No abstract available.

Microglia play a role in maintaining and resolving brain tissue homeostasis. In pathological conditions, microglia release pro-inflammatory cytokines and cytotoxic factors, which aggravate the progression of neurodegenerative diseases. Autophagy pathway might be involved in the production of pro-inflammatory cytokines and cytotoxic factors in microglia, though details of the mechanism remain largely unknown. In the present study, we examined the role of the autophagy pathway in activated BV2 microglia cells. In BV2 cells, rapamycin treatment activated the formation of anti-LC3-labeled autophagosomes, whereas the ATG5 depletion using siRNA-ATG5 prevented the formation of LC3-labeled autophagosomes, indicating that BV2 cells exhibit an active classical autophagy system. When treated with LPS, BV2 cells expressed an increase of anti-LC3-labeled dots. The levels of LC3-labeled dots were not suppressed, instead tended to be enhanced, by the inhibition of the autophagy pathway with siRNA-ATG5 or wortmannin, suggesting that LPS-induced LC3-labeled dots in nature were distinct from the typical autophagosomes. The levels of LPS-induced expression of iNOS and IL6 were suppressed by treatment with rapamycin, and conversely, their expressions were enhanced by siRNA-ATG5 treatment. Moreover, the activation of the autophagy pathway using rapamycin inhibited cell death of LPS-stimulated microglia. These results suggest that although microglia possess a typical autophagy pathway, the glial cells express a non-typical autophagy pathway in response to LPS, and the activation of the autophagy pathway suppresses the expression of iNOS and IL6, and the cell death of LPS-stimulated microglia.
Autophagy* ; Brain ; Cell Death* ; Cytokines ; Homeostasis ; Interleukin-6* ; Microglia* ; Neurodegenerative Diseases ; Neuroglia ; Sirolimus

Toxic epidermal necrolysis (TEN) is the most severe form of skin reactions caused by drugs or infection. Acute pulmonary complications in TEN are often observed. The mortality is especially high in those who suffer chronic pulmonary complications of TEN such as bronchiolitis obliterance, which occur as a consequence of bronchial epithelial injury. We report a case of a 16-year-old male who had required mechanical ventilation due to acute respiratory distress syndrome caused by TEN at 8 years of age. Although the patient initially recovered from acute respiratory distress syndrome, he required mechanical ventilation again due to severe chronic pulmonary complications of bronchiolitis obliterance and bronchiectasis caused by respiratory epithelial detachment. Thereafter, chronic bronchitis and chronic sinusitis has persisted due to mucosal ciliary dysfunction and several episodes of spontaneous pneumothorax has occurred. However, despite these persisting and serious sequelae of TEN, the patient has survived for 8 years. We report a rare case of a patient with long-term chronic pulmonary complications who had previously suffered TEN 8 years ago.
Adolescent ; Bronchiectasis ; Bronchiolitis ; Bronchitis, Chronic ; Epidermal Necrolysis, Toxic* ; Humans ; Male ; Mortality ; Pneumothorax ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Sinusitis ; Skin

PURPOSE: All-trans retinoic acid (ATRA) modulates immune responses by affecting T cells. Several studies have revealed that allergic inflammation of the lower airways is negatively associated with the vitamin A concentration. However, the role of ATRA in allergic inflammation of the upper airways is unclear. We investigated the effects of ATRA in an allergic rhinitis mouse model. METHODS: BALB/c mice except control groups (CON group) were sensitized with and challenged intra-nasally with Dermatophagoides farina (AR group). The ATRA groups were administered ATRA intraperitoneally. The steroid groups were administered steroid intranasally (ST group). Allergic symptoms and the average eosinophil number were counted. Cytokines and transcription factors were measured by Real-Time PCR and Western blotting. Der f-specific immunoglobulin E (IgE) was measured. Flow cytometry results of CD4+CD25+Foxp3+ T cells were analyzed. RESULTS: The symptom scores were lower in the ATRA group than in the AR group and higher than in the CON group. The levels of IgE were lower in the ATRA group than in the AR group and higher than in the CON and ST groups. The levels of Foxp3, TGF-beta, and IL-10 mRNA, as well as the percentage of CD4+CD25+Foxp3+ T cells, were higher in the ATRA group than in theAR group. In the ATRA group the levels of IFN-gamma mRNA were higher, and the levels of GATA-3 and IL-4 mRNA, and ROR-gammat were lower. In Western blotting analyses, the expression patterns of all factors, except Foxp3, showed similar to those of mRNA expression. CONCLUSIONS: ATRA has anti-allergic effects in an allergic rhinitis model, and its underlying mechanisms mainly include the induction of regulatory T cells and the inhibition of Th2 responses.
Animals ; Blotting, Western ; Cytokines ; Eosinophils ; Flow Cytometry ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interleukin-10 ; Interleukin-4 ; Mice* ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; Pyroglyphidae ; Real-Time Polymerase Chain Reaction ; Rhinitis* ; RNA, Messenger ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Th17 Cells ; Th2 Cells ; Transcription Factors ; Transforming Growth Factor beta ; Tretinoin* ; Vitamin A

