We aimed to investigate the effect of in vitro allergen challenge on activation of eosinophils and expression of intercellular adhesion molecule-1(ICAM-1) in the epithelial and endothelial cells of the nasal mucosa of allergic rhinitics. MATERIALS AND METHODS: Inferior turbinate mucosal specimens which were obtained from 16 perennial allergic rhinitics and sensitized to D. farinae during conchotomy operations were used. Each mucosal specimen was divided into six pieces. The first two pieces were used as basic control group without culture, the second two pieces as culture-control group which was cultured with diluent only, and the last two pieces as antigen-challenge group cultured with D. farinae solution for 24 hours. Specimens were immunohistochemically stained using monoclonal antibody against eosinophil cationic protein(EG1 for all eosinophils and EG2 for activated forms) and ICAM-1. RESULTS: Average counts of EG1 cells and EG2+ cells within 1 mm of lamina propria of nasal mucosa were 14 and 11 respectively in the basic control group, 17 and 19 in culture control group, and 16 and 16 in the antigen-challenge group. ICAM-1 expression on vessels was observed more than half of t,he vessels in the nasal mucosa and there was no significant difference between groups, however, its expression on the epithelial cells was most prominent in the antigen-challenge group (2.1 in basic control group, 3.3 in culture control group, and 6.2 in antigen-challenge group). CONCLUSION: Most of the eosinophils infiltrating into the nasal mucosae out of vessels in allergic rhinitics are activated forms. Significant up-regulation of epithelial ICAM-1 expression by antigen-challenge suggests that ICAM-1 contributes to the transmigration of eosinophils from the subepithelial tissue into the epithelial cell layer and then finally into the nasal secretion.
Endothelial Cells ; Eosinophils* ; Epithelial Cells ; Intercellular Adhesion Molecule-1* ; Mucous Membrane ; Nasal Mucosa* ; Turbinates ; Up-Regulation

BACKGROUND: Eosinophils are suggested to play a deleterious role in the inflammatory disease of the respiratory mucosa by releasing granule substances such as major basic prorein and eosinophil cationic protein. To investigate the contribution of eosinophils in the pathogenesis of nasal polyps and the mechanism of their accumulation and activation, we observed the eosinophil inhllration and expression of endotjelial and epithelial cell adhesion molecules in the nasal polyp tissues. MATERIALS AND METHODS: Polyp and inferior turbinate mueosal specimens (polyp group) taken out of 20 patients and 10 inferior turbinate mucosa specimens of non-allergic and non-infectious controls (control group) were immunohistochemically stained using EG1, EG2, and mAb for the ICAM-1, VCAM-1 and E-seleetin. The number of EG1 (+) and EG2 (+) cells within lmm2 of tissue and the expression of ICAM-1, VCAM-1 and E-seleetin on the vessels (% of total vessel) and epithelial eelis (area x intensity) were compared among three groups. RESULTS:The inferior turbinate mucosae of nasal polyp patients .were infiltrated by signifieantly higher number of eosinophils (EG1:17, EG2:16/mm2) compared with those of controls (EGi:0, EG2:0/mm2) (p<0.05), and the polyp tissue revealed much more eosinophils (EG1: 213, EG2:154/mm2) than inferior turbinates of same patients and those of controls (p<0.001). ICAM-1 expression in the vessels was frequenly observed both in polyps and in the turbinate mucosae with significant difference (median:85% vs. 67%, p<0.05), and ICAM-1 expression in the epithelial ceils was significantly different between the polyp and turbinate groups (median:9 vs. 2.5, p<0. 01). VCAM-1 was moderately expressed on the vessels of both polyps and turbinate mucosac (median:37%, 14%, respectively) and their expressions were significantly different (p<0.01). E-selectin expression was moderate to low both in the polyps and in the turbinate mucosae (median:18%, 10% respectively) and their expressions were not significantly different (p>0.05). CONCLUSION: Most of the eosinophils infiltrated into nasal tissue as well as nasal polyps were activated forms and they were significantly increased in the nasal polyps compared to the inferior turbinate mueosae of the same patients and control subjects. Significantly increased expression of ICAM-1 and VCAM-1 on the vessels and increased epithelial ICAM-1 expression in the nasal polyps indicate that interactions of eosinophils with ICAM-1 and VCAM-1 participate in the pathogenesis of nasal polyps.
E-Selectin ; Eosinophil Cationic Protein ; Eosinophils* ; Epithelial Cells ; Humans ; Intercellular Adhesion Molecule-1 ; Mucous Membrane ; Nasal Polyps* ; Polyps ; Respiratory Mucosa ; Turbinates ; Vascular Cell Adhesion Molecule-1

