models have been built from the sectioned images of a male cadaver. It was recently discovered that popular PDF file enables users to approach the numerous surface models conveniently on Adobe Reader. Purpose of this study was to present a PDF file including systematized surface models of human body as the beneficial contents. To achieve the purpose, fitting software packages were employed in accordance with the procedures. Two-dimensional (2D) surface models including the original sectioned images were embedded into the 3D surface models. The surface models were categorized into systems and then groups. The adjusted surface models were inserted to a PDF file, where relevant multimedia data were added. The finalized PDF file containing comprehensive data of a whole body could be explored in varying manners. The PDF file, downloadable freely from the homepage (http://anatomy.co.kr), is expected to be used as a satisfactory self-learning tool of anatomy. Raw data of the surface models can be extracted from the PDF file and employed for various simulations for clinical practice. The technique to organize the surface models will be applied to manufacture of other PDF files containing various multimedia contents.
Cadaver ; Human Body ; Humans ; Image Processing, Computer-Assisted ; Male ; *Models, Biological ; *Software ; User-Computer Interface