Semicircular canal dehiscence is a rare but well-described condition to be induced noise or straining. Patients with Superior semicircular canal dehiscence (SSCD) present with a wide variety of symptoms. Reported case is a 51-year-old woman who presented with intermittent vertigo and left-side aural fullness for one month after traffic accident. To establish the diagnosis, high resolution temporal bone CT scanning has been performed to demonstrate bone defect overlying superior semicircular canal, and vestibular auditory symptoms and signs are evaluated through vestibular function test and auditory examination. Cognitive behavior therapy, vestibular rehabilitation and vestibular suppressants are prescribed. Auditory symptoms and vertigo have been subsided. At the same time, Presented depression and anxiety have been improved after 3 month treatment and the quality of life of patient has been improved.
Accidents, Traffic ; Anxiety ; Cognitive Therapy ; Depression ; Female ; Humans ; Middle Aged ; Noise ; Quality of Life ; Semicircular Canals ; Sprains and Strains ; Temporal Bone ; Vertigo ; Vestibular Function Tests

OBJECTIVES: Childhood allergic diseases are a major concern because they lead to a heavy economic burden and poor quality of life. The purpose of this study was to investigate the prevalence of childhood atopic dermatitis, asthma, allergic rhinitis, and the comorbidity of allergic diseases in Seoul, Korea. METHODS: We conducted a cross-sectional survey between May and October 2010 to evaluate the prevalence of childhood allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, using a questionnaire from the International Study of Asthma and Allergies in Childhood group. Each questionnaire was completed by the parent or guardian of a child. RESULTS: In the 31,201 children studied, the prevalence of atopic dermatitis symptoms in the past 12 months was 19.3% in children 0 to 3 years of age, 19.7% in children 4 to 6 years of age, 16.7% in children 7 to 9 years of age, and 14.5% in children 10 to 13 years of age (p for trend < 0.001). The prevalence of asthma in these age groups was 16.5%, 9.8%, 6.5%, and 5.4%, respectively (p for trend < 0.001). The prevalence of allergic rhinitis in these age groups was 28.5%, 38.0%, 38.5%, and 35.9%, respectively (p for trend = 0.043). The percentage of subjects with both atopic dermatitis and asthma, both asthma and allergic rhinitis, or both atopic dermatitis and allergic rhinitis was 2.5%, 4.7%, and 8.7%, respectively. The prevalence of comorbid allergic diseases decreased with age (p for trend < 0.001). CONCLUSIONS: Our study revealed that the prevalence of some allergic diseases, such as atopic dermatitis and asthma, was relatively high in very young children and that all of the principal allergic diseases in children often co-exist.
Asthma ; Child ; Comorbidity ; Cross-Sectional Studies ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Parents ; Prevalence ; Quality of Life ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires

BACKGROUND: We have hypothesized that, if a low resistant gravity-flow membrane oxygenator is used, then the twin blood sacs of TPLS can be located at downstream of the membrane oxyenator, which may double the pulse rate at a given pump rate and increase the pump output. The purpose of this study was to determine the optimal configuration for the ECLS circuits by using the concept of pulse energy and pump output. MATERIAL AND METHOD: Animals were randomly assigned to 2 groups in a total cardiopulmonary bypass model. In the serial group, a conventional membrane oxygenator was located between the twin blood sacs. In the parallel group, the twin blood sacs were placed downstream of the gravity-flow membrane oxygenator. Energy equivalent pressure (EEP) and pump output were collected at pump-setting rates of 30, 40, and 50 BPM. RESULT: At the given pump-setting rate, the pulse rate was doubled in the parallel group. Percent changes of mean arterial pressure to EEP were 13.0+/-1.7, 12.0+/-1.9 and 7.6+/-0.9% in the parallel group, and 22.5+/-2.4, 23.2+/-1.9, and 21.8+/-1.4% in the serial group at 30, 40, and 50 BPM of pump-setting rates. Pump output was higher in the parallel circuit at 40 and 50 BPM of pump-setting rates (3.1+/-0.2, 3.7+/-0.2 L/min vs. 2.2+/-0.1 and 2.5+/-0.1 L/min, respectively, p=0.01). CONCLUSION: Either parallel or serial circuit configuration of the ECLS generates effective pulsatility. As for the pump out, the parallel circuit configuration provides higher flow than the serial circuit configuration.
Animals ; Arterial Pressure ; Cardiopulmonary Bypass ; Heart Rate ; Humans ; Life Support Systems* ; Membranes ; Oxygenators, Membrane

