Annexin-1 (ANX1) is a 37 kDa protein that is induced and secreted by glucocorticosteroid hormone. The secreted ANX1 has been believed to exert its function by binding to its putative rnembrane receptor. In this report we demonstrate that ANXl receptor (ANX1R) signal blocks the interleukin-1B (IL-1B) receptor signal pathway in human peripheral blood mononuclear cells (PBMCs). When PBMCs were treated with both IL-1B (100 ng/ml) and PMA (10 ng/ml) in the absence or presence of dexamethasone for 5 days, dexamethasone (100 nM) suppressed lymphocyte proliferation to 24% of the control. However addition of anti-ANX1 polyclonal antibody of 1:200 and 1:1,000 dilution to this system induced recovery of proliferation to 80% and 40%, respectively, when compared to the control. In the mixed lymphocyte reaction, dexamethasone suppressed lymphocyte proliferation to 9% of that of control when stimulated with IL-1B (100 ng/ml) and phorbol myristate acetate (10 ng/ml). Addition of anti-ANX1 polyclonal antibody (1:1,000) to this system also recovered the proliferation to 20% of that of the control system. In the ANX1 receptor induction experiment using flow cytometry, ANX1 receptor expression on lymphocytes, CD4+ T cells, CD8+ T cells and monocytes increased depending on the externally added IL-1B ranging from 10 to 1,000 ng/ml. From these results, it is evident that dexamethasone induces ANX1 secretion into the culture medium and anti-ANX1 polyclonal antibody abolishes the effects of dexamethasone. Furthermore these results imply that extracellular ANX1 exerts its effects by binding to the receptor on the cell membrane and the activated signal(s) of ANX1R block IL-1B receptor signal in the lymphocytes.
Cell Membrane ; Dexamethasone ; Flow Cytometry ; Humans ; Interleukin-1* ; Lymphocyte Culture Test, Mixed ; Lymphocytes* ; Monocytes ; Signal Transduction ; T-Lymphocytes ; Tetradecanoylphorbol Acetate*

OBJECTIVES: Pneumonia is one of the leading causes of death in the intensive care unit (ICU). Many biomarkers for predicted prognosis have been suggested; among these, procalcitonin (PCT) is known to increase in cases of bacterial infection. However, there have been many debates regarding whether PCT is an appropriate prognostic marker for pneumonia. Therefore, we investigated whether PCT can serve as a biomarker for pneumonia, and compared it with CURB-65, which is a known tool for predicting the prognosis of pneumonia. METHODS: Levels of PCT and CURB-65 scores were compared between 30-day non-survival (n = 30) and survival (n = 101) patients. Relationships between PCT and CURB-65 were determined by using linear regression analysis, as well as by using receiver operating characteristic (ROC) curve analysis and calculation of the area under the curve (AUC). High and low PCT groups were compared. RESULTS: High PCT and high CURB-65 score were positively associated with 30-day mortality. For the prediction of 30-day mortality, initial PCT and CURB-65 exhibited AUCs of 0.63 and 0.66; these were not significantly different (P = 0.132). We found that the high PCT group had a higher rate of initial treatment failure (91%, P = 0.004). CONCLUSIONS: Initial PCT can be a prognostic biomarker for mortality in severe pneumonia, similar to the CURB-65 score. Initial high PCT was positively associated with initial treatment failure.
Area Under Curve ; Bacterial Infections ; Biomarkers ; Cause of Death ; Critical Care ; Humans ; Intensive Care Units ; Linear Models ; Mortality ; Pneumonia ; Prognosis ; ROC Curve ; Treatment Failure

Osteoid osteoma is a relatively common benign tumor that most commonly affect the cortex of the long bone, Adolescent and young adult males are most frequently affected. It causes aching pain that worsens at night and commonly is relieved by aspirin. The typical radiographic appearance is a lucent nidus with surrounding dense cortical thickening. If the lesion is located in intra-articular cancellous bone, an osteoid osteoma may present with clinical findings that are more indicative of an inflammatory synovitis, and with atypical radiographic findings such as lack of both surrounding sclerosis and a lucent nidus. Therefore intra-articular osteoid osteoma may pose a diagnostic difficulty. Recently, we experienced 3 cases of intra-articular osteoid osteoma(2 humeral haed, 1 femoral head) and present them in detail.
Adolescent ; Aspirin ; Humans ; Male ; Osteoma, Osteoid ; Sclerosis ; Synovitis ; Young Adult

STUDY DESIGN: The authors reviewed 14 patients with neurologic deficits caused by ossification of ligamentum flavum(OLF) of thoracic and thoracolumbar spine. OBJECTIVE: To evaluate the clinical and roentgenographic characteristics and suggest the treatment method of the OLF in the thoracic and thoracolumbar spine. SUMMARY OF LITERATURE REVIEW: The reported OLF mainly developed at the thoracolumbar area. It compressed the spinal cord and resulted to the symptoms of thoracic myelopathy. The methods of treatment were posterior decompression including laminectomy or laminoplasty, and sometimes anterior and posterior decompression, with or without fusion. The OLF was not common disease yet and many surgeons have met a problem in making the decision of the extent of posterior decompression multiple or selective. METHODS: The authors reviewed 14 patients with the OLF using clinical reports and roentgenographic studies. We checked the plain roentgenograms, computed tomograms, and magnetic resonance imagings. We performed the posterior decompression using total laminectomy without fusion. We divided three groups according to the operative methods. Group I included the patients with one or two levels of OLF treated with posterior extensive laminectomy. Group II included the patients with OLF in three or more levels, or combined other cord-compressing diseases. They had been treated with multiple posterior or anterior decompression for the entire cord-compressing levels. Group III included the patients with same conditions as group II but they had been treated with selective decompression for the mainly symptomatic levels of OLF. RESULTS: We found the OLF at 54 segments of 14 patients. The involvement of OLF was 29 segments(53.7%) in thoracolumbar and 25 segments(46.3%) in thoracic area. The most commonly involved segment was T10-11(16.7%) and the second was T11-12(14.8%). Clinically the most common neurologic deficit was motor weakness and sensory deficit. The most symptomatic level of OLF was T10-11 and T12-Ll segment(28.6% at each) and the next was T11-12 segment(21.4%). We got the favorable results in group I and group III. But the final results of group II were not good. CONCLUSION: The OLF was most common at the thoracolumbar area and the symptoms and signs were revealed same as those of the thoracic myelopathy. We obtained favorable clinical results after posterior laminectomy without fusion in cases with the OLF in 1-2 segments. In the cases with multiple OLF in three or more segments, or the cases with other cord-compressing diseases, we could get more favorable results in the patients with the selective decompression than the patients with multiple decompression for the entire cord-compressing diseases.
Decompression ; Humans ; Laminectomy ; Ligamentum Flavum* ; Neurologic Manifestations ; Spinal Cord ; Spinal Cord Diseases ; Spine*

