Ankylosing spondylitis is an inflammatory disorder of unknown etiology that primarily affect, the spine, the axial skeleton, and the large proximal joints of the body with striking tendancy toward fibrosis with secondary ossification and ankylosis of involved joints. This study was carried out to analyse clinical manifestation, evaluate disease activity indicator and set up diagnostic work-up. 38 cases of ankylosing spondylitis were studied at Department of Orthopedic Surgery, Seoul National University from Oct. 1987 to Mar. 1989. Following results were obtained. l. Average age was 28.5 years and all patients were male. 2. Low back pain was the most frequent symptom(63%) and back stiffness was next(13%). 3. S-I joint change on x-ray was the most frequently found abnormalities(100%) and HLA B27 (+) was next(97%). 4. SI/S ratio was inversely correlated with duration of symptom and seems to be significant durng the early phase of disease. 5. As a disease activity indicator, CRP was more reliable than ESR during follow up.
Ankylosis ; Clinical Study ; Fibrosis ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain ; Male ; Orthopedics ; Seoul ; Skeleton ; Spine ; Spondylitis, Ankylosing ; Strikes, Employee

BACKGROUND: Echocardiographically detected left ventricular(LV) hypertrophy is a risk factor for cardiovascular morbidity and mortality. A better understanding of the determinants of LV mass may aid in strategies directed toward the promary and secondary prevention of LV hypertrophy and its consequences. Previous studies have reported that male gender, arterial blood pressure(BP), obesity, age, aortic valvular stenosis, dietary sodium, endocrine factors, and physical activity are positively correlated with LV mass. Of these determinants male gender, hypertension, and obesity are well known but age and blood pressure in healthy adults are controversial. To assess the determinants of LV mass, the relation of 2-dimensional(2D) echocardiographically determined LV mass to body mass inedx(BMI), age, sex, casual BP, and 24 hour ambulatory blood pressure(ABP : systolic, diastolic, and mean BP of 24 hour, day-time, and night-time) was examined in healthy adults. METHODS: The study population consisted of 200 healthy adults who were normotensive, nonobese, and had no evidence of cardiovascular disease(range in age from 20 to 69 years, five decades, 20 men and 20 women per each decade). LV mass was derived from area length method measurements obtained by 2D echocardiography and corrected for height. ABP monitoring was performend over 24 hour(divided into day-time(6am-10pm) and night-time(10pm-6am)periods) with 30 minute inervals. RESULTS: 1) BMI was significantly and independently related to LV mass corrected for height (p<0.001, partial R2=0.31 in men and 0.43 in women). An increase of BMI by 1 kg/m2increased LV mass corrected for height by 1.9g/m in men and 2.0g/m in women. 2) Age was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.15 in men and 0.17 in women). The increments of Lv mass corrected for height per decade were 2.1 g/m in men and 3.4 g/m in women. 3) Gender was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.12), which was greater in men than in women by 6.34g/m. 4) Casual Bp and 24 hour ABP were not significantly associated with LV mass corrected for height in total population and women, and 24 hour systolic BP was significantly related to LV mass corrected for height only in men(p<0.001) with weak partial R2(0.05). CONCLUSION: BMI, age, and male gender were statistically significant and independent correlates of LV mass corrected for height(p<0.001). Maintenance of ideal body weight and normal BP, weight reduction in obese persons and BP control inhypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequalae.
Adult* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Constriction, Pathologic ; Echocardiography* ; Female ; Humans ; Hypertension ; Hypertrophy ; Ideal Body Weight ; Male ; Mortality ; Motor Activity ; Obesity ; Risk Factors ; Secondary Prevention ; Sodium, Dietary ; Weight Loss