BACKGROUND: Recently, it has been established that plateletpheresis needs more efficiency and shorter processing time. Fenwall laboratories developed a new collection chamber for CS-3000 Plus, PLT-30TM collection chamber, which can reduce the processing time with efficient collection. We evaluated the PLT-30TM collection chamber by comparing it with A-35 collection chamber that has been used as a standard collection chamber of CS-3000 Plus us. METHODS: Thirty platelet collection procedures were performed using the CS 3000 Plus with A-35 collection chamber and PLT-30TM collection chamber. The changes of the hematologic parameters between pre- and post-donation in donors and the total platelets yields and the contaminated WBCs in the plateletpheresis products were evaluated. In processing, the yield predictor calibration was adjusted to 1.00 and 1.13 in A-35 and PLT-30TM respectively. Yield predictors of pheresis were the same as 3.5x1011 in both and end point volumes were calculated from the CS-3000 Plus. Processing volume and processing times were compared between A-35 and PLT-30TM groups. RESULTS: With PLT-30TM collection chamber, 3.38+/-0.72x1011/L platelets were harvested, whereas 3.20+/- 0.73x1011/L were collected with A-35 collection chamber, which was not significantly different. But processing time with the PLT-30TM collection chamber was more reduced than that with the A-35 collection chamber by about 20 minutes (PLT-30TM : 88.6+/-8.4 min, A-35 : 106.7+/-11.7min). Collection efficiency of PLT-30TM chamber was 50.7+/-12.5% and that of A-35 chamber was 44.4 + 8.8%. The leukocyte contamination of the platelet concentrates were not statistically different(PLT-30TM: 0.0-3.6x106, A-35 : 0.1-4.1x106). CONCLUSIONS: PLT-30TM collection chamber has the advantages of shortening the donation time and decreasing the processing volume with better collection efficiency and flexibility of platelet concentrate volume.
Blood Component Removal ; Blood Platelets ; Calibration ; Humans ; Leukocytes ; Plateletpheresis ; Pliability ; Tissue Donors

No abstract available.
Echocardiography, Transesophageal*

Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Some coercive aspects of culture in the medical field that have traditionally been regarded as routine practice are now gradually changing in the aftermath of the MeToo movement that has come to Korea, due to improved awareness of sexual violence. It is important for the medical community to endeavor to eradicate sexual violence by implementing the measures against sexual violence proposed by medical organizations, including the Korean Medical Women's Association. The medical field should undergo a self-purification process, so that medical personnel can change themselves and their own behavior in the context of the medical profession, which is a noble occupation that deals with life-and-death matters. As such, essential elements of the training system of doctors should be maintained. Developing action plans to properly deal with sexual violence incidents in medical institutions can be considered the first step in this process.
Korea ; Occupations ; Sex Offenses

Infantile cortical hyperostosis is a disease of infants which is characterized by formation of cortical subperiosteal new bone of the the body. Pain and soft tissue swelling over the affected parts, associated with fever and irritability, are found frequently with the disease. Usually self-limiting, it is not as a rule followed by any residual skeletal deformity. A case of Infantile cortical hyperostosis in three months-old baby was diagnosed and followed up to ten months.
Congenital Abnormalities ; Fever ; Humans ; Hyperostosis, Cortical, Congenital ; Infant