BACKGROUND: The use of a low-dose naloxone infusion concomitant with intravenous morphine PCA (patient-controlled analgesia) attenuates opioid-related side effects without reducing analgesic effects. The authors compared the incidence of morphine-related side effects and the quality of analgesia in adding low-dose naloxone, normal saline or droperidol to an IV fentanyl PCA regimen. METHODS: One hundred eight patients undergoing ocular plastic surgery were enrolled in the study. General anesthesia was induced and maintained with propofol TCI (target controlled infusion), vecuronium or pancuronium and nitrous oxide. After intubated, they received intravenous fentanyl as PCA. They were randomized to receive normal saline, droperidol or low-dose naloxone concomitant with IV fentanyl PCA. Verbal rating scores for pain, the degree of patients' satisfaction (1-4), nausea, vomiting, requests for antiemetics, urinary retention, pruritus and respiratory depression were recorded after 24 hours. RESULTS: There was no difference in the VRS (verbal rating score) for pain, degree of the satisfaction and the incidence of nausea, vomiting and requests of antiemetics among the three groups. There was no incidence of pruritus or respiratory depression. One subject developed urinary retention in the control group, and three cases in the droperidol group, but none was developed in the low-dose naloxone group. CONCLUSIONS: There was no difference in the prevention of postoperative nausea, or vomiting among the normal saline, droperidol, and naloxone groups with an IV fentanyl PCA. Low-dose naloxone, however, had a reducing effect on urinary retention; it may become an alternative choice according to the anesthesiologist's preference.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Antiemetics ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine ; Naloxone* ; Nausea ; Nitrous Oxide ; Pancuronium ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Propofol ; Pruritus ; Respiratory Insufficiency ; Surgery, Plastic ; Urinary Retention ; Vecuronium Bromide ; Vomiting

PURPOSE: To report the results of preschool vision screening in South Korea in 2003. METHODS: Nation wide, population-based vision screening tests were conducted in preschool children over the age of 3 years from March to September 2003. The first step involved home-screening using picture cards. The children who did not pass the first test were sent to public health care centers, where their visual acuity was re-tested. After the re-tests, some children were referred to ophthalmologists. The referral criteria for visual acuity were: age 3, less than 0.5 visual acuity; age 4 or older, less than 0.63 visual acuity in at least one eye. RESULTS: Among 56,836 subjects who had been enrolled, 2,637 (4.6%) children were referred to ophthalmologists. Refractive error was found in 1,746 (66.2%) children. Amblyopia was discovered in 480 (18.2%) children. Anterior segment abnormalities were detected in 269 (10.2%) children, manifest strabismus was detected in 169 (6.4%) children, and fundus abnormalities were found in 17 (0.6%) children. Myopic astigmatism (31.0%) was the most common type of refractive error. Refractive error (87.9%) was the most common cause of amblyopia and exodeviation (63.9%) was the most common type of strabismus. CONCLUSIONS: From the results of the 2003 Preschool Vision Screening, we collected data about the ophthalmic abnormalities that can affect visual development in children. This information will foster improvement in the overall quality and design of preschool vision screening systems.
Amblyopia ; Astigmatism ; Child ; Child, Preschool ; Exotropia ; Humans ; Korea* ; Public Health ; Referral and Consultation ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity

BACKGROUND: Optimal control for the management of the length of stay in the postanesthesia care unit (PACU) following general anesthesia in adults is an important strategy for surgical patients' care. A model to predict the results of the PACU stays could be used to improve the utilization of the PACU and resources of the operating room through a more efficient arrangement. The purpose of this study was to evaluate the performance of the decision tree based analysis using clinical sets of data from adult patients undergoing general anesthesia. METHODS: The decision tree was trained with 351 clinical sets (86% in 409 data sets) using a Chi-squared automatic interaction detection (CHAID) algorithm and validated through independent testing of 58 cases (14%). Twenty-two independent variables were used to find determinant variables and to predict categorical dependent values (lengths of stay in the PACU). RESULTS: The decision tree based analysis correctly predicted in 68% of real situations and identified influencing variables as intubation state, complication in the PACU, and intraoperative transfusion. CONCLUSIONS: We concluded that the decision tree based analysis could provide a useful predictive and classifying model for the optimization of limited resources of the PACU. The decision tree based analysis is an alternative way of classifying, and a predicting method for developing a model for lengths of stay in the PACU with easy interpretation and clear graphical displays of the structure of variables.
Adult ; Anesthesia, General ; Decision Trees ; Humans ; Intubation ; Length of Stay* ; Operating Rooms

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child* ; Humans ; Nephrotic Syndrome*