Immotile cilia syndrome is an inherited disorder characterized by specific ultrastructural defects of cilia and associated impairment of ciliary motion and mucociliary clearance. Disorders of ciliary structure or function result in chronic sinopulmonary diseases manifested as chronic sinusitis, bronchitis, otitis media, nasal polyposis, and ultimately bronchiectasis. In addition, situs inversus, dextrocardia, and infertility can be associated with dysfunctional ciliary activity. We experienced a case of immotile cilia syndrome presenting with recurrent bronchitis, pneumonia, chronic sinusitis, otitis media, and bronchiectasis. She was diagnosed by lack of dynein inner arm on electron microscopy. Treatment included chest percussion, bronchodilators, antibiotics, and surgical intervention. She has been followed up at regular intervals. We report this case with related literatures.
Anti-Bacterial Agents ; Arm* ; Bronchiectasis ; Bronchitis ; Bronchodilator Agents ; Cilia ; Ciliary Motility Disorders* ; Dextrocardia ; Dyneins* ; Infertility ; Microscopy, Electron* ; Mucociliary Clearance ; Otitis Media ; Percussion ; Pneumonia ; Sinusitis ; Situs Inversus ; Thorax

PURPOSE: Despite the increasing prevalence of allergic rhinitis, there are difficulties in early diagnosis and proper treatment due to lack of education and misunderstanding of the disease. Development of efficient education materials based on the level of awareness of allergic rhinitis is required. Therefore, this study was aimed to develop a questionnaire for investigating the level of awareness of allergic rhinitis. METHODS: Questions related to the level of awareness of allergic rhinitis were prepared on the basis of the literature, professional advice and inquiries from patients and caregivers. These items were categorized into 4 areas: (1) basic knowledge, (2) symptoms, (3) diagnosis and environmental management and (4) treatment. Through the eight preliminary survey on 38 adults, a questionnaire of 60 items was developed. The results were analyzed by using SPSS 12.0. RESULTS: A tool for investigating the level of awareness was completed, which was composed of 20 items with an internal reliability of 0.67. According to the results of the survey with 60 items, the areas of basic knowledge, symptoms and environmental management of allergic rhinitis showed high awareness. The items regarding the association between allergic rhinitis and asthma, necessity of regular checkup, awareness of maintenance treatment, importance of treatment with intranasal steroids, and the influence of treatment on immunity, growth and development of patient showed low awareness. CONCLUSION: A reliable tool was developed for investigating the level of awareness of allergic rhinitis. It may be useful in developing educational materials to optimize its educational effect on allergic rhinitis.
Adult ; Asthma ; Caregivers ; Early Diagnosis ; Growth and Development ; Humans ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial ; Steroids

Purpose: Gait evaluation in patients with dizziness is essential during both initial evaluation and vestibular rehabilitation. Inertial measurement unit (IMU)-based gait analysis systems are clinically applicable in patients with dizziness. Since dizzy patients can utilize visual inputs to compensate for vestibular deficits, it is more difficult for them to walk with their eyes closed (EC). In this study, we compared gait characteristics during forward walking with both eyes open (EO) and EC between healthy subjects and dizzy patients. Materials and Methods: Forty-nine healthy controls (mean age 37.18±10.71 years) and 23 patients with dizziness (mean age 49.25± 15.16 years) were subjected to vestibular and gait analyses. Medical histories, physical examinations, and vestibular function tests ruled out possible vestibular deficits in the controls. Subjects were instructed to walk at a comfortable pace for 10 m under two conditions (EO or EC). Spatiotemporal parameters, kinematics, and simulated kinetics of each gait recording were recorded using a shoe-type IMU system and analyzed. Results: Although gait speeds were slower, stride lengths were smaller, and double support times were increased under the EC, compared to the EO condition, in both healthy subjects and dizzy patients, the difference was more prominent in dizzy patients.Phase coordination index values did not differ significantly in either group. Gait asymmetry (GA) increased significantly under the EC condition, compared to the EO condition, in dizzy patients. Conclusion GA during forward walking was greater in dizzy patients under an EC condition than under an EO condition.