The diagnostic accuracy of myelography, electromyography, and clinical-neurological findings in 64 patients on whom the presence of herniated intervertebral disc was proved surgically from March, 1974 to February, 1980 in Severance Hospital was discussed and the results of this study was compared with those in comparable studies in the literature. 1. Of the cases in which operation revealed disc herniation or protrusion, the clinical neurological diagnosis was correct in 71.9%, the myelographic diagnosis was coincided in 79.7%, the electromyographic diagnosis was agreed in 73.4%. 2. In the patients which the patellar tendon reflex was weak or absent, operation revealed a herniation between L3 and L4 in 66.7%. The disc herniation bewteen L4 and L5 was noted in 93.0% of patients with weakness of the extensors of the great toe. Of the patients in whom the Achilles tendon reflex was weak or absent, operation revealed a tumbosacral disc herniation in 87.0%. 3. If the myelogram showed lumbar disc changes, these changes were confirmed at operation in the same level in all patients. 4. A disc herniation between L3 and L4 was demonstrated in aH cases of the patients had L4 denervation of the electromyographic findings. The disc herniation between L4 and L5 was seen in 93.0% of them had L5 denervation. A lumbosacral disc herniation was noted in 83.3% of them had 51 denervation. 5. Polyphasic motor units were significant in the absence of diagnosis of the herniated lumbar disc. 6. Signs of denervation in the spinal muscalature but not in the leg muscles were considered significant in patients with diagnostic problems of the lumbar radiculopathy. In summary, it is suggested that electromyography is not superior to the myeolgraphy or the clinicalneurogical examination. But the electromyography aids the surgeon in the dlagnosis of a compression lesion of a specific nerve root.
Achilles Tendon ; Denervation ; Diagnosis ; Electromyography ; Humans ; Intervertebral Disc ; Leg ; Muscles ; Myelography ; Patellar Ligament ; Radiculopathy ; Reflex ; Toes

The femoral neck in children is dense and is small in diameter and its periosteum is thicker and stronger than that of an adult. Thus, fractures of the femoral neck in children, unlike the 60-year-old woman, are rare and usually require severe violence and this accounts for the high frequency of associated injuries. Since these fractures are rare and the femoral neck in children has many anatomic and physiologic differences, we have to consider some factors that work against treatment of these fractures. Twenty seven cases of fractures of the femoral neck in children which were treated at Severance Hospital, Yonsei University College of Mediicne from Jan. 1971 to Dec. 1980 were analyzed both clinically and radiologically and the following results were obtained. 1. Among the 27 patients, the ratio of boys and girls was 2:1 and the highest incidence was between the ages of 3 and 5 years. 2. The main course of fractures was traffic accidents, 14 cases (51.9%) and the other causes were falling from a height (37.0%) and a few cases of a slip and a fall. 3. According to the classification of Delbet and Colonna, the cervico-trochanteric fracture (40.8%) was the commonest type and 13 cases (48.1%) were displaced fractures. 4. Common associated injuries were pelvic bone fractures, skull fractures, cerebral concussion and soft tissue injuries. 5. Fifteen cases (55.6%) were treated by conservative treatment and ten cases (37.0%) by closed reduction & internal fixation. 6. 23 of the 27 cases were followed for from 6 months to 10 years, average 19 months. The results were analyzed according to Ratliffs assessment and 14 cases (60.9%) showed good results. 7. Total cases with complications were 14 (60.9%), the commonest complication being coxa vara (40.8%) and the other main complications being premature epiphyseal closure (39.1%) and avascular necrosis (30.1%). 8. Secondary treatment was done in 6 cases and correction osteotomy was done in 4 cases which had showed a poor result. 9. Finally, factors affecting results were type of fracture, degree of displacement, maintenance of reduction, interval between injury and treatment, complications and patients age. 10. The authors recommend closed reduction and internal fixation with some threaded pins for all type II and type III fractures.
Accidental Falls ; Accidents, Traffic ; Adult ; Brain Concussion ; Child ; Classification ; Clinical Study ; Coxa Vara ; Female ; Femur Neck ; Humans ; Incidence ; Middle Aged ; Necrosis ; Osteotomy ; Pelvic Bones ; Periosteum ; Skull Fractures ; Soft Tissue Injuries ; Violence

Some coercive aspects of culture in the medical field that have traditionally been regarded as routine practice are now gradually changing in the aftermath of the MeToo movement that has come to Korea, due to improved awareness of sexual violence. It is important for the medical community to endeavor to eradicate sexual violence by implementing the measures against sexual violence proposed by medical organizations, including the Korean Medical Women's Association. The medical field should undergo a self-purification process, so that medical personnel can change themselves and their own behavior in the context of the medical profession, which is a noble occupation that deals with life-and-death matters. As such, essential elements of the training system of doctors should be maintained. Developing action plans to properly deal with sexual violence incidents in medical institutions can be considered the first step in this process.