PURPOSE: The Epstein-Barr Virus (EBV) is associated with a variety of human lymphocytic and epithelial malignancies. EBV is thought to display exclusive tropism for B lymphocytes, follicular dendritic cells, and pharyngeal epithelia via specific receptors (C3d receptors, CR2, CD21). Recent evidence, however, challenged this belief. We designed this experiment to determine the incidence of EBV receptor in various malignant tumor cell lines and normal lymphocyte subsets. MATERIALS AND METHODS: We have examined the incidence of EBV receptor, CD21 on the 10 healthy adult peripheral blood (PB), 10 umbilical cord blood (CB), 4 immortalized lymphoblastoid B cells by EBV infection (CSUP-1, CSUP-2, CSUP-3, CSUP-4), 3 EBV-positive B cell lymphoma cell lines (Jiyoye, IM-9, PTLC-1), 1 EBV-negative B cell lymphoma cell line (JeKo-1), 3 T cell lymphoma and leukemia cell lines (CCRF-CEM, H9, CEM-CM3), one histiocytic lymphoma cell line (U-937) and 5 gastric cancer cell lines (KATO III, AGS, SNU-1, SNU-5, and SNU-16). EBV receptor, C3d receptor was identified by flow cytometry (FACSCalibur) using FITC-conjugated or PE-conjugated CD21 monoclonal antibody. Also we investigated the expression of CD3, CD5, CD7, CD19, CD20, IgM, IgG, Ig and Ig by using FITC-conjugated or PE-conjugated monoclonal antibody, on above cell lines. RESULTS: The expressions of CD21 molecule were 10.99 3.84% and 9.22 5.39% in adult PB lymphocytes and CB lymphocytes, respectively. The anti-human CD21 antibody was positive for CD19-positive or CD20-positive B lymphocytes. The CD3-positive or CD7-positive T lymphocytes were negative for anti-human CD21 antibody in PB and CB. But, CD21 antibody was weakly positive for CD5-positive lymphocytes. EBV-positive cell lines expressed variable ranges from 0.9% to 5.2% for CD21 antigen, while EBV-negative lymphoma cell line, JeKo-1 expressed 5.5%. All T lymphoma and leukemia cell lines and gastric cancer cell lines did not express CD21 antigen. But U-937 expressed 14.4% for CD21 antigen. CONCLUSION: These results suggested that the CD21 antigen was expressed in CD20 or CD19-positive mature B cells, CD5-dim positive lymphocytes, some EBV-positive and negative B cell lymphoma cell lines, and a histiocytic lymphoma cell line. Further evaluation on the nature of CD5-dim positive cells, which was expressing CD21 molecule, is revealed, especially in reference to EBV association in some peculiar subtypes of peripheral T cell lymphoma.
Adult ; B-Lymphocytes ; Cell Line ; Cell Line, Tumor ; Dendritic Cells, Follicular ; Epstein-Barr Virus Infections ; Fetal Blood ; Flow Cytometry ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Leukemia ; Lymphocyte Subsets ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Receptors, Complement 3d ; Stomach Neoplasms ; T-Lymphocytes ; Tropism*

No abstract available.
Breast* ; Lymphoma*

BACKGROUND: In case of tuberculous pneumonia, differentiation from bacterial lobar pneumonia is sometimes very difficult because clinical symptoms, signs and radiological images are very similar. So we investigated the usefulness of CA125, which is known to increase in tuberculous diseases, in differential diagnosis between tuberculous pneumonia (TBPN) and community acquired bacterial lobar pneumonia (LP). METHODS: Serum CA125 level was measured in 20 patients with TBPN (female 12 male 8: mean age 36.1 years) and 14 patients with LP (female 5 male 9: mean age 45.1 years) by radioimmunoassay (Centocor(R) CA125 RIA kit). RESULTS: 1) The serum CA125 level in TBPN (333.7 283.5 u/ml) was higher than in LP (60.9 66.2 u/ml). (P < 0.05) 2) If we took cut-off value as 195 u/ml in differential diagnosis between TBPN and LP, the sensitivity and specificity of CA125 level in the diagnosis of TBPN were 70% and 93%, respectively. 3) There was no significant difference in serum CA125 level between noncavitary TBPN (242.1 +/- 16.6 u/ml,n=10) and cavitary TBPN (399.6 +/- 318.4 u/ml,n=10). (P > 0.05) 4) Following up of serum CA125 level after initiation of antituberculosis treatment showed rapid decline and approach to near normal range in 6 months. CONCLUSION: High serum CA125 level (> 195 u/ml) was useful in differential diagnosis of TBPN from LP.
Diagnosis ; Diagnosis, Differential ; Humans ; Male ; Pneumonia* ; Radioimmunoassay ; Reference Values ; Sensitivity and Specificity

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.
Atrophy ; Magnetic Resonance Spectroscopy ; Muscles ; Piriformis Muscle Syndrome ; Sciatic Nerve ; Sciatic Neuropathy ; Uterine Cervical Neoplasms

Serum aspartate aminotransferase (AST) is a common enzyme for the evaluation of the hepatic, muscular and cardiac diseases and is produced also at kidney, brain, pancreas, lung, leukocytes, erythrocytes, etc. The elevation of its activity is usually caused by the necrosis of hepatocytes when there are not muscular injuries or myopathies. Recently, it is found that AST can exist as a macroenzyme by forming a complex with an immunoglobulin and this complex is erroneously considered to indicate the presence of liver disease as a result of elevation of AST activity on routine blood chemistry analysis. We experienced the patient with isolated AST elevation due to the formation of AST-mmunoglobulin complex confirmed by AST isoenzyme electrophoresis (EP).
Aspartate Aminotransferases ; Brain ; Chemistry ; Electrophoresis ; Erythrocytes ; Heart Diseases ; Hepatocytes ; Humans ; Immunoglobulins ; Kidney ; Leukocytes ; Liver Diseases ; Lung ; Muscular Diseases ; Necrosis ; Pancreas

A human malignant lymphoid cell line(JeKo-1) was established from a Korean patient with retroperitoneal tumor presenting peripheral blood and bone marrow involvement by malignant lymphoid cells. This cell line was established from peripheral blood, and the cell line had the identical immunophenotypic features as malignant cells from the peripheral blood. The established cell line had features of a mature B-cell phenotype with no evidence for commitment to other lineages. The JeKo-1 grows in suspension with a doubling time of 33 hours. By light and electron microscopic examination, the established cells had a follicular center showing, a small, cleaved, lymphoid appearance, and had a large amount of cytoplasm containing few vacuoles and an irregular cytoplasmic membrane. Immunophenotypic analyses with monoclonal antibodies using flow cytometry showed a monoclonal IgM kappa and CD5- B-cell phenotype. The cells were non-reactive for T-cells and myeloid/monocyte antigens, and no evidence of Epstein-Barr virus nuclear antigen by polymerase chain reaction. DNA analysis showed a hypodiploid stemline with a DNA index of 0.83. The established cells were strongly reactive for bcl-2 and c-myc onco-protein, but lacked expression of multidrug resistance gene protein, p-glycoprotein by Western blot analysis. Karyotypic analysis of JeKo-1 showed 40-41 chromosomes. This cell line should be a valuable tool to study the dissemination of malignant lymphoma into the peripheral blood and bone marrow.
Humans

The metastasis of uterine leiomyosarcoma to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiomyosarcoma, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiomyosarcoma.
Carboplatin ; Deglutition ; Drug Therapy* ; Leiomyosarcoma* ; Lymphatic Diseases* ; Neck ; Neoplasm Metastasis ; Paclitaxel ; Radiotherapy* ; Spinal Canal ; Spinal Cord Compression ; Spine

PURPOSE: We evaluated brain perfusion SPECT findings of MELAS syndrome and mitochondrial myopathy in correlation with MR imaging in search of specific imaging features. MATERIALS AND METHODS: Subjects were five patients (four females and one male; age range, 1 to 25 year) who presented with repeated stroke-like episodes, seizures or developmental delay or asymptomatic but had elevated lactic acid in CSF and serum. Conventional non-contrast MR imaging and Tc-99m-ethyl cysteinate dimer (ECD) brain perfusion SPECT were performed and imaging features were analyzed. RESULTS: MRI demonstrated increased T2 signal intensities in the affected areas of gray and white matters mainly in the parietal (4/5) and occipital lobes (4/5) and in the basal ganglia (1/5), which were not restricted to a specific vascular territory. SPECT demonstrated decreased perfusion in the corresponding regions of MRI lesions. In addition, there were perfusion defects in parietal (1 patient), temporal (2), and frontal (1) lobes and basal ganglia (1) and thalami (2). In a patient with mitochondrial myopathy who had normal MRI, decreased perfusion was noted in left parietal area and bilateral thalami. CONCLUSION: Tc-99m ECD SPECT imaging in patients with MELAS syndrome and mitochondrial myopathy showed hypoperfusion of parieto-occipital cortex, basal ganglia, thalamus and temporal cortex, which were not restricted to a specific vascular territory. There were no specific imaging features on SPECT. The significance of abnormal perfusion on SPECT without corresponding MR abnormalities needs to be evaluated further in larger number of patients.
Basal Ganglia ; Brain* ; Female ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondrial Encephalomyopathies ; Mitochondrial Myopathies* ; Occipital Lobe ; Perfusion ; Rabeprazole ; Seizures ; Thalamus ; Tomography, Emission-Computed, Single-